ORS 741.002
Duties, powers and functions of Oregon Health Authority
- rules
(1)
The duties of the Oregon Health Authority include:(a)
Administering a health insurance exchange in accordance with federal law to make qualified health plans available to individuals and groups throughout this state.(b)
Providing information in writing, through an Internet-based clearinghouse and through a toll-free telephone line, that will assist individuals and small businesses in making informed health insurance decisions and that may include:(A)
The rating assigned to each health plan and the rating criteria that were used;(B)
Quality and enrollee satisfaction survey results; and(C)
The comparative costs, benefits, provider networks of health plans and other useful information.(c)
Establishing and maintaining an electronic calculator that allows individuals and employers to determine the cost of coverage after deducting any applicable tax credits or cost-sharing reduction.(d)
Operating a call center dedicated to answering questions from individuals seeking enrollment in a qualified health plan.(2)
The authority shall:(a)
Screen, certify and recertify health plans as qualified health plans according to the requirements, standards and criteria adopted by the authority under ORS 741.310 (Requirements for purchase of insurance through exchange and for participation of insurers in exchange) and ensure that qualified health plans provide choices of coverage.(b)
Decertify or suspend, in accordance with ORS chapter 183, the certification of a health plan that fails to meet federal and state standards in order to exclude the health plan from participation in the exchange.(c)
Promote fair competition of carriers participating in the exchange by certifying multiple health plans as qualified under ORS 741.310 (Requirements for purchase of insurance through exchange and for participation of insurers in exchange).(d)
Assign ratings to health plans in accordance with criteria established by the United States Secretary of Health and Human Services and by the authority.(e)
Establish open and special enrollment periods for all enrollees, and monthly enrollment periods for Native Americans that are consistent with federal law.(f)
Assist individuals and groups to enroll in qualified health plans, including defined contribution plans as defined in section 414 of the Internal Revenue Code and, if appropriate, collect and remit premiums for such individuals or groups.(g)
Facilitate community-based assistance with enrollment in qualified health plans by awarding grants to entities that are certified as navigators as described in 42 U.S.C. 18031(i).(h)
Provide employers with the names of employees who end coverage under a qualified health plan during a plan year.(i)
Certify the eligibility of an individual for an exemption from the individual responsibility requirement of section 5000A of the Internal Revenue Code.(j)
Provide information to the federal government necessary for individuals who are enrolled in qualified health plans through the exchange to receive tax credits and reduced cost-sharing.(k)
Provide to the federal government any information necessary to comply with federal requirements including:(A)
Information regarding individuals determined to be exempt from the individual responsibility requirement of section 5000A of the Internal Revenue Code;(B)
Information regarding employees who have reported a change in employer; and(C)
Information regarding individuals who have ended coverage during a plan year.(L)
Take any other actions necessary and appropriate to comply with the federal requirements for a health insurance exchange.(m)
Work in coordination with the Oregon Health Policy Board in carrying out its duties.(3)
The authority may adopt rules necessary to carry out its duties and functions under ORS 741.001 (Health insurance exchange) to 741.540 (Complaints and investigations confidential).(4)
The authority may contract or enter into an intergovernmental agreement with the federal government to perform any of the duties and functions described in ORS 741.001 (Health insurance exchange) to 741.540 (Complaints and investigations confidential). [2011 c.415 §3; 2012 c.38 §1; 2012 c.107 §88; 2015 c.3 §17; 2021 c.569 §18]
Source:
Section 741.002 — Duties, powers and functions of Oregon Health Authority; rules, https://www.oregonlegislature.gov/bills_laws/ors/ors741.html.
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