461-155-0360 Effective 09/01/16
Pursuit of Cost-Effective Employer Sponsored Health Insurance
- This rule applies to the OSIPM program and is for the purpose of applying OAR 461-120-0345.
- The Health Insurance Group (HIG) determines if employer sponsored health insurance meets the criteria as cost effective for the purpose of OAR 410-120-1960.
- If the insurance is determined to be cost effective and the client or eligible applicant pursues the insurance, HIG will authorize reimbursement of the client or eligible applicant's portion of the premium per OAR 410-120-1960.
- If the insurance is determined to be cost effective and the client or eligible applicant fails to pursue cost effective employer sponsored insurance, the Department will apply a penalty per OAR 461-120-0345.
Statutory/Other Authority: ORS 411.060, 411.404
Statutes/Other Implemented: ORS 411.060, 411.404