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Oregon - Compensation & Benefit Legislation

OREGON - AASHOWME

Demonstrates www.BenefitsReview.com™ site. Illustrates insurance carriers' coverages within the State.

 

OREGON - ADOPTED CHILD HEALTH CARE MANDATE

OBRA 1993 (Federal) requires group health plans to honor medical and child support orders. Also, plans must treat adopted children like biological children covered by the plan, and plans are precluded from applying pre-existing condition exclusions to an adopted child where no such exclusion applies to a newborn biological child. Health plans that covered the cost of pediatric vaccines as of May 1, 1993, and fail to continue that level of coverage, will be subject to an excise tax penalty applicable to plans that fail to meet the health care continuation coverage requirements under OBRA 1993.

 

Mandatory coverage of birth of adopted children is included in state's newborn health care coverage.

 

Preventive care for children: No.

 

(Oregon Rev. Stat. Sections 743.707, 743.716)

 

OREGON - ALCOHOLISM & DRUG ABUSE

Mandatory coverage.

 

Minimum yearly inpatient coverage: no statutory requirements.

 

Minimum yearly outpatient coverage: no statutory requirements.

 

Minimum lifetime coverage: Inpatient: $4,500 for adults, $4,000 for children (for hospitalization); $3,500 for adults, $3,000 for children (for residential programs); outpatient : $1,500 for adults, $2,000 for children; inpatient and outpatient combined: $8,500 for adults or children.

 

(Oregon Rev. Stat. Section 743.556)

 

OREGON - CAFETERIA PLAN TAX LAWS

State income tax, unemployment insurance tax on salary reduction: State Unemployment Insurance law has no specific provision on cafeteria plans, but employer payments and salary reductions for health and accident, group term life insurance benefits, and retirement are specifically excluded from wages under state Unemployment Insurance law and may be excluded even when provided through a cafeteria plan.

 

OREGON - CONTINUATION OF COVERAGE CONVERSIONS

State reports no statutory requirements.

 

OREGON - COORDINATION OF BENEFITS

Requires use of the birthday rule if coordinating benefits. Based on 1986 National Association of Insurance Commissioner Rules model. (Oregon Admin. R. 836-20-765 et seq)

 

OREGON - COST-OF-LIVING

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian cost-of-living data and U.S. Automobile Cost Survey.

 

OREGON - DRUG TESTING AND EMPLOYEE ASSISTANCE BENEFITS

Who is Covered by Statute: All employees and applicants (breathalyzer test only).

 

Applicant Testing: Applicant testing is allowed, but breathalyzer test may be administered only if applicant consents or if employer has reasonable grounds to believe applicant is under the influence of alcohol.

 

Employee Testing: Employee testing is used to screen out applicants or to discharge or discipline employees.

 

How Test Results are Used: Test results may be used to screen out applicants or to discharge or discipline employees.

 

Enforcement of Statutes: Statute is enforced by Commissioner of the Bureau of Labor and Industries.

 

Employee Remedies: None.

 

Employer Penalties: Violation is treated as unlawful employment practice.

 

Who Pays for Testing: State has no statutory requirements.

 

Employee Assistance Benefits: State has no statutory requirements.

 

Other Requirements: None.

 

(Oregon Rev. Stat. Sections 659.225 thru 659.227.)

 

OREGON - GROUP HEALTH CODE ADDITIONS (MANDATED)

Adopted Children: All individual and group health insurance policies that provide coverage for children in the family also shall cover adopted children effective upon placement for adoption. Coverage of adopted children shall include benefits for injury or sickness including treatment of medically diagnosed congenital defects and birth abnormalities. (S1138, 1995) (Oregon Rev. Stat. Section 743.707.)

 

Alcoholism and Drug Abuse: Group policies covering hospital or medical expenses must cover costs of chemical dependency, including alcoholism, of at least $4,500 for adults and $4,000 for minors for inpatient care; $3,500 for adults and $3,000 for minors for residential care; inpatient, residential and day minimum of $8,500 for minors and an outpatient minimum of $1,500 for adults and $2,000 for minors if a person is not also requesting payments of treatment of mental and nervous conditions. Treatment costs of at least $10,500 for adults and $12,500 for children must be covered for persons receiving care for chemical dependency and mental or nervous conditions. (Oregon Rev. Stat. Section 743.556.)

 

Coverage Continuation and Conversion: Group policies must provide continuation rights to terminating employees and their dependents, striking employees, employees hospitalized on the date of termination of a policy immediately replaced with a policy from another insurer, and employees suffering injury or illness and covered by worker's compensation. (Oregon Rev. Stat. Section 743.610.527-530.) Policies must provide continuation rights to dependents who case to be eligible due to death of the insured or dissolution of marriage if the surviving or separated spouse is at least 55. (Oregon Rev. Stat. Section 743.610.) Group policies must provide conversion rights to terminating employees and dependents entitled to continued coverage under Section 743.610.

 

Dependent Children: Policies providing coverage for dependent children must cover an insured's children not living with the insured for whom the insured is financially responsible. (Oregon Rev. Stat. Section 743.716.) Policies must provide coverage for the dependent children of unmarried women on the same basis as for children of married women. (Oregon Rev. Stat. Section 743.721.)

 

DES: Insurers may not deny coverage to a person solely because the person's mother used diethylstilbestrol (DES) prior to the person's birth. (Oregon Rev. Stat. Section 743.710.)

 

Diabetes: Group policies must cover costs of diabetes self management education programs. (Oregon Rev. Stat. Section 743.704.)

 

Maternity: Policies providing maternity coverage must offer the same benefits to married and unmarried women. (Oregon Rev. Stat. Section 743.721.)

 

Maxillofacial Prosthetic Services: Group policies must cover maxillofacial prosthetic services necessary to restore and manage defective head and facial structures. (Oregon Rev. Stat. Section 743.706.)

 

Mental Health: Group policies covering hospital or medical expenses must cover inpatient, residential, and day or partial hospitalization costs of at least $8,500 for adults and $10,500 for children, and outpatient costs of at least $2,000. Treatment costs of at least $10,500 for adults and $12,500 for children must be covered for persons receiving care for chemical dependency and mental or nervous conditions. (Oregon Rev. Stat. Section 743.556.)

 

Newborns: Policies providing family coverage must provide benefits for newborns from the moment of birth for injury or sickness including treatment of medically diagnosed congenital defects and birth abnormalities. (Oregon Rev. Stat. Section 743.707.)

 

Point of Service Plans: Group health plans covering more than 25 employees must make available a point of service benefit plan providing services on a discounted fee for service basis with reasonable access to a broad array of licensed providers within a certain geographical service area. (S979, 1995) (Oregon Rev. Stat. Section 743.)

 

Policies for Small Employers: Providers of health insurance to small employers (businesses employing no more than 25 workers and no fewer than two workers during at least 50 percent of the working days during the preceding year; the majority of workers must be employed within the state of Oregon) must offer worker two basic health benefit plans. One plan must be in the form of insurance, and the other one must be consistent with the federal Health maintenance Organization Act. (S152, 1995.) (Oregon Rev. Stat. Sections 743.730(30), 743.733-743.737.)

 

Providers: State hospitals: Policies may not deny reimbursement for covered services solely because they were rendered by a state owned or operated hospital or state approved community mental health or disabilities program. (Oregon Rev. Stat. Section 743.701.) Optometrists, psychologists, nurse practitioners, dentists, clinical social workers, and acupuncturists: Costs of services must be covered if the provider is licensed, the service is within the provider's scope of services, and the service is covered by the policy. (Oregon Rev. Stat. Sections 743.703-722.) Selection policies: Insurers requiring patients to designate participating primary care providers must permit female patients to select women's health care providers as their primary care providers for annual preventive women's health examinations and pregnancy care. (S814, 1995) (Oregon Rev. Stat. Section 743.) Insurers that require patients to select participating primary care physicians must allow patients to change physicians at will; patients must be allowed, however, to change doctors no more than two times during any 12 month period, and are limited to changing to physicians who are accepting new patients. (S979, 1995) (Oregon Rev. Stat. Section 743.)

 

OREGON - GROUP HEALTH FOR SMALL EMPLOYERS

For insurance plans offered to small employers:

 

OREGON - GROUP LIFE CODE ADDITIONS

Employer required to pay part of premium: No.

 

Percent of employees who must elect coverage (if employees pay part of premium): No statutory requirements.

 

Percent of employees who must be covered if employer pays all of premium: 100%

 

Minimum number of employees in group plan: 75% of eligible members of the group, or 10 (whichever is greater).

 

Employer prohibited as beneficiary: No.

 

Grace period (days): 31.

 

Mandatory conversion: Yes.

 

Other provisions: None.

 

(Oregon Rev. Stat. Sections 743.303, 743.312, 743.333)

 

OREGON - HOLIDAYS

January 1, Washington's Birthday (or 3rd Monday in February), Memorial Day (or last Monday in May), July 4, Labor Day (or 1st Monday in September), Veterans Day, and December 25 are state holidays in all 50 states and in the District of Columbia. Other holidays under State law include: Martin Luther King's birthday (or 3rd Monday in January), Thanksgiving, Sunday. Other: A day that the President and the Governor both appoint as holiday. If any holiday (except Sunday) falls on a Sunday, following Monday is a holiday. (Oregon Rev. Stat. Sections 187.020-187.020)

 

OREGON - IMMIGRATION (PREVAILING WAGE POLICY)

See U.S. Federal General Administrative Letter 1-2000

 

OREGON - JURY DUTY & WITNESS TIME OFF

Employer Restriction For Discharging Employee For Taking Leave For Jury Service: Yes.

 

Remedies and Penalties: Court may order relief, including reinstatement with back pay for discharged employee.

 

Other Requirements: None reported. (Oregon Rev.Stat. Section 10.090.)

 

Employer Restriction For Discharging Employee For Taking Leave to be a Witness: State reports no statutory requirements.

 

Remedies and Penalties: State reports no statutory requirements.

 

Other Requirements: State reports no statutory requirements.

 

OREGON - LEAVES OF ABSENCE

Employers Subject to Leave Laws: Employers with 25 or more employees.

 

Criteria for Eligibility: Employed for more than 180 days for parental leave; employed for 180 days and average 25 hours of work per week for family leave.

 

Maximum length of leave: 12 weeks in a 12 month period. A woman who takes leave because of pregnancy related disability may take an additional 12 weeks for another purpose. An employee who takes 12 weeks of parental leave may take an additional 12 weeks of sick child leave.

 

Paid Leave: State does not require paid leave.

 

Acceptable Reasons for Leave: Family leave: care for serious condition of employee, spouse, child, parent, in-law. Parental leave: birth/adoption of a child.

 

Employment Guarantees After Leave: Entitled to reinstatement in the position held prior to leave or equivalent position.

 

Use of Vacation or other Time-off Benefits: Parental leave: Employer may require employee to first use accrued time off benefits before commencing leave. Family leave: Employee may opt to use accrued time off benefits to extend leave.

 

Certification Required: Employer may require certification of health condition if leave is taken to care for family member with serious health condition.

 

Effect Of Leave on Other Benefits: Benefits cease during leave unless employer is obligated to provide them under a separate contract.

 

Effect of Seniority Accrual During Leave: Seniority benefits do not accrue during leave.

 

Minimum Requirements for Notification to Employer: 30 days prior written notice is required. In an emergency, verbal or written notice within 24 hours of commencement of leave is required.

 

Conditions for Denial of a Request For Leave: Family leave: If family members health condition is not life threatening or terminal, request for leave may be denied if another family member is available to provide care. Parental leave: If husband and wife work for the same employer and combined leave would exceed 12 weeks, employer may refuse request for both to take leave at the same time.

 

(Oregon Rev. Stat. Sections 659.360, 659.365, 659.389, 659. 470 - 659.494, 659.565, 659.570.)

 

See U.S. Federal Family and Medical Leave Act

 

OREGON - LONG TERM DISABILITY CODE ADDITIONS

State does not require employer to provide long term disability benefits; although many employers do in order to remain competitive in hiring/retention of employees.

 

See LEAVES OF ABSENCE (above), WORKERS' COMPENSATION (below) and U.S. Federal Americans With Disabilities Act

 

OREGON - MANDATED PROVIDERS

Optometrists, dentists, psychologists, social workers, and nurse practitioners. Mandatory coverage for denturists, acupuncturists, and physician assistants. (Oregon Rev. Stat. Sections 743.703, 743.709, 743.712, 743.713, 743.714, 743.719, 743.722, 743.724)

 

OREGON - MENTAL HEALTH CARE

Mandatory coverage.

 

Minimum lifetime coverage: Inpatient: $4,000 for adults, $6,000 for children (for hospitalization); $1,000 for adults, $2,500 for children (for residential programs); inpatient and outpatient combined: $8,500 for adults, $10,500 for children. (Oregon Rev. Stat. Section 743.556)

 

OREGON - MINIMUM WAGE

$6.50 per hour (effective January 1, 1999).

 

Exemptions: Certain professionals, agriculture workers, domestics, and outside sales. Students (sub-minimum wage of 75%), apprentices (sub-minimum wage of 75%, and handicapped workers in special environments may be lowered by regulation. (Oregon Rev. Stat. Sections 653.020, 653.025, 653.030, 653.070)

 

See U.S. Minimum Wage

 

OREGON - NEW HIRE REPORTING

Who is required to report: Employers in certain industries.

 

Who must be reported: All new employees and rehires of qualifying employers.

 

Exempt from reporting: No exemptions.

 

Form(s) to file: State form or W-4.

 

Filing deadline: Within 20 days of hire.

 

Employer information to be included: Name, address, and state EIN.

 

Employee information to be included: Name and SSN.

 

Penalty for failure to report: N/A.

 

(Or. Rev. Stat. Ann. Section 25.790)

 

OREGON - NEWBORN CARE MANDATE

Mandated coverage.

 

Preventive care for children: No. (Oregon Rev. Stat. Sections 743.707, 743.716)

 

OREGON - PARENTAL LEAVE

See U.S. Federal Family and Medical Leave Act

 

OREGON - PRE-EXISTING CONDITIONS

For insurance plans offered to small employers, no exclusion of coverage more than 6 months following the effective date of coverage due to a pre-existing condition. (Oregon Rev. Stat. Sections 743.730, 743.736, 743.737)

 

See U .S. FEDERAL Health Insurance Portability & Accountability Act

 

OREGON - PROTECTED CLASSIFICATIONS

Age:  Yes.

Race:  Yes.

Color: Yes.

National Origin: Yes.

Ancestry:  Yes.

Religion: Yes.

Sex:  Yes.

Pregnancy:  Yes.

Sexual Harassment: Yes.

Or. Rev. Stat. Sections 240.306, 659.010, 659.020, 659.029, 659.030.)

 

OREGON - SALARY SURVEY

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian wages & salaries (covering 3,000 positions).

 

OREGON - SHORT TERM DISABILITY CODE ADDITIONS

State does not require employer or employee participation in short term disability plans.

 

OREGON - TERMINATION & SEVERANCE PAY

Date pay is due if employee is discharged: Immediately.

 

Date due if employee resigns: Payment due immediately if employee gives more than 48 hours notice, excluding weekends and holidays. If employee fails to give 48 hours notice, payment is due on the earlier of payday or 5 days excluding weekends and holidays.

 

Wages: Yes. (Case law appears to define wages to include all compensation contracted to be paid by employer.)

 

Vacation Pay: Yes. (Case law appears to define wages to include all compensation contracted to be paid by employer.)

 

Holiday : Yes. (Case law appears to define wages to include all compensation contracted to be paid by employer.)

 

Sick leave: Yes. (Case law appears to define wages to include all compensation contracted to be paid by employer.)

 

Severance : Yes. (Case law appears to define wages to include all compensation contracted to be paid by employer.)

 

(Oregon Rev. Stat. Section 652.140. See State re. Nilsen v. Oregon State Motor Association, 432 P. 2d 512 (OR 1967); Harryman v. Roseburg Rural Fire Protection District, 420 P. 2d 51 (OR, 1966))

 

OREGON - UNEMPLOYMENT TAX

Employer Contributions:

 

 

Voluntary Contribution Provision: No.

 

(Oregon Rev. Stat. Sections 657.430, 657.435, 657.457, 657.458, 657.462, 657.475, 657.552, 657.660.)

 

OREGON - VACATION PAY

See TERMINATION & SEVERANCE PAY (above)

 

OREGON - VOTING TIME OFF

State reports no statutory requirements.

 

OREGON - WORKERS' COMPENSATION

Private Employers: Mandatory as to all employments. Elective as to sole proprietors, except in construction and some corporate officers who are also directors with a substantial ownership interest. (Note: Ownership interest not required for certain family farms.)

 

Public Employers: Mandatory coverage to state, departments, cities, or towns and other political sub-divisions. Covers volunteer trainees in state schools for deaf and blind. Excludes cities under 200,000 population with equivalent compensation.

 

Exceptions: Under specified circumstances: Domestics, casual labor, interstate transportation, certain charitable for relief work, newspaper carriers, certain amateur athletes and sports officials, volunteer ski patrols and volunteers in the ACTION Program, personnel under federal permits, owners and operators of certain motor vehicles, and commission-paid real estate agents, foster care providers.

 

Special Coverage Provisions: Voluntary as to excepted employments. Covers clients in Vocational Rehabilitation Division. Excepted employer may elect coverage for selves or excepted employees. (Note: Prime contractors can become liable for providing coverage for sub-contractors and their employees.)

 

(U.S. Chamber of Commerce, 1994 Analysis of Workers' Compensation Laws.)