SALEM – All 12 health insurance companies in the individual, small group, and large group markets in Oregon failed to comply fully with the Reproductive Health Equity Act (RHEA) at varying levels, according to reports released today by the Oregon Department of Consumer and Business Services’ (DCBS) Division of Financial Regulation (DFR). The agency found that most noncompliance involved improperly charging copays, coinsurance, and deductibles or failing to cover mandated benefits.
The division examined Aetna Life Insurance Company, BridgeSpan Health Company, Cigna Health and Life Insurance Company, HealthNet Health Plan of Oregon, Kaiser Foundation Health Plan of the Northwest, Moda Health Plan, PacificSource Health Plans, Providence Health Plan, Regence BlueCross BlueShield of Oregon, Samaritan Health Plans, UnitedHealthcare Insurance Company, and UnitedHealthcare of Oregon.
The examinations found that each of the 12 insurers failed to pay all eligible claims according to RHEA requirements. They applied copays, coinsurance, and deductibles, which are prohibited under RHEA for reproductive health and preventive care services. In some cases, insurers improperly denied claims for RHEA covered services.
In addition, the reports found that three insurers – Aetna, BridgeSpan, and Regence – failed to cover certain types of contraceptives or applied improper limitations on the amount or timing of when a member could refill a prescription.
Finally, examiners found that Cigna, HealthNet, Kaiser, and Samaritan each failed to properly resolve all consumer complaints and maintain adequate records demonstrating that they timely and adequately resolved member complaints, appeals, and grievances.
“RHEA is a critically important tool in the state’s effort to remove barriers to reproductive health care,” said Oregon Insurance Commissioner Andrew Stolfi, who is also the DCBS director. “As with every law, our insurers had an obligation to fully and timely implement each aspect of RHEA across all of their systems. It is disappointing to see that this did not happen. We will continue to monitor each insurer until they fully comply with RHEA and make whole any consumer harmed by these failures.”
Throughout the examination process, the division identified issues for each insurance company to immediately address to ensure members receive benefits mandated under the law, and progress towards full implementation of RHEA was observed and noted in several reports. Completion of these reports, which are similar to audits, is one of many steps the division takes in monitoring and addressing insurer compliance with the law.
Next steps include implementation of corrective action plans and ongoing data reporting and compliance monitoring with each insurer, as well as issuing regulatory guidance to clarify expectations. The DFR enforcement team will also now review the reports to determine appropriate penalties, restitution, and other action for each company. Finally, the division plans to continue working with community partners to raise awareness of benefits available under RHEA and other reproductive health laws. Consumers who believe they have not received the services or benefits they are owed under the law are encouraged to contact their insurer or the division’s consumer advocacy team at 888-877-4894 (toll-free) or go to the DFR help page.
The Oregon Legislature passed House Bill 3391 (RHEA) in 2017. Starting in 2019, health insurance companies were required to provide, with no cost share, a specified list of reproductive health, sexual health, preventive care, and other health care services, including contraception and abortion.
For more information on available benefits and to find a list of health insurance plans subject to RHEA, visit DFR’s reproductive health benefits webpage.
For more information on the RHEA examination process, findings, and recommendations, visit the division’s RHEA webpage.
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About Oregon DFR: The Division of Financial Regulation is part of the Department of Consumer and Business Services, Oregon’s largest business regulatory and consumer protection agency. Visit dfr.oregon.gov and www.dcbs.oregon.gov.
Salem – It’s a day to recognize employer and worker successes in cultivating safe and healthy jobsites. It’s a day to engage in direct conversations – including employee feedback – about what’s working and what can be improved. It’s a day to pause and reflect on future challenges and to forge new plans to minimize or eliminate worksite hazards.
Employers and workers across the state are invited to take part in Safety Break for Oregon, coordinated by Oregon OSHA. The annual event – now in its 20th year – calls on employers, supervisors, and workers across Oregon to take the time to celebrate their safety and health achievements, and to examine and renew their efforts to shield people from harm while on the job.
Will you take the Wednesday, May 10, stand-down as an opportunity to refresh your knowledge and training? Will you conduct a clear-eyed assessment of where safety and health could be improved at your worksite? Or will you celebrate your successes and recognize emerging safety leaders?
The choice of activity is yours. Sign up now. You could even win a $100 prize.
“Employers across all types of industries can use this statewide stand-down as an opportunity to remind everyone at their business or organization about the importance of health and safety in the workplace,” said Renee Stapleton, administrator for Oregon OSHA. “Not merely symbolic, Safety Break for Oregon is a time to carefully consider on-the-job safety and health, and to bring employers and employees together to talk about hazards, protective methods, and expectations – all with an emphasis on preventing injury and illness in the workplace.”
Oregon OSHA encourages employers and workers to share their Safety Break activities on social media; tag Oregon OSHA on Facebook and LinkedIn with #SafetyBreak.
As you plan your Safety Break event, make sure to follow the current COVID-19 guidance and workplace rules. If you have questions about how to apply Oregon OSHA rules to your workplace, contact our technical specialists for free. If you want free and confidential help reviewing and improving your safety and health program, contact our consultation services. Moreover, Oregon OSHA offers many free education and training resources that you may find helpful as you plan your Safety Break for Oregon activity.
Employers that sign up online by Friday, May 5, and participate in Safety Break for Oregon will be entered to win one of three $100 checks to be used for a luncheon of their choice.
The prizes will go to participating companies as part of a random drawing. The Oregon SHARP Alliance sponsors the contest. The nonprofit group promotes safety and health management by encouraging teamwork and cooperation among people, employers, and organizations to improve workplace health and safety for Oregon workers.
For more information, ideas on how to host an event, or to download graphics, visit the Safety Break for Oregon website.
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Oregon OSHA, a division of the Department of Consumer and Business Services, enforces the state's workplace safety and health rules and works to improve workplace safety and health for all Oregon workers. For more information, go to osha.oregon.gov.
The Department of Consumer and Business Services is Oregon's largest business regulatory and consumer protection agency. For more information, go to www.oregon.gov/dcbs.
Salem – Registration is open for the Oregon Governor’s Occupational Safety and Health (GOSH) Conference, to be held March 6-9 at the Oregon Convention Center in Portland. With more than 160 workshops and sessions, the conference – the largest workplace health and safety event in the Pacific Northwest and one of the largest in the U.S. – offers a comprehensive set of learning opportunities for improving the health and safety of workers across a variety of industries.
“This event provides a unique chance for organizations to rejuvenate their commitment to on-the-job safety and health,” said Renee Stapleton, administrator of the Oregon Occupational Safety and Health Division (Oregon OSHA). “Everyone from professionals in the field to employers, supervisors, and workers can use GOSH as a resource in helping bolster their efforts to create and maintain safe and healthy job sites.”
Keynote speaker Steven Eberlein, resilience director at Ethos Preparedness, will address the importance of preparing for earthquakes. Eberlein has dedicated his career to education and advocacy in the realm of disaster preparedness, with specific focus on workplaces and communities in the Cascadia subduction zone and San Andreas Fault system.
During his GOSH keynote presentation, Eberlein will touch on several topics, including earthquake and tsunami preparedness for the home and office, creating a preparedness culture in the workplace, and training. In addition to his keynote presentation, Eberlein will conduct a breakout session about Shake Alert!, the earthquake early warning system.
Eberlein said one of his key messages will be that a culture of preparedness grows from the bottom up, not the top down, with people putting in the energy and time to make it happen.
“Studies have shown that people are not even minimally prepared for disasters in an increasingly disaster-prone world. In an unsparing examination of its own efforts, FEMA concluded that only the development of ‘individual cultures of preparedness’ from the bottom up could eventually lead to a more resilient nation,” Eberlein said. “Your workplace is potentially such a culture. With your leadership, your work community is 75 percent more likely to prepare. I hope that the audience will see that culture isn’t something that happens to us – it’s something that we have the power to create through our personal advocacy efforts.”
Eberlein said delivering the keynote at GOSH is one of the greatest honors of his career. “I realized early in my speaking career that convincing everyone to prepare is an unrealistic aim that overestimates my own influence,” he said. “My role is to influence influencers to exercise their influence. The GOSH Conference is a critical gathering of those influencers. I’m eager to share my concerns and strategies for creating a new preparedness culture so that we can make a difference together.”
Oregon OSHA encourages safety committee members, emerging environmental health and safety professionals, safety managers, and human resources personnel to mark their calendars for the 2023 GOSH Conference. The event offers many opportunities to learn about best practices for specific workplace health and safety issues, meet new vendors and suppliers, and reconnect and share ideas with industry peers.
In addition to topics for general industry and safety committees, the event will offer session tracks on many specialties, including:
- Construction
- Motor vehicle safety
- Safety and health leadership
- Workplace violence
- Communication and training
- Emergency preparedness and response
- Agriculture, pesticides, and cannabis
- Health care, ergonomics, and safety
- Organizational development and culture building
- Utilities
- Risk management
- Environmental and hazardous waste
Register now for the GOSH Conference. Check out the conference’s social media toolkit, which includes graphics attendees may use to show their involvement and share their activities. Stay connected to GOSH Conference updates by signing up to receive emails. Learn more by visiting the GOSH Conference website, contacting the Oregon OSHA conference section at 503-947-7411 or emailing Oregon.GOSH@dcbs.oregon.gov.
Meanwhile, registration for the Columbia Forklift Challenge – a hallmark of the GOSH Conference – is open to participants. On Wednesday, March 8, trained forklift drivers will compete for cash in an obstacle course designed to test their skills and safe operation.
The GOSH Conference is a joint effort of the American Society of Safety Professionals Columbia-Willamette Chapter, Oregon OSHA, and labor and businesses in Oregon and southwest Washington.
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Oregon OSHA, a division of the Department of Consumer and Business Services, enforces the state's workplace safety and health rules and works to improve workplace safety and health for all Oregon workers. For more information, go to osha.oregon.gov.
The Department of Consumer and Business Services is Oregon's largest business regulatory and consumer protection agency. For more information, go to www.oregon.gov/dcbs.
SALEM – Winter in Oregon brings rain – and lots of it. This year is no different and the Division of Financial Regulation (DFR) reminds people to be prepared. The forecast for this weekend and into next week is for continued rain and with flooding already happening in the Northwest, there are ways you can be ready.
Most Oregonians with flood coverage have it through the National Flood Insurance Program. You can also purchase private flood insurance through your insurance company. Typical homeowners or renters policies do not cover flood damage. If your insurance company does not offer flood insurance, you can shop different companies that do.
DFR has resources available on its website about flood insurance. It is important to be prepared before flooding takes place. One way to do that is to build a financial first-aid kit and inventory. You can do this by:
- Saving account numbers – Have a safe place where those are stored and accessible.
- Having an inventory of your belongings – Take pictures or videos of your items and write down a record of what you have.
- Backing up computer files – Consider backing up your information to a secure cloud storage service or keeping an external device with important information backed up somewhere other than your home.
- Securing important documents – It is critical to keep important papers in a water-tight fire safe or a bank deposit box.
More information on this checklist can be found here.
The division also has additional storm damage resources available.
“Water damage from flooding can be devastating to your home,” said Andrew Stolfi, insurance commissioner and Department of Consumer and Business Services director. “Much like a fire, flooding and storm damage can destroy your home and the items you care most about inside it. Being prepared will make dealing with the aftermath much easier.”
If you do have coverage and need to file a claim, immediately contact your insurer or agent. Also, save any receipts from repairs, housing, food, mitigation (sand bags, pumps, etc.) because reimbursements may be part of your coverage.
Before going back into your home, make sure it is safe to do so. Flood damage can make buildings insecure and unsteady. Also, you want to be careful of gas leaks and electrical wires in flooded areas.
If you don’t have flood insurance, consider purchasing it. Even those who don’t live in flood zones are susceptible under certain conditions. Contact your agent or the National Flood Insurance Program.
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About Oregon DFR: The Division of Financial Regulation is part of the Department of Consumer and Business Services, Oregon’s largest business regulatory and consumer protection agency. Visit dfr.oregon.gov and www.dcbs.oregon.gov.