New law addresses insurance, wildfire

With homeowners in Sisters Country — and across Oregon — concerned about keeping their homeowners insurance policies in the face of industry-wide wildfire risk concerns, when the clock strikes midnight on January 1, 2024 many new laws immediately take effect. The Oregon Division of Financial Regulation (DFR) reports that Senate Bill (SB) 82 strengthens consumer protections for homeowners dealing with wildfire-related issues. It requires insurance companies to explain, using property-specific characteristics, why a policy might not be getting renewed or why a rate is going up, and to reflect in rating and underwriting plans how that insurer addresses or considers wildfire risk mitigation actions.

These actions could include creation of defensible space, home hardening, and community-based mitigation activities. It also requires insurers to allow up to 36 months to repair, rebuild, or replace damaged or lost property if it was directly related to a fire that was subject of an order under the Emergency Conflagration Act. This bill also prohibits insurance companies from using statewide wildfire risk maps published by the Oregon Department of Forestry as a basis for canceling or declining to renew a policy or increasing premiums.

This is one of several laws taking immediate effect with the turn of the new year.

• SB 192 directs the Oregon Prescription Drug Affordability Board to develop a plan for upper payment limits to contain costs of prescription drugs in the state, requires pharmacy benefit managers to provide price transparency reports to Oregon Department of Consumer and Business Services (DCBS), expands health insurance company transparency reporting, and makes other technical changes to strengthen DCBS prescription drug pricing programs. Pharmacy benefit managers will report annually to DCBS about certain rebates, fees, price protection payments, and other payments received from prescription drug manufacturers, shedding more light on the effect of industry practices on the prices Oregonians pay for drugs.

• SB 536 establishes new disclosure and care obligations for the sale of annuities in Oregon and permits the sale of registered index-linked annuities in the state. Producers and brokers must also complete, at a minimum, a four-hour training course with a continuing education provider that has registered with DCBS.

• SB 628 requires health benefit plan coverage of certain treatments for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections.

• SB 797 requires health insurance policies that cover expenses of hospital, medical, or surgical services to cover medically necessary prosthetic and orthotic devices.

• SB 1041 prevents group and individual health benefit plans that cover supplemental and diagnostic breast examinations from imposing deductibles, co-insurance, co-payments, or any other out-of-pocket expenses on those services.

• SB 1529 passed in 2022 with a delayed implementation date and was amended in 2023 by House Bill (HB) 3008. It requires health benefit plan coverage of three primary care or behavioral health visits with a co-pay of no more than $5 and requires health benefit plan issuers to automatically assign members to primary care providers (PCP) if they do not select a PCP after the first 90 days of the plan year.

• HB 2002 establishes a right to make decisions about an individual’s reproductive health and allows any person to bring a civil action against a public body to enforce this right. The bill also establishes a statutory requirement for health benefit plans to cover gender-affirming treatment. It also prohibits medical malpractice insurers from taking adverse action against health care providers for providing reproductive health or gender-affirming care services that are legal in Oregon.

• HB 2052 requires data brokers to register with DCBS before collecting, selling, or licensing brokered personal data in Oregon. DFR published a press release on this new law on Dec. 13.

• HB 2282 updates the Oregon state law codification of the Affordable Care Act preventive services coverage requirements to ensure access to this coverage in the event of a successful legal challenge to the ACA requirements.

• HB 2574 prohibits cost sharing for health benefit plan coverage of post-exposure prophylactic drugs for the prevention of HIV. The bill also requires all Oregon hospitals to have policies and procedures in place for the dispensing of post-exposure prophylactic (PEP) drugs and requires the Oregon Health Authority to provide PEP drugs to Type A and B rural hospitals at no cost.

• HB 2982 requires homeowners insurance issuers to offer 70 percent of property contents coverage without requiring policyholders to submit an inventory if a total loss occurs due to a declared disaster.

• HB 2994 expands coverage of bilateral cochlear implants, hearing aids, and hearing assistive technology. Also, the bill requires health benefit plans to reimburse the costs associated with these services if they are prescribed by a licensed healthcare professional, and requires specific information in adverse benefit determination notices related to claims for hearing-related items and services.