Oregon Administrative Rules
Chapter 461 - DEPARTMENT OF HUMAN SERVICES, SELF-SUFFICIENCY PROGRAMS
Division 135 - SPECIFIC PROGRAM REQUIREMENTS
Section 461-135-0990 - Specific Requirements; Reimbursement of Cost-Effective, Employer-Sponsored Health Insurance Premiums

Universal Citation: OR Admin Rules 461-135-0990

Current through Register Vol. 63, No. 9, September 1, 2024

(1) Clients or an eligible applicant (see section (2) of this rule) for a client in the OSIPM program may be reimbursed for their share of the premiums for private or employer-sponsored group health insurance if:

(a) The insurance covers a member of the benefit group (see OAR 461-110-0750);

(b) The insurance coverage is a comprehensive major medical plan that includes inpatient and outpatient hospital, physician, lab, x-ray and full prescription coverage; and

(c) The premium is cost-effective (see OAR 461-155-0360 and OAR 410-120-1960).

(2) An "eligible applicant" may be a non-Medicaid individual living in or outside of the household. The Department may pay a portion of or the entire premium if payment of the premium for the non-Medicaid individual is necessary in order to enroll the Department client in the group health plan (see OAR 410-120-1960).

Stat. Auth.: ORS 411.060, 411.070, 414.042

Stats. Implemented: ORS 411.060, 411.070, 414.042

Disclaimer: These regulations may not be the most recent version. Oregon may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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