State Update

Oregon Proposes Administrative Fee for Stand-Alone Dental Plans in State’s Health Insurance Marketplace

(State Policy, ACA) Permanent link   All Posts

Cover Oregon is the name of Oregon’s new health insurance marketplace. Cover Oregon was established in accordance with the Affordable Care Act and will offer the state’s residents health insurance beginning October 1. On July 25, the Cover Oregon Finance & Audit Committee unanimously approved a proposal to add a $0.93 per member per month administrative fee, separate from the previously approved medical administrative fee. The new administrative fee would only apply to insurance carriers offering stand-alone dental plans. Both the medical and dental administrative fees would become effective starting January 1, 2014. The dental administrative charge will be due in full to the marketplace on the last business day of the month. Payments not made by the 10th day of the following month will be assessed a late payment penalty of 1% of the amount due. According to Cover Oregon staff, it is expected that the state will generate approximately $674,000 annually from the dental administrative fees. Enrollment in stand-alone dental plans is estimated to reach 72,400, which makes up one-third of the projected total enrollment in the state’s health insurance marketplace. Click here to view the July 25 committee meeting agenda as well as meeting minutes and additional materials. The Board of Directors will vote on the dental administrative fee during its upcoming board meeting.