OAR 461-135-0990: Specific Requirements; Reimbursement of Cost-Effective, Employer-Sponsored Health Insurance Premiums

Edition: Current OARD snapshotEffective: 2016-09-01Last verified: 2026-09-07

(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).

Official history and status

Statutory/Other Authority: ORS 411.060, 411.070 & 414.042

Statutes/Other Implemented: ORS 411.060, 411.070 & 414.042

History: SSP 31-2016, f. & cert. ef. 9-1-16 SSP 25-2016(Temp), f. 6-30-16, cert. ef. 7-1-16 thru 12-27-16 SSP 16-2014, f. & cert. ef. 7-1-14 SSP 35-2011, f. 12-27-11, cert. ef. 1-1-12 SSP 38-2009, f. 12-31-09, cert. ef. 1-1-10 SSP 29-2009(Temp), f. & cert. ef. 10-1-09 thru 3-30-10 SSP 23-2008, f. & cert. ef. 10-1-08 SSP 10-2007, f. & cert. ef. 10-1-07 SSP 22-2004, f. & cert. ef. 10-1-04 SSP 1-2003, f. 1-31-03, cert. ef. 2-1-03 AFS 15-1999, f. 11-30-99, cert. ef. 12-1-99 AFS 10-1998, f. 6-29-98, cert. ef. 7-1-98 AFS 3-1997, f. 3-31-97, cert. ef. 4-1-97 AFS 10-1995, f. 3-30-95, cert. ef. 4-1-95 AFS 2-1994, f. & cert. ef. 2-1-94 AFS 28-1992, f. & cert. ef. 10-1-92 AFS 2-1992, f. 1-30-92, cert. ef. 2-1-92

This rule cites

  • section (2) of this rule — target_record_not_published
  • OAR 461-110-0750 — resolved
  • OAR 461-155-0360 — target_record_not_published
  • OAR 410-120-1960 — resolved

Cited by

Official source: https://secure.sos.state.or.us/oard/