Looking to purchase group health insurance for your Oregon business?

Choosing the right group health plan for your Oregon company can be considered a significant financial investment in your employees. For many companies, health insurance is one of the highest expenses after payroll. It is essential to work with a broker that understands the immense financial responsibility. As a Portland Oregon Group Health Insurance / Employee Benefit Broker I offer a broad selection of Oregon group health insurance plans to design group benefits for businesses from the leading Oregon health insurance companies which include:

  • Aetna Health Insurance
  • Cigna
  • Heath Net of Oregon
  • Kaiser Permanente
  • Providence Health Plan
  • PacificSource Health Plans
  • Regence BlueCross BlueShield of Oregon
  • United Healthcare
  • MODA Insurance
  • Samaritan Health Plans

Oregon and Federal Requirements

Under the Affordable Care Act (ACA), an employer with at least 50 full-time (working more than 30 hours per week) employees must offer health insurance coverage for full-time employees and their dependents. Dependent children must be offered coverage up until age 26. If insurance is not offered, is not affordable, or is substandard, and any employee uses a tax credit to purchase individual insurance via the Oregon Health Insurance Marketplace, you can be subject to fines. Employers must report subsidized health care costs on the employee’s W-2 form to promote transparency.

Oregon Group Health Insurance Options

When purchasing group health coverage, a variety of options are presented to you for consideration. Most plans fall into one of two categories:

  • HMO Plans (Health Maintenance Organization) provide services through contracted providers. Members are only covered for services from these providers.
  • PPO Plans (Preferred Provider Organization) contracts with certain providers. Members receive lower-cost treatment from these providers, and pay higher fees with others.

An HMO has more restrictions such as a limited network although may be more affordable. A PPO may provide your employees more flexibility in choosing their health providers, but may also incur more cost to your company and employees.

The premiums for these plans might vary based on a number of factors including deductibles, co-insurance, and co-payments. These have the ability to be tailored to fit your budget and to meet the affordability provisions of the ACA.

Creating Group Health Insurance Plans That Meet Your Needs

I design health insurance plans that are competitive and attract and retain employees while balancing your budget needs. Employee benefits discussed and designed for your business include the following: 

  • Group Health Insurance
  • Group Dental Insurance
  • Group Short Term Disability Insurance
  • Long Term Disability Insurance
  • Health Savings Accounts (HSA)
  • Health Reimbursement Accounts (HRA)
  • Group Vision Insurance
  • Group Term Life Insurance
  • Employee Assistance Programs
  • Flexible Spending Accounts (FSA)
  • Key Person
  • Individual Plans

 Below are frequently asked questions that I receive regarding group health insurance for Oregon businesses. 

The Oregon Legislature passed House Bill 2002 which fundamentally changes the Small Employer Health Insurance rating rules in the State of Oregon with new and renewing groups beginning on or after April 1, 2008.

HB 2002 expanded the definition of an Oregon Small Employer Groups from 2-25 to 2-50 employees.  “Small Employer” means an employer that employed an average of at least 2 but not more than 50 employees on business days during the preceding calendar year, the majority of whom are employed within this state, and who employs at least 2 eligible employees on the date on which coverage takes effect.

An employee of a small employer who works on a regularly scheduled basis, with a normal work week of 17.5 or more hours.  The employer may determine hours worked for eligibility between 17.5 and 40 hours per week, subject to the rules of the carrier.
In addition to rating for subscriber ages, plan design, family status and location of groups, carriers may now rate for the following:


 Dependent or Spouse and Dependent ages (not just employees)

 Tobacco use

 Percentage of employees & dependents participating in the insurance plan

 Premium contribution by the employer and employee

 Expected claims experience (min or max of 5%)

 How many years group has had their plan with their current carrier

 Health promotion engagement by employees and dependents


Each carrier has the ability to file different combinations of the above criteria.

No. Insurance companies are now required to file their rating factors for groups of 2-50 employees, not just 2-25, which means carriers must treat all small groups the same and consistent with how they filed their new rating practice, leaving no flexibility in rate changes.

Yes, the small group plans must also comply with the following state defined regulations:

 Waiting periods for coverage for new hires cannot be longer than 90 days.

 All categories of employees, management, non-management, etc, must have the same hours per week and probationary period for eligibility.

 Employers may not ‘class out’ employees for the purpose of denying eligibility for health coverage.

Yes.  Effective January 1, 2008, Oregon House Bill 2007 established that same-sex domestic partners have essentially the same rights under state law as do spouses. Subsequently, the Oregon Insurance Division interpreted this law to mandate coverage for Oregon registered (same-sex) domestic partners in insurance contracts.
The law set up a registry program through which domestic partnerships may register with a county clerk’s office to formalize their relationship.  As a result of a temporary injunction that was lifted on Feb. 1, domestic partners were able to register beginning on Feb. 4, 2008.  To register, the individuals in a domestic partnership must file a Declaration of Domestic Partnership, and will receive a Certificate of Registered Domestic Partnership.  This Certificate then becomes part of the state’s Domestic Partnership registry.
Some carriers will require documentations, others will not.  Members interested in registering their domestic partnership should contact their County Clerk’s office to access a Declaration of Domestic Partnership form.  Forms are also available to the public on the Department of Human Services, Center for Health Statistics web site.
This varies by carrier. Some carriers are automatically offering it to all domestic partners, some will only automatically cover “registered” domestic partners and may require that the employer elect an additional rider (usually at no additional cost) that will allow coverage for non-registered same sex and opposite sex domestic partners. Check with your agent or carrier for specifics on your domestic partner coverage options.