OR HB2540

Insurers must credit amounts enrollees pay directly to health care providers toward their deductible and annual out-of-pocket expenses when the service is medically necessary, covered under the plan, and paid at less than the average in-network discounted rate

Enrollees qualify for the credit only when they do not submit the claim to the insurer themselves

Insurers must establish a process for enrollees to submit claims for these credits, including required documentation, or allow enrollees to use the insurer's existing claims system

Health maintenance organizations (HMOs) are exempt from these requirements

Applies to health benefit plans issued, renewed, or extended on or after the effective date of the Act