Annual health insurance report

51 or more employees

The large group market is made up of employers that have 51 or more employees that choose to purchase insurance for their employees rather than self-insure.

There are approximately 635,000 Oregonians, or about 16 percent of the population, insured in this market. The insured portion of the market is subject to consumer protection laws, such as mandated benefits and claims-handling rules. There are no laws regulating rates in this market and no requirement that coverage be offered to all groups. 

The division reviews and approves the content of large group insurance contracts to ensure that they include coverage mandates and meet consumer protection standards. Legal requirements that apply to both small and large groups are guaranteed issue and renewability, mandated benefits, nondiscrimination, and pre-existing condition prohibitions. Oregon laws governing large groups are not applicable to self-insured employers.