LH BULLETIN NO. 2020-05
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LH BULLETIN NO. 2020-05
To: All Health Insurance Companies, Health Maintenance Organizations and Other Interested Parties
From: Glen Mulready, Oklahoma Insurance Commissioner
Date: October 30, 2020 (Revised May 20, 2021)
Re: Mental Health Parity II
The purpose of this bulletin is to provide further guidance regarding 36 O.S. § 6060.11 as it relates to amendments passed by the Oklahoma Legislature under SB 1718 (2020) and effective November 1, 2020.
Oklahoma law requires all health insurance companies to cover benefits for mental health and substance use disorders that are equal to benefits for treatment for all other physical diseases and disorders. Treatment limitations applicable to mental health or substance use disorder benefits shall be no more restrictive than the predominant treatment limitations applied to substantially all medical and surgical benefits covered by a plan.
All health benefit plans must meet the requirements of the federal Paul Wellston and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended, and federal guidance or regulations issued under these acts including 45 C.F.R. § 146.136, 45 C.F.R. § 147.160 and 45 C.F.R. § 156.115 (a)(3).
Carriers must demonstrate compliance to MHPAEA through the submission of an annual report to the Insurance Commissioner on or before April 1 of each year that details their compliance to the requirements as set forth in 36 O.S. § 6060.11(E). The reports shall include a comprehensive review of all elements outlined in the act that demonstrates benefits are comparable to and are applied no more stringently than to medical and surgical benefits in the same classifications of benefits. The format of these annual reports can be found at: https://www.oid.ok.gov/mentalhealthparity/.
Implementation of the requirements as set out in 36 O.S. §§ 6060.11-6060.13 and this Bulletin, shall be included at the time a health benefit plan is offered, issued or upon renewal of a policy on or after the effective date of the new law (November 1, 2020).
With the passing of 2021 Senate Bill 887, no later than December 31, 2021, and by December 31 of each year thereafter, the Commissioner shall make available to the public the reports submitted by insurers, as required in this Bulletin 2020-05 during the most recent annual cycle; provided, however, that any information that is confidential or a trade secret shall be redacted.
The Commissioner shall identify insurers that have failed in whole or in part to comply with the full extent of reporting required in this Bulletin and shall make a reasonable attempt to obtain missing reports or information by June 1 of the following year.
The reports submitted by insurers and the identification by the Commissioner of noncompliant insurers shall be made available to the public by posting on the Internet website of the Insurance Department on the Mental Health Parity page.
Any filing violations of this Bulletin will be subject to 36 O.S. § 311.1 penalties.
Questions or comments regarding this bulletin should be directed to the Legal Division at the Oklahoma Insurance Department, 400 NE 50th Street, Oklahoma City, OK 73105.