Posts by: Britney Han

Mental Health Awareness Month 2021

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Oklahoma Insurance Department

For Immediate Release:
May 25, 2021

Mental Health Awareness Month 2021:
Know What’s Covered

By Oklahoma Insurance Commissioner Glen Mulready 

May is National Mental Health Awareness Month and many people have been experiencing greater stresses since the COVID-19 pandemic. Many families are still facing economic challenges and anxieties about the health of loved ones. In honor of Mental Health Awareness Month, I would like to take a moment to remind Oklahomans that all comprehensive major medical insurance plans are required by law to cover mental health and substance abuse services.

Under Oklahoma law, health insurers offering comprehensive health insurance plans must have an adequate network of providers and treatment facilities for mental health and substance use disorder conditions. They cannot limit the number of visits you make to such providers and cannot charge greater co-pays for outpatient mental health and substance disorder services than other primary care medical services. Here is some helpful insurance information to help you understand your access to mental health services.

Mental Health Coverage Options

The federal parity law generally applies to the following types of health insurance:

  • Employer-sponsored health coverage for small groups (under 50 employees) and large groups (over 50 employees).
  • Coverage purchased through health insurance exchanges created under the health care reform law also known as the Affordable Care Act (ACA).
  • Children’s Health Insurance Program (CHIP).
  • Medicaid program (SoonerCare). Requirements may vary, contact the Oklahoma Healthcare Authority if you are unsure how the federal parity law applies to your Medicaid benefits.

Eligibility and Claim Issues

Check your description of plan benefits — it should include information on behavioral health services or coverage for mental health and substance use disorders. If you still aren’t sure, contact your insurance company directly or contact us at 800-522-0071.

If your mental health claim is denied, always ask why. Your health plan will have a process to review and appeal denied claims. You or your provider may also file a complaint with us. Check out the National Alliance on Mental Illnesses’ tips for what to do if you’re denied care by your insurance carrier.

Additional Resources

For more information on consumer rights and protections, visit our Mental Health page at www.oid.ok.gov/mentalhealth. You can also visit the Oklahoma Department of Mental Health and Substance Abuse Services at https://www.ok.gov/odmhsas or call 2-1-1.

When it comes to our well-being, mental health is just as important as physical health. Check with your health insurance company to find out what options are available. Many plans offer special hotlines or cover mental health visits through telehealth. If you need help, please reach out.

For more insurance information, please contact the Oklahoma Insurance Department at 1-800-522-0071 or visit our website at www.oid.ok.gov.

 

Questions or comments should be directed to
Communications Director, Liz Heigle
Liz.Heigle@oid.ok.gov | (405) 819-2221

Welcome to Medicare Virtual Fair Available for Oklahomans Nearing Age 65

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Oklahoma Insurance Department

For Immediate Release:
May 24, 2021

Welcome to Medicare Virtual Fair Available for Oklahomans Nearing Age 65

 

OKLAHOMA CITY –The Medicare Assistance Program (MAP) at the Oklahoma Insurance Department (OID) is partnering with the Administration for Community Living (ACL) to host the Welcome to Medicare Virtual Fair on June 23, 2021, from 2:00 – 6:00 p.m. CST. This is a national event for people turning 65, retiring or joining Medicare because of a disability. There is no cost to attend. Visit here to register.

There will be general sessions with expert presenters on Medicare eligibility, enrollment, costs, and coverage options. In the general sessions, the event will offer subtitles in English and a live transcript in Spanish. You can visit state-specific virtual exhibits at any time during this event. MAP encourages Oklahomans to join this national event to get trusted, unbiased Medicare education and ask live questions to the MAP counselors.

“Whether you’re new to Medicare or returning, this is a great opportunity for Oklahomans to learn about coverage options, financial assistance and important deadlines,” MAP Director Ray Walker said. “You can join us at any time during the event and ask questions to our counselors.”

Visit www.shiphelp.org for more details. MAP is part of the national Senior Health Insurance Counseling Program (SHIP) network, funded in part by the U.S. ACL, Office of Healthcare Information and Counseling. MAP provides one-on-one counseling and information for people eligible for Medicare. All services are free, unbiased, and confidential. For more information, contact the MAP at 1-800-763-2828 or visit https://www.map.oid.ok.gov.

If you have questions about other insurance issues, please contact the Oklahoma Insurance Department at 1-800-522-0071 or visit our website at www.oid.ok.gov.

Questions or comments should be directed to
Communications Director, Liz Heigle
Liz.Heigle@oid.ok.gov | (405) 819-2221

BULLETIN NO. LH 2021-02

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Oklahoma Insurance Department

LH BULLETIN NO. 2021-02

To:      All Health Insurance Companies and Health Maintenance Organizations
Re:      Extension of “Non-Enforcement” (Transitional) Policies through Calendar Year 2022
From:  Glen Mulready, Insurance Commissioner
Date:   May 14, 2021

The purpose of this bulletin is to inform all Oklahoma licensed health insurance carriers of the requirements of the Oklahoma Insurance Department (OID) as they relate to the bulletin released by the Center for Medicare and Medicaid (CMS) on January 19, 2021 regarding the Extension of Limited Non-Enforcement Policy through 2022.

Under previous guidance CMS announced that, with permission by State Regulators, health insurance issuers could choose to continue certain coverages that would otherwise be cancelled under the Public Health Service Act and would not be considered to be out of compliance with market reforms if specific conditions were met. With guidance issued on January 19, 2021, CMS announced it would extend this policy again to include policy years beginning on or before October 1, 2022, provided that all such coverage comes into compliance with the specified requirements by January 1, 2023.

Based on this most recent CMS announcement the Department advises carriers that existing transition policies may be renewed for policy years beginning on or before October 1, 2022, provided that all transition policies end by January 1, 2023. In an effort to minimize market disruption, issuers will again be given the discretion to renew existing extended transition policies in the individual and small group markets with a 12 month policy duration or shorter than 12 month duration provided that all affected policies terminate in compliance with the January 1, 2023 deadline. Renewal actions will be
consistent with and conform to Oklahoma law governing insurance renewals.

Health insurance issuers that renew under the extended transitional policy must provide the required notice to affected individuals and small businesses as specified in the CMS January 19, 2021 guidance.

Questions or comments applicable to this bulletin should be directed to Mike Rhoads, Deputy Commissioner, at mike.roads@oid.ok.gov or Kim Bailey, General Counsel, at kim.bailey@oid.ok.gov at the Oklahoma Insurance Department, 400 North East 50th St., Oklahoma City, OK 73105-1816.

To see this bulletin in PDF, CLICK HERE.

BULLETIN NO. LH 2021-01

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Oklahoma Insurance Department

LH BULLETIN NO. 2021-01

To:      All Health Insurance Companies and Health Maintenance Organizations
Re:      Step Therapy Protocol Requirements
From: Glen Mulready, Commissioner
Date:  May 11, 2021

On November 1, 2019, 63 O.S. § 7310 relating to step therapy protocols for prescription drug coverage (the “Step Therapy Law”) became effective. The law applies to all insurers doing business in Oklahoma that utilize a step therapy protocol or contract with pharmacy benefit managers (PBMs) or utilization review organizations that use step therapy protocols.

The Department has recently become aware that certain provisions of the statute are not being followed. Complaints have been registered that health insurance plan providers, as defined in the statute, are out of compliance with regard to timely responses for a step therapy exception. The statute provision reads:

“A health insurance provider shall respond to a request for a step therapy exception, or any appeal therefore, within seventy-two (72) hours of receipt of the request or appeal. If a patient’s prescribing healthcare provider indicates exigent circumstances exist, the health insurance plan provider shall respond to such request or appeal within twenty-four (24) hours of receipt of the request or appeal. If the health insurance plan provider fails to respond within the required time, the step therapy exception or appeal shall be deemed granted. Upon granting a step therapy exception, the health insurance plan provider shall authorize coverage for, and dispensation of the prescription drug prescribed by the patient’s healthcare provider.”

Health insurance plan providers are further instructed to review, follow, and grant step therapy exceptions submitted in compliance to the requirements set forth in Section 2 of the statute. These provisions permit an exception when supported by clinical documentation meeting the criteria outlined in subsections a-e of Section 2 of the statute.

The Department issues this guidance to inform and educate health insurance plan providers on the provisions in the statute and to restate the required compliance to the response time and exception criteria as outlined. We encourage the industry to work collaboratively with providers in this area.

Questions or comments applicable to this bulletin should be directed to Mike Rhoads, Deputy Commissioner, at the Oklahoma Insurance Department, 400 North East 50th St., Oklahoma City, OK 73105-1816 or by phone at (918-295-3700).

To see this bulletin in PDF, CLICK HERE.

Storm Recovery Tips from the Oklahoma Insurance Department

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Oklahoma Insurance Department

For Immediate Release:
April 30, 2021

Storm Recovery Tips from the Oklahoma Insurance Department

 

The Oklahoma Insurance Department (OID) is offering help to Oklahomans who are affected by Wednesday night’s severe weather. The OID is dedicated to helping those with damage have their insurance claims handled promptly and fairly.

“Filing an insurance claim can be an intimidating process,” Insurance Commissioner Glen Mulready said. “But we are here for those who suffered from Wednesday’s storms. We want to make sure they get the assistance they need to recover as quickly as possible.”

The OID’s Consumer Assistance division is ready to help anyone who received damage from this week’s storms. Here are some tips for storm victims:

  1. Have your roof inspected by a trusted roofing contractor. If the damages are below your deductible, you would need to pay for the repairs; If they are much larger than your deductible turn the claim in to your insurance carrier.
  2. Contact your insurance company or agent as soon as possible. Ask what forms, documents and information you will need to provide in order to process your claim. Keep in mind that replacement cost policies require the work to be completed within six months of the date of loss in order to receive the replacement cost payments that were withheld.
  3. Access and document Damage. Take photos or video of the damage. Unless your insurance company tells you to, don’t throw anything away.
  4. Make the necessary repairs to prevent further damage. Cover broken windows, holes, leaking roofs and damaged walls. Do not have permanent repairs made until your insurance company has inspected the property and you have reached an agreement with them on the cost of appropriate repairs. Move undamaged items to a safe location when necessary to avoid theft or additional loss.
  5. Save all receipts. If you made repairs to your property, save all receipts including those from the temporary repairs that might be covered by your insurance policy.
  6. Ask about additional living expenses. If your home is damaged to the extent that it is unlivable, ask your insurance provider if you have coverage for living expenses incurred while repairs are being made.

Remember these tips when you’re dealing with contractors to avoid fraud:

  • Always get more than one bid.
  • Check references and phone numbers. Contractor complaint information is collected by the Better Business Bureau. You can call the Construction Industries Board to make sure the contractor has a valid license to do business in the state and that they carry liability insurance.
  • Don’t pay upfront and don’t make your final payment until the job is finished.
  • Avoid contractors who offer to waive your deductible or promise a rebate.
  • Never sign a contract with blank spaces and always keep a copy for your records.

If you have questions about other insurance issues, please contact the Oklahoma Insurance Department at 1-800-522-0071 or visit our website at www.oid.ok.gov.

Questions or comments should be directed to
Communications Director, Liz Heigle
Liz.Heigle@oid.ok.gov | (405) 819-2221

If April Showers Bring May Flowers, Get Flood Insurance Today

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Oklahoma Insurance Department

For Immediate Release:
April 21, 2021

If April Showers Bring May Flowers,
Get Flood Insurance Today

By Oklahoma Insurance Commissioner Glen Mulready 

 

As a resident of Tulsa for the past 25 years, it was devastating to watch our neighbors’ homes destroyed in May 2019. It was emotional because it was not just the building itself they lost, but also the contents. When my boys and I went out to help clean the waterlogged neighborhoods, we found pictures, keepsakes, kids’ drawings and letters from loved ones—all things that can’t be replaced. We are back to April two years later and I want all Oklahomans to ask themselves if they have the necessary insurance coverage to mitigate its consequences.

During the late hours of April 30 and the morning of May 1, 17 tornadoes struck Oklahoma. The storm carried 5 to 6 inches of rainfall. Thousands of Oklahomans were devastated by flooding resulting in more than $31 million in estimated losses. More than 6,000 flood claims were reported. Unfortunately, many residents did not have flood insurance and some are still trying to recover today.

As April showers bring May flowers, I’m encouraging Oklahomans to Get Ready now and prepare for the worst. Flooding can cause catastrophic damage, and preparation now will lead to a better recovery later. Here are three important reasons to consider flood insurance today: 

 

  1. You Live in Oklahoma Flooding is the number one natural disaster in the United States. While most standard homeowners policies cover tornadoes, hail, and wildfires, they do NOT cover floods. There is at least a 1 in 4 chance of flooding in high-risk areas during a 30-year mortgage.
  2. 30-Day Waiting Period It typically takes 30 days for aflood policy to go into effect, so the time to buy is well before a disaster. That is why you need to purchase or renew flood insurance well in advance. Waiting until you see the water rushing is too late.Get flood coverage under the National Flood Insurance Program (NFIP) today.
  3. Cost of Flooding Flooding can be an emotionally and financially devastating event. According to theFederal Emergency Management Agency, an inch of water in a home could cause more than $27,000 in damages. About 33% of all flood claims come from outside of high-risk areas. In 2019 nationally, the average flood insurance claim payment was $53,301while the average flood insurance premium payment was $674.

 

While we cannot prevent another flood from occurring, we can get our state financially prepared for the damage when it hits. Let’s make sure that Oklahomans understand their flood risk. As I always like to remind folks…If it rains where you live, it can flood where you live.

If you have questions about other insurance issues, please contact the Oklahoma Insurance Department at 1-800-522-0071 or visit our website at www.oid.ok.gov.

 

Questions or comments should be directed to
Communications Director, Liz Heigle
Liz.Heigle@oid.ok.gov | (405) 819-2221

Oklahoma Insurance Department to Host Virtual Fraud Conference Beginning May 6

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Oklahoma Insurance Department

For Immediate Release:
April 20, 2021

Oklahoma Insurance Department to Host Virtual Fraud Conference Beginning May 6

 

OKLAHOMA CITY –The Oklahoma Insurance Department (OID) is partnering with the Oklahoma Social Security Administration, the Oklahoma Department of Securities, the Oklahoma Attorney General’s Office, the Oklahoma Banker’s Association and AARP Oklahoma to host the Annual Hoodwinked Fraud Conference. This virtual event begins May 6, 2021. Additional events will follow each Thursday on May 13, 20, 27 and June 3, 10, 17 at 10 a.m. The Hoodwinked Fraud Conference will offer various fraud-related webinar sessions, from Medicare and healthcare fraud to Social Security scams, relationship scams, cyber scams, investment, banking fraud and securities fraud.

Hoodwinked will educate Oklahomans on the latest white-collar crimes and provide tips for staying safe. This virtual event will consist of seven educational webinars led by speakers with diverse areas of expertise such as state agency directors, Medicare professionals and individuals from the fraud prevention fields. This year, the Oklahoma Social Security Administration (SSA) is joining for the first time as Social Security fraud is on the rise. According to Jose Olivero, the Public Affairs Specialist at the SSA, they receive over 35,000 telephone scams reported monthly.

“We are excited to offer our virtual conference again this year and grateful to our partners who’ve come together to help make this possible,” said Insurance Commissioner Glen Mulready. “In this unprecedented time when fraudsters are taking advantage of fear and uncertainty, we are looking to bring our community together and offer resources that will help Oklahomans protect themselves and their loved ones.”

“We continue to see some older scams that have been modified to fit the current pandemic climate as well as some new scams, all targeting seniors,” said Ray Walker, Director of the Medicare Assistance Program at the OID. “This is a great opportunity to learn how to protect yourself and what to do if you think you may have become a victim.”

Registration for the event is complimentary and open online at www.oid.ok.gov. Click here for speaker information and updates about the conference. Follow OID on Facebook, Instagram, LinkedIn and Twitter to stay informed about the event.

If you have questions about other insurance issues, please contact the Oklahoma Insurance Department at 1-800-522-0071 or visit our website at www.oid.ok.gov. 

 

Questions or comments should be directed to
Communications Director, Liz Heigle
Liz.Heigle@oid.ok.gov | (405) 819-2221

Bulletin PC 2021-01 Oklahoma Market Assistance Program (OK-MAP) Annual Assessment

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Oklahoma Insurance Department

PC BULLETIN NO. 2021-01

 

TO: ALL PROPERTY AND CASUALTY INSURERS LICENSED IN OKLAHOMA
ALL RATING AND ADVISORY ORGANIZATIONS
ATTENTION: STATE FILING DIVISION

RE: OKLAHOMA MARKET ASSISTANCE PROGRAM (OK-MAP) ANNUAL ASSESSMENT

FROM: GLEN MULREADY, INSURANCE COMMISSIONER

DATE: April 12, 2021

 

PURPOSE OF THIS BULLETIN

The Oklahoma Market Assistance Program (OK-MAP) Plan of Operation and the Oklahoma Insurance Code allow the program to collect an assessment from all insurers authorized to write property and casualty insurance in the State of Oklahoma. The purpose of the assessment is to help fund the program so that it may continue its efforts in assisting Oklahoma consumers in finding homeowners insurance. The amount of the assessment is $150 and all member insurers will receive an invoice for that amount during the first week of May 2021.

36 O.S. § 6422 requires OK-MAP members to participate in all assessments and writings of the program. The statute also allows for imposition of a penalty against members who fail to pay the assessment, including revocation of an insurer’s certificate of authority and a fine of up to $5,000.

The assessment is due on September 1, 2021. Please remit payment to the following address:

Oklahoma Market Assistance Program
PO Box 13488
Oklahoma City, OK 73113

Please do not send payment to the Oklahoma Insurance Department.

Additional information regarding OK-MAP is available online at www.mapsprogram.com.

Questions applicable to this bulletin should be directed to:

Marletta Bruner, Rate and Form Division, at Marletta.Bruner@oid.ok.gov;
Cuc Nguyen, Rate and Form Division, at Cuc.Nguyen@oid.ok.gov; or
Bo Debose, Legal Division, at Bo.Debose@oid.ok.gov

The Oklahoma Insurance Department encourages readers of this bulletin to periodically check the Department’s website at https://www.oid.ok.gov for news and updates to bulletins and other relevant material.

Attorney General Hunter, Insurance Commissioner Mulready Announce $25 Million Settlement with Farmers Insurance

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Oklahoma Insurance Department

April 5, 2021

Attorney General Hunter, Insurance Commissioner Mulready Announce $25 Million Settlement with Farmers Insurance

 

OKLAHOMA CITY – Attorney General Mike Hunter and Insurance Commissioner Glen Mulready today announced a $25 million settlement with Farmers Insurance for the company’s handling of earthquake claims.

An investigation revealed that Farmers denied or failed to properly pay approximately one thousand earthquake claims submitted by Oklahomans who purchased coverage to protect their property. As a result, the company will reopen the claims process and re-evaluate the claims using an independent administrator. Claims approved by the independent administrator will be paid pursuant to an individual insured’s policy.

“This is a great win for Oklahomans who paid premiums for a Farmers earthquake insurance policy,” Attorney General Mike Hunter said. “I am happy to announce that after negotiations, Farmers agreed to this settlement. Through an exhaustive process, we will ensure each Oklahoman who sustained legitimate damage from an earthquake and submitted a claim to Farmers will have an opportunity for their claim to be independently reviewed and the damage to their property repaired.”

According to the agreement, Farmers will make additional payments as needed if property damages exceed the agreed upon amount to pay eligible earthquake claims.

“This latest settlement serves as another example that the attorney general and I are committed to protecting all Oklahoma consumers,” said Oklahoma Insurance Commissioner Glen Mulready. “We appreciate the partnership of the attorney general in resolving this matter.”

Terms of Agreement and Payout

An earthquake claims review process will be formed to re-examine every eligible earthquake claim.

Farmers will send each eligible Oklahoman a written notice that their claim has been re-opened for review and describe the earthquake claims review process.

If an eligible individual has more than one eligible earthquake claim, all eligible earthquake claims will be re-examined.

The state and Farmers will mutually agree upon an independent, third-party claim administrator with substantial experience in the handling, or reviewing, of property damage claims in Oklahoma. Farmers shall have no prior or existing relationship with the claim administrator.

Documents will be available later.

Get Ready for COVID-19 Vaccines

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Oklahoma Insurance Department

For Immediate Release:
March 29, 2021

Get Ready for COVID-19 Vaccines:
Insurance Coverage and Misinformation

By Oklahoma Insurance Commissioner Glen Mulready 

Thanks to the Oklahoma State Department of Health (OSDH) and all the front-line workers, Oklahoma has now entered Phase 4 of its vaccine distribution plan. With three COVID-19 vaccines available, all Oklahomans are now eligible for vaccination. As we’re on track to get our “normal” back, I’d like to remind you that the cost of obtaining a vaccine will not be a barrier for Oklahomans, regardless of health insurance status.

The Coronavirus Aid, Relief and Economic Security (CARES) Act, provides funding for the vaccine itself. It also requires most health insurance companies to cover qualifying coronavirus preventive services without imposing any cost-sharing requirements, such as a copay, coinsurance or deductible. If you are covered under Medicare or Medicaid, your vaccine will be paid for by the Medicare’s trust fund. If you don’t have insurance, your vaccine is still covered. Healthcare providers will get reimbursed through the Provider Relief Fund.

If you received an unexpected bill for a COVID-19 vaccine or qualifying associated visit, you should contact the provider or your insurance company and alert them of the error. If you have issues with your health insurance company regarding a bill related to COVID-19, please file a complaint with the Oklahoma Insurance Department (OID) at www.oid.ok.gov/ or contact the Consumer Assistant at 800-522-0071. Also, here are some key takeaways to avoid fraud related to COVID-19 vaccines.

  • You don’t need to pay to get a COVID-19 vaccine appointment. Visit the OSDH’s website to make your appointment. You can also ask your doctor or provider how to get the vaccine near where you live.
  • Getting a COVID-19 vaccine is free. Whether you have health insurance or not, the vaccines are always free. Providers can seek reimbursement from your insurance company, but there are no co-pays or cost-sharing. If you’re asked to pay money, contact the OID at 800-522-0071.
  • You cannot buy a COVID-19 vaccine. Please do not fall for the ads that come via email or pop up on your social media feed offering early access to a vaccine. The vaccine is available only at federal and state-approved locations.
  • Vaccinations will not impact your life insurance benefits. Life insurance policies clearly spell out what might cause your insurer to deny a benefit. Receiving a COVID-19 vaccine would not void a policyholder’s life insurance coverage. Contact your agent if you have questions or concerns about the details of your policy.
  • Never give out your personal financial information. No one from a vaccine distribution site, state agency, healthcare provider’s office, insurance company or Medicare will contact you to ask for your Social Security, credit card or bank account number to get the vaccine.

For more insurance information, please contact the Oklahoma Insurance Department at 1-800-522-0071 or visit our website at www.oid.ok.gov.

 

Questions or comments should be directed to
Communications Director, Liz Heigle
Liz.Heigle@oid.ok.gov | (405) 819-2221