Posts by: Britney Han

Bulletin No. LH 2020-02

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CORONA VIRUS (COVID-19)


To: All Life & Health Insurance Companies and Health Maintenance Organizations
From: Glen Mulready, Insurance Commissioner
Date: March 17, 2020
Re: CORONAVIRUS (COVID-19)


The Governor of the State of Oklahoma has issued a Declaration of Emergency. That Executive Order 2020-07 was issued March 15, 2020. All health carriers, other insurance industry representatives and other interested parties are encouraged to review the latest Oklahoma information about COVID-19 released by the Oklahoma Department of Health. ( https://coronavirus. health.ok.gov/). The Department is issuing this bulletin to assist individuals and entities regulated by the Department in effectuating the provisions of insurance related services during this urgent public health challenge. The Oklahoma Department of Insurance is asking health carriers providing coverage through health benefit plans to Oklahoma residents to take the following immediate measures related to the potential impact of COVID-19.

• Health carriers should review their internal processes and continuity of operations,including ability to telecommute, to ensure that they are prepared to address COVID-19 cases in Oklahoma and serve their members, including by providing insureds with information and timely access to all medically necessary covered health care services. As the COVID-19 situation continues to evolve, health carriers should continually assess their readiness and make any necessary adjustments. This includes notifications to producers and brokers to keep consumers up to date.

• Access to accurate information and avoiding misinformation are critical. Therefore, health carriers should inform insureds of available benefits specifically related to telemedicine, quickly respond to insured inquiries, and consider revisions needed to streamline responses and benefits for insureds. Health carriers should make all necessary and useful information available on their websites and staff their nurse-help lines accordingly.

• Health carriers should waive any cost-sharing for COVID-19 laboratory tests so that cost-sharing does not serve as a barrier to access to this important testing. In addition, health carriers should also waive the cost-sharing for an in-network provider office visit and an in-network urgent care center visit when testing for COVID-19.

• Given that COVID-19 is a communicable disease, some insureds may be using telehealth services instead of in-person health care services. Health carriers should review and ensure their telehealth programs with participating providers are robust and will be able to meet any increased demand. Additionally, health carriers should waive telehealth copayments for insureds and reimburse the provider for the copayment.

• Health carriers are asked to verify their provider networks are adequate to handle a potential increase in the need for health care services in the event COVID-19 cases are diagnosed in Oklahoma. If a health carrier does not have a health care provider in its network with the appropriate training and experience to meet the particular health care needs of an insured, health carriers are asked to make exceptions to provide access to an out-of-network provider at the in-network cost-sharing.

• Timely decision making is critically important to responding appropriately to COVID-19, and it is particularly important with respect to utilization review. Health carriers are reminded that utilization review decisions must be made in the timeframes required. Health carriers should not use preauthorization requirements as a barrier to access necessary treatment for COVID-19, and health carriers should be prepared to expedite utilization review and appeal processes for services related to COVID-19, when medically appropriate.

• Health carriers should, where appropriate, make expedited formulary exceptions if the insured is suffering from a health condition that may seriously jeopardize the insured’s health, life, or ability to regain maximum function or if the insured is undergoing a current course of treatment using a non-formulary prescription drug.

• Health carriers should identify and remove barriers to testing and treatment of COVID-19 and be prepared to address COVID-19 cases in Oklahoma. The Department extends its appreciation to health carriers in working with the State to address this public health challenge.

• Health carriers shall not cancel the coverage of any person who has been diagnosed with COVID-19 and is unable to return to work or maintain coverage under their current health carrier because of COVID -19 for the next ninety (90) days. Health carriers should extend the traditional thirty (30) day grace period to a sixty (60) day grace period for nonpayment of premiums. Federal rules governing marketplace policies (ACA) will remain in effect with respect to grace periods.

PHARMACY BENEFIT MANAGER

• Pharmacists writing “COVID-19” or substantially similar language on a prescription shall be equivalent to receiving a signature. The goal is to reduce requirements for face-to-face interactions. Pharmacy benefit managers should immediately cease all audits while the Declaration of Emergency is in place. Additionally, a sixty (60) day supply may be provided for a thirty (30) day prescription for maintenance drugs with appropriate copays. This does not apply to controlled substances. Further, all restrictions on pharmacies doing mail order should be waived.

• Pharmacy benefit managers and allied health providers are subject to price gouging laws. The Department will continue to work with the Attorney General to enforce them. This Bulletin is intended to apply to all insured plans that are regulated by the Oklahoma Insurance Department, but it is strongly recommended that Oklahoma self-funded plans follow the same directives. The provisions of this bulletin are in effect until the emergency is no longer in effect.

Oklahoma Insurance Department
400 North East 50th St.
Oklahoma City, OK 73105

Questions or comments applicable to this bulletin should be directed to Mike Rhoads or Ron Kreiter
mike.rhoads@oid.ok.gov
ron.kreiter@oid.ok.gov

About the Oklahoma Insurance Department The Oklahoma Insurance Department, an agency of the State of Oklahoma, is responsible for the education and protection of the insurance-buying public and for oversight of the insurance industry in the state.

COVID-19 FAQs

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Insurance Questions and Answers on COVID-19

General

Is the OID open?

Yes, the OID offices in Oklahoma City and Tulsa are open to the public.  The OID is following local and federal CDC guidelines related to COVID-19.

I'm experiencing difficulties with my insurance carrier. What should I do?

Please contact our Consumer Assistance Team at 800-522-0071.

Health Insurance

Will my health plan cover testing?

Yes.  Health plans are required to cover COVID-19 diagnostic testing without cost-sharing, prior authorization or other medical management requirements.  Contact your insurance company and your primary care provider if you have questions about receiving a test.

I don't want to go into a doctor’s office. What other options will my health plan pay for?

Because of advances in tele-health medicine you have the option to have a virtual office visit with your physician.  You should contact the physician’s office to make arrangements for the visit just as you would for an in-office visit.  Tele-health visits may be subject to a co-pay or other cost sharing provision.  If you are seeking a COVID-19 diagnostic test contact your physician who will direct you to a point-of-care testing site. You can also contact your county health department for testing locations and requirements.

Prescription

Can I refill my prescriptions early to keep extra on hand?

Keeping extra medication on hand, for example a 90 day supply, is dependent upon your benefit plan.  In most cases, with the approval of your physician, a prescription for a 90 day supply can be written and will need to conform to network requirements (preferred or mail order).

Travel Insurance

Will travel insurance cover me if my plans change because of COVID-19?

Most standard travel insurance does not cover losses caused by an epidemic or pandemic. If you purchased the CFAR policy, you may be covered for a portion of your trip cost. Contact your cruise line, airline or tour provider to see if any refund is offered by them first.

Business and Insurance Industry

Insurance Department Confirms Active Investigation of Unlicensed Home Warranty Company

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Insurance Department Confirms Active Investigation of Unlicensed Home Warranty Company

OKLAHOMA CITY – Insurance Commissioner Glen Mulready announced today that the Oklahoma Insurance Department (OID) is actively investigating the unlicensed activity of  Choice Home Warranty.

So far, the OID has received numerous consumer complaints alleging that Choice Home Warranty did not pay their home warranty service claims. OID issued a cease and desist order to the unlicensed company in 2017. OID’s current investigation revealed that Choice Home Warranty issued policies without the required license and in violation of the cease and desist order.

A New Jersey-based company, Choice Home Warranty has solicited customers nationwide from its website. OID is currently processing consumer complaints and sending letters to the company demanding refunds be issued to the contract holders.

“This violation will not be tolerated in Oklahoma,” said Mulready. “Our first priority is consumer protection, and this should serve as a reminder for all consumers to be diligent about researching the legitimacy of a business before they buy a contract or service.”

Consumers should call the OID first before buying a warranty service contract or insurance product to verify that a company is properly licensed in Oklahoma.

Service warranty companies are required to have an OID-issued license, to solicit, negotiate or sell home warranty service contracts in Oklahoma.

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

About the Oklahoma Insurance Department
The Oklahoma Insurance Department, an agency of the State of Oklahoma, is responsible for the education and protection of the insurance-buying public and for oversight of the insurance industry in the state.

For more information, contact:
Liz Heigle
405-819-2221
Liz.Heigle@oid.ok.gov

Will Travel Insurance Cover Coronavirus?

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Get Ready for Spring Break: Will Travel Insurance Cover Coronavirus?

By Oklahoma Insurance Commissioner Glen Mulready 

 

Spring Break is several days away, and whether your plans include a cruise ship, a beach, or a magical theme park, you may want to consider purchasing travel insurance for your upcoming trip. Like most of you, I have been reading news about the coronavirus COVID-19 and the impact that it might have on the global community and the insurance industry. With the COVID-19 outbreak upending travelers’ plans, it is important to know what travel insurance covers.
.

Can’t decide if you need travel insurance? Here are some questions to help you decide.

 

  1. I’m afraid to travel due to COVID-19 and want to cancel my trip. Am I covered?

    Trip cancellation for concern or fear of travel associated with an epidemic or pandemic is usually not covered. However, more expensive policies such as Cancel For Any Reason (CFAR) coverage may be able to refund a portion of your insured pre-paid, non-refundable trip cost. Note that with CFAR coverage, the insurance policy must be purchased within a set amount of days and notified at least 48 hours prior to scheduled departure.

  2. Will travel insurance cover me if I get sick on a cruise ship?

    Most travel insurance policies will protect travelers who become sick while traveling if the policy includes medical coverage. Also, check with your health plan to see if it would cover medical expenses if you get sick or hurt on your trip. This is especially important if you’re traveling abroad because most health plans, including Medicare, won’t cover treatment in another country.

  3. What if my cruise line or airline cancels a trip due to COVID-19?

    Most standard travel insurance does not cover losses caused by an epidemic or pandemic. If you purchased the CFAR policy, you may be covered for a portion of your trip cost. Contact your cruise line, airline or tour provider to see if any refund is offered by them first.

Travel insurance plans cost between 4%-10% of your trip expenses. I encourage travelers to determine their actual risk, understand what they are trying to cover and then find a policy that accomplishes that. If you decide travel insurance is a good option for your trip, make sure you know exactly what the plan covers before buying.

To monitor the latest information on COVID-19:

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

About the Oklahoma Insurance Department 

The Oklahoma Insurance Department, an agency of the State of Oklahoma, is responsible for the education and protection of the insurance-buying public and for oversight of the insurance industry in the state. 

For more information, contact:

Liz Heigle 405-522-0683 Liz.Heigle@oid.ok.gov

Oklahoma Insurance Department Celebrates New Facility with Ribbon-Cutting Ceremony

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FOR IMMEDIATE RELEASE:
March 5, 2020

Oklahoma Insurance Department Celebrates New Facility with Ribbon-Cutting Ceremony

OKLAHOMA CITY – On March 3, 2020, state and local officials joined Insurance Commissioner Glen Mulready for a ribbon-cutting ceremony to celebrate the completion of the Oklahoma Insurance Department’s (OID) new building located at 400 NE 50th Street in Oklahoma City.

The 32,500 square-foot, state-of-the-art facility is the first standalone State Insurance Department building in Oklahoma history. The entire building construction process took approximately two years from design to occupancy with the grand opening held on Tuesday, March 3, 2020.

The building project was made possible by House Bill 2308 (2018) allowing OID to lease the land from the Commissioners of the Land Office (CLO) while owning the building. Through lease payments to the CLO, $3.7 million will go to public education over a 55-year lease. The OID is a non-appropriated state agency, thus all construction costs will have no impact on the general revenue fund.

“This great new facility will better allow us to meet the needs of the Oklahoma consumers, the insurance industry and our staff,” Mulready said.

Governor Kevin Stitt and Insurance Commissioner Glen Mulready cut the ribbon together to celebrate the official opening of the OID’s new facility located at 400 NE 50th Street.

About the Oklahoma Insurance Department
The Oklahoma Insurance Department, an agency of the State of Oklahoma, is responsible for the education and protection of the insurance-buying public and for oversight of the insurance industry in the state.

 

For more information, contact:
Liz Heigle
405-819-2221
Liz.Heigle@oid.ok.gov

FB No. 2020-01

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Sales and Solicitation on behalf of captive business and OAC 365 :25-15-8


To: All Oklahoma Licensed Captive Insurance Companies
From: Glen Mulready, Insurance Commissioner
Date: February 25, 2020
Re: Sales and Solicitation on behalf of captive business and OAC 365 :25-15-8


The purpose of this bulletin is to clarify the compliance requirements that must be met & maintained in order to sell or solicit on behalf of a Captive Insurance Company licensed in Oklahoma as filed under OAC 365:25-15-8, which states the following:

365:25-15-8 No person shall in or from within this State, act as an insurance manager, broker, producer, salesman, or reinsurance intermediary for captive business without the authorization of the Insurance Commissioner. Application for such authorization must be on a form prescribed by the Insurance Commissioner.

The Department interprets the above provision of the Oklahoma Captive Insurance Companies Regulation to require any person(s) selling, soliciting, or negotiating insurance, on behalf of an Oklahoma licensed captive insurance company, must first comply with the requirements of the Oklahoma Producer Licensing Act.

Questions or comments applicable to this bulletin should be direct to Donald Ashwood (donald.ashwood@oid.ok.gov), Oklahoma Insurance Department, 400 NE 50th Street, OKC, OK 73105.

Bulletin No. LH 2020-01

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Extension of “Non-Enforcement” (Transitional) Policies through Calendar Year 2021


To: All Health Insurance Companies and Health Maintenance Organizations
Re: Extension of “Non-Enforcement” (Transitional) Policies through Calendar Year 2021
From: Oklahoma Insurance Department
Date: February 25, 2020


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 31, 2020 regarding the Extension of Limited Non-Enforcement Policy through 2021.

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 out of compliance with market reforms if specific conditions were met. With guidance issued in its January 31, 2020, announcement CMS has extended the policy again, to policy years beginning on or before October 1, 2021, provided that all such coverage comes into compliance with the specified requirements by January 1, 2022. 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, 2021, provided that all transition policies end by January 1, 2022.

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 sho1ter than 12-month duration provided that all affected policies terminate in compliance with the January 1, 2022 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 31, 2020 guidance.

Questions or comments applicable to this bulletin should be directed to
Mike Rhoads (mike.rhoads@oid.ok.gov) or
Gordon Amini ( gordon.amini@oid.ok.gov )

Oklahoma Insurance Department
400 North East 50th St.
Oklahoma City, OK 73105- 1816.

Oklahoma Insurance Department’s New Location

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FOR IMMEDIATE RELEASE:
February 3, 2020

Oklahoma Insurance Department’s New Location

OKLAHOMA CITYEffective February 10, the Oklahoma Insurance Department (OID)’s Oklahoma City Office will be relocated to our new facility: 

 

Oklahoma Insurance Department
400 NE 50
th Street
Oklahoma City, OK 73105
 

 

As part of the moving process, email and network access will be limited from Wednesday, February 5 through Friday, February 7, 2020. The Oklahoma Insurance Department will resume normal operations on Monday, February 10, 2020 on its regular schedule from 8:00 a.m. to 5:00 p.m. For immediate assistance during this time, you may call Communications Director Liz Heigle at 405-522-0683. 

 

We thank you for your patience and cooperation during these few days as we transition to a more efficient and effective office environment. 

 

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

About the Oklahoma Insurance Department
The Oklahoma Insurance Department, an agency of the State of Oklahoma, is responsible for the education and protection of the insurance-buying public and for oversight of the insurance industry in the state.

 

For more information, contact:
Liz Heigle
405-819-2221
Liz.Heigle@oid.ok.gov

Insurance Department Donates Shotguns to Help Underfunded Law Enforcement Agencies

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FOR IMMEDIATE RELEASE:
January 30, 2020

Insurance Department Donates Shotguns to Help Underfunded Law Enforcement Agencies

Insurance Commissioner Glen Mulready today donated a Remington 870 Shotgun to the Coweta Police Department Chief Mike Bell at the Oklahoma Insurance Department (OID)’s Oklahoma City office.

“It is much appreciated more than you know,” Bell said. “As a small agency, we can’t afford equipment like this. It will greatly enhance our services.”

For the last few months, the Oklahoma Insurance Department’s Anti-Fraud Unit has worked with the Office of Management and Enterprise Services (OMES) to transfer the shotguns d to other law enforcement agencies in need. These shotguns were ordered by the previous administration for newly hired investigators to attend the police academy. Once those certifications were completed, the Unit no longer needed them.

“We only intend to hire experienced, pre-certified officers from this point on, so we are donating the firearms to other law enforcement agencies in need,” Anti-Fraud Chief Investigator Rick Wagnon said. “Instead of sending these shotguns to State Surplus to be auctioned off to the public, we wanted to get these directly transferred to underfunded law enforcement agencies.”

Once OMES approved the transfer, Wagnon contacted the Oklahoma Association of Chiefs of Police and the Oklahoma Sheriff’s Association for a list of underfunded agencies that each association could recommend. From that list, Commissioner Mulready drew the winners randomly and contacted each agency to schedule a shotgun handoff.

Wagnon said they carefully selected small, underfunded agencies that could get the most benefit from this donation. He also said the most of these agencies do not have shotguns and are excited to receive them.

“The goal of this firearm donation is to enable underfunded law enforcement agencies to acquire firearms at no cost in support of their mission,” Mulready said. “We are grateful for our law enforcement agencies and their service to our citizens.”

Mulready said that the department will donate a total of 7 shotguns to the following agencies:

Ser#  Name 
RS92196G  Sheriff Larry Lane, Sequoyah County SO 
RS92213G  Chief Bob Ernst, Perkins PD 
RS92238G  Sheriff Marty Grisham, Love County SO 
RS92242G  Chief Mike Bell, Coweta PD 
RS92246G  Chief John O’mara, Kiefer PD 
RS92250G  Sheriff Joe Janz, Kiowa County SO 
RS99172G  Sheriff Tim Turner, Haskell County SO 

DONATED ITEM(S): Remington 870 Shotguns (Police Magnum), 18″ Barrel, Parkerized Finish, Ghost Rings Sites, Collapsible/Pistol stock, Forearm Flashlight, and Rapid Assault Tactics (RAT) Nylon Carry Case.

 

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.

About the Oklahoma Insurance Department
The Oklahoma Insurance Department, an agency of the State of Oklahoma, is responsible for the education and protection of the insurance-buying public and for oversight of the insurance industry in the state.

For more information, contact:
Liz Heigle
405-819-2221
Liz.Heigle@oid.ok.gov

Anti-Fraud Chief Investigator Rick Wagnon (left), Coweta Police Department Chief Mike Bell and Insurance Commissioner Glen Mulready (right) on Thursday in Oklahoma City, OK.

Anti-Fraud Chief Investigator Rick Wagnon (left), Coweta Police Department Chief Mike Bell and Insurance Commissioner Glen Mulready (right) on Thursday in Oklahoma City, OK

Insurance Commissioner Mulready Announces New Chief of Staff

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FOR IMMEDIATE RELEASE:
January 29, 2020

Insurance Commissioner Mulready Announces New Chief of Staff

OKLAHOMA CITY –Oklahoma Insurance Commissioner Glen Mulready has named Brian Downs to serve as Chief of Staff for the Oklahoma Insurance Department (OID). A native Oklahoman, Downs currently serves as the State Health Information Exchange Director and Special Assistant to the Governor’s Front Porch Initiative.

 

“Brian’s leadership experience, professionalism and his tireless commitment to Oklahoma citizens make him a perfect fit for this position,” Mulready said. “He has built a level of trust and respect with state and national leaders on both sides of the aisle. I am confident that his leadership will maintain the positive momentum as we continue to move forward with our team’s vision of becoming a Top 10 insurance department.”

 

Downs previously served as Chief of Staff for Speaker Jeff Hickman in the Oklahoma House Representatives and Chief of Staff and Director of State and Federal Policy at the Oklahoma State Department of Health.

 

“Commissioner Mulready continually challenges the Department staff to strive for their best as they serve the public. He’s not afraid of changes and he’s dedicated to making OID a Top 10 insurance department. Following his example, I will champion Commissioner Mulready’s vision and do my best to serve Oklahomans in this role,” Downs said.

 

Downs will begin his new role on January 30th, 2020.

 

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

About the Oklahoma Insurance Department
The Oklahoma Insurance Department, an agency of the State of Oklahoma, is responsible for the education and protection of the insurance-buying public and for oversight of the insurance industry in the state.

 

For more information, contact:
Liz Heigle
405-819-2221
Liz.Heigle@oid.ok.gov