Posts by: Britney Han

NAIC Names Commissioner Mulready Chair of Health Insurance and Managed Care (B) Committee

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For Immediate Release:
January 25, 2022

National Association of Insurance Commissioners Names Commissioner Mulready Chair of Health Insurance and Managed Care (B) Committee

 

OKLAHOMA CITY – The National Association of Insurance Commissioners (NAIC) announced last week that Oklahoma Insurance Commissioner Glen Mulready would serve as chair of the NAIC Health Insurance and Managed Care (B) Committee for the 2022 term.

“I’m humbled by the opportunity to serve in this role and I want to thank NAIC President Dean Cameron for his confidence in selecting me to chair this important committee,” Commissioner Mulready said. “Health insurance continues to be a priority concern for consumers and I look forward to working with my colleagues and federal officials to make health insurance more affordable and accessible not only for Oklahoma but also for the rest of the nation.”

Commissioner Mulready also serves as Chair of the NAIC/Federal Emergency Management Agency (FEMA) Advisory Group and Chair of the Midwest Zone, which represents 13 states and is part of the NAIC Executive Committee.

The NAIC is the U.S. standard-setting and regulatory support organization created and governed by insurance regulators from all 50 states, the District of Columbia and five U.S. territories. Through the NAIC, state insurance regulators establish standards and best practices, conduct a peer review and coordinate regulatory oversight.

The mission of the Health Insurance and Managed Care (B) Committee is to analyze policy implications and their effect on the states of proposed and enacted federal legislation and regulations as well as examine factors that contribute to rising health care costs and insurance premiums. More information about the (B) Committee can be found at https://content.naic.org/cmte_b.htm.

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

New Year, New Job: Ask About Insurance

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For Immediate Release:
January 25, 2022

 

New Year, New Job: Ask About Insurance

By Oklahoma Insurance Commissioner Glen Mulready

2022 is here! Now is a great time to set goals and make resolutions. The new year can also be a great time to start a new career journey. Whether you have a job lined up or you’re getting ready for a career change, changing jobs can affect your insurance. According to the U.S. Bureau of Labor Statistics, benefits generally make up a third of a company’s compensation package. And insurance is a big part of that package.

When you’re going to a job interview, ask your potential employer about the benefits. Here is some important information you should know before accepting a new job.

Health Insurance

  • Will they pay all or some of your monthly premium?
  • Can you add your family to your plan? What is the cost?
  • How much will you have to pay in copays, deductibles or coinsurance?
  • What does the plan cover?

Always compare costs and benefits before you switch. Make sure to review your health plan’s “Summary of Benefits and Coverage (SBC)” to compare options based on price, benefits and other features that may be important to you. If a company does not offer health insurance and you need to buy your own, use our health insurance guide.

Life or Disability Insurance

Employer benefits packages vary when it comes to taking care of employees who become sick or disabled. Speak with your new employer for information about their disability insurance program or options to purchase coverage from a group plan.

If your new job doesn’t offer life or disability insurance, ask human resources at your previous job if you can keep your old policies or convert them to policies that you can take with you. You can also buy your own life and disability insurance.

Health Savings Account (HSA) or Flexible Spending Account (FSA)

It’s important to take care of any work accounts from your old job. If you previously had an HSA, FSA or separate vision or dental insurance, make sure you know what you need to do to transfer, close or keep them. Ask about any fees and deadlines for closing or transferring an account.

Waiting Period or COBRA

Lastly, don’t forget to ask when your benefits will start. You may have to wait before your new coverage begins. If your new plan has a waiting period, ask your former employer if you can keep the plan you had at your old job until your new coverage starts. Ask about COBRA coverage and check our COBRA information.

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

 

For more information, contact:

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

OID Reaches $4.8M Settlement Agreement with CVS Caremark

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For Immediate Release:
January 20, 2022

OID Reaches $4.8M Settlement Agreement with CVS Caremark for Alleged Violations of the Patient’s Right to Pharmacy Choice Act, Dependent On Federal Court Decision

 

OKLAHOMA CITY – On January 20, 2022, the Oklahoma Insurance Department (OID) announced that the Department entered into a Settlement Agreement with CVS Caremark regarding its collection of transaction fees from pharmacies for Medicare Part D and ERISA plan claims. Under the terms of the agreement, CVS Caremark, a Pharmacy Benefits Manager (PBM), will pay the state of Oklahoma a total of $4.8 million to settle the violations. This will include $2.3 million for Oklahoma pharmacies and an additional $2.5 million in penalties.

In September 2020, OID began an investigation into transaction fees charged by CVS Caremark to Oklahoma pharmacists and pharmacies, which OID believes violates the Patient’s Right to Pharmacy Choice Act. Whether Oklahoma law is preempted by the federal regulations governing Medicare and ERISA plans is currently pending before the U.S. District Court in the Western District of Oklahoma in Pharmaceutical Care Management Association (PCMA) v. Mulready. The distribution of restitution and penalties included in the Settlement Agreement is dependent upon the outcome of the PCMA v. Mulready litigation and whether or not the Court finds the Patient’s Right to Pharmacy Choice Act is preempted by federal law.

“We take our role of protecting Oklahoma consumers very seriously and are committed to enforcing the laws. CVS Caremark was cooperative during our investigation, we were able to work together through negotiations to ensure there is a level playing field that is abiding by the rules of PRPCA and other PBM statutes,” Oklahoma Insurance Commissioner Glen Mulready said. “With the rising cost of healthcare throughout the pandemic, it is more important than ever to ensure companies fully comply with our laws to protect consumers and other businesses.”

“While questions remain about the extent to which enforcement of the Patient’s Right to Pharmacy Choice Act may ultimately be preempted by federal law, we must not stand idle while fees charged in violation of the law are being paid by Oklahoma businesses and consumers,” OID’s Director of PBM Compliance and Enforcement Kelli Price said. “In this spirit and with respect for the purpose of the Act, the Department and CVS Caremark have worked together cooperatively to come up with a fair resolution.”

PBMs manage prescription drug benefits on behalf of health insurers, Medicare Part D drug plans, large employers and other payors. Typically, PBMs act as intermediaries between pharmacies filling prescriptions and prescription drug plans, often influencing what medications will be covered and the costs of those drugs for both consumers and pharmacies.

In recent years, PBMs have faced growing scrutiny and legislation across the U.S. To file a PBM complaint, visit https://www.oid.ok.gov/pbm-complaint-form/.

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

Free at Home COVID-19 Tests Available for Oklahomans Starting January 15

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For Immediate Release:
January 14, 2022

Free at Home COVID-19 Tests Available for Oklahomans Starting January 15

 

OKLAHOMA CITYToday, the Oklahoma Insurance Department issued a special notice regarding coverage of at-home, over-the-counter (OTC) COVID-19 tests. Beginning January 15, 2022, group health plans and health insurance issuers offering group or individual health insurance coverage must cover OTC COVID-19 tests. Under the new guidelines, the tests may either be free or reimbursed by the insurer. Health plans and insurance companies are incentivized to set up a network of pharmacies or retailers so their members can conveniently order or pick up COVID-19 tests that will be covered up-front. OID requested that all regulated insurance companies provide a description of how the administration of coverage for at-home OTC COVID-19 tests will be handled and communicated to their insureds and members. 

“Like the rest of the nation, Oklahoma is facing a new surge with the omicron variant. Continued testing is critical to fighting the COVID-19 pandemic and ensuring the health and safety of our communities,” Insurance Commissioner Glen Mulready said. “I encourage Oklahomans to take advantage of at-home testing and available local testing sites to help keep people safe with early detection.” 

If you purchase an over-the-counter COVID-19 test from a pharmacy, store, or online retailer and are charged for your test, keep your receipt and submit a claim to your insurance company for reimbursement. If your plan has not set up a network of preferred stores, pharmacies, and online retailers at which you can obtain a test with no out-of-pocket expense, consumers will be reimbursed the amount of the cost of the test.

For example, if you buy a two-pack of tests for $34, the plan or insurer would reimburse $34. If your plan has set up a network of preferred stores, pharmacies, and online retailers at which you can obtain a test with no out-of-pocket expense, you can still obtain tests from other retailers if you buy them outside of that network. Your plan is required to reimburse you at a rate of up to $12 per individual test (or the cost of the test, if less than $12). Save your receipt(s) to submit to your plan for reimbursement at a rate of up to $12 per individual test (or the cost of the test, if less than $12). 

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

Special Notice of Coverage of OTC COVID Test

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Special Notice of Coverage of OTC COVID Test


Date:     January 14, 2022

To:         All Health Insurance Companies, Health Maintenance Organizations, PBMs and Other Interested Parties

From:    Glen Mulready, Commissioner

Re:        Special Notice Regarding Coverage for At-Home, Over-the-Counter COVID-19 Tests


On January 10, 2022, the Departments of Labor, Health and Human Services (“HHS”), and the Treasury (collectively, the “Departments”), announced that insurance companies and group health plans must cover the cost of at-home, over-the-counter (“OTC”) COVID-19 tests. The Oklahoma Insurance Department (“OID”) is releasing this Special Notice with the purpose of providing information and assisting with implementation of the requirement to cover at-home, OTC COVID-19 test purchases.

Beginning January 15, 2022, group health plans and health insurance issuers offering group or individual health insurance coverage must cover OTC COVID-19 tests that meet the statutory criteria under section 6001(a)(1) of the Families First Coronavirus Response Act (“FFCRA”), including tests obtained without the involvement of a health care provider. This coverage must be provided without imposing any cost-sharing requirements, prior authorization, or other medical management requirements.

Plans and issuers are strongly encouraged to provide direct coverage for the OTC tests through preferred pharmacies, retailers, or other entities with no out-of-pocket cost to prevent consumers from needing to submit a claim for reimbursement. To incentivize creating a preferred network to provide direct coverage, the Departments are allowing a safe harbor reimbursement limitation when a test is purchased at a non-preferred pharmacy or retailer at a rate of $12.00 per test or the cost of the test, whichever is less.

OID requests that all regulated insurance companies provide a description of how the administration of coverage for at-home OTC COVID-19 tests will be handled and communicated to their insureds and members. This description should include, but is not limited to, any applicable preferred network arrangements, point-of-sale purchase arrangements, procedures and provisions governing claim reimbursement, exclusions or limitations, and, if a preferred network is created, implementation of the safe harbor reimbursement limitation.

It is the intent of OID to make this information available to the public at the OID website. Please direct all submissions to Data.Call@oid.ok.gov no later than February 4, 2022.

Questions concerning this Notice should be directed to Data.Call@oid.ok.gov.

Oklahoma Consumers Have More Health Insurance Options for 2022 ACA Plans

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For Immediate Release:
October 4, 2021

Oklahoma Consumers Have More Health Insurance Options for 2022 ACA Plans

 

OKLAHOMA CITY – The Oklahoma Insurance Department (OID) announced today which health insurance companies will be offering plans in the Oklahoma Affordable Care Act (ACA) Marketplace for 2022. Two new insurers will be joining the Marketplace next year giving Oklahoma consumers more health insurance options. Starting this year, consumers will also have  an extra 30 days to make plan selections during the ACA Open Enrollment Period for individual health insurance plans running from November 1, 2021 through January 15, 2022.

The same six insurers that offered individual health plans on the 2021 Marketplace will return for 2022 — Blue Cross Shield of Oklahoma (BCBSOK), Bright Health, Medica Insurance Company, Oscar Health, UnitedHealthCare (UHC) and CommunityCare Oklahoma (CCOK). In 2022, Centene/Celtic DBA Ambetter in Oklahoma and Friday Health Plans will join the existing six carriers. BCBSOK and Medica offer statewide plans while the others will be found in selected areas in Oklahoma.

“I’m excited to offer more options for Oklahoma consumers who do not have health insurance through their employer, Medicare or Medicaid,” Oklahoma Insurance Commissioner Glen Mulready said. “Oklahoma had only two plan options when I was first elected, and now we will have eight options in 2022. I am a firm believer in the free market and that competition drives down cost and encourages innovation and efficiency. This news is a clear indicator of a more stable, competitive market and illustrates the work we are doing at the OID to encourage new companies to offer more products to all Oklahomans.”

Plan options, monthly premium and total annual out-of-pocket costs for 2022 will be available at www.healthcare.gov/see-plans/ later this month upon release of this information by the Centers for Medicare and Medicaid Services. 

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

Insurance Commissioner Approves Loss-Cost Reduction for 2022 Workers’ Comp

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For Immediate Release:
September 21, 2021

Insurance Commissioner Approves Loss-Cost Reduction for 2022 Workers’ Comp

 

OKLAHOMA CITY – Commissioner Glen Mulready today announced that the Oklahoma Insurance Department had approved a 9.4 percent decrease in workers’ compensation insurance loss costs for 2022. This reduction will lead to lower premiums for many Oklahoma businesses.

Loss costs are the average cost of lost wages and medical payments of workers injured per $100 of payroll or as a percentage of payroll. Since 2011, there has been a 59 percent decrease in loss costs. Moreover, Oklahoma lost-time claim frequency has come down significantly over the last 15 years (by almost 50%), and is projected to continue to decline into 2022.

I am excited to approve this decrease and help businesses in our state,” Commissioner Mulready said. “In 2014, the Workers’ Compensation Commission became effective, and this commitment to a new administrative system, along with our cost-efficient, competitive workers’ compensation insurance market continues to show employers that Oklahoma is an attractive place to do business.

The National Council on Compensation Insurance (NCCI), a licensed rating and advisory organization, collects annual data on workers’ compensation claims for the insurance industry. NCCI is authorized to make recommended lost cost filings on behalf of workers’ compensation insurance companies in Oklahoma.

The new loss costs will go into effect for new and renewing policies effective January 1, 2022.

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

2021 Life Insurance Awareness Month

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For Immediate Release:
September 20, 2021

2021 Life Insurance Awareness Month

By Oklahoma Insurance Commissioner Glen Mulready  

 

In the last year and a half, many of us have experienced losses. The Oklahoma Insurance Department has lost three team members, and I too have experienced losses of family and friends. Losing colleagues and loved ones is emotional and reminds us of what really matters. It’s during these times that we need to evaluate how we can take care of our families after we pass.

September is Life Insurance Awareness Month, making it the perfect time to evaluate your life insurance needs. I encourage Oklahomans to take a few minutes this month to help your loved ones get prepared for uncertainties and protect their futures.

 

As a life insurance policyholder, there are important steps you should take now: 

  • Update your policies. Have you had a life-changing event such as the birth of a child or a divorce? It’s important to update your policies after a major life event to make sure that you have the appropriate beneficiaries listed.
  • Check your policies. Make sure that all beneficiaries are included and that the contact information for those listed beneficiaries is correct. Place a current copy of the policy with your will or other estate paperwork in a safe place where family and beneficiaries can easily find it.
  • Let your beneficiaries know about the policies. Provide beneficiaries or trusted advisors, such as accountants and attorneys, with the name of the life insurance company holding the policy.

While it’s important for policyholders to plan and prepare, tens of millions of dollars in death benefits still go unclaimed each year because beneficiaries lack basic information about their deceased loved one’s life insurance policies. To help Oklahomans locate unclaimed benefits, the Oklahoma Insurance Department (OID) launched the Life Insurance Policy Locator (LIPL) through the National Association of Insurance Commissioners in 2016. The OID has assisted 4,948 requests, which led to 1,389 matches with a total claim amount of $18,844,127 since it was created. These numbers show how beneficial LIPL is to Oklahomans in a time of grieving through simplifying the search in finding beneficiaries.

When loved ones pass away, the last thing someone should have to do is dig through boxes searching for their life insurance policy. The best way to avoid this dilemma is by sitting down with your loved ones and having conversations. Inform your beneficiaries that they are named in your life insurance policy. If you’d prefer not to let them know directly, make sure a trusted advisor, such as an accountant or attorney, is aware. If you believe that you are a beneficiary of a life insurance policy but don’t have the information you need to collect, the LIPL might be able to help.

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

BULLETIN NO. LH 2021-04 (REVISED)

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LH BULLETIN NO. 2021-04 (SECOND REVISION)


To: All Health Insurance Companies, Health Maintenance Organizations,  PBMs, and other Interested Parties
Re: Insulin Medication Cost-Sharing Caps 
From: Glen Mulready, Commissioner
Date: November 29, 2021

Revised language is underlined.

The Oklahoma Insurance Department (Department) is releasing this bulletin with the purpose of providing guidance on the interpretation of HB 1019, amending 36 O.S. § 6060.2 (effective November 1, 2021), as it relates to statutory limits on a policyholder’s out-of-pocket cost for prescription insulin medications.

Section 1(A)(7) of HB 1019 (36 O.S. § 6060.2(A)(7) effective November 1, 2021) states in part:

Any carrier that provides coverage for insulin pursuant to this section shall cap the total amount that a covered person is required to pay for insulin at an amount not to exceed Thirty Dollars ($30.00) per thirty-day supply or Ninety Dollars ($90.00) per ninety-day supply of insulin for each covered insulin prescription, regardless of the amount or type of insulin needed to fill the prescription or prescriptions of the covered person.

It is the position of the Department, based on the statutory text specific to insulin medication cost coverage, that the out-of-pocket monthly cap shall apply regardless of whether the policyholder has met the annual deductible or coinsurance requirements within a given policy. Effective November 1, 2021, the Department understands the dollar caps associated with thirty-day and ninety-day supplies for insulin medication to be applicable to existing health benefit plans as well as upon issue or renewal of a benefit plan.

As stated above, the dollar caps apply to each thirty-day or ninety-day supply of insulin prescription regardless of amount or type. Accordingly, if a policyholder’s thirty-day supply of insulin consists of three different insulin prescriptions, then the covered policyholder shall be required to pay a maximum of $30.00 out-of-pocket for each of the three insulin prescriptions.

The provisions of 36 O.S. § 6060.2(A)(7) are pre-empted by federal laws governing Medicare, located at 42 U.S.C. §§ 1395 et seq., and are not applicable to Medicare Part D plans. However, the provisions of 36 O.S. § 6060.2(A)(7) are not pre-empted by the Employment Retirement Income Security Act (“ERISA”) pursuant to the holding of Rutledge v. Pharmaceutical Care Management Assoc., which finds in part that “ERISA does not pre-empt state rate regulations that merely increase costs or alter incentives for ERISA plans without forcing plans to adopt any particular scheme of substantive coverage.” 141 S.Ct. 474, 480, 208 L.Ed.2d 327 (2020). It is therefore the position of the Department that the insulin cost-sharing caps created by 36 O.S. § 6060.2(A)(7) are applicable to any health plan . . . to the extent permitted by [ERISA],” including, but not limited to, self-funded ERISA plans.

Questions concerning this bulletin should be directed to Mike Rhoads, Deputy Commissioner, at Mike.Rhoads@oid.ok.gov, Kim Bailey, General Counsel, at Kim.Bailey@oid.ok.gov, and/or the Oklahoma Insurance Department located at 400 NE 50th Street, Oklahoma City, OK 73105-1816.

Get Ready for 2022 Medicare Open Enrollment

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For Immediate Release:
September 13, 2021

Get Ready for 2022 Medicare Open Enrollment: 
Free Seven-Week Webinar Series for Oklahomans

 

OKLAHOMA CITY – The Oklahoma Insurance Department (OID) will hold its annual Medicare Open Enrollment webinar series from October 6 through November 17, 2021. The 7-week webinar series will educate Oklahomans on the different parts of Medicare, eligibility, enrollment options and how they can personalize their Medicare plan based on their needs. Participants can sign up for one or all seven webinars. Each webinar is free, but registration is required. 

Expert speakers from the Oklahoma Medicare Assistance Program (MAP) and the Centers for Medicare & Medicaid Services will lead seven educational sessions. This year, OID is offering one of the sessions in Spanish to help the Spanish-speaking community learn more about their options.

“We are excited to host the ‘Welcome to Medicare’ session in Spanish,” MAP Director Ray Walker said. “MAP offers one-on-one counseling and information available in both English and Spanish. All services are free, unbiased and confidential.”

In addition to the staff counselors within the department, MAP contracts with several agencies around the state to provide the same types of Medicare education and support. You can find a list of these agencies at www.map.oid.ok.gov.

Agenda of the 2022 Medicare Open Enrollment Webinar Series: 

  • October 6 at 11 a.m. — Medicare Updates for 2022 
  • October 13 at 11 a.m. — Medicare Part D 
  • October 20 at 11 a.m. — Medicare Part B 
  • October 27 at 11 a.m. — Medicare Advantage Plans 
  • November 3 at 11 a.m. — Medicare Supplement Plans 
  • November 10 at 11 a.m. — Welcome to Medicare in Spanish (New!) 
  • November 17 at 11 a.m. — Social Security 101

 

To register or for more information, visit www.oid.ok.gov/MOEP.

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