Posts by: Britney Han

Why Insurance Business Transfers?

   |   By  |  0 Comments

For Immediate Release:
July 27, 2022

Why Insurance Business Transfers?

By Oklahoma Insurance Commissioner Glen Mulready  

Innovation moves our state forward. At the Oklahoma Insurance Department (OID), we’re committed to creating an environment that embraces innovative thinking. One of the innovative tools we’ve recently brought to Oklahoma is the Insurance Business Transfer (IBT). Oklahoma’s IBT law became effective in November 2018 and Oklahoma became the first U.S. state to embrace IBTs under a structure that closely mimics Part VII Transfers that have taken place in the U.K. for 20 years. In October 2020, Oklahoma became the first state in the U.S. to have an IBT completed and approved by the courts. Since then, we completed the second IBT in August 2021 and are working on our third.

An IBT is a process that allows for a transfer of a block of insurance business from one existing insurance company to another. Oklahoma’s IBT statute includes life, health, property and casualty liabilities, and is open to both runoff and active books of business. This cutting-edge mechanism focuses on the protection of consumers while allowing insurance companies to strategically deploy assets to their areas of focus. IBTs create considerable flexibility and financial security for companies, help eliminate uncertainty, reduce administrative expenses and simplify regulation. More importantly, an IBT can connect policyholders with a company that better understands their policy and coverage.

I support mechanisms like IBTs to bring an economic boost to our state, security to consumers and reliability and finality to the insurance industry. As Oklahoma continues to be the leader of IBTs, we’re pleased to host the 2022 Captive & IBT Conference in Oklahoma City in August. I believe this event will bring new opportunities to our state and propel our innovative economy forward. At the Captive & IBT conference, I will be speaking as a panelist in the “Why IBT?” session with various leading experts. Join our discussion and learn about the benefits of IBTs, key trends in the runoff transaction market and how OID can help you with this process.

It’s the first in-person conference we are hosting since the COVID-19 pandemic. I’m excited to showcase Oklahoma’s endless possibilities to risk managers, business owners, regulators, financial executives and insurance professionals. Registration is required to attend the event and limited seats are available. For more information about the event, visit www.oid.ok.gov/CIBTC/ and follow OID on Facebook, Twitter, Instagram and LinkedIn.

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

Special Notice Regarding Statutory Changes regarding Senate Bill 1806

   |   By  |  0 Comments


Special Notice Regarding Statutory Changes regarding Senate Bill 1806


Special Notice to all Bail Bondsman, July 8, 2022

To:       All Bail Bondsman, Professional Bail Bondsmen and Multi-County Agent Bail Bondsmen and Other Interested Parties.

From: Glen Mulready, Commissioner

Re:       Special Notice Regarding Statutory Changes regarding Senate Bill 1806, effective November 1, 2022.


Changes to Title 59 of the Oklahoma Statutes are as follows:

Title 59. Chapter 33 § 1320 (A) & (B). Registration Requirement – Certified Copy of Appointment Limitation on Number of Bonds Written

Currently: A bondsman has to register his or her license with the sheriff and court clerk of the county in which the bondsman resides or offices. A bondsman can write bonds on no more than ten (10) defendants per year in each of the remaining seventy six counties. (Note this does not apply to Bondsman licensed as a multicounty/ professional bondsman)

Change: Language has been stricken from the statute pertaining to the Ten Bond Limitation and the requirement to register a license in the county where the bondsman resides or offices. Effective November 1, 2022, bondsman are required to register their license in the office of the court clerk in any county in which the bondsman intends to write bonds. There is no longer a ten bond limitation.

 

Title 59. Chapter 33 § 1327 (H). Surrender of Defendant – Hold Order – Exoneration of Bondsman and Insurer – Bond Exonerated by Operation of Law

Currently: This section was added to the statute.

Change: The court shall not Issue an order modifying the terms of a previously set bond unless the order has also been signed by the bail bondsman, bail bond surety, or both acknowledging the changes made to the bond prior to the defendant’s release. Failure to provide this notice shall exonerate the bond by operation of law.

 

Please read the information provided and make the necessary changes to your business practices to ensure you are compliant with the amended statutes.  The statutory changes were a joint effort between the Oklahoma Insurance Department and the Bail Industry working together.

Questions concerning this Notice should be directed to Lewis Garrison at lewis.garrison@oid.ok.gov.

Embracing Innovation for Oklahoma Consumers

   |   By  |  0 Comments

Embracing Innovation for Oklahoma Consumers

By Oklahoma Insurance Commissioner Glen Mulready  

For the past two years, the insurance industry and the regulatory community have worked tirelessly to protect consumers during the COVID-19 pandemic. Together, we learned to pivot, adapt and grow. Customer behavior is rapidly changing, and more businesses are looking for different ways to protect their assets. The insurance industry has responded by finding creative ways to serve customers and meet their needs.  At the Oklahoma Insurance Department (OID), we highly encourage this.  I am a firm believer in a competitive free market. I also believe that change encourages innovation and efficiency. 

An example of this creative response is Degree Insurance, a new startup and a recently approved Oklahoma insurer. The company has introduced a new policy to make investing in a college degree a lower risk. As a parent of three college students myself, I know firsthand the cost of attending college can be a heavy burden, especially when there’s no salary guarantee post-graduation. In addition, many young graduates are worried about the return on investment (ROI) as their degree does not promise better jobs and bigger earnings in the future. 

According to the Federal Reserve, 55% of bachelor’s degree recipients took out student loans. The average debt at graduation from four-year public and private nonprofit colleges was $28,400 in 2020. Today, Americans owe nearly $1.75 trillion in student loan debt. Many students, including my kids, come to college in hopes of finding a niche where they can excel in a specific field of interest, graduating with a degree, and finding a well-paying job. 

These student loan debt statistics show that higher education is the largest uninsured investment most people ever make without any guaranteed ROI. The ONLY thing that is guaranteed is how much students will pay for their degree. This unique concept can help ensure that ROI and ease the financial burden for many students. I believe an innovation like this will help colleges attract and retain more students, improve college graduation rates, and lower unemployment rates. 

This insurance policy guarantees that upon graduation, students will earn an income for their first five years at the average for academic fields based on actuarial information. If they do not make as much as the policy guarantees in those five years post-graduation, the company will pay off the difference between the guaranteed amount and the actual salary amount. For almost every big decision people make in their lives, they have insurance — family, house, car —so why not college degrees? 

With so much changing in the world and the surge of new risks, now is the time for our industry to evolve to cope with inevitable changes and provide creative solutions to satisfy different customer needs with the appropriate resources. To keep our Oklahoma insurance market competitive, I believe the insurance industry needs to embrace new technology and innovation to make sure risk is understood and consumers are protected. With new cutting-edge tools like this, insurers will be able to provide the level of service customers expect and stay one step ahead of whatever comes next in this ever-evolving industry. 

Growing Oklahoma Captive Industry

   |   By  |  0 Comments

For Immediate Release:
June 29, 2022

Growing Oklahoma Captive Industry

By Oklahoma Insurance Commissioner Glen Mulready   

 

Oklahoma is a great place to do business. As one of the fastest-growing domiciles for captives in the country, the Oklahoma Insurance Department (OID) is attracting more and more companies to do business here. A captive insurance company provides great flexibility to business owners who want to take control of their insurance programs. Captives exist to underwrite the risk of their owner(s) and affiliates. Between 2017 and 2021, Oklahoma’s captive premium volume increased significantly, rising to $214.4 million in 2021, up from $147.3 million in 2017.

Oklahoma now has 40 licensed captives—more than one-third of these were issued during my first two years in office. In 2019 and 2020, captives domiciled in Oklahoma generated over $1 million in premium taxes to help fund public safety pensions and the state’s general revenue fund. With OID’s supportive, efficient regulatory platform, companies of various industries around the country recognize Oklahoma as a highly competitive jurisdiction.

To help Oklahoma continue to be the hub of innovation and technology, OID is hosting its first Oklahoma Captive & Insurance Business Transfer (IBT) Conference on August 24-25 at the Omni Oklahoma City Hotel. This two-day conference will address new and emerging risks facing companies and organizations worldwide. We’ll bring together subject matter experts to share insights on captive insurance and IBTs and educate stakeholders on the benefits of these cutting-edge mechanisms. This conference will demonstrate how captives can offer solutions that may not be available in the traditional insurance marketplace.

It’s the first in-person conference we are hosting since the COVID-19 pandemic. And I’m excited to showcase Oklahoma’s endless possibilities to risk managers, business owners, regulators, financial executives and insurance professionals. Registration is required to attend the event and limited seats are available. For more information about the event, visit www.oid.ok.gov/CIBTC/ and follow OID on Facebook, Twitter, Instagram and LinkedIn

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. 6-2022

   |   By  |  0 Comments

BULLETIN NO. 6-2022

To: All Health Insurance Companies, Health Maintenance Organizations, PBMs and Other Interested Parties
Re: Unfair Claims Settlement Practice: Pharmacy Benefit Calculations
From: Glen Mulready, Insurance Commissioner
Date: June 13, 2022

 

The Oklahoma Insurance Department (“Department”) is releasing this bulletin with the purpose of providing information to issuers of health benefit plans as defined by 36 O.S. § 1250.2(5) regarding HB 3495, a bill enacted during the 2022 Regular Session of the Oklahoma Legislature amending 36 O.S. § 1250.5. HB 3495 took effect on May 16, 2022.

Prior to the enactment of HB 3495, the Department released guidance in Bulletin No. LH 2021-05 regarding a conflict between federal requirements governing health savings account (“HSA”) eligibility and the language in 36 O.S. § 1250.5(18) requiring a health benefit plan issuer to combine all payments made toward a prescription when calculating an enrollee’s total contribution.

Section 1(18) of HB 3495, now codified as 36 O.S. § 1250.5(18), addresses the previous conflict and provides the following clarification:

However, if, under federal law, application of this paragraph would result in health savings account ineligibility under Section 223 of the federal Internal Revenue Code, as amended, this requirement shall apply only for health savings accounts with qualified high-deductible health plans with respect to the deductible of such plan after the enrollee has satisfied the minimum deductible, except with respect to items or services that are preventive care pursuant to Section 223(c)(2)(C) of the federal Internal Revenue Code, as amended, in which case the requirements of this paragraph shall apply regardless of whether the minimum deductible has been satisfied.

The Department understands this clarification to mean that in the case of an enrollee with a qualified high-deductible health plan (“HDHP”) and correlating HSA, the requirement to calculate any third-party payment toward a prescription as part of the enrollee’s total contribution will apply only after the enrollee’s deductible under their HDHP is satisfied. This understanding is subject to change if differing guidance is issued by the Internal Revenue Service.

As previously advised in Bulletin No. LH 2021-05, health benefit plan issuers are strongly encouraged to continue to communicate the effects of applying funds from third parties when making payments for prescriptions to members enrolled in an HDHP with an associated HSA.

 

Questions applicable to this bulletin should be directed to:

Kim Hunter, General Counsel, at kim.hunter@oid.ok.gov or Molly Clinkscales, Assistant General Counsel at molly.clinkscales@oid.ok.gov.

Bulletin No. 7-2022

   |   By  |  0 Comments

BULLETIN NO. 7-2022

To: All Health Insurance Companies, Health Maintenance Organizations, PBMs and Other Interested Parties
Re: Unfair Claims Settlement Practice: Claim Refunds
From: Glen Mulready, Insurance Commissioner
Date: June 13, 2022

 

The Oklahoma Insurance Department (“Department”) is releasing this bulletin with the purpose of providing information to issuers of health benefit plans as defined by 36 O.S. § 1250.2(5) regarding HB 3495, a bill enacted during the 2022 Regular Session of the Oklahoma Legislature amending 36 O.S. § 1250.5. HB 3495 took effect on May 16, 2022.

Section 1(15) of HB 3495, now codified as 36 O.S. § 1250.5(15), considers the following to be an unfair claims settlement practice:

Requesting a refund of all or a portion of a payment of a claim made to a claimant more than twelve (12) months or a health care provider more than eighteen (18) months after the payment is made. This paragraph shall not apply:

a. if the payment was made because of fraud committed by the claimant or health care provider, or

b. if the claimant or health care provider has otherwise agreed to make a refund to the insurer for overpayment of a claim[.]

Previously, 36 O.S. § 1250.5(15) prohibited an insurer from requesting refunds after twenty-four months. As of May 16, 2022, it is an unfair claims practice to request a refund from claimants more than twelve months after the claim was paid and from health care providers more than eighteen months after the claim was paid.

 

Questions applicable to this bulletin should be directed to:

Kim Hunter, General Counsel, at kim.hunter@oid.ok.gov or Molly Clinkscales, Assistant General Counsel at molly.clinkscales@oid.ok.gov.

Bulletin No. 5-2022 (Senate Bill 737)

   |   By  |  0 Comments

BULLETIN NO. 5-2022

 

To: ALL PHARMACY BENEFITS MANAGERS LICENSED IN OKLAHOMA
Re: SENATE BILL 737
From: GLEN MULREADY, INSURANCE COMMISSIONER
Date: June 8, 2022

 

PURPOSE OF THIS BULLETIN

Oklahoma SB 737 was codified into Title 36 § 6962 of the Oklahoma Statutes and includes a declaration of emergency, thus taking effect immediately upon Governor Stitt’s signature on April 21, 2022.  This measure includes new requirements which will have a significant impact on the Pharmacy Benefits Management industry. The Department hopes that this bulletin will clarify what is required.

Overview

SB 737 prohibits any pharmacy benefits manager (PBM) from engaging in the practice of spread pricing as defined in the measure and from charging a pharmacist or pharmacy certain fees as they relate to participation in a retail pharmacy network. Additionally, PBMs must disclose to insurers, self-funded employers, unions or other PBM clients the existence of the respective aggregate prescription drug discounts, rebates received from drug manufacturers, and pharmacy audit recoupments. PBMs must also provide the Insurance Commissioner with certain data pertaining to pharmaceutical manufacturer and provider contracts, plan utilization data, plan pricing data, pharmacy utilization data, and pharmacy pricing data. Such reports to the Commissioner will occur on a quarterly basis.

The measure empowers the Insurance Commissioner to suspend or revoke a PBM’s license and to censure such managers for any violation relating to the Patient’s Right to Pharmacy Choice Act, the Pharmacy Audit Integrity Act, or other relevant statutes. The Commissioner may assess an administrative fine on top of any other fines levied against a manager ranging from $100.00 to $10,000.00. Each day that a PBM operates without a license from the Insurance Department will be deemed a violation of the Patient’s Right to Pharmacy Choice Act.

Spread pricing prohibition: Oklahoma statutes define spread pricing as “a prescription drug pricing model utilized by a pharmacy benefits manager in which the PBM charges a health benefit plan a contracted price for prescription drugs that differs from the amount the PBM directly or indirectly pays the pharmacy or pharmacist for providing pharmacy services”. Oklahoma statute now prohibits spread pricing. PBMs must cease all spread pricing, even if it is permitted in their contract with an Oklahoma pharmacy. If a PBM does have a spread pricing provision in their contract, they must remove that language when the contract is renewed.

Participation fees: 36 O.S. § 6962 now prohibits PBMs from charging Oklahoma pharmacies fees related to: an application fee, an enrollment or participation fee, a credentialing or recredentialing fee, a change of ownership fee, or a fee for the development or management of claims processing services or claims payment services.

Disclosures:  SB 737 requires certain disclosures to organizations that the PBM conducts business with. A PBM must now “fully disclose to insurers, self-funded employers, unions or other PBM clients the existence of the respective aggregate prescription drug discounts, rebates received from drug manufacturers and pharmacy audit recoupments”

Every PBM must also Provide the Insurance Commissioner, insurers, self-funded employer plans and unions unrestricted audit rights of and access to the respective PBM pharmaceutical manufacturer and provider contracts, plan utilization data, plan pricing data, pharmacy utilization data and pharmacy pricing data;

Additionally, PBMs are also required to maintain, for no less than three (3) years, documentation of all network development activities including but not limited to contract negotiations and any denials to providers to join networks. This documentation shall be made available to the Commissioner upon request;

Reporting: Every Pharmacy Benefits Manager licensed in the State of Oklahoma must report to the Commissioner, on a quarterly basis for each health insurer payor, the following information:

a. the aggregate amount of rebates received by the PBM,
b. the aggregate amount of rebates distributed to the appropriate health insurer payor,
c. the aggregate amount of rebates passed on to the enrollees of each health insurer payor at the point of sale that reduced the applicable deductible, copayment, coinsure or other cost sharing amount of the enrollee,
d. the individual and aggregate amount paid by the health insurer payor to the PBM for pharmacy services itemized by pharmacy, drug product and service provided, and
e. the individual and aggregate amount a PBM paid a provider for pharmacy services itemized by pharmacy, drug product and service provided.

Each PBM licensed in the State of Oklahoma will be required to submit its “Oklahoma Pharmacy Benefits Manager Quarterly Data Report” to the Oklahoma Insurance Department (“Department”) beginning in October 2022.

Every Oklahoma Pharmacy Benefits Manager Quarterly Data Report submitted to the Department by a PBM must be in Excel software spreadsheet format that is searchable and in a manner which allows for the data to be arranged and organized.  All other file types will be rejected. Each report submitted by a PBM must also specify the time-period to which the data included in the report pertains.

For reporting purposes, please go to the following link to access an acceptable template as required by the Department: https://www.oid.ok.gov/regulated-entities/pbm/.  This is the only reporting format which will be accepted by the Department.  Each report submitted by a PBM should have a file name identifying the PBM’s license number, the year and the specific quarter (time-period) for which the report is being submitted.  For example, if XYZ Company (OK PBM License #999999) is submitting a report for the third (3rd) quarter of 2022, the ideal file name of the report would be as follows:  “999999-2022.3rd Qtr.OK PBM Data Report.xlsx” in Excel.

On or before the last day of each month in which it is due, each report submitted by a PBM should be delivered electronically to the Department at PBMReporting@oid.ok.gov in a manner that is without redaction and which is neither encrypted nor password protected.

Accompanying each report submission, a PBM must also provide the contact information for a specific representative of the PBM who may be contacted by the Department with regards to the report submitted should the need arise.  The PBM representative’s contact information provided should include their direct telephone number and email address. Additionally, each report submission must be accompanied by a general attestation of authenticity (see below) signed by the representative of the PBM who prepares the report.

Attestation Example:

“In compliance with Title 36 O.S. § 6962 (D)(5), the PBM Quarterly Aggregate Data Report herein attached is submitted to be filed with the Oklahoma Insurance Department and I hereby attest to the accuracy of the data and facts represented within this document as of [Date submitted].”

 

Questions applicable to this bulletin should be directed to:

the PBM Compliance and Enforcement Division, Oklahoma Insurance Department at PBMReporting@oid.ok.gov.

BULLETIN NO. 4-2022

   |   By  |  0 Comments

BULLETIN NO. 4-2022

 

To: ALL PROPERTY AND CASUALTY INSURERS LICENSED IN OKLAHOMA
Re: HOUSE BILL 3495 & 36 O.S. §1250.5
From: GLEN MULREADY, INSURANCE COMMISSIONER
Date: May 31, 2022

 

PURPOSE OF THIS BULLETIN

The purpose of this bulletin is to inform all property and casualty insurers of the changes made to the Unfair Claim Settlement Practices found at 36 O.S. 1250.5(7), effectuated by House Bill 3495.

Effective May 16, 2022, 36 O.S. §1250.5(7) has been amended to state “any policy that specifies a time limit covering damage to a roof due to wind or hail must allow the filing of claims after the first anniversary but no later than twenty-four (24) months after the date of the loss, if the damage is not evident without inspection.”

The Department also encourages consumers/insureds to have their roofs inspected by a reputable expert once a year or after a major hail or wind event.

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

 

Questions applicable to this bulletin should be directed to:

Jason Johnston, Consumer Assistance Division, at Jason.Johnston@oid.ok.gov; or

Bo DeBose, Legal Division, at Bo.Debose@oid.ok.gov

2022 Emergency Rule Amendments

   |   By  |  0 Comments

Medicare Fraud Prevention Week: Join the Oklahoma Insurance Department for the Summer Senior Fraud Live Events This Summer

   |   By  |  0 Comments

For Immediate Release:
June 1, 2022

Medicare Fraud Prevention Week:
Join the Oklahoma Insurance Department for the Summer Senior Fraud Live Events This Summer

 

OKLAHOMA CITY – In conjunction with the first national Medicare Fraud Prevention Week, the Oklahoma Insurance Department’s (OID) Medicare Assistance Program (MAP) is inviting Medicare beneficiaries to the Summer Senior Fraud Live Events on June 23 and July 14. OID has partnered with MAP, the Oklahoma Social Security Administration, the Oklahoma Department of Securities, the Oklahoma Attorney General’s Office, AARP Oklahoma and the National Insurance Crime Bureau to educate and empower Oklahomans in the fight against fraud targeting senior citizens.

“We’re excited to bring back these in-person events and continue to work with our partners to help Oklahomans protect themselves from fraud,” Director of the MAP division Ray Walker said. “Educational events like this will help individuals stay safe and protect the Medicare program for generations to come.”

The Summer Senior Fraud Live Events, funded in part by the SMP grant through the Administration for Community Living, will be held at the OID’s Oklahoma City office. These in-person events will consist of two one-day sessions led by speakers with diverse areas of expertise such as state agency directors, Medicare professionals and fraud prevention professionals. The topics include Medicare and healthcare fraud, contractor fraud, cyber scams, investment fraud and securities fraud. These events are free for senior adults and include breakfast. Registration is required because of limited capacity. To register, visit oid.ok.gov/summerseniorfraud/.

The Medicare Fraud Prevention Week, held June 5-11, kicks off on June 5, or “6-5,” because most people become eligible for Medicare when they turn 65 years old. Learn more about Medicare Fraud Prevention Week at www.smpresource.org

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.

 

For more information, contact:

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