Discount Medical Plan Organization

Discount Medical Plan Organizations (DMPO)

Regulations 36 § 1219.4
Oklahoma Insurance Department (OID)

Regulated Industry Services

RIS@oid.ok.gov

The Regulated Industry Services (RIS) Division oversees the licensing, registration, and regulation of business entities that are not traditional insurance carriers. These business entities are, however, legally obligated to be regulated in some capacity by the OID.

Discount Medical Plan Organizations – defined

A Discount Medical Plan Organization (DMPO) is a company or entity that sells membership plans providing access to discounted rates for health care services, such as doctor visits, dental care, vision care, and prescriptions, in exchange for a recurring membership fee or dues.

A DMPO can provide discounts on services like:

  • Doctor visits
  • Hospital services
  • Surgery
  • Emergency room care
  • Ambulance services
  • Dental care
  • Eye exams and eyeglasses
  • Mental health services
  • Substance abuse treatment
  • Chiropractic care
  • Podiatry (foot care)
  • Lab tests
  • Medical equipment and supplies

A DMPO may not provide:

  • The DMPO does not pay your medical bills. You still pay the provider, just at a lower rate.
  • It is not insurance and does not work like insurance.
  • Members usually pay a fee to join the plan and then get access to the discounted prices.
  • Providers must agree in writing to offer their services at a discounted price.

Discount Medical Plan Organization Licensing fees:

$250.00 Annual registration fee
$100.00 Annual Affiliate Exempt DMPO registration fee
Cycle – Annual on the last day of the issue month
See Due Date & Fees in the sidebar for more information.

Licensing Requirements

Regulations: 36 § 1219.4

Before a Discount Medical Plan Organization can do business in Oklahoma, it must:

  • Prior to registration, each DMPO shall establish an Internet website.
  • Be a valid business – The organization must be a real company, like an LLC, corporation, or partnership. Be registered with the Oklahoma Secretary of State.
  • All forms used, including the written agreement per 36 § 1219.4(G) shall first be filed with the Insurance Department.
    • Every form filed shall be identified by a unique form number placed in the lower left corner of each form.
    • A filing fee of Twenty-five Dollars ($25.00) per form shall be payable electronically upon submission. (Submitted via Serff to Rate and Form)
  • Complete an (initial or renewal) application in OPTins. See sidebar for more information.
  • Audited Financial Statement required. Each registered DMPO (except an affiliate) is required to maintain a net worth of at least One Hundred Fifty Thousand Dollars ($150,000.00).
  • Copy of agreement between members and DMPO.
  • Copy of agreement between marketer and DMPO.
  • Marketer Listing: DMPOs must keep an updated list of all their approved doctors and providers on the website. This includes each marketer’s name, address, phone number, and website. Retail DMPOs need a list of Independent Contractors.
  • Surety Bond – $35,000 naming the Oklahoma Insurance Commissioner as the claimant.
  • Biographical affidavit for owners and/or officers, except affiliates.

Exempt DMPOs:

Prior to the sale, marketing, or solicitation, an exempt DMPO is required to register and submit the same requirements as mentioned above; however, the fees are reduced to $100.00.

Exempt DMPOs include:

A provider who provides discounts to his or her own patients.

An affiliate of a licensed insurance company, HMO, group health service organization, or motor service club.

Quarterly filings: Marketer List

Marketer Listing: DMPOs must maintain an up-to-date list of all their approved doctors and providers on their website. This includes each marketer’s name, address, phone number, and website. Retail DMPOs need a list of Independent Contractors.

Contact Change Requests

How to Submit:

  • Upload the Contact Change Form to the most recent initial or renewal application in OPTins. See sidebar for link.
  • OID will update and attach the change to the SBS system record.

Timeliness Requirements:

  • Changes in legal business name, DBA/assumed name, address, or contact email must be
    submitted within 30 days.
  • Submissions made after 30 days must include a $50 violation fee.

Payment:

  • Violation fees must be paid online through the “Pay RIS Violation Fee” webpage. See sidebar for link.