APA WF 23-02 Insure Oklahoma Self-Funded/Self-Insured Plans
The proposed rules will update Insure Oklahoma policy to comply with Oklahoma Senate Bill 1323, which added language to Title 56 Oklahoma Statutes (O.S.) § 1010.1. The policy additions mirror the bill’s language regarding self-funded/self-insured plans to address that qualified benefit plans may become a self-funded or self-insured benefit plan if certain criteria are met.
Please view the circulation document here: APA WF # 23-02 and submit feedback via the comment box below.
Circulation Date: 01/03/2023
Comment Due Date: 01/18/2023
Medical Advisory Committee (MAC) Meeting: 05/04/2023
Board Meeting: 05/17/2023
Comments
Bridges Health:
Bridges Health appreciates the flexibility the proposed rule would provide for benefit plans.
Ashley Scott:
On behalf of Commissioner Mulready and the Department I am proposing the following change and comment:
317:45-5-1(d)(3)
~Strike the word "and" after "section" and insert "in addition to all other health benefits.
~Strike "by the Centers for Medicare and Medicaid Services" and add "under applicable federal laws.
The new langauge with our proposed changes would read:
"(3) The self-funded or self-insured benefit plan continues to cover all essential health benefits listed in (a) of this section in addition to all other health benefits that are required under applicable federal laws."
In addition to coverage requirements of the Centers for Medicare and Medicaid Services, there are laws and regulations enforced by the Department of Labor, Health and Human Services, and the Treasury applicable to self-funded and self-insured plans. As the Oklahoma Insurance Department does not regulate self-funded or self-insured qualified benefit plans, this change in the language will ensure members of self-funded or self-insured Insure Oklahoma plans receive health benefit coverage in accordance with all federal laws applicable to such plans.
