Posts by: Britney Han

BULLETIN NO. 9-2023

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Oklahoma Insurance Department

BULLETIN NO. 9-2023

To: Oklahoma Professional Employer Organizations (PEOs)
Re: 2023 PEO Legislative Changes
From: Glen Mulready, Insurance Commissioner
Date: August 15, 2023

 

The Regulated Industry Services (RIS) Division of the Oklahoma Insurance Department (OID) oversees the registration and regulation of Professional Employer Organizations (PEOs). We will begin sending out informational emails to the industry to increase awareness and encourage open dialogue so you can remain compliant.

Legislative Changes (SB 638) effective November 1, 2023

Disclaimer: The following is an overview of the law changes pertaining to PEO registrations.  Refer to the Oklahoma Supreme Court Network (OSCN) webpage to research all the statutes pertaining to Oklahoma Professional Employer Organization Recognition and Registration Act, 40 O.S. §§ 600.1 – 600.9 (the new statute version is posted on the OSCN webpage).

40 O.S. § 600.4(B)(1)(g).

Financial Statement prepared within 365 (was 180 days) of application – a financial statement setting forth the financial condition of the PEO or PEO Group, as of a date not earlier than three hundred sixty-five (365) days prior to the date submitted to the Commissioner, prepared in accordance with generally accepted accounting principles, and audited or reviewed by an independent certified public accountant licensed to practice in the jurisdiction in which such accountant is located. A PEO Group may submit combined or consolidated audited or reviewed financial statements to meet the requirements of this section.

40 O.S. § 600.4(B)(4).

Name or contact change – Each person, PEO, or PEO Group shall electronically submit, in a form and manner prescribed by the Commissioner, along with any applicable fees, any change of legal business name, “doing business as” or assumed name, address, or contact email address within thirty (30) days after the change occurred. Any submission of a change of legal name, “doing business as” or assumed name, address, or contact email address received more than thirty (30) days after the change occurred shall be accompanied by a fee of Fifty Dollars ($50.00).

40 O.S. § 600.4(C)(2).

Reinstatement – A registration expired for failure to submit a renewal application may be reinstated within ninety (90) days after the expiration date by electronically submitting a fee in an amount that is twice the amount of the renewal fee and a renewal application in the form and manner prescribed by the Insurance Commissioner, along with any transaction or other applicable fees. The Commissioner shall require a person, PEO, or PEO Group whose registration has been expired for more than ninety (90) days to reapply as if a new applicant and pay an application fee equal to an amount that is twice the initial application fee in addition to any fines imposed. All applications received after the registration has been expired for more than ninety (90) days shall include a detailed report of professional employer services provided in this state during the period of expired registration.

40 O.S. § 600.4(J).

Days to respond – Every person, PEO, or PEO Group, upon receipt of any inquiry from the Commissioner, shall, within twenty (20) days from the date of receipt of the inquiry, furnish the Commissioner with an adequate response to the inquiry.

40 O.S. § 600.4(B)(2)(c).  This statute remains unchanged.  Effective November 1, 2023, we will start enforcing the requirement as written in the statute.  CPA Statements certifying payment of only “state taxes” will be rejected.

Quarterly CPA Statement – an independent Certified Public Accountant must certify that, as of the end of the most recent calendar quarter, the PEO or PEO Group has paid all of its state and federal payroll taxes, health and workers’ compensation premiums, and contributions to employee retirement plans in a timely and appropriate manner.

Questions concerning this bulletin should be directed to the Oklahoma Insurance Department’s Regulated Industry Services Division at 405-522-8398 or by email to ris@oid.ok.gov.

BULLETIN NO. 8-2023

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Oklahoma Insurance Department

BULLETIN NO. 8-2023

To: Oklahoma Perpetual Care Fund Permit Holders
Re: 2023 PCF Legislative Changes
From: Glen Mulready, Insurance Commissioner
Date: August 15, 2023

 

The Regulated Industry Services (RIS) Division of the Oklahoma Insurance Department (OID) oversees the Perpetual Care Fund (PCF) permits. We will begin sending out informational emails to the industry to increase awareness and encourage open dialogue so you can remain compliant.

Legislative Changes effective November 1, 2023

SB 544

Disclaimer: The following is an overview of the law changes pertaining to PCF permits.  Refer to the Oklahoma Supreme Court Network (OSCN) webpage to research all the statutes pertaining to PCF regulated under 36 O.S. § 7101 – 7112 (the new statute version is posted on the OSCN webpage).

36 O.S. § 7106(A).

90 Day Reinstatement – a permit expired for failure to submit a renewal application and fee may be reinstated within ninety (90) days after the expiration date by electronically filing a renewal application, paying a fee in an amount that is double the renewal fee, and paying any transaction or other applicable fees in the form and manner prescribed by the Commissioner.

Expired Permit – The Commissioner shall require a permit holder whose permit has been expired for more than ninety (90) days to reapply as if a new applicant and pay an application fee equal to an amount that is double the renewal fee, in addition to any other fines imposed. Any application received after the permit has been expired for more than ninety (90) days shall include a detailed report of the Perpetual Care Trust Fund services provided in this state during the period that the permit was expired.

36 O.S. § 7106(B).

Electronic filing of Annual Report due March 15th – The owner of a cemetery maintaining a Perpetual Care Trust Fund or certificate of deposit in lieu of a Perpetual Care Trust Fund shall, by March 15 of each calendar year, electronically file a report and pay any applicable fees in the manner and form prescribed by the Commissioner. Such report shall show the statutorily required information, for the preceding calendar year.

36 O.S. § 7112(B).

Enforcement -The Insurance Commissioner may, after an opportunity for hearing, censure an owner of a cemetery, levy a fine not to exceed One Thousand Dollars ($1,000.00) for each occurrence, or any combination of the above for violation of any provision of the Perpetual Care Fund Act or any rules promulgated in accordance with the act.

Questions concerning this bulletin should be directed to the Oklahoma Insurance Department’s Regulated Industry Services Division at 405-522-4628 or by email to ris@oid.ok.gov.

BULLETIN NO. 7-2023

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Oklahoma Insurance Department

BULLETIN NO. 7-2023

To: Oklahoma Third-Party Administrators (TPAs)
Re: 2023 TPA Legislative Changes
From: Glen Mulready, Insurance Commissioner
Date: August 15, 2023

 

The Regulated Industry Services (RIS) Division of the Oklahoma Insurance Department (OID) oversees the registration and regulation of Third-Party Administrators (TPAs). We will begin sending out informational emails to the industry to increase awareness and encourage open dialogue so you can remain compliant.

Legislative Changes (SB 553) effective November 1, 2023

Disclaimer: The following is an overview of the law changes pertaining to TPA registrations.  Refer to the Oklahoma Supreme Court Network (OSCN) webpage to research all the statutes pertaining to the Third-Party Administrator Act, 36 O.S. § 1441 – 1452 (the new statute version is posted on the OSCN webpage).

36 O.S. § 1450(C) and (F)(3).

Third Party Background Check – language requiring an independent third-party background check was removed.  The National Association of Insurance Commissioners (NAIC) Biographical Affidavit will continue to be required.

36 O.S. § 1450(E).

Expired License – The renewal application and fees shall be filed and paid electronically in a form and manner prescribed by the Commissioner. A license that expires for failure to submit a renewal application may be reinstated within ninety (90) days after the expiration date by electronically submitting a fee in an amount of Two Hundred Dollars ($200.00) in a form and manner prescribed by the Commissioner and any other transaction or other fee deemed necessary by the Commissioner. All applications received after the license has expired for more than ninety (90) days shall include a detailed report of administrator services provided in this state during the period of expired licensure.

36 O.S. § 1450(J).

Name or Contact Change Information – Each administrator shall electronically submit, in a form and manner prescribed by the Commissioner, any change of legal business name, “doing business as” or assumed name, address, service agent contacts information, or contact email address, and any necessary fees within thirty (30) days after the change occurred. Any submission of a change under this subsection that is received more than thirty (30) days after the change occurred shall be accompanied by a fee of Fifty Dollars ($50.00).

36 O.S. § 1450(K).

Days to respond – Upon receipt of any inquiry from the Insurance Commissioner, a licensed administrator shall furnish the Commissioner with an adequate response to the inquiry within twenty (20) days from receipt of the inquiry.

Questions concerning this bulletin should be directed to the Oklahoma Insurance Department’s Regulated Industry Services Division at 405-521-6651 or by email to ris@oid.ok.gov.

New Scam Alert: COVID-19 Test Kit and Self-Catheter Kit Medicare Fraud

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Oklahoma Insurance Department

For Immediate Release:
August 9, 2023

New Scam Alert: COVID-19 Test Kit and Self-Catheter Kit Medicare Fraud

 

OKLAHOMA CITY – The Oklahoma Insurance Department (OID)’s Medicare Assistance Program (MAP) warns about rising cases of Medicare fraud across the state. Recent cases of fraud focus on COVID-19 test kits and self-catheter kits.

COVID-19 Test Kit Fraud

With the end of the COVID-19 Public Health Emergency, test kits are no longer available for free after May 11, 2023. Scammers began taking advantage of Medicare beneficiaries by sending at-home COVID-19 test kits and billing Medicare for the test they never requested. Also, many beneficiaries have seen charges on their Medicare Summary Notices (MSNs) for COVID-19 tests they have yet to receive, with cases ranging from individual test kits to bulk shipments.

Since June, the MAP has received over 55 calls reporting this issue, leading to 276 unrequested COVID-19 test kits. The cumulative impact remains significant despite not every test kit leading to Medicare payment. At an approximate rate of $94 per test kit, the total payment by Medicare is estimated to exceed $18,000.

Self-Catheter Kit Fraud

Medicare recipients also reported urinary catheters being billed to Medicare when they don’t have a medical diagnosis that requires these medical supplies. The monetary implications are substantial, with Medicare being charged nearly $3,000 for each beneficiary allegedly receiving these unneeded catheters.

How to Protect Yourself from Fraud

The OID’s MAP division is available to help all Oklahomans prevent, detect and report Medicare fraud. The MAP Director Ray Walker encourages Medicare beneficiaries, their families and caregivers to contact his division immediately if they see suspicious activity, such as billing for unwanted and unnecessary at-home COVID-19 tests or other items and services they didn’t receive.

“Unfortunately, the pandemic provided fraudsters with many opportunities to take advantage of Medicare beneficiaries to benefit themselves,” said Walker. “We are actively working with State and Federal partners to detect and fight these new, emerging scams.”

Medicare allows claims to be submitted up to 12 months after receiving an item or service receipt. This results in charges showing up on MSNs for alleged medical services and equipment from months earlier. The MAP counselors can help beneficiaries determine a course of action to address their situation and report the potential fraud to the proper authorities.

About MAP

MAP is a division of the Oklahoma Insurance Department, funded by grants through the Administration for Community Living, Office of Healthcare Information and Counseling. The Senior Medicare Patrol (SMP) grant provides funding to educate beneficiaries and their family members on ways to prevent Medicare fraud, as well as how to report potential fraud. MAP also provides one-on-one counseling and information for people eligible for Medicare. All services are free, unbiased and confidential. MAP empowers and assists Medicare beneficiaries, their families, and caregivers to make informed Medicare decisions and ways to protect their Medicare identity.

If you suspect you or a loved one is a victim of Medicare fraud or abuse, please get in touch with the OID’s MAP division at (800) 763-2828 or visit MAP.OID.OK.GOV.

 

Media questions or comments should be directed to
Chief of Communications, Liz Heigle
Liz.Heigle@oid.ok.gov | (405) 819-2221

OID’s Medicare Assistance Program Director Ray Walker Elected as Bi-Regional Representative for Regions VI and VIII

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Oklahoma Insurance Department

For Immediate Release:
August 8, 2023

OID’s Medicare Assistance Program Director Ray Walker Elected as Bi-Regional Representative for Regions VI and VIII

 

OKLAHOMA CITY – During the 2023 SMP/SHIP/MIPPA National Conference in Washington, D.C., the Oklahoma Insurance Department (OID)’s Medicare Assistance Program Director Ray Walker has been elected as the Bi-Regional Representative for Regions VI and VIII for the National State Health Insurance Assistance Program (SHIP) Steering Committee. As the Bi-Regional Representative, Walker will play a pivotal role in advocating for the needs of the SHIP community in both regions. Region VI includes Arkansas, Louisiana, New Mexico, Texas and Oklahoma. Region VIII includes Colorado, Montana, North Dakota, South Dakota, Utah and Wyoming.

“I am honored to serve as the Bi-Regional Representative for Region VI and VIII,” Walker said. “I look forward to collaborating with fellow representatives and continuing our collective efforts towards providing unbiased help to Medicare beneficiaries, their families and caregivers.”

“Ray’s election is not only a recognition of his professional accomplishment but also a testament to the respect and admiration he has earned from his colleagues in the Medicare industry,” Insurance Commissioner Glen Mulready said. “We are fortunate to have an individual as dedicated and accomplished as Ray to represent Oklahoma and our neighboring states.”

The SHIP Steering Committee is a nationally recognized organization dedicated to supporting and enhancing the quality of SHIPs across the United States. Membership is only extended to the individuals that have shown professionalism, experience and commitment to serve and represent the mutual interests of the SHIPs at the national level. The Committee consists of nine directors—five HHS Regional representatives and four “at large” representatives.

To learn more about SHIP, please visit https://www.shiphelp.org/. If you have Medicare-related questions or concerns, please visit map.oid.ok.gov.

The OID’s Medicare Assistance Division attending the 2023 SMP/SHIP/MIPPA National Conference in Washington, D.C.

 
Media questions or comments should be directed to
Chief of Communications, Liz Heigle
Liz.Heigle@oid.ok.gov | (405) 819-2221

BULLETIN NO. 6-2023

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Oklahoma Insurance Department

BULLETIN NO. 6-2023

To: Oklahoma Licensed Resident Producers, Insurers, and Continuing Education Providers
Re: Annuity Suitability And Best Interest Standard Producer Training
From: Glen Mulready, Insurance Commissioner
Date: August 3, 2023

 

Effective September 1, 2023, Oklahoma has adopted the Annuity Suitability and Best Interest Standard Model Act (#275), which amends the training requirements for Producers involved in the sale, solicitation, or negotiation of annuities.  The training requirements are now located in Oklahoma Administrative Code (OAC) 365:25-17-7.1.

Effective September 1, 2023, Producers who hold a life insurance line of authority, who were not engaged in the sale of annuities prior to September 1, 2023, and who desire to start selling annuities must complete an approved four (4) hour annuity training course within six (6) months after September 1, 2023 (no later than February 29, 2024). A Producer who fails to complete the training by this deadline must immediately cease selling annuities until the training is completed. Producers who obtain a life insurance line of authority on or after September 1, 2023, shall not engage in any annuity sales until they successfully complete an approved four (4) hour annuity training course.

The training required under this regulation must consist of a minimum length of four (4) credit hours and must cover various topics, including, but not limited to: the types of annuities and various classifications of annuities; identification of the parties to an annuity; how product specific annuity contract features affect consumers; the application of income taxation of qualified and non-qualified annuities; the primary uses of annuities; and appropriate standard of conduct, sales practices, replacement and disclosure requirements. Approved Oklahoma Continuing Education Providers will submit this course under the course group “Annuity Best Interest 4 Hours.”

Producers who have completed the current Department approved “Annuity” training course prior to November 1, 2023, must complete one of the following options within six (6) months after November 1, 2023 (no later than April 30, 2024):

  • A new four (4) credit hour training course approved by the Department. The course group will be identified as “Annuity Best Interest 4 Hours”; or
  • A new one (1) credit hour training course approved by the Department. The course group will be identified as “Annuity Best Interest 1 Hour.”

The new one (1) credit hour training must cover topics, including, but not limited to: appropriate sales practices, replacement, and disclosure requirements under the amended regulation. Approved Oklahoma Continuing Education Providers will submit this course under the course group “Annuity Best Interest 1 Hour.”

An insurer offering annuity products is still required to verify that a Producer has completed the training requirements prior to allowing the Producer to sell annuity products.  Insurers can fulfill this responsibility by obtaining certificates of completion for the training course or by obtaining reports from the Oklahoma Insurance Department’s database system, State Based Systems (SBS).

Producers who satisfy annuity training requirements of another state will be considered compliant with the Oklahoma training requirements if the other state’s training requirements are substantially similar to the Oklahoma requirements set forth in OAC 365:25-17-7.1. Producers will also be considered compliant if they satisfy components of training requirements of any other course(s) if such components are substantially similar to the requirements set forth in OAC 365:25-17-7.1.

In addition to the Producer training requirements, prior to the recommendation or sale of any annuity, the Producer must be responsible for disclosure and documentation obligations as outlined in OAC 365:25-17-7(a)(2) and 365:25-17-7(a)(4).  Forms for this requirement can be found using the hyperlink Annuity Forms, (Forms Appendix A-C): https://www.oid.ok.gov/licensing-and-education/

Questions concerning this bulletin should be directed to the Oklahoma Insurance Department’s Licensing & Education Division at 405-521-3916 or by email at licensing@oid.ok.gov.

Insurance Tips for Back-to-School Season

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Oklahoma Insurance Department

For Immediate Release:
August 2, 2023

Insurance Tips for Back-to-School Season

By Oklahoma Insurance Commissioner Glen Mulready

 

As the parent of three sons—one in undergrad, one in grad school and one starting his professional career, I understand how exciting (and a little scary) this time can be for students and parents. Whether you are a recent high school graduate going into college or a nervous parent getting ready for your child’s first day, it is important to review your insurance policies to ensure your entire family is adequately protected.

As the school year gets underway across the state, I’d like to remind Oklahomans that having proper insurance can provide greater peace of mind and protect your family from financial disaster. Here are insurance tips to help make your back-to-school season go more smoothly.

Home

If your student is moving into a dorm room, your homeowners policy will likely cover their personal property in case of a loss. Ask your child to let you know if they buy a new computer or other pricey items. You should double check with your agent or insurance company to ensure your coverage will cover these items.

Students living off-campus should consider renters insurance. This coverage will protect students’ personal property and provide liability coverage if someone is injured on the property. Premiums for renters insurance can range between $13-$30 a month, depending on the location and size of the rental unit and the value of the possessions. A home inventory is always a good idea whether they live on or off-campus. This list of items will make a future insurance claim much quicker and easier to settle.

Auto

Oklahoma requires every car to have auto liability coverage. Auto liability insurance pays for property damage and bodily injury to someone else if you are found responsible for an accident up to your policy’s limits. If the title to the car is in your student’s name, they must have their own policy. If your college student is driving a vehicle you own, your child can likely stay on your policy and be listed as a driver.

If your student is heading to college without a vehicle, you might be eligible for a “student away at school” car insurance discount. Check with your insurance agent or company and let them know where the car will be stored if the address differs from what’s on your policy.

Health

Students have several options for health insurance coverage while away at college. If your children are covered under your insurance now, they will still be covered while at school. Any insurance plan that offers dependent coverage must make that available until the dependent is 26. If you are currently enrolled on an HMO, your child may need to return to your home area for routine care and may have emergency care only while at school.

Many colleges and universities also offer their own student health insurance plans. The premiums and features vary widely from school to school. Check with your student’s school health center to see available coverage options.

Denied Insurance Claims

If your family experiences a claim denial or settlement disagreement, you can file a complaint at oid.ok.gov/complaint. The Oklahoma Insurance Department’s Consumer Assistance team is here to help mediate claims between policyholders and insurance companies.

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

Commissioner Mulready Provides Update on CVS/Caremark Resolution for 90-Day Prescriptions

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Oklahoma Insurance Department

For Immediate Release:
July 28, 2023

Commissioner Mulready Provides Update on CVS/Caremark Resolution for 90-Day Prescriptions

 

OKLAHOMA CITY – In March, the Oklahoma Insurance Department (Department) filed an administrative action against Caremark for alleged violations of “steering patients” to CVS pharmacies and prescription mail-order services. The Judge granted a continuance on the hearing, which is now set for November 6, 2023.

Since the filing, the Department has been in discussions with large client employers, such as, AT&T, Southwest Airlines, and Phillips 66. In addition to those conversations, we have met with Caremark, and they now have a plan in place to allow 90-day and mail order options.

“I am thankful we were able to get CVS to expedite this redirection and start implementing this plan now,” Mulready said. “Many Oklahoma consumers who have been impacted will have 90-day and mail order options available to them this month.”

Below is the most recent update on this issue:

  • All impacted out-of-state clients have been offered the option to reinstate the benefits for their Oklahoma members.
  • By July 31, 2023, 79% of the Oklahomans covered by clients who elected the CVS’ solution will have 90-day mail order prescription access. This percentage excludes clients who have opted out of the solution to implement a 90-day mail and retail benefit and those members who are terminating coverage.

Caremark will continue to work with its clients and the OID as they reinstate 90-day mail order for impacted Oklahomans.

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

 
Media questions or comments should be directed to
Chief of Communications, Liz Heigle
Liz.Heigle@oid.ok.gov | (405) 819-2221

Get Help Paying for Your Medicare Prescription Drug Costs with Extra Help

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Oklahoma Insurance Department

For Immediate Release:
July 27, 2023

Get Help Paying for Your Medicare Prescription Drug Costs with Extra Help

 

OKLAHOMA CITY – With rising inflation and interest rates, the federal Extra Help Program may be helpful if you are a Medicare beneficiary with limited income and resources. The Extra Help program assists qualified Medicare beneficiaries with out-of-pocket expenses associated with Medicare Part D prescription drug expenses. You also won’t have to pay a Part D late enrollment penalty while you get Extra Help.

More than 10,000 Medicare beneficiaries in Oklahoma may be eligible for this program but have yet to apply. The Medicare Assistance Program (MAP) is a division of the Oklahoma Insurance Department that can help Medicare beneficiaries understand and apply for this assistance. MAP provides free, unbiased information to help Oklahomans understand Medicare, Medicare supplements, Medicare Advantage, and other health plan options.

“Having to choose between buying groceries or paying for prescription drugs is a decision no one should have to make,” MAP Director Ray Walker said.

The income and resource limits in 2023:

Your situation Income limit Resource limit
Individual $1,660/month $9,090
Married couple $2,239/month $13,630

 

Resources include the value of the things you own. Some examples are real estate other than your primary residence, bank accounts, including checking, savings, and certificates of deposit, stocks, bonds, mutual funds and IRAs. Your primary residence, personal possessions and your vehicle do not count as a resource.

Individuals who qualify for this program will receive assistance with their Medicare Part D prescription drug plans. This means that individuals eligible for Full Extra Help will have their Part D monthly premium paid up to $32.90 per month and will pay a reduced copay of $4.15 for generic drugs and $10.35 for name-brand drugs.

“Even with higher income and resources, you may qualify for partial Extra Help. This program will pay all or part of the monthly premium as well as a portion of the copays and coinsurance,” Walker added.

To see if you qualify for the Extra Help program, please call the Oklahoma Medicare Assistance Program at 1-800-763-2828 or visit https://www.oid.ok.gov/ship-low-income-subsidy/.

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

 

Media questions or comments should be directed to
Chief of Communications, Liz Heigle
Liz.Heigle@oid.ok.gov | (405) 819-2221

BULLETIN NO. 5-2023

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Oklahoma Insurance Department

BULLETIN NO. 5-2023

To: Oklahoma Licensed Resident Producers, Adjusters, and Continuing Education Providers
Re: Earthquake CE Requirement: Oklahoma Administrative Code 365:25-3-1 and 365:25-3-14
From: Glen Mulready, Insurance Commissioner
Date: July 25, 2023

 

Effective September 1, 2023, the one-hour earthquake continuing education requirement will no longer be applicable for licensees holding a property line of authority.  The Earthquake course group will remain intact, with no impact on the currently active courses. The course group will continue to apply towards general continuing education credit for all license types.

For license renewals processed prior to September 1, 2023, completion of the one-hour earthquake coverage requirement will remain mandatory. For license renewals processed after September 1, 2023, continuing education on earthquake coverage will not be required.

Courses that contain information about earthquake coverage will continue to be reviewed under the Earthquake course group indefinitely.

Questions concerning this bulletin should be directed to the Oklahoma Insurance Department’s Licensing & Education Division at 405-521-3916 or by email at licensing@oid.ok.gov.