OK-SAFE, Inc. Blog

May 3, 2011

OK Exchange Language Found! SB 971 Establishes an Insurance “Network”


Dropping the term “exchange” in favor of “network” and adding “private enterprise” to the title is apparently aimed at providing assurance to Oklahomans that this OK Republican administration is serious about not implementing a Health Insurance Exchange in Oklahoma.

Here is the language found in the newly introduced SB 971, the replacement for the controversial HB 2130, which narrowly passed the OK House on 3/17/11 and which the Senate refused to hear.

See if you can see much assurance that a framework for an exchange is not being built if this bill passes…bill language below:

SB 971, by Myers/Jolley of the Senate and Sears/Martin,(Scott) of the House.

BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:

SECTION .     AMENDATORY     Section 2, Chapter 128, O.S.L. 2009 (36 O.S. Supp. 2010, Section 4602), is amended to read as follows:

Section 4602.  A.  The Insurance Commissioner in collaboration with the Oklahoma Health Care Authority shall advise and aid the Health Care for the Uninsured Board (HUB) in its duties.  The Insurance Commissioner is hereby authorized to promulgate such reasonable rules as are necessary to implement the purposes of this act.

B.  The State Board of Health shall direct the implementation and duties of the HUB to assist the Insurance Commissioner.  The duties of the HUB shall be to:

1.  Advise, consult with, and make recommendations to the Commissioner as to the matters addressed in subsection C of this section; and

2.  Assist and advise the Commissioner on such other matters as the Commissioner may submit for recommendations to the State Board of Health

The purpose of this act is to allow Oklahoma to establish and operate its own Health Insurance Private Enterprise Network to facilitate access to health insurance and enhance competition in the individual and small employer health insurance markets.

B.  As used in this act:

1.  “Aggregate premiums” means a mechanism to pay insurance premiums with contributions from multiple sources;

2.  “Defined contribution” means pretax dollars contributed by the employer;

3.  “Insurance producer” has the same meaning as defined in Section 1435.2 of Title 36 of the Oklahoma Statutes;

4.  “Network” means the Health Insurance Private Enterprise Network; and

5.  “Network Board” means the Health Insurance Private Enterprise Network Board.

C.  The Health Insurance Private Enterprise Network shall be established as a state-beneficiary public trust.

D.  The Network shall be governed by a board of directors.  The Network Board shall consist of seven (7) members as follows:

1.  One member appointed by the Governor representing health insurance carriers granted a certificate of authority by the Oklahoma Department of Insurance;

2.  One member appointed by the Speaker of the House of Representatives representing consumers and who has purchased policies through the Network or is reasonably expected to purchase policies through the Network;

3.  One member appointed by the Governor who shall be a health care provider;

4.  One member appointed by the Governor who shall be a representative of employer groups;

5.  One member appointed by the President Pro Tempore of the Senate who shall be an insurance agent or broker;

6.  The Insurance Commissioner; and

7.  The Secretary of Health and Human Services.

E.  The Insurance Commissioner shall serve as chair of the Network Board.  The Network Board shall appoint an Executive Director.

F.  In order to avoid the establishment of a federal exchange, the Network shall have the minimum authority under state law that is necessary to implement its purposes.  Funding for the Network shall come from state and private sources.

G.  The purpose of the Network shall be to:

1.  Increase choice and competition in the health insurance market of Oklahoma;

2.  Provide more choices and options in the health insurance market for employees in the state;

3.  Promote and encourage portability of coverage;

4.  Promote a competitive, patient-centered, market based health insurance system that includes a defined-contribution health insurance alternative for employer-sponsored coverage which includes an aggregate premium system;

5.  Encourage health insurance carriers to collaborate with medical providers to offer health insurance coverage that provides consumers quality care delivered in the most cost-effective manner; and

6.  Establish a fair and impartial health insurance producer referral network for the purpose of assisting individual and qualified small employers in obtaining health insurance coverage through the Network.

H.  The Network shall not:

1.  Exercise regulatory authority over any entity;

2.  Discriminate against any qualified health insurance carrier willing to participate in the Network; or

3.  Supplant any marketplace outside the Network.

I.  The Commissioner Network Board shall:

1.  Establish a system of certification for insurance programs offered in this state to be recommended offered by the HUB the Network; and

2.  Establish a system for the credentialing of licensed insurance producers who intend to market insurance programs certified by the state in accordance with this section.

3.  Establish a system of counseling, including a website, for those individuals who are without health insurance and are not covered by Medicaid, that includes but is not limited to:

a.            educating consumers about insurance programs certified by the state in accordance with this section,

b.            aiding consumers in choosing policies that cover medically necessary services for that consumer, and

c.             educating consumers on how to utilize primary and preventative care in order to reduce the unnecessary utilization of services by the consumer; and

4.  Establish a system whereby if an individual qualifies for a subsidy under the premium assistance program, established in Section 1010.1 of Title 56 of the Oklahoma Statutes, that person is able to become enrolled through the HUB in conjunction with local, qualified insurance producers.

J.  All personal information generated through the purchase of any policy purchased through the Network shall remain confidential between the insurer and the insured.

K.  The Network Board shall promulgate rules as necessary to implement the purposes of this act and to help individuals facilitate the selection of health insurance coverage and to allow health insurance carriers to provide market based health insurance products without unnecessary regulation and burdens.

SECTION .     AMENDATORY     Section 3, Chapter 128, O.S.L. 2009 (36 O.S. Supp. 2010, Section 4603), is amended to read as follows:

Section 4603.  A.  The Insurance Commissioner in collaboration with the Oklahoma Health Care Authority shall initiate a program to encourage enrollment of individuals, not covered by insurance or enrolled in Medicaid in health insurance programs.

B.  Upon treatment of an uninsured individual or an individual not covered by enrolled in Medicaid, a health care provider shall refer the individual to the HUB Network established in Section 2 4602 of this act title to begin the enrollment process in a certified insurance plan or the premium assistance program established in Section 1010.1 of Title 56 of the Oklahoma Statutes, if eligible.

SECTION .  The provisions of this act shall be subject to legislative review and renewal no later than May 25, 2014.

SECTION .  This act shall become effective November 1, 2011.

53-1-1708            ARE        4/27/2011 4:10:04 PM

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1 Comment »

  1. […] From OK-SAFE […]

    Pingback by House Votes to Derail Government Takeover of Healthcare | AxXiom for Liberty — May 5, 2011 @ 6:42 am


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