Bona fide association health plans.

1. Law
2. Oklahoma Statutes
3. Insurance
4. Bona fide association health plans.

A. "Bona fide association" means any association that has a current form M-1 filed with and accepted by the United States Department of Labor showing Oklahoma as the state of operation and:

1. Is formed under a pathway established in accordance with the applicable provisions of 29 CFR 2510; or

2. Was previously established or is newly formed under federal regulatory guidance effective prior to August 20, 2018.

B. "Bona fide association health plan" means a health benefit plan that is sponsored by a bona fide association as defined in subsection A of this section.

C. The provisions of the Small Employer Health Insurance Reform Act shall not apply to a health benefit plan issued to a bona fide association health plan.

D. Each bona fide association health plan that meets the requirements of this section shall be considered a large group for purposes of application of the Oklahoma Insurance Code.

E. A bona fide association health plan shall be subject to the following requirements:

1. The bona fide association health plan shall be delivered or issued for delivery to a bona fide association in a form that meets the requirements of Section 4502 of Title 36 of the Oklahoma Statutes;

2. The bona fide association health plan shall comply with any federal nondiscrimination requirement applicable to the association health plan;

3. Small employer groups that have two (2) or more eligible employees and that are members of the association may not be excluded from the association health plan;

4.a.Except as provided in subparagraph b of this paragraph, the association health plan shall maintain an eighty percent (80%) retention rate.

• b.The eighty percent (80%) retention rate specified in subparagraph a of this paragraph shall not include employer groups or working owners that:
• (1)go out of business, whether through merger, acquisition or any other reason,
• (2)no longer meet eligibility requirements for membership in the association,
• (3)no longer meet participation requirements for employers that are set forth in the plan documents, or
• (4)fail to pay premiums.
• c.A bona fide association health plan that fails to maintain the eighty percent (80%) retention rate during any year may have twelve (12) months to correct the retention level before being required to become subject to the requirements of the Small Employer Health Insurance Reform Act.
• d.A bona fide association health plan may not require a contract under this subsection between the bona fide association health plan and the member to be effective for a period of longer than two (2) years. This provision shall not be construed to prevent a contract from being extended for additional two-year periods or preventing the member from voluntarily electing a contract period of longer than two (2) years; and

5. Each bona fide association health plan shall be available to be marketed and sold by all licensed agents and brokers of the health carrier, at the health carrier's standard commission and/or fee schedule for the calendar year.

Added by Laws 2019, c. 265, § 3, eff. Nov. 1, 2019.

Download our app to see the most-to-date content.