§36-6530. Bona fide association health plans.
509 words·~2 min read·
/ok/title-36-insurance/36-6530·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
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:
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.