Oklahoma § 36-6530 - Bona fide association health plans

§ 36-6530. 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:

Oklahoma Statutes - Title 36. Insurance

(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.