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STATE OF OKLAHOMA

1st Session of the 53rd Legislature (2011)34

56

7

8

SENATE BILL NO. By: Myers and Jolley of theSenateand

Sears and Martin (Scott) ofthe House

AS INTRODUCED9

1011121314

1516171819

An Act relating to health insurance access; amendingSections 2 and 3, Chapter 128, O.S.L. 2009 (36 O.S.Supp. 2010, Sections 4602 and 4603), which relate toHealth Care for Oklahomans Act; eliminating theHealth Care for the Uninsured Board; authorizing theestablishment and operation of the Health InsurancePrivate Enterprise Network; defining terms;establishing the Network as a state-beneficiarypublic trust; providing for a Board of Directors;requiring the appointment of an Executive Director;specifying membership; requiring the InsuranceCommissioner to serve as chair; specifying fundingsources for the Network; specifying purposes of theNetwork; prohibiting the Network from taking certainactions; modifying duties of the Network Board;requiring certain information to remain confidential;authorizing the Board to promulgate rules; clarifyingpurpose of certain program; requiring legislativereview and renewal; and providing an effective date.

20 I BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:21 SECTION 1. AMENDATORY Section 2, Chapter 128, O.S.L.22 I 2009 (36 O.S. Supp. 2010, Section 4602), is amended to read as23 I follows:24

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l I Section 4602. A. 'Tnr Tnn~lr;Tnrr C'nmminninnr.r in rnll"nnr;1tinn2 ',liththe OJclo.homo.IIeo.lth Co.re l\uthority oho.ll o.d~Jioe o.nd o.id the3 PO',ltn (',rO'fnr tn(' TTninnllY('c]Bn

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1 3. "Insurance producer" has the same meaning as defined In2 I Section 1435.2 of Title 36 of the Oklahoma Statutes;3 4. "Network" means the Health Insurance Private Enterprise4 I Network; and5 5. "Network Board" means the Health Insurance Private6 I Enterprise Network Board.7 I C. The Health Insurance Private Enterprise Network shall be8 I established as a state-beneficiary public trust.

9 I D. The Network shall be governed by a board of directors. The10 I Network Board shall consist of seven (7) members as follows:11 I 1. One member appointed by the Governor representing health12 I insurance carriers granted a certificate of authority by the13 I Oklahoma Department of Insurance;14 I 2. One member appointed by the Speaker of the House of15 I Representatives representing consumers and who has purchased16 I policies through the Network or is reasonably expected to purchase17 I policies through the Network;18 I 3. One member appointed by the Governor who shall be a health19 I care provider;20 I 4. One member appointed by the Governor who shall be a21 I representative of employer groups;22 I 5. One member appointed by the President Pro Tempore of the23 I Senate who shall be an insurance agent or broker;24 I 6. The Insurance Commissioner; and

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1 I 7. The Secretary of Health and Human Services.2 I E. The Insurance Commissioner shall serve as chair of the

3 I Network Board. The Network Board shall appoint an Executive4 I Director.5 F. In order to avoid the establishment of a federal exchange,6 I the Network shall have the minimum authority under state law that is7 I necessary to implement its purposes. Funding for the Network shall8 I come from state and private sources.

9 I G. The purpose of the Network shall be to:10 I 1. Increase choice and competition in the health insurance11 I market of Oklahoma;12 2. Provide more choices and options in the health insurance13 I market for employees in the state;1415

3.4.

Promote and encourage portability of coverage;Promote a competitive, patient-centered, market based health

16 I insurance system that includes a defined-contribution health17 I insurance alternative fOr employer-sponsored coverage which includes18 I an aggregate premium system;19 I 5. Encourage health insurance carriers to collaborate with20 I medical providers to offer health insurance coverage that provides21 I consumers quality care delivered in the most cost-effective manner;22 I and23 I 6. Establish a fair and impartial health insurance producer24 I referral network for the purpose of assisting individual and

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1 I qualified small employers in obtaining health insurance coverage2 Ithrough the Network.3 I H. The Network shall not:4 I 1. Exercise regulatory authority over any entity;5 I 2. Discriminate against any qualified health insurance carrier6 Iwilling to participate in the Network; or7 I 3. Supplant any marketplace outside the Network.SIT. The Commiooioner Network Board shall:

9 I 1. Establish a system of certification for insurance programs10 I offered in this state to be recommended offered by the IIUB the11 INetwork; and12 I 2. Establish a system for the credentialing of licensed13 Iinsurance producers who intend to market insurance programs14 Icertified by the state in accordance with this section.15 3. Eotab1ioh a oyoteffiof couno cling including a ~eboite for16 thooe indi~v~idualo.;ho arc -.lithouthealth inouranee and are not17 r'0"~ r1 t-n:>t- ~nr111r1rn 'l-,nt- ~ n nnt- 1 ~m; t-rr1 t-n1819202122

a.

b.

e.

educating conoumero about inourance programo certifiedby the otate in accordance ~ith thio oection,aiding conoumero in choooing policieo that covermedically neceooary oerviceo for that conoumer, andr"'r111r"t-~Tlrr rnTlnllmr"'"Y'n nTl nn-- t-n llt-~1~7r"' nl~~m"r~' "Tlr1

23 preventative care in order to reduce the unneceooary24 llt- ~1 ~ "":>+-~nTl nr ,....r"'r,~i rrn 1;'" t-nr ~nTlnllmr"Y" :lTlr1

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, lifico for 0'eBal Ejuodl"lf on In v"fl"reby 1 , "' h a ayotem - .. , hed in 00.,0Bat~b 10 eat~b12GI , l""egr~m,toncc

rcmium 0.0320 . , able toidy under the P tbo.t Dereon 10au a Sto.tutco,f the Oklahomo. ; n';"l i fi reTitle 56 0 .. 1> loon., .1010.1 0 , rnn;;md;on ..;h tncc HUB 1n .11 rei tnrn.Ja .hrrnmr rDr

5 inouroncc produccro.6 J. All personal information generated through the purchase of7 I any policy purchased through the Network shall remain confidential8 I between the insurer and the insured.9 I K. The Network Board shall promulgate rules as necessary to

10 I implement the purposes of this act and to help individuals11 I facilitate the selection of health insurance coverage and to allow12 I health insurance carriers to provide market based health lnsurance13 I products without unnecessary regulation and burdens.14 SECTION 2. AMENDATORY Section 3, Chapter 128, O.S.L:15 12009 (36 O.S. Supp. 2010, Section 4603), is amended to read as16 I follows:17 Section 4603. A. The Insurance Commissioner in collaboration18 with the Oklahoma Health Care Authority shall initiate a program to19 I encourage enrollment of individuals, not covered by insurance or20 I enrolled in Medicaid in hcolth inouroncc proqromG.21 I B. Upon treatment of an uninsured individual or an individual22 I not covcrcd by enrolled in Medicaid{ a health care provider shall23 I refer the individual to the HUB Network established in Section ~24 I 4602 of this ~ title to begin the enrollment process in a

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1 I certified insurance plan or the premium assistance program2 I established in Section 1010.1 of Title 56 of the Oklahoma Statutes,3 I if eligible.4 I SECTION 3. The provisions of this act shall be subject to5 I legislative review and renewal no later than May 25, 2014.6 I SECTION 4. This act shall become effective November I, 2011.7

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