BULLETIN NO. 2-2023

To: Oklahoma Licensed Producers, Oklahoma Licensed Health Insurers and HMOs and Other Interested Parties
Re: Special Enrollment Period for Medicare Supplement Policies – OAC 365: 10-5-129.2
From: Glen Mulready, Insurance Commissioner
Date: March 30, 2023

 

Beginning April 1, 2023, and throughout the remainder of 2023, the disenrollment of certain individuals that have been continuously enrolled in SoonerCare (Oklahoma Medicaid program) and no longer meeting eligibility requirements, will take place by the Oklahoma Health Care Authority (OHCA).  The re-determination process, required by the Consolidated Appropriations Act of 2023, will include individuals that became eligible for Medicare coverage during the continuous enrollment period and did not enroll in Medicare coverage or were automatically enrolled in Medicare by the Social Security Administration.

A Special Enrollment Period (SEP) permitting qualified individuals to apply and enroll in a Medicare Supplement policy without underwriting considerations by the issuer will be permitted under Oklahoma Administrative Code 365:10-5-129.2, as follows:

365:10-5-129.2 Special enrollment period for Medicare supplement policies

  • An issuer of Medicare supplement policies in this State shall issue any Medicare supplement policy the carrier sells in this State to an individual eligible for Medicare if the individual:
  • Is enrolled in SoonerCare (Oklahoma Medicaid) and remained enrolled in SoonerCare due to a suspension of terminations by the Oklahoma Health Care Authority during the COVID-19 Public Health Emergency.
  • Enrolled in Medicare Parts A and B within six (6) months of the later date of termination or disenrollment of SoonerCare benefits (or, if a notice is not received, notice that a claim has been denied because of such a termination of disenrollment); or the date that the SoonerCare benefits terminate or cease;
  • Applies for Medicare supplement policy during the 63-day period following the date of enrollment in Medicare Part B;
  • Submits evidence of the date of termination or disenrollment from SoonerCare with the application for a Medicare supplement policy.
  • With respect to applicants of a Medicare supplement policy under section (a), the issuer shall not deny or condition the issuance or effectiveness of a Medicare supplement policy that is offered and available for sale in this State, nor discriminate in the pricing of such a Medicare supplement policy, because of health status, claims experience, receipt of health care, or medical condition and shall not impose any exclusion of benefits based on a preexisting condition under such a Medicare supplement policy.

Regulated entities can direct inquiries regarding this bulletin to Kim Hunter at kim.hunter@oid.ok.gov.