Doak Disappointed by Denial of Obamacare Waiver Request

OKLAHOMA CITY –Oklahoma Insurance Commissioner John D. Doak expressed grave disappointment Wednesday that Oklahoma’s request for a waiver on Medical Loss Ratio requirements from the U.S. Department of Health and Human Services was rejected. 

Announcement of the rejection came yesterday from Washington. 

“This decision could lead to a massive disruption of our insurance markets in Oklahoma,” Doak said in response.

The Medical Loss Ratio (MLR) in essence is a calculation of what percentage of each policyholder dollar is spent on delivering benefits or improving care, versus how much is spent on administration and profits. The Patient Protection and Affordable Care Act (PPACA) has set an 80 percent minimum MLR for companies doing business in the individual and small-group health insurance markets; an 85 percent MLR for large-group plans.

Oklahoma Insurance Department in September sought a gradual phase-in of the 80 percent ratio in the individual market only, rather than immediate and strict enforcement of those targets by the Department of Health and Human Services (HHS). No changes were requested by Oklahoma for the small-group and large-group markets.

Noting the disproportionate and potentially damaging effect of the high MLR on certain smaller companies and the possible impact in particular on Oklahoma’s rural communities, Doak requested that insurers be required to meet a 65 percent MLR for 2011, 70 percent in 2012 and 75 percent in 2013, with full compliance with the 80-percent standard for individual policies by the time the bulk of PPACA’s provisions are fully in force in 2014.

“We asked for a decision that would first and foremost do no harm to the current markets,” said Mike Rhoads, Deputy Commissioner of Life and Health Insurance at OID. “We wanted to keep coverage available, to keep all carriers large and small in our individual market.” 

Meeting MLR requirements should be easier for much larger carriers, which can spread the cost of administration over a vast base of policyholders. 

Conversely, Doak believes certain smaller companies might be forced to comply with PPACA’s MLR provisions by reductions in force that destroy Oklahoma jobs, meanwhile limiting consumers’ access to the counsel of licensed agents and decreasing the availability of customer service to policyholders. Some small companies might decide to leave the Oklahoma market altogether, surrendering progressively larger segments of the market to one or two major carriers and reducing consumer choice. 

New Rule Restores Health Insurance Market for Children

Oklahoma City – Oklahoma Gov. Mary Fallin on Monday gave her approval to an emergency rule intended to close an insurance gap created by federal health care reform.

For some 18 months, “child-only” policies for ages 19 and under have not been sold by any insurance company doing business in Oklahoma, a response by insurers to new federal regulations in the Patient Protection and Affordable Care Act. Insurance Commissioner John D. Doak said yesterday that Gov. Fallin’s signature should revive that market for the vast majority of uncovered children.

The revised emergency rule permits carriers to determine the age range in which they intend to offer coverage to all applicants during defined enrollment periods. Deputy Commissioner of Health and Life Insurance Mike Rhoads said insurers are expected to resume selling child-only policies for applicants ages 1 to 19.

A special enrollment period for coverage will take place in January and February 2012.

“I applaud Gov. Fallin’s decision to provide coverage options to as many Oklahoma children as possible,” Doak said. “I look forward to health insurers re-entering the Oklahoma child-only market during the new year.”

Doak noted that coverage has always remained available for children of all ages as part of family insurance plans, and that disadvantaged Oklahoma children were still covered by programs like SoonerCare. Child-only insurance is purchased by parents or guardians whose incomes don’t qualify for government programs and who cannot or choose not to buy private coverage for the whole family.

“For 18 months this specific type of coverage has been completely unavailable due to federal interference in the insurance market,” said Doak.

Recent tremors should prompt policy review

Oklahoma City– Over the past few days, minor earthquakes have rattled Oklahoma homes and businesses. At least seven tremors have been reported in Oklahoma during the month of October alone. Yet there are cracks in the insurance policies of many Oklahomans.


Most property insurance policies exclude damage caused by earthquakes. Oklahoma Insurance Commissioner John D. Doak said Friday that now is a good time for policyholders to speak with their agents – and for agents to be fully prepared to inform their policyholders – about the subject of earthquake insurance.

After tremors occur a waiting period normally exists before coverage can be added to a homeowners or commercial property insurance policy, but immediately in the wake of a quake is a good time for consumers and insurers to discuss all options. Policyholders should inventory their belongings and speak with their agent to be sure their existing coverage is sufficient. For clients who already have or who do purchase earthquake coverage, agents should be sure the consumer is aware that normally the policy has a separate and often substantial deductible.


“Earthquakes can strike at any time and without warning,” Commissioner Doak said Friday. “But in Oklahoma, we’ve been getting clues for some time now that a damaging event could be in our future. There is no time like the present to consider that future, and the policyholder’s potential need for earthquake coverage.”


Commissioner Doak referred Oklahomans wanting more information about this type of coverage to the National Association of Insurance Commissioners’ “Consumer’s Guide to Earthquake Insurance.”

Understanding Faith-Based Options for Health Care

By John D. Doak, Oklahoma Insurance Commissioner

With health care costs escalating and the federal government grasping for control of everything from the purse strings to your choice of doctors, specialists and treatments, many Oklahomans are searching for innovative, individualized ways to achieve wellness. Among those options are faith-based health-care “sharing ministries.”

Often invoking Scripture such as Galations 6:2 – “Carry each other’s burdens, and in this way you will fulfill the laws of Christ” – these organizations in effect are nonprofit cooperatives. An estimated 100,000 people nationwide have joined such bill-sharing groups, which act as an organizational clearinghouse for information between participants who have financial, physical or medical needs and participants who presently have the ability to pay for the benefits of those who have needs. Members deposit monthly fees into an account and managers of the organization distribute the funds to pay bills incurred by individual members.

Many members of these organizations say they also receive spiritual support from their health-care sharing ministry, beyond the financial impact of the group.

An added benefit for those who join these health-care sharing ministries is that their participation makes them no longer subject to Washington’s individual mandate to purchase insurance, which eventually will be enforced as part of President Barack Obama’s Patient Protection and Affordable Care Act provided the federal law is not overturned in the courts. Section 1501(b) of the PPACA adds Section 5000A to the Internal Revenue Code, exempting members of a health-care sharing ministry from being required to purchase private insurance.

As a man of great faith, an opponent of PPACA, and an advocate of free-market solutions to insurance issues, I support health-care sharing ministries as an option for Oklahoma consumers.

But I must also make it clear that the Oklahoma Insurance Department by law cannot provide consumer protections to those who choose to participate in health-care sharing ministries.

Some history on the subject might illustrate that point.

Under the previous administration, the Oklahoma Insurance Department found that a health-care sharing ministry known as Medi-Share was actually operating in this state as an insurance company without license to do so.

In 2008, Medi-Share was enjoined by OID from acting as an insurer in the state of Oklahoma. That same year, the Oklahoma Legislature amended the requirements of the state Insurance Code 36 O.S. § 110(11) to provide that the Insurance Department did not have regulatory powers over health-care sharing ministries. Meanwhile, Medi-Share modified its operations so that it facilitated direct member-to-member sharing of health care expenses, making its operating model compliant with the revised Oklahoma law. In 2009, Medi-Share resumed operations in Oklahoma as a health-care sharing ministry.

What this means in layman’s terms is that  while faith-based sharing organizations might be an option to make health care more affordable and to keep the federal government out of your family’s health care choices, you cannot bring consumer complaints to me as your Insurance Commissioner or to the Oklahoma Insurance Department for resolution. You will have to settle any potential dispute with your health-care sharing ministry on your own.

Consider this as you weigh the decision to join a health-care sharing ministry.

For more information on this topic or about any form of insurance in Oklahoma, don’t hesitate to contact the Oklahoma Insurance Department’s Consumer Assistance Hotline at (800) 522-0071. You can also visit us online at oid.ok.gov.

Insurance Commissioner supports health care compact

CapitolBeatOK Staff Report (Published 17-Mar-2011)

Oklahoma Insurance Commissioner John Doak praised members of the state Senate Thursday (March 17) who approved Senate Bill 722, a measure that would establish the provisions for Oklahoma to join an interstate health care compact to empower state legislatures, rather than the federal government, to continue dealing with health care issues.

“I have always opposed the federal takeover of our health care system that was approved by the previously Democratically-controlled Congress and signed by President Barrack Obama,” said Doak. “Senate Bill 722 is another way Oklahoma can reassert its control of what truly is a state issue. I am glad to see that the Senate approved the measure and I urge members of the House to approve it as well.”

Senate Bill 722, by Senator Clark Jolley, an Edmond Republican, and Representative Glen Mulready, a Tulsa Republican, establishes the provisions necessary for Oklahoma to join an interstate health care compact that reaffirms the authority of the participating state legislatures to deal with health care issues. The bill would allow each compact member to enact its own health care laws and share information with other states in the compact.

The bill won Senate approval Tuesday and now goes to the House for consideration.

“The health care compact contained in SB 722 does not conflict with the efforts of Oklahoma Attorney General Scott Pruitt and other state attorneys general, state legislators and members of Congress to repeal or modify the Obama health care bill. I believe it supports those efforts by allowing Oklahoma and other states to reaffirm their authority to address health care issues,” Doak said.

The bill also does not interfere with the acceptance of federal monies for health care, Doak noted.

Gov. Fallin, Commissioner Doak Support Free-Market Based Health Insurance Exchange

Governor Mary Fallin and Insurance Commissioner John Doak today sent the following letter to State Representatives in support of House Bill 2130:

To: Oklahoma State Representatives
From: Governor Mary Fallin and Insurance Commissioner John Doak

Dear Representative,

Gov. Mary Fallin

We would like to make you aware of the extraordinary opportunity Oklahoma has to be a national leader in designing and implementing a conservative, free-market based health insurance exchange.

As you know, the idea of an Oklahoma Health Insurance Exchange is not a new one. In 2009, the legislature passed a bill that authorized the creation of a health insurance exchange portal where consumers could compare and research various private health insurance plans in one online location.

As mentioned in the State of the State address, our goal is to create an insurance exchange where small businesses and individuals can pool their money to expand their purchasing power, increase competition and ultimately reduce costs. Our vision is to protect consumers and guarantee the role of licensed agents and brokers. Therefore, we are asking for your support for HB 2130, which establishes a governance structure for an Oklahoma Exchange.

We believe the creation of this Oklahoma Health Insurance Exchange represents a great opportunity for our state to develop a national model for providing citizens with quality private health insurance. I also believe it represents an important opportunity for conservative policymakers to offer a positive agenda for Oklahoma families.

Insurance Comm. John Doak

The Commissioner and I strongly oppose ObamaCare and will continue to work to have it overturned. We are proud to stand with General Scott Pruitt and his efforts to have this law ruled unconstitutional. This is now our opportunity to stand up for our 10th amendment rights and create an Oklahoma based free-market exchange.

An Oklahoma Health Insurance Exchange would be an online marketplace where costs are reduced, where insurance products could be bought and sold to meet individual needs and where all insurers could compete to promote real choices for consumers. This is the exchange that my administration, the Insurance Commissioner, the Speaker, the Pro Tem, and others are dedicated to creating. We look forward to working with all stakeholders on the legislation to ensure everyone is represented appropriately. We hope you are as excited by this opportunity as we are.