{"data":{"id":"us-ok/okla.-stat.-tit.-36-36-6530.5","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 36, § 36-6530.5","heading":"Board of Directors – Duties – Sunset of Program","body":"A. The Board of Directors of the Oklahoma Individual Health\n\nInsurance Market Stabilization Program shall:\n\n1. Develop, implement and administer the Program.\n\nImplementation of the Program shall be contingent upon Oklahoma's\n\napproval for and receipt of federal funds to implement and sustain\n\nthe Program;\n\n2. Apply for and utilize federal funding for the reinsurance\n\nprogram, as provided in subsection C of this section;\n\n3. Make payments to provide for the market stabilization\n\nactivities authorized by this act and for administrative expenses\n\nincurred or estimated to be incurred during the period for which\n\nassessment is made;\n\n4. Establish administrative and accounting processes and\n\nprocedures for the operation of the Program and create operating\n\nrules to effectuate the provisions of this act including but not\n\nlimited to:\n\na. determine eligibility of individuals to receive\n\ncoverage under the Program,\n\nb. establish standards for qualification based upon\n\nhealth status, health conditions, prior or current\n\ninsurance coverage status, health costs as a result of\n\nutilization of consuming health care,\n\nc. establish the dollar amount of claims for eligible\n\nindividuals after which the Program will provide\n\npayments to health insurance plans and the proportion\n\nof such claims above such dollar amount that the\n\nProgram will pay,\n\nd. establish the rate at which the Program will reimburse\n\na health insurance plan for claims incurred for an\n\nenrolled individual's claims, above the attachment\n\npoint and below the reinsurance cap,\n\ne. determine the threshold amount for claims costs\n\nincurred by a health insurance plan for an enrolled\n\nindividual's claims, after which the claims costs for\n\nbenefits are no longer eligible for reinsurance\n\npayments, and\n\nf. determine the diagnosed health condition of an\n\neligible individual for which the Program will provide\n\npayments to health insurance plans for claims incurred\n\nafter such diagnosis is made; and\n\n5. Apply for, accept and receive federal funding for the\n\noperation of the Program, including the following:\n\na. approval of a waiver provided by Section 1332 of the\n\nPatient Protection and Affordable Care Act, \"1332\n\nState Innovation Waiver\", authorizing federal funding\n\nto support market stabilization program payments,\n\nb. Oklahoma's participation in any federal grant program\n\nor programs, or\n\nc. any combination of the above approaches.\n\nB. In the event Oklahoma is unable to secure federal approval\n\nof a 1332 State Innovation Waiver or secure funding from federal\n\ngrant programs within two (2) years from the effective date of this\n\nact, the Oklahoma Individual Health Insurance Market Stabilization\n\nProgram shall sunset, and any remaining monies shall be returned to\n\ninsurers on a pro rata basis based on the amount each insurer has\n\npaid in assessments since the creation of the Program.\n\nC. To the extent that federal funds become available under\n\nfederal law, regulation or executive action, the Board may:\n\n1. Apply for the funds; and\n\n2. Use the funds to establish and administer a reinsurance\n\nprogram for the purposes of the Oklahoma Individual Health Insurance\n\nMarket Stabilization Act.\n\nD. The Board shall not have the authority to assess insurers,\n\nemployers, policies or plans or any other entity to fund the\n\nprogram. The Board may accept funding from other sources for the\n\npurpose of the Oklahoma Individual Health Insurance Market\n\nStabilization Act.","path":["OK Code","Title 36"],"source_url":"https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os36.pdf","current_through":"2026-08-14","vintage":"open-us-law v2026.08, retrieved 2026-09-14","retrieved_at":"2026-09-14T18:32:36Z","sha256":"07af9eef3836c413185ee7343b8e455720ab68edf573615d177e9288976927ba","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-36-36-6530.4","next":"us-ok/okla.-stat.-tit.-36-36-6530.6"},"notice":"GroundRules: Original legal text. Not legal advice."}