# OK Bulletin LH 2021-05: Bulletin No. LH 2021-05: Special Notice 36 O.S. 1250.5

> Oklahoma · Agency guidance · In force

URL: https://www.frixlaw.com/law-library/statutes/OK_INS_B_LH_2021-05

## Section

- **Citation:** OK Bulletin LH 2021-05
- **Heading:** Bulletin No. LH 2021-05: Special Notice 36 O.S. 1250.5
- **Jurisdiction:** Oklahoma
- **Kind:** Agency guidance
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Oklahoma Insurance Department Bulletins / Bulletin No. LH 2021-05: Special Notice 36 O.S. 1250.5

## Text

BULLETIN NO. LH 2021-05

To:
All Health Insurance Companies, Health Maintenance Organizations, PBMs

and Other Interested Parties

Re:
Special Notice Regarding 36 O.S. 1250.5 (18)

From: Glen Mulready, Commissioner

Date: October 29, 2021

The Oklahoma Insurance Department (“Department”) is releasing this Bulletin with the
purpose of providing information to health insurance issuers regarding HB 2678, a bill enacted
during the 2021 Regular Session of the Oklahoma Legislature, amending 36 O.S. § 1250.5
with the effective date of November 1, 2021.

Section 1(18) of HB 2678 (to be codified as 36 O.S. § 1250.5(18)) considers the following to
be an unfair claim settlement practice:

As a health insurer that provides pharmacy benefits or a pharmacy benefits manager
that administers pharmacy benefits for a health plan, failing to include any amount paid
by an enrollee or on behalf of an enrollee by another person when calculating the
enrollee’s total contribution to an out-of-pocket maximum, deductible, copayment,
coinsurance or other cost sharing arrangement.

Health plan issuers must take notice that when an enrollee’s health plan is a high deductible
health plan (“HDHP”) connected to a health savings account (“HSA”), counting third-party
payments, such as discounts, vouchers, financial assistance, or other out-of-pocket reduction
payments, toward enrollee out-of-pocket expenses will make that enrollee’s contribution
ineligible toward their HSA pursuant to 26 U.S.C. § 223.

Beginning November 1, 2021, all existing health plans under an HDHP and associated HSA
arrangement or upon issue or renewal of such a health plan must be administrated in
compliance with HB 2678 (to be codified as 36 O.S. § 1250.5(18)). The Department is actively
engaging with the Legislature to seek clarification regarding the conflict between the state
statute and federal requirements governing HSA eligibility
1, 2021, all existing health plans under an HDHP and associated HSA
arrangement or upon issue or renewal of such a health plan must be administrated in
compliance with HB 2678 (to be codified as 36 O.S. § 1250.5(18)). The Department is actively
engaging with the Legislature to seek clarification regarding the conflict between the state
statute and federal requirements governing HSA eligibility. In the interim, the administration
of pharmacy claims must be in compliance with state law, which will require the issuer to
combine all payments made toward a prescription when calculating the enrollee’s total
contribution. The issuer must also comply with federal law, which prohibits any contribution
from an HSA from being combined with any third-party payment with exceptions for
contributions made toward preventative care and cost-sharing occurring after the deductible is
reached.

If payments made from an HSA are deemed ineligible, the tax benefits provided by the HSA
could be lost for that payment and potentially create a serious tax event for the enrollee. The
Department strongly encourages health plan issuers to promptly contact members enrolled in
an HDHP with an associated HSA and clearly communicate the effects of applying funds from
third parties and their HSA when making payments for prescriptions.

Questions concerning this bulletin should be directed to Kim Bailey, General Counsel, at
kim.bailey@oid.ok.gov
or
Molly
Clinkscales,
Assistant
General
Counsel
at
molly.clinkscales@oid.ok.gov.

## Nearby sections

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- [OK Bulletin 2015-03 Bulletin No. 2015-03: (OK-MAP) Annual Assessment](https://www.frixlaw.com/law-library/statutes/OK_INS_B_2015-03.md)
- [OK Bulletin 2017-01 Bulletin No. 2017-01 Pharmacy Benefit Managers Re: Surety Bond](https://www.frixlaw.com/law-library/statutes/OK_INS_B_2017-01.md)
- [OK Bulletin 2019-01 Bulletin No. 2019-1: Federal Government Shutdown](https://www.frixlaw.com/law-library/statutes/OK_INS_B_2019-01.md)
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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/OK_INS_B_LH_2021-05. Check the current official text before relying on it. Not legal advice.
