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STATE OF OKLAHOMA
1st Session of the 59th Legislature (2023)
SENATE BILL 548 By: Montgomery
AS INTRODUCED
An Act relating to prepaid vision plans; creating the
Prepaid Vision Plan Act; providing short title;
defining terms; requiring cer tificate of authority
for certain plan providers be obtained by certain
date; establishing application procedures; requiring
certain accompaniments with application; establishing
provisions for approval of application; establishing
expiration date of certifi cate of authority;
establishing provisions for renewal of certificate of
authority; requiring certain prepaid vision plan
organizations respond to Insurance Commissioner by
certain date; requiring certain plan organizations to
maintain certain tangible net equity; requiring plan
organizations with certain expenses to maintain
certain tangible net equity or deposit; establishing
provisions for exemption to certain deposit
requirements; requiri ng certain plan organizations to
maintain certain financial reserv e; establishing
provisions for membership coverage policies;
requiring approval by Commissioner of certain policy;
requiring certain report be submitted to Commissioner
by certain date in ce rtain manner; establishing
components of report; requiring certain tax be paid
to the State Treasurer; allowing for offset of
certain tax with state corporate income tax;
providing for suspension or revocation of certain
certificate of authority subject to certain
conditions; requiring certain restrictions be imposed
on certain suspensions and revocations; providing for
certain fine to be imposed; providing for hearing for
certain plan organizations; establishing requirements
for certain advertising and sal es material; requiring
submission of material to Commissioner; establishing
approval requirements; prohibiting disapproved
materials from certain use; providing certain
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exceptions; requiring certain statutory obligations
apply to plan organizations; allow ing Commissioner to
conduct certain examinations; directing promulg ation
of rules; providing for codification; and providing
an effective date.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. NEW LAW A ne w section of law to be codified
in the Oklahoma Statutes as Secti on 6104 of Title 36, unless there
is created a duplication in numb ering, reads as follows:
This act shall be known and may be cited as the “Prepaid Vision
Plan Act”.
SECTION 2. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 6105 of Title 36, unless there
is created a duplication in numb ering, reads as follows:
As used in this act:
1. “Covered expense” means costs incurred by a provider who has
agreed in writing not to bill members, except for permissible
supplemental charges;
2. “Member” means an individual who is enrolled in an
individual or group prepaid vision plan as a principal subscriber
and any dependents entitled to vision care services under the plan
solely because of their statu s as a dependent of the principal
subscriber;
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3. “Membership coverage” means any certificate or contract
issued to a member specifying the vision coverage to which the
member is entitled;
4. “Net equity” means the excess of total assets over total
liabilities, excluding liabilities whi ch have been subordinated in a
manner acceptable to the Insurance Commissioner;
5. “Prepaid vision plan” means any contractual agreement
whereby any prepaid vision plan organization undertakes to provide
payment of vision services directly, to arrange for prepaid vision
services, or to pay or make reimbursement for any vision service not
provided for by other insura nce;
6. “Prepaid vision plan organization” means any person who, or
organization or entity that, undertakes to conduct one or more
prepaid vision plans providing only vision services ;
7. “Prepaid vision services” means services included in the
practice of optometry in all of its branches as defined pursuant to
Section 581 of Title 59 of the Oklahoma Statutes;
8. “Provider” means any person licens ed or otherwise authoriz ed
to furnish prepaid vision services in this state o ther than an
authorized insurer;
9. “Tangible net equity” means net equity reduced by the value
assigned to intangible assets including, but not limite d to,
goodwill, going concern value, organizational exp enses, start-up
costs, long-term prepayments of deferred c harges, nonreturnable
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deposits, and obligations of officers, directors, owners, or
affiliates, except short-term obligations of af filiates for goods or
services arising in the normal course of business that are payable
on the same term as equivalent transactions with nonaffilia tes and
that are not past due ; and
10. “Uncovered expense” means the cost of health care services
that are the obligation of a prepaid vision plan organization for
which:
a. a member may be liable in the e vent of the insolvenc y
of the organization, and
b. alternative arrangements acceptable to the
Commissioner have not been mad e to cover the costs.
SECTION 3. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 6106 of Title 36, unless there
is created a duplication in numb ering, reads as follows:
A. No person, organization, or entity, unless authorized
pursuant to an approved application under Section 5 of this act
shall establish or operate a prepaid vision plan organization in
this state or sell, offer to sell, solicit offers to purchase, or
receive advance or periodi c consideration in conjunction with a
prepaid vision plan without obtaining and maintaining a certificate
of authority.
B. On or before February 1, 2024, every prepaid vision plan
organization operating in this state shall submit an application for
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a certificate of authority to the Insurance Commissioner . Each
applicant may continue to operate as an organization until the
Commissioner acts upon the application.
SECTION 4. NEW LAW A new section of l aw to be codified
in the Oklahoma Statutes as Section 6107 of Title 36, unless there
is created a duplication in numb ering, reads as follows:
A. An application for a certificate of authority to operate as
a prepaid vision plan organization shall be filed with the Insurance
Commissioner in the form and manner prescribed by the Commissioner.
The application shall be verified by an officer or authorized
representative of the applicant and shall set forth or be
accompanied by:
1. A copy of any basic organizational document of the applicant
such as the articles of incorporation, arti cles of association,
partnership agreement, trust agreement, or other applicable
documents, with all amendments to the documents;
2. A copy of any bylaws, rules, regulations, or similar
documents regulating the conduct of the internal affairs of the
applicant;
3. A list of the names, addresses, and official positions of
the persons who are responsible for the conduct of the busines s
affairs of the applicant, in cluding all members of the board of
directors, board of truste es, executive committee, or other
governing board or committee, and the principal officers , in the
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case of a corporation, or the partners or members in the case of a
partnership or association ;
4. A copy of any contract made or to be made between any
providers of vision services or persons listed in parag raph 3 of
this subsection and the applicant;
5. A statement generally describing the prepaid vision plan
organization, the facilities, personnel of the organization, and all
prepaid vision plans offered b y the organization;
6. A copy of the form of indiv idual or group membership
coverage or a copy of the contract to be issued to t he members;
7. Financial stateme nts showing assets, liabiliti es, and
sources of financial support of the applicant. I f the financial
affairs of the applicant are audited by ind ependent certified public
accountants, a copy of the most recent regular certi fied financial
statement for the applicant shall satisfy the requirement of this
paragraph, unless the Commissioner determines that additional or
more recent financial informatio n is required;
8. A description of the proposed me thod of marketing the
prepaid vision plan, a financial prospectus which includes a three -
year projection of the initial operating results anti cipated, and a
statement as to the s ources of working capital available for the
operation of the prepaid vision plan a nd any other source of
funding;
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9. A power of attorne y, duly executed by the applicant if not
domiciled in this state , appointing the Commissione r as the true and
lawful representative for service of process for the applicant in
this state upon whom all lawful process in any legal action or
proceeding against the prepaid vision plan organization on a cause
of action arising in this state may be serv ed;
10. A fee of One Hundred Dollars ($100.00 ) for issuance of a
certificate of authority; and
11. Any other information as the Commissioner may require .
B. Within ten (10) days following any modification for
information previously furnished as required by subsection A of this
section, a prepaid vision pla n organization shall file a notice of
the modification with the Commissione r.
SECTION 5. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 6108 of Title 36, unless there
is created a duplicatio n in numbering, reads as follows:
A. Issuance of a certificate of a uthority for a prepaid vision
plan organization shall be granted by the Insurance Commissioner if
the Commissioner is satisfied that the following conditions are met:
1. The persons, organization, or entity responsible f or
conducting the business affairs of the prepaid vision plan
organization are competent, trustworthy, and are professionally
capable of providing or arranging for the pro vision of services
offered;
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2. The prepaid vision plan organization constitutes an
appropriate mechanism to achieve an effective prepaid vision plan ;
3. Each officer responsible for conducting the business affairs
of the prepaid vision plan organization has filed with the
Commissioner a fidelity bond in the amount of Fifty Thousand Doll ars
($50,000.00); provided, the bond is subject to the approval of the
Commissioner;
4. The financial struc ture of the prepaid vision plan
organization may reasonabl y be expected to meet obligations for
payment of services for members and prospective members. In making
this determination, the Commissioner may con sider:
a. the financial soundness of the arrangements made
pursuant to the provisions of the prepaid vision plan
for services and the schedule of charges used,
b. any agreement with an insurer, hospital, medical
service corporation, or any other organization for
ensuring the payment or prepaid vision services ,
c. provisions in the plan for automatic coverage of
vision service if the prepaid plan is discontinued,
and
d. the sufficiency of the agreement for prepaid vision
services with providers of vision services; and
5. The Commissioner has not made a determination that the
prepaid vision plan organization is not competent, trustworthy, or
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financially responsible, and the organization has not had any
insurance license denied for cause by any state.
B. 1. A certificate of autho rity shall expire at midnight on
June 30 following the date of issu ance or last renewal date. If th e
prepaid vision plan organization remains in compliance with the
provisions of this act and pays a renewal fee of One Hundred Dollars
($100.00), the certificate of authority may be renewed.
2. Renewal fees paid to the Commissioner pursuant to paragraph
1 of this subsection shall be deposit ed into the State Insurance
Commissioner Revolving Fund.
C. Every prepaid vision plan organiza tion, upon receipt of any
inquiry from the Insurance Commissioner, shall furnish the
Commissioner with an adequate response t o the inquiry within twenty
(20) days from the receipt of inquiry.
SECTION 6. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 6109 of Title 36, unless there
is created a duplication in num bering, reads as follows:
A. 1. Except as approved in accordance with subsection C of
this section, each prepaid vision plan organization shall at all
times have and maintain tangible net equity equal to the greater of:
a. Fifty Thousand Dollars ($50,000 .00), or
b. two percent (2%) of the organization’s annual gross
premium income, up to a maximum of the required
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capital and surplus of an accident and health
insurance policy.
2. A prepaid vision plan organization that has uncovered
expenses in excess of Fifty Thousand Dollars ($50,000.00), as
reported on the most re cent annual financial statement file d with
the Insurance Commissioner, shall maintain tangible net equity equal
to twenty-five percent (25%) of the uncovered expense in excess of
Fifty Thousand Dollars ($50,000.00) in addition to the tangible net
equity required by paragraph 1 of this subsection.
B. 1. Each prepaid vision plan organization shall deposit with
the Commissioner cash, securities, other measures deemed acceptable
by the Commissioner, or any combination thereof in an amount equal
to Twenty-Five Thousand Dollars ($25,000.00) plus tw enty-five
percent (25%) of the tangible net equity required in subsection A of
this section; provided, however, that the d eposit shall not be
required to exceed One Hundred Thousand Dollars ($100,000.00).
2. The deposit shall be an admitted asset of the prepaid vision
plan organization in the determination of tangible net equity.
3. All income from deposits shall be an asset of the prepaid
vision organization. A prepaid vision plan organization may
withdraw a deposit or any part thereof after making a substitute
deposit of an equal amount and value. Any securities shall be
approved by the Commissioner before bei ng substituted.
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4. The deposit shall be used to protect the interests of the
prepaid vision plan organizat ion’s members and to assure
continuation of vision plan services to members of a prepaid vision
plan organization that is in rehabilitation or conservation. If a
prepaid vision plan organi zation is placed in receivership or
liquidation, the deposit shall be an asset subject to the provisions
of the Rehabilitation and Liquidation Act pursuant to Section 1901
et seq. of Title 36 of the Oklahoma Statutes.
5. The Commissioner may reduce or eliminate the deposit
requirement if the prepaid vision pla n organization has made an
acceptable deposit with the state or jurisdiction of domicile for
the protection of members, wherever located, and delivers to the
Commissioner a certificate to that effect, duly authenticated by the
appropriate state official holding the deposit.
C. Upon application by a prepaid vision plan organization, the
Commissioner may waive some or all of the requirements of subsection
A of this section for any period of time the Comm issioner deems
proper upon a filing that either:
1. The prepaid vision plan organization has a net equity of at
least Five Million Dollars ($5,000 ,000.00); or
2. An entity having a net equity of at least Five Million
Dollars ($5,000,000.00) furnishes to the Commissioner a written
commitment, acceptable to the Commissioner, to provide for the
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uncovered expenses of the prepaid limited health service
organization.
SECTION 7. NEW LAW A new section of l aw to be codified
in the Oklahoma Statutes as Section 6110 of Title 36, unless there
is created a duplication in numbering, reads as follows:
A. A prepaid vision plan organization shall maintain for the
protection of members a financial reserve consisting of at lea st two
percent (2%) of all prepaid charges collected from members of the
prepaid vision plan until the reserve totals Five Hundred Thousand
Dollars ($500,000.00). This reserve shall be in additio n to the
deposit prescribed by Section 6 of this act.
B. The reserve prescribed by this se ction shall not apply with
respect to a prepaid vision plan organization which is funded by the
federal government, state, or any p olitical subdivision thereof .
SECTION 8. NEW LAW A new section of law to be codified
in the Oklahoma Statute s as Section 6111 of Title 36, unless there
is created a duplication in numb ering, reads as follows:
A. Every member of a prepaid vision plan shall be issue d a
membership coverage pol icy by the prepaid vision plan organ ization.
No policy for membership c overage or amendment to the policy shall
be issued or delivered to any person in this state until a copy of
the policy for membership coverage or amendment to the policy has
been filed with and approved by the Insurance Commissioner.
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B. A policy for membership coverage shall contain a statement
of:
1. The prepaid vision services or other benefits to which the
member is entitled un der the prepaid vision plan ;
2. Any limitations of the services or benefits to which the
member is entitled under the prepaid vision plan;
3. Information as to how services may be obtained; and
4. The obligation of the member for charges for the prepaid
vision plan.
C. Any member of a prepaid vision plan shall be free to select
any licensed vision practitioner to provide vision services and
prepayment or reimbursement determinations shall be made wi thout
regard to whether the practitioner is a participating or
nonparticipating member of the plan. The provisions of this
subsection shall be printed on t he policy for membership c overage.
D. Membership coverage shall contain no provisions or
statements which are unjust, unfair, untrue, inequitable,
misleading, deceptive, or which encourage misrepresentati on as
determined by the Commissioner.
E. The Commissioner shall approve any policy of membership
coverage if the requirements of this section are complied with and
the prepaid vision plan, in the judgment of the Commissioner, is
able to meet its financial obligations for the membership coverage.
It shall be unlawful for a prepaid vision plan organization to issue
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a policy until it is approved by the Commissioner. If the
Commissioner does not disapprove any policy within thirty (30) days
after filing, the policy shall be deemed approved. If the
Commissioner disapprove s a policy of membership coverage, the
Commissioner shall notify the prepaid vision plan organization,
specifying the reasons for disapproval. The Commissioner shall
grant a hearing on any disapproval within thirty (30) days after a
request in writing for a hearing i s received by the Commissioner
from the prepaid vision plan organization.
SECTION 9. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 6112 of Title 36, unless there
is created a duplication in numbering, reads as follows:
A. On or before March 1 of each calendar year, every prepaid
vision plan organization offering coverage in this state shall file
with the Insurance Commissioner a report of the business act ivities
of the organization for the preceding calendar year. The report
shall be signed by at least two principal officers of the
corporation and the signatures shall be notarized .
B. A report submitted un der this section shall be in the form
and manner prescribed by the Commissioner and shall include:
1. A financial statement of the organization, including a copy
of the balance sheet, receipts, and disbursements of the
organization for the subject year certified by an indepen dent
certified public accountant. The Commissioner may accept a full
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report of the most recent examination of a foreign prepaid vision
plan, certified to by the appropriate examining official of another
state;
2. Any material changes in the information required to be
provided pursuant to Section 4 of this act;
3. The number of persons who have become members during the
preceding year, the total number of members of the plan as of the
end of the year, and the number of memberships terminated during the
year;
4. The costs of all car e provided and the number of members who
received care pursuant to the provisions of the prepaid vision plan;
and
5. Any other information relating to the performance of the
prepaid vision plan organiza tion deemed necessary by the
Commissioner.
SECTION 10. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 6113 of Title 36, unless there
is created a duplication in numb ering, reads as follows:
A. At the time of filing the annual report prescribed by
Section 9 of this act, each prepaid vision plan sh all pay to the
State Treasurer through the Insurance Commissioner a tax for
transacting a prepaid vision plan . The obligation shall be two
percent (2%) of prepaid net charg es received from members in this
state for both domestic and foreign organiza tions.
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B. An organization may offset this tax in whole or in part by
payment of state corporate income tax as provided pursuant to
Section 2355 of Title 68 of the Oklahoma Statutes. However, an
organization is prohibited from carrying over to a succeeding year
any credit for paying corporate in come tax not used during a year.
SECTION 11. NEW LAW A new section of la w to be codified
in the Oklahoma Statutes as Section 6114 of Title 36, unless there
is created a duplication in numb ering, reads as follows:
A. The Insurance Commissioner may suspend or revoke any
certificate of authority issued pursuant to this act if the
Commissioner finds that the prepaid vision plan organization:
1. Is operating contrary to the basic organization al documents
of the organization or in a manner contrary to that described in or
reasonably inferred from any information submitted pursuant to
Section 4 of this act;
2. Issues membership coverage which does not comply with the
requirements of Section 8 of this act;
3. Does not provide or arrange f or basic vision services
appropriate to a prepaid vision plan;
4. Can no longer be exp ected to meet the obligations to members
or prospective members of the prepaid vision plan;
5. Uses fraudulent, coercive, or dishonest practices, or
demonstrates incompetence, untr ustworthiness, or financial
irresponsibility in the conduct of business;
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6. Fails to deal equitably with any providers or other persons
or facilities which offer services covered within a contract or
policy issued pursuant to this act; or
7. Fails to substantially comply with the insurance laws of
this state or violates any regulation, rule, subp oena, or order of
the Commissioner.
B. When the certificate of authority of a prepaid vision plan
organization is suspended, the organization shall not accept, during
the period of such suspension, any additional members except newly
acquired dependents of existing members and shall not engage in any
advertising or solicit ation.
C. When the certificate of au thority of a prepaid vision plan
organization is revoked, the organization shall terminate op eration
of the organization in this state immediately and shall conduct no
further business except as may be ess ential to the orderly
conclusion of the business affairs of th e organization. The
Commissioner, by written order, may permit further operation of the
organization as the Commissioner finds to be in the best interest of
members of the organization.
D. In addition to or in lieu of an y applicable suspension or
revocation of a certificate of authority, the Commissioner may
invoke a fine not to exceed One Thousand Dollars ( $1,000.00) for
each violation. The payment of the fine may be enforced in the same
manner as civil judgments may be enforced.
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E. A prepaid vision p lan organization which has had its
certificate of authority denied, suspended, or revoked, or has
suffered an adverse determination by the Commissioner shall be
entitled to a hearing pursuant to the provisions of the
Administrative Procedures Act under Section 250 et seq. of Title 75
of the Oklahoma Statutes.
SECTION 12. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 6115 of Title 36, unless there
is created a duplication in numbering, reads as foll ows:
A. No advertising or sales material relating to a prepaid
vision plan organization shall be issued or delivered to any person
in this state until a copy of the material has been filed with and
approved by the Insu rance Commissioner. Within thirty (3 0) days
after the submission of advertising or material under this
subsection, the Commissioner shall issue a determination approving
or disapproving of the material. Disapproval of the advertising or
material shall be on the basis that, in whole or in part, the
material is false, deceptive, or m isleading. Written notification
shall be issued to an organiza tion that has materials disapprove d
pursuant to this subsection. Thereafter, the disapproved
advertising material shall not be used. Violation of the provisions
of this subsection sh all entitle the Commis sioner in his or her
discretion and without additional ca use to withdraw approval of any
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membership coverage with respect to which adver tising or sales
material is used.
B. Offers to sell prepai d vision insurance by advertising or
publication of material by a prepaid vision plan or ganization or
anyone acting on behalf of the o rganization to inform members or
prospective members of the plan as to the coverage offered by the
plan and the operation of the organization shall not be a violatio n
of any provisions of law relating to solicitation of customers or
advertising by prepaid vision plan providers if the advertising or
sales material:
1. Is approved prior to use by the Commissioner upon
determination by the Commissioner that the material is not
inaccurate, false, deceptive, or misleading;
2. Does not identify the providers of vision services nor
describe their professional qualifications, except upon request of
the member or prospective member;
3. Does not describe the professional experience or attainments
of providers of vision services individuall y or as a group, or
contain language that states, evaluates, or lauds the professional
competence, skills, or reputations of the providers; and
4. Shall not cause any providers of vision services to violate
any professional ethics or laws that prohibit the solicitation of
patients.
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SECTION 13. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 6116 of Title 36, unless there
is created a duplication in numb ering, reads as follows:
A. Article 12 of Title 36 of the Oklahoma Statu tes relating to
unfair trade practices and f rauds shall apply to prepaid vision p lan
organizations, except to the extent the Insurance Commissioner may
determine that particular provisio ns of the article shall not apply
to prepaid vision pl an organizations.
B. The Commissioner may conduct an examination of the business
affairs of any prepaid vision plan organization as often as the
Commissioner deems necessary for the pro tection of the interests of
the people of this state.
C. Any rehabilitation, liquidation, or co nservation of a
prepaid vision plan organization shall be conducted pursuant to the
provisions for the rehabilitation, liquid ation, or conservation of
an insurer provided for by Articles 18 and 19 of Title 36 of the
Oklahoma Statutes.
D. The Commissioner shall promulgate any rules nece ssary to
effectuate the provisions of the Prepaid Vision Plan Act .
SECTION 14. This act shall become effective November 1, 2023.
59-1-392 RD 1/17/2023 5:34:05 PM