['Employee Benefits']
['Multiple Employer Welfare Arrangements (MEWA)']
06/13/2024
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Summary of differences between federal and state regulations
Among the various employee benefit programs established and governed by ERISA are multiple employer welfare arrangements (MEWAs), which are subject as well to state regulatory and fiscal standards consistent with ERISA. Federal ERISA covers MEWAs. Oklahoma does have laws governing MEWAs. They do, however, refer to the federal definition. Other provisions include the following:
- One or more of the employer members of the MEWA must be either domiciled in this state or has its principal place of business or principal administrative office in this state; or the MEWA solicits an employer that is domiciled in this state or that has its principal place of business or principal administrative office in this state.
- MEWAs must be administered only by a licensed insurer or a licensed third party administrator.
- One cannot operate a MEWA without a license unless it offers or provides benefits that are fully insured by an authorized insurer, is exempt from state insurance regulation per ERISA, has no more than two employer members that share substantial common support other than income generated by their respective similar business classification, has no more than two employer members, which together have a combined net worth of more than $5,000,000.00, or has been in existence and has provided health insurance for at least five years prior to January 1, 1993.
- If the plan offers services for vision care or medical diagnosis and treatment for the eye, it must allow optometrists to be providers of those services.
- If the plan covers maternity benefits, it must cover a minimum of 48 hours of inpatient care following a vaginal delivery, or 96 hours of inpatient care following a delivery by caesarean section.
- The plan must cover audiological services and hearing aids for children.
- The plan must cover prostate cancer screening.
State
Contact
Regulations
Oklahoma Statutes
Title 36 Insurance
§§36-633 through 36-640; §36-3634.11; §§36-6060.3, 36-6060.7, 36-6060.8, 36-6060.10
§36-4405.1
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