SECTION 310:657-17-2. Contents of the insurers' or insureds' contract

  Each contract shall contain a clear statement of the following:

(1)   Plan's name and address;

(2)   Eligibility requirements;

(3)   Medical and health services in the area;

(4)   Emergency care services and procedures for authorizing emergency services by non-Plan providers;

(5)   Out of area services;

(6)   Limits and excluded items;

(7)   Employee termination;

(8)   Employee reinstatement;

(9)   Claims procedures, if any;

(10)   Dispute resolution and grievance procedures;

(11)   Continuing coverage;

(12)   Extension of benefits;

(13)   Substitution of creditors;

(14)   Geographic service area;

(15)   Entire contract provision;

(16)   Term of coverage;

(17)   Renewing contract;

(18)   Canceling contract;

(19)   Reinstatement of contract;

(20)   Grace period; and

(21)   Conformity with state law.

[Source: Added at 12 Ok Reg 2977, eff 6-16-95 (emergency); Added at 13 Ok Reg 2127, eff 6-13-96; Amended at 23 Ok Reg 2404, eff 6-25-06]