SECTION 317:45-11-27. Closure

(a)   Members are mailed a notice 10 days prior to closure of eligibility.

(b)   The employer and employees' eligibility are tied together. If the employer no longer meets the requirements for Insure Oklahoma then eligibility for the associated employees enrolled under that employer are also ineligible.

(c)   The employee's certification period may be terminated when:

(1)   the member requests closure;

(2)   the member moves out-of-state;

(3)   the covered member dies;

(4)   the employer's eligibility ends;

(5)   a review indicates a discrepancy that makes the member or employer ineligible;

(6)   the employer is terminated from Insure Oklahoma;

(7)   the member fails to pay their premium;

(8)   the qualified benefit plan or carrier no longer meets the requirements set forth in this chapter;

(9)   the member begins receiving SoonerCare or Medicare benefits;

(10)   the member begins receiving coverage by a private benefit policy or plan;

(11)   the member or employer reports any change affecting eligibility; or

(12)   the member no longer meets the eligibility criteria set forth in this Chapter.

(d)   This subsection applies to applicants eligible according to 317:45-11-20(a) through (c) and 317:45-11-20(f) through (h). The member's certification period may be terminated when:

(1)   the member requests closure;

(2)   the member moves out-of-state;

(3)   the covered member dies;

(4)   the employer's eligibility ends;

(5)   a review indicates a discrepancy that makes the member or employer ineligible;

(6)   the member fails to pay their premium;

(7)   the member becomes eligible for SoonerCare or Medicare;

(8)   the member begins receiving coverage by a private benefit policy or plan;

(9)   the member or employer reports any change affecting eligibility; or

(10)   the member no longer meets the eligibility criteria set forth in this Chapter.

[Source: Added at 24 Ok Reg 101, eff 8-2-06 (emergency); Added at 24 Ok Reg 963, eff 5-11-07; Amended at 26 Ok Reg 2169, eff 6-25-09; Amended at 27 Ok Reg 727, eff 2-4-10 (emergency); Amended at 27 Ok Reg 1528, eff 6-11-10; Amended at 27 Ok Reg 2391, eff 7-1-10 (emergency); Amended at 28 Ok Reg 1574, eff 6-25-11; Amended at 33 Ok Reg 916, eff 9-1-16]