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Oklahoma Administrative Code (Last Updated: March 11, 2021) |
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TITLE 365. Insurance Department |
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Chapter 10. Life, Accident and Health |
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Subchapter 19. Health Insurance Purchasing Groups |
SECTION 365:10-19-2. Applicability and scope
Latest version.
- (a) This Part shall apply to any health benefit plan written for a Health Insurance Purchasing Group pursuant to the Act.(b) This Part shall apply to any health benefit plan that issues or delivers a policy or certificate in this state pursuant to the Act.(c) The provisions of the Act and this Part shall not apply to an individual health benefit plan delivered or issued for delivery in this state.(d) The provisions of the Act and this Part shall apply to HIPGs formed for citizens in the State of Oklahoma.(e) For the purpose of this act, a health insurer does not include a MEWA as defined in 36 O.S. § 634.(f) If an eligible employer is issued a health benefit plan pursuant to the Act, the provisions of the Act and this Part shall continue to apply to the health benefit plan in the case that the employer subsequently employs more than one hundred (100) eligible employees. A HIPG health carrier providing coverage to such an employer shall, within sixty (60) days of becoming aware that the employer has more than one hundred (100) eligible employees but no later than the anniversary date of the employer's health benefit plan, notify the employer that the provisions of the Act and this Part shall cease to apply to the employer if such employer fails to renew its current health benefit plan or elects to enroll in a different health benefit plan.(g) A HIPG health carrier providing coverage to an employer pursuant to the Act shall, within sixty (60) days of becoming aware that the employer has fifty (50) or fewer eligible employees, notify the employer of the options and protections available to the employer under the Small Employer Health Insurance Reform Act as set out pursuant to 36 O.S. § 6511 et seq., including the employer's option to purchase a small employer health benefit plan from any small employer carrier.(h) A carrier that is not operating as a Health Insurance Purchasing Group carrier in this state shall not become subject to the provisions of the Act and this Part solely because an employer that was issued a health insurance purchasing group plan in another state by that HIPG health carrier moves to this state and the coverage remains in force.