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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 40. Health Maintenance Organizations (HMO) |
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Subchapter 5. Life, Accident & Health Division and Consumer Assistance and Claims Division Rules |
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Part 15. DISCONTINUATION OF HMO |
SECTION 365:40-5-81. Individual market
Latest version.
- (a) If an HMO elects to discontinue offering a particular contract form for health coverage offered in the individual market, coverage under such form shall be discontinued only if:(1) The HMO provides notice to the Department and to each covered individual provided coverage under this contract form of such discontinuation at least ninety (90) days prior to the date of the discontinuation of such coverage;(2) The HMO offers to each individual provided coverage under this contract form the option to purchase any other individual health coverage currently being offered by the HMO for individuals in such market in the state; and(3) In exercising the option to discontinue coverage of this contract form and in offering the option of coverage under subparagraph (b)(2),1 the HMO acts uniformly without regard to any health-status-related factor of enrolled individuals or individuals who may become eligible for such coverage.(b) If an HMO elects to discontinue offering all health coverage in the individual market in this state, health coverage shall be discontinued only if:(1) The HMO provides notice to the Department and to each individual of such discontinuation at least one hundred eighty (180) days prior to the date of the expiration of such coverage; and(2) All health coverage issued or delivered for issuance in the state in the individual market is discontinued and coverage under such health coverage in such market is not renewed.