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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 365:40-5-82. Group market
Latest version.
- (a) An HMO may discontinue offering a particular contract form of group health coverage offered in the small-group market or large-group market only if:(1) The HMO provides notice to the Department and to each contractholder provided coverage under this form in such market, and to participants and beneficiaries covered under such coverage, of such discontinuation at least ninety (90) days prior to the date of the discontinuation of such coverage;(2) The HMO offers to each contractholder provided coverage under this form in such market the option to purchase any other health coverage currently being offered by the HMO in such market; and(3) In exercising the option to discontinue coverage of this form and in offering the option of coverage under subparagraph (a)(2) above, the HMO acts uniformly without regard to the claims experience of those contractholders or any health-status-related factor that relates to any participants or beneficiaries covered or new participants or beneficiaries who may become eligible for such coverage.(b) In any case in which an HMO elects to discontinue offering all health coverage in the small-group market or the large-group market, or both, in this state, health coverage shall be discontinued only if:(1) The HMO provides notice to the Department and to each contractholder, and participants and beneficiaries covered under such coverage, of such discontinuation at least one hundred eighty (180) days prior to the date of the discontinuation of such coverage; and(2) All health coverage issued or delivered for issuance in this state in such markets is discontinued and coverage under such health coverage in such market is not renewed.