Oklahoma § 36-1162 - Reinstatement into individual health plan coverage Right to request - Time - Written notice

§ 36-1162. Reinstatement into individual health plan coverage Right to request - Time - Written notice

A. No Oklahoma resident activated for military service, and no

spouse or any dependents of such a resident who become eligible for

a federal government-sponsored health insurance program as a result

of such activation, shall be denied reinstatement into the same

individual coverage with the same health plan that such resident

lapsed as a result of activation or becoming covered by the federal

government-sponsored health insurance program. Such resident will

have the right to reinstatement in the same individual coverage

without medical underwriting and in the same rating tier that the

resident held prior to activation or becoming covered under the

federal government-sponsored health insurance program, subject to

payment of the current premium charged to other persons of the same

age and gender that are covered under the same individual coverage.

Except in the case of birth or adoptions that occur during the

period of activation, reinstatement must be into the same membership

type, or a membership type covering fewer persons, as such resident

held prior to lapsing the individual coverage, and at the same or

higher deductible level. The reinstatement rights shall not be

available to an insured or dependents if the activated person is

discharged from the military under other than honorable conditions.

B. The health plan with which the reinstatement is being

requested must receive a request for such reinstatement no later

than thirty (30) days following the later of deactivation or loss of

coverage under the federal government-sponsored health insurance

program. The health plan may request proof of loss and the timing

of the loss of such government-funded coverage in order to determine

eligibility for reinstatement into the individual coverage. The

effective date of the individual coverage will be the first of the

month following receipt of the notice requesting reinstatement.

C. All health plans must provide written notice to the

policyholder of individual coverage of the rights described in

subsection A of this section and amendments thereto. In lieu of the

Oklahoma Statutes - Title 36. Insurance

inclusion of such notice in the individual coverage policy, an

insurance company will satisfy the notification requirement by

providing a single written notice either:

1. To a policyholder enrolling into the individual coverage

initially after the effective date of this act, in conjunction with

the enrollment process; or

2. By mailing written notice to policyholders whose coverage

was effective prior to the effective date of this act no later than

ninety (90) days following the effective date of this act.

Added by Laws 2006, c. 264, § 40, eff. July 1, 2006.