Oklahoma § 36-4509 - Extension and termination of coverage under group

§ 36-4509. Extension and termination of coverage under group

accident and health policy and contracts of hospital or medical

service or indemnity.

A. When an insured employee or a dependent whose group

insurance coverage is terminated and the coverage is subject to the

provisions of the Consolidated Omnibus Budget Reconciliation Act of

1985 (COBRA), Pub. L. 99-272, April 7, 1986, 100 Stat. 82, neither

subsection B or C of this section applies.

B. In the case of an employee whose insurance is terminated for

any reason other than termination of the group plan or termination

for gross misconduct under a group policy providing hospital,

medical or surgical, or Christian Science care and treatment expense

benefits; or contract of hospital or medical service or indemnity;

or prepaid health plan or health maintenance organization subscriber

contract, such employee and the dependents of the employee shall be

offered continuation of coverage under the group policy or contract

for a period of at least sixty-three (63) days after such

termination. The carrier shall notify the terminated employee of

the availability of this continuation of coverage option in writing

within thirty (30) days of receiving notice from the plan sponsor of

the employee’s termination of coverage. The terminated employee

shall request in writing the continuation of group coverage not

later than the thirty-first day after the date the terminated

employee is given notification of the availability of this

continuation of coverage option. Premiums may be charged for the

continuation of coverage period. The premiums charged shall be the

premiums which would have been charged for the coverage provided

Oklahoma Statutes - Title 36. Insurance

under the group policy or contract had termination not occurred.

Continuation of coverage pursuant to this section may be terminated:

1. For employee’s failure to make timely premium payments;

2. On the date the group coverage terminates in its entirety if

the group coverage terminates in its entirety during the

continuation of coverage period; or

3. If the employee and the dependents of the employee otherwise

become entitled to similar insurance from some other source during

the continuation of the coverage period.

C. If an employee has been covered for at least six (6) months

under any group accident and health insurance policy delivered in

this state, providing hospital, medical or surgical, or Christian

Science care and treatment expense benefits, or under a contract of

hospital or medical service or indemnity, and the individual

employee has had his employment terminated or the group itself is

terminated, then the termination shall not affect coverage of the

insured or his dependents for any continuous loss which commenced

while the insurance was in force. The extension of benefits beyond

the period the insurance was in force may be predicated upon the

continuous total disability of the person insured or his or her

dependents or the expenses incurred in connection with a plan of

surgical treatment, which shall include maternity care and delivery

expenses, which commenced prior to the termination. The coverage

for the extension of benefits shall be for the maximum benefits

under the terminated policy or for a time period of not less than

three (3) months in the case of basic coverage or six (6) months in

the case of major medical coverage. Premium monies may be charged

for the period of the extension of benefits. The premiums charged

shall be the premiums which would have been charged for the coverage

provided under the group policy or contract had termination not

occurred.

Added by Laws 1975, c. 110, § 1, eff. Jan. 1, 1976. Amended by Laws

1985, c. 328, § 20, emerg. eff. July 29, 1985; Laws 1986, c. 251, §

42, eff. Nov. 1, 1986; Laws 1988, c. 18, § 1, eff. Nov. 1, 1988;

Laws 2009, c. 207, § 1, emerg. eff. May 18, 2009; Laws 2012, c. 44,

§ 12, eff. Nov. 1, 2012.

NOTE: Laws 2009, c. 176, § 33 repealed by Laws 2010, c. 2, § 12,

emerg. eff. March 3, 2010.