Oklahoma § 36-4509.2 - Acceptance by succeeding carriers - Preexisting

§ 36-4509.2. Acceptance by succeeding carriers - Preexisting

conditions limitations or waiting requirements.

A. When an insured individual or a dependent who was covered by

group insurance pursuant to the provisions of the Health Insurance

Portability and Accountability Act of 1996, 29 U.S.C.A., Section

1181 et seq., gains employment with an employer who provides for

health insurance through a group plan, the succeeding group carrier

shall accept the insured individual and dependents of the insured

individual who were covered under the prior coverage and shall not

apply limitations or exclusions based on preexisting conditions or

apply waiting-period requirements for the insured individual or the

dependents of the insured individual beyond the time when any

surviving exclusion or waiting period with the prior carrier would

have been fulfilled. The insured individual and any dependents of

such individual must apply for the new coverage within sixty-three

(63) days following the date of termination of prior creditable

coverage.

B. When an insured individual or dependent who was covered by

individual insurance pursuant to the provisions of the Health

Insurance Portability and Accountability Act of 1996, 29 U.S.C.A.,

Section 1181 et seq., gains employment with an employer who provides

for health insurance through a group plan, the succeeding group

carrier shall accept the insured individual and dependents of the

insured individual who were covered under the prior coverage and

shall not apply limitations or exclusions based on preexisting

conditions or apply waiting-period requirements for the insured

individual or the dependents of the insured individual beyond the

time when any surviving exclusion or waiting period with the prior

carrier would have been fulfilled. The insured individual and any

dependents of such individual must apply for the new coverage within

sixty-three (63) days following the date of termination of prior

creditable coverage.

C. Insurance carriers receiving an application for individual

insurance may underwrite the risk or decline coverage based on the

underwriting guidelines of the insurance carrier.

D. When there is a lapse in the coverage of the insured

individual or a dependent of the insured individual provided for by

subsections A, B, and C of this section for any reason other than a

probationary period or similar waiting period imposed pursuant to

personnel policies of an employer, the provisions of subsections A,

B, and C of this section shall not apply to the person whose

coverage lapsed.

E. When an individual employee who was covered under a group

health insurance plan terminates employment with an employer and

gains employment with another employer who provides for health

insurance through a group plan, the carrier of the succeeding

Oklahoma Statutes - Title 36. Insurance

employer shall not apply preexisting conditions limitations or

exclusions of preexisting conditions or apply waiting-period

requirements for the individual employee or his dependents covered

under the group plan of the previous employer beyond the time when

any surviving exclusion or waiting period with the prior carrier

would have been fulfilled, provided the individual employee applies

for the new coverage within thirty-one (31) days following the date

of eligibility for participation in the plan in accordance with the

employment or personnel policies of the employer of such

participation.

F. When there is a lapse in the coverage of the individual

employee provided for by subsection E of this section for any reason

other than a probationary period or similar waiting period imposed

by the employment or personnel policies of the employer, the

provisions of subsection E of this section shall not apply.

Added by Laws 1992, c. 304, § 3, eff. Jan. 1, 1993. Amended by Laws

1993, c. 76, § 1, emerg. eff. April 18, 1993; Laws 1995, c. 224, §

1, eff. Nov. 1, 1995; Laws 1997, c. 180, § 4, emerg. eff. May 12,

1997; Laws 1998, c. 304, § 1, eff. July 1, 1998; Laws 2001, c. 363,

§ 23, eff. July 1, 2001; Laws 2014, c. 389, § 1, emerg. eff. June 3,

2014.