Oklahoma § 36-4528 - Areas served – Services and plans permitted to be offered

§ 36-4528. Areas served – Services and plans permitted to be offered

by single administrative organization – Rating characteristics.

A. Nothing in this act shall be construed as preventing one or

more Health Insurance Purchasing Groups (HIPG) from serving

different areas, whether or not contiguous, by providing for some or

all of the following through a single administrative organization or

otherwise:

Oklahoma Statutes - Title 36. Insurance

1. Coordinating the offering of the same or similar health

benefits coverage in different areas served by the different HIPG;

or

2. Providing for crediting of deductibles and other costsharing for individuals who are provided a health benefits plan

through the HIPG or affiliated HIPG after:

a.

a change of eligible employers through which the

coverage is provided, or

b.

a change in place of employment to an area not served

by the previous HIPG.

B. No HIPG health carrier shall be required to offer HIPG

health benefits plans, or health benefits plans not subject to

state-mandated health benefits, to non-HIPG organizations,

associations, or employer groups, including but not limited to the

small employer health insurance group marketplace in this state.

C. Nothing in this act shall be construed as precluding a HIPG

from providing for adjustments in amounts distributed among the HIPG

health carriers offering a health benefits plan through the HIPG,

based on factors such as the relative health care risk of members

enrolled under the coverage offered by the different issuers.

D. Nothing in this act shall be construed as precluding a HIPG

from establishing minimum participation and contribution rules for

eligible employers that apply to become purchasers in the HIPG, so

long as the rules are applied uniformly for all HIPG health

carriers.

E. The HIPG may determine what rating characteristics it will

allow in the health benefit plan including, but not limited to, age,

sex, industry, geography, or health.

F. If health is used as a rating characteristic, then the rates

for the groups having two through fifty members will be subject to

the small employer group rating law as required in the Small

Employer Health Insurance Reform Act but may be considered separate

from any small groups sold outside the HIPG.

Added by Laws 2002, c. 276, § 8, eff. Nov. 1, 2002.