Oklahoma § 36-6513 - Application of act to certain group health benefit plans

§ 36-6513. Application of act to certain group health benefit plans

A. Except as otherwise provided in this section and in Section

3 of this act, the Small Employer Health Insurance Reform Act shall

apply to any group health benefit plan that provides coverage to two

(2) or more eligible employees of a small employer in this state and

to individual health benefits plans providing coverage for the

eligible employees of a small employer which may include the

employer when three (3) or more of such individual plans are sold to

a small employer if any of the following conditions are met:

1. Any portion of the premium or benefits is paid by or on

behalf of the small employer;

Oklahoma Statutes - Title 36. Insurance

2. An eligible employee or dependent is reimbursed, whether

through wage adjustments or otherwise, by or on behalf of the small

employer for any portion of the premium; or

3. The health benefit plan is treated by the employer or any of

the eligible employees or dependents as part of a plan or program

for the purposes of Section 162 or Section 106 of the United States

Internal Revenue Code.

B. 1. Except as provided in paragraph 2 of this subsection,

for the purposes of the Small Employer Health Insurance Reform Act,

carriers that are affiliated companies or that are eligible to file

a consolidated tax return shall be treated as one carrier and any

restrictions or limitations imposed by the Small Employer Health

Insurance Reform Act shall apply as if all health benefit plans

issued to small employers in this state by such affiliated carriers

were issued by one carrier, unless on or before July 1, 1992, the

respective affiliate carriers operated with separate books of

business as insurers of health benefit plans in which event each

such affiliate carrier shall be treated as a separate carrier.

2. An affiliated carrier that is a health maintenance

organization granted a certificate of authority by the Insurance

Commissioner pursuant to the provisions of Sections 6901 through

6951 of Title 36 of the Oklahoma Statutes may be considered to be a

separate carrier for the purposes of the Small Employer Health

Insurance Reform Act.

Added by Laws 1992, c. 329, § 3, eff. Sept. 1, 1992. Amended by

Laws 1994, c. 211, § 3, eff. July 1, 1994; Laws 1999, c. 360, § 1,

eff. July 1, 1999; Laws 2000, c. 171, § 3, eff. July 1, 2000; Laws

2012, c. 151, § 2, eff. Nov. 1, 2012; Laws 2019, c. 265, § 2, eff.

Nov. 1, 2019.