Oklahoma § 36-6516 - Renewability of health benefit plans - Election not to

§ 36-6516. Renewability of health benefit plans - Election not to

renew - Geographic service area.

A. A health benefit plan subject to this act shall be renewable

with respect to all eligible employees and dependents, at the option

of the small employer, except in any of the following cases:

1. Nonpayment of the required premiums;

2. Fraud or misrepresentation of the small employer or, with

respect to coverage of individual insureds, the insureds or their

representatives;

3. Noncompliance with the carrier's minimum group participation

requirements;

Oklahoma Statutes - Title 36. Insurance

4. Noncompliance with the carrier's employer contribution

requirements;

5. Repeated misuse of provider network provisions;

6. The small employer carrier elects to nonrenew all of its

health benefit plans issued to small employers in this state. In

such a case the carrier shall:

a.

provide advance notice of its decision under this

paragraph to the Insurance Commissioner in each state

in which it is licensed, and

b.

provide notice of the decision not to renew coverage

to all affected small employers and to the

Commissioner in each state in which an affected

covered individual is known to reside at least one

hundred eighty (180) days prior to the nonrenewal of

any health benefit plan by the carrier. Notice to the

Commissioner under this subparagraph shall be provided

at least three (3) working days prior to the notice to

the affected small employers; or

7. The Commissioner finds that the continuation of the coverage

would:

a.

not be in the best interests of the policyholders or

certificate holders, or

b.

impair the carrier's ability to meet its contractual

obligations. In such instance the Commissioner may

assist affected small employers in finding replacement

coverage.

B. A small employer carrier that elects not to renew a health

benefit plan under paragraph 6 of subsection A of this section shall

be prohibited from writing new business in the small employer market

in this state for a period of five (5) years from the date of notice

to the Commissioner.

C. In the case of a small employer carrier doing business in

one established geographic service area of the state, the provisions

of this section shall apply only to the carrier's operations in such

service area.

Added by Laws 1992, c. 329, § 6, eff. Sept. 1, 1992.