Advertising prohibited - Exemptions - Preparation of summary document - Disclaimer - Notice of noncoverage.

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A. No person, including a member insurer, agent or affiliate of a member insurer, shall make, publish, disseminate, circulate or place before the public, or cause directly or indirectly to be made, published, disseminated, circulated or placed before the public, in any newspaper, magazine or other publication, or in the form of a notice, circular, pamphlet, letter or poster, or over any radio station or television station, or in any other way, any advertisement, announcement or statement which uses the existence of the Oklahoma Life and Health Insurance Guaranty Association of this state for the purpose of sales, solicitation or inducement to purchase any form of insurance or other coverage covered by the Oklahoma Life and Health Insurance Guaranty Association Act. Provided, however, that this section shall not apply to the Oklahoma Life and Health Insurance Guaranty Association or any other entity which does not sell or solicit insurance or coverage by a health maintenance organization.

B. The Association shall have a summary document describing the general purposes and current limitations of the Association and complying with subsection C of this section. This document shall have been submitted to, and approved by, the Insurance Commissioner. Sixty (60) days after receiving such approval, no member insurer shall deliver a policy or contract described in paragraph 1 of subsection B of Section 2025 of this title to a policy owner, contract owner, certificate holder or enrollee unless the document is delivered to the policy or contract holder prior to or at the time of delivery of the policy or contract, except if subsection D of this section applies. The document should also be available upon request by a policy owner, contract owner, certificate holder or enrollee. The distribution, delivery or contents or interpretation of this document shall not mean that either the policy or the contract or the holder thereof would be covered in the event of impairment or insolvency of a member insurer. The description document shall be revised by the Association as amendments to the act may require. Failure to receive this document does not give the policyholder, contract holder, certificate holder, enrollee or insured any greater rights than those stated in this act.

C. The document prepared under subsection B of this section shall contain a clear and conspicuous disclaimer on its face. The Commissioner shall promulgate a rule establishing the form and content of the disclaimer. The disclaimer shall:

1. State the name and address of the life and health insurance guaranty association and insurance department;

2. Prominently warn the policy owner, contract owner, certificate holder or enrollee that the Life and Health Insurance Guaranty Association may not cover the policy or contract or, if coverage is available, it will be subject to substantial limitations, exclusions and conditioned on continued residence in the state;

3. State that the member insurer and its agents are prohibited by law from using the existence of the Oklahoma Life and Health Insurance Guaranty Association for the purpose of sales, solicitation or inducement to purchase any form of insurance or health maintenance organization coverage;

4. Emphasize that the policy or contract holder should not rely on coverage under the Oklahoma Life and Health Insurance Guaranty Association when selecting an insurer;

5. Provide other information as directed by the Commissioner.

D. No insurer or agent may deliver a policy or contract described in paragraph 1 of subsection B of Section 2025 of this title, but excluded under subparagraph a of paragraph 2 of subsection B of Section 2025 of this title from coverage under the Oklahoma Life and Health Insurance Guaranty Association Act, unless the insurer or agent, prior to or at the time of delivery, gives the policy owner, contract owner, certificate holder or enrollee a separate written notice which clearly and conspicuously discloses that the policy or contract is not covered by the Life and Health Insurance Guaranty Association. The Commissioner shall by rule specify the form and content of the notice.

Added by Laws 1981, c. 133, § 23. Amended by Laws 1987, c. 177, § 8, eff. Nov. 1, 1987; Laws 2019, c. 384, § 12, eff. Nov. 1, 2019.


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