Exemption for health benefit plans from autism spectrum disorder coverage.

  1. Law
  2. Oklahoma Statutes
  3. Insurance
  4. Exemption for health benefit plans from autism spectrum disorder coverage.

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A. 1. A health benefit plan that, at the end of its base period, experiences a greater than one percent (1%) increase in premium costs pursuant to providing applied behavior analysis for treatment of autism spectrum disorders shall be exempt from the provisions of this act.

2. To calculate base-period-premium costs, the health benefit plan shall subtract from premium costs incurred during the base period, both the premium costs incurred during the period immediately preceding the base period and any premium cost increases attributable to factors unrelated to benefits for treatment of autism spectrum disorders.

3.a.To claim the exemption provided for in subsection A of this section a health benefit plan shall provide to the Insurance Commissioner a written request signed by an actuary stating the reasons and actuarial assumptions upon which the request is based.

  • b.The Commissioner shall verify the information provided and shall approve or disapprove the request within thirty (30) days of receipt.
  • c.If, upon investigation, the Commissioner finds that any statement of fact in the request is found to be knowingly false, the health benefit plan may be subject to suspension or loss of license or any other penalty as determined by the Commissioner, or the State Commissioner of Health with regard to health maintenance organizations.

Added by Laws 2016, c. 230, § 4, eff. Nov. 1, 2016.


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