Renewability of health benefit plans - Election not to renew - Geographic service area.

  1. Law
  2. Oklahoma Statutes
  3. Insurance
  4. Renewability of health benefit plans - Election not to renew - Geographic service area.

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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;

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.


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