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317:45-11-27.Closure

[Revised 09-01-16]
(a) Members are mailed a notice 10 days prior to closure of eligibility.

(b) The employer and employees' eligibility are tied together. If the employer no longer meets the requirements for Insure Oklahoma then eligibility for the associated employees enrolled under that employer are also ineligible.

(c) The employee's certification period may be terminated when:

(1) the member requests closure;

(2) the member moves out-of-state;

(3) the covered member dies;

(4) the employer's eligibility ends;

(5) a review indicates a discrepancy that makes the member or employer ineligible;

(6) the employer is terminated from Insure Oklahoma;

(7) the member fails to pay their premium;

(8) the qualified benefit plan or carrier no longer meets the requirements set forth in this chapter;

(9) the member begins receiving SoonerCare or Medicare benefits;

(10) the member begins receiving coverage by a private benefit policy or plan;

(11) the member or employer reports any change affecting eligibility; or

(12) the member no longer meets the eligibility criteria set forth in this Chapter.

(d) This subsection applies to applicants eligible according to 317:45-11-20(a) through (c) and 317:45-11-20(f) through (h). The member's certification period may be terminated when:

(1) the member requests closure;

(2) the member moves out-of-state;

(3) the covered member dies;

(4) the employer's eligibility ends;

(5) a review indicates a discrepancy that makes the member or employer ineligible;

(6) the member fails to pay their premium;

(7) the member becomes eligible for SoonerCare or Medicare;

(8) the member begins receiving coverage by a private benefit policy or plan;

(9) the member or employer reports any change affecting eligibility; or

(10) the member no longer meets the eligibility criteria set forth in this Chapter.

Disclaimer. The OHCA rules found on this Web site are unofficial. The official rules are published by the Oklahoma Secretary of State Office of Administrative Rules as Title 317 of the Oklahoma Administrative Code. To order an official copy of these rules, contact the Office of Administrative Rules at (405) 521-4911.