Okla. Stat. tit. 36, § 36-4524
This is the official text of Okla. Stat. tit. 36, § 36-4524, part of Oklahoma’s Stat. tit. 36, — part of the compiled statutory law of Oklahoma, published by the state as "Stat. tit. 36,." Browse the sections below, each linked to its official government source.
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Rates – Choice of plans – Benefits not required to
Official statutory text
contain state-mandated benefits – Plan requirements – Premium
discounts and modification of copayments or deductibles.
Oklahoma Statutes - Title 36. Insurance Page 997
A. Each Health Insurance Purchasing Group (HIPG), in
conjunction with a HIPG health carrier, shall make available a
health benefits plan in the manner described in this section to all
eligible employers and eligible employees at rates, including
employers’ and employees’ shares, on a policy- or product-specific
basis which may vary only as permitted under law.
B. Subject to subsection C of this section, a HIPG shall not
offer a health benefit plan which unfairly discriminates against
eligible employees.
C. Nothing in this act shall be construed as requiring a HIPG
health carrier to provide coverage outside the service area of the
insurer or organization.
D. Each HIPG shall provide a health benefits plan only through
contracts with HIPG health carriers and shall not assume insurance
risk with respect to the coverage.
E. Except as provided in this act, the HIPG may develop or
offer a health benefits plan for its members, in whole or in part,
not subject to state-mandated health benefits.
F. The HIPG shall offer at least two types of plans to its
members, including one plan providing a choice of deductibles with
state-mandated health benefits.
G. The HIPG may also offer a health benefits plan not subject
to state-mandated health benefits which does not contain standard
provisions or rights required to be present in a health benefits
plan pursuant to law or regulations unrelated to a specific illness,
injury or condition of the insured, for the provisions as may be
determined by rules and regulations of the Commissioner.
H. Every health benefits plan offered through a HIPG shall:
1. Be underwritten by a HIPG health carrier that:
a. is licensed or otherwise regulated under state
law,
b. meets all applicable state standards relating to
consumer protection, including, but not limited
to, state solvency and market conduct, and
c. offers the coverage under an approved contract
with the HIPG;
2. Be approved or otherwise permitted to be offered under law;
3. Provide full portability of creditable coverage for
individuals who remain members of the same HIPG notwithstanding that
they change the eligible employer through which they are members;
and
4. Comply with the provisions of the Oklahoma Insurance Code in
their sales and solicitation of insurance including, but not limited
to, the Trade Practices Act, and to the degree that an agent is
involved in the solicitation, sale or purchase of a health benefits
plan offered to a HIPG, that agent must be duly licensed by the
Oklahoma Statutes - Title 36. Insurance Page 998
State Insurance Department and hold a valid license to transact the
business of insurance.
I. A HIPG shall be subject to the requirements of the Small
Employer Health Insurance Reform Act.
J. Nothing in this act shall be construed as precluding a HIPG
health carrier from offering a health benefits plan through a HIPG
by establishing premium discounts for members, or from modifying
otherwise applicable copayments or deductibles in return for
adherence to programs of health promotion and disease prevention, so
long as the programs are agreed to in advance by the HIPG and comply
with all other provisions of this act and do not discriminate among
similarly situated members.
discounts and modification of copayments or deductibles.
Oklahoma Statutes - Title 36. Insurance Page 997
A. Each Health Insurance Purchasing Group (HIPG), in
conjunction with a HIPG health carrier, shall make available a
health benefits plan in the manner described in this section to all
eligible employers and eligible employees at rates, including
employers’ and employees’ shares, on a policy- or product-specific
basis which may vary only as permitted under law.
B. Subject to subsection C of this section, a HIPG shall not
offer a health benefit plan which unfairly discriminates against
eligible employees.
C. Nothing in this act shall be construed as requiring a HIPG
health carrier to provide coverage outside the service area of the
insurer or organization.
D. Each HIPG shall provide a health benefits plan only through
contracts with HIPG health carriers and shall not assume insurance
risk with respect to the coverage.
E. Except as provided in this act, the HIPG may develop or
offer a health benefits plan for its members, in whole or in part,
not subject to state-mandated health benefits.
F. The HIPG shall offer at least two types of plans to its
members, including one plan providing a choice of deductibles with
state-mandated health benefits.
G. The HIPG may also offer a health benefits plan not subject
to state-mandated health benefits which does not contain standard
provisions or rights required to be present in a health benefits
plan pursuant to law or regulations unrelated to a specific illness,
injury or condition of the insured, for the provisions as may be
determined by rules and regulations of the Commissioner.
H. Every health benefits plan offered through a HIPG shall:
1. Be underwritten by a HIPG health carrier that:
a. is licensed or otherwise regulated under state
law,
b. meets all applicable state standards relating to
consumer protection, including, but not limited
to, state solvency and market conduct, and
c. offers the coverage under an approved contract
with the HIPG;
2. Be approved or otherwise permitted to be offered under law;
3. Provide full portability of creditable coverage for
individuals who remain members of the same HIPG notwithstanding that
they change the eligible employer through which they are members;
and
4. Comply with the provisions of the Oklahoma Insurance Code in
their sales and solicitation of insurance including, but not limited
to, the Trade Practices Act, and to the degree that an agent is
involved in the solicitation, sale or purchase of a health benefits
plan offered to a HIPG, that agent must be duly licensed by the
Oklahoma Statutes - Title 36. Insurance Page 998
State Insurance Department and hold a valid license to transact the
business of insurance.
I. A HIPG shall be subject to the requirements of the Small
Employer Health Insurance Reform Act.
J. Nothing in this act shall be construed as precluding a HIPG
health carrier from offering a health benefits plan through a HIPG
by establishing premium discounts for members, or from modifying
otherwise applicable copayments or deductibles in return for
adherence to programs of health promotion and disease prevention, so
long as the programs are agreed to in advance by the HIPG and comply
with all other provisions of this act and do not discriminate among
similarly situated members.
Status: in_force · Read it on the official government site
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