Okla. Stat. tit. 36, § 36-6052
This is the official text of Okla. Stat. tit. 36, § 36-6052, 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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Copayment requirements - Disclosure of calculations -
Official statutory text
Penalty - Rules.
A. Any policy, contract or agreement issued or renewed by an
insurer, as defined in Section 6054 of Title 36 of the Oklahoma
Statutes, or any contract or agreement issued or renewed for any
preferred provider or other provider arrangement or managed care
plan, which requires the insured or enrollee to make a copayment
when benefits are provided, shall disclose to the insured or
enrollee the calculation for the copayment. In no case shall the
copayment be based on a higher figure than either the amount billed
or the amount paid, whichever is less. This subsection shall apply
to any health insurance plan offered through the State and Education
Employees Group Insurance Act.
B. Any insurer, hospital or licensed health care provider
determined to be in violation of subsection A of this section by the
Insurance Commissioner, the State Board of Health or the appropriate
health care professional licensing entity, after notice, shall be
subject to an administrative fine of not less than One Thousand
Dollars ($1,000.00) or more than Five Thousand Dollars ($5,000.00)
for each violation. Notice under this section shall include a
statement of violations on which the fine is based and notice of the
opportunity for a hearing.
C. The Insurance Commissioner, the State Board of Health or the
appropriate health care professional licensing entity shall
promulgate rules providing for enforcement of the provisions of this
act. In addition, each entity may promulgate rules providing for
suspension or revocation of a license for substantial failure to
comply with the provisions of this act. Such rules shall provide
Oklahoma Statutes - Title 36. Insurance Page 1068
for notice and a hearing prior to the suspension or revocation of a
license.
A. Any policy, contract or agreement issued or renewed by an
insurer, as defined in Section 6054 of Title 36 of the Oklahoma
Statutes, or any contract or agreement issued or renewed for any
preferred provider or other provider arrangement or managed care
plan, which requires the insured or enrollee to make a copayment
when benefits are provided, shall disclose to the insured or
enrollee the calculation for the copayment. In no case shall the
copayment be based on a higher figure than either the amount billed
or the amount paid, whichever is less. This subsection shall apply
to any health insurance plan offered through the State and Education
Employees Group Insurance Act.
B. Any insurer, hospital or licensed health care provider
determined to be in violation of subsection A of this section by the
Insurance Commissioner, the State Board of Health or the appropriate
health care professional licensing entity, after notice, shall be
subject to an administrative fine of not less than One Thousand
Dollars ($1,000.00) or more than Five Thousand Dollars ($5,000.00)
for each violation. Notice under this section shall include a
statement of violations on which the fine is based and notice of the
opportunity for a hearing.
C. The Insurance Commissioner, the State Board of Health or the
appropriate health care professional licensing entity shall
promulgate rules providing for enforcement of the provisions of this
act. In addition, each entity may promulgate rules providing for
suspension or revocation of a license for substantial failure to
comply with the provisions of this act. Such rules shall provide
Oklahoma Statutes - Title 36. Insurance Page 1068
for notice and a hearing prior to the suspension or revocation of a
license.
Status: in_force · Read it on the official government site
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