§ 6908. Group or individual contract--Delivery--Required provisions--Evidence of coverage--Fili...
Oklahoma Statutes AnnotatedTitle 36. Insurance
36 Okl.St.Ann. § 6908
§ 6908. Group or individual contract--Delivery--Required provisions--Evidence of coverage--Filing and review of forms
2. The contract shall not contain provisions or statements which are unjust, unfair, inequitable, misleading, deceptive, or which encourage misrepresentation as defined by Articles 12 and 12A-1 of the Insurance Code.1
An evidence of coverage may be filed as part of the group contract to describe the provisions required in this paragraph.
B. In addition to those provisions required in paragraph 3 of subsection A of this section, an individual contract shall provide for a ten-day period to examine and return the contract and to refund any premiums. If services were received during the ten-day period, and the subscriber returns the contract to receive a refund of the premium paid, he or she must pay for those services.
D. Every health maintenance organization doing business in this state shall comply with the provisions of Article 36A of the Insurance Code.2
F. If an evidence of coverage issued pursuant to and incorporated in a contract issued in this state is intended for delivery in another state and the evidence of coverage has been approved for use in the state in which it is to be delivered, the evidence of coverage need not be submitted to the Insurance Commissioner of this state for approval.
G. 1. Every form required by this section shall be filed with the Insurance Commissioner not less than thirty (30) days prior to delivery or issue for delivery in this state. At any time during the initial thirty-day period, the Insurance Commissioner may extend the period for review an additional thirty (30) days. Notice of an extension shall be in writing. At the end of the review period, the form is deemed approved if the Insurance Commissioner has taken no action. The filer must notify the Insurance Commissioner in writing prior to using a form that is deemed approved.
3. When a filing is disapproved or approval of a form is withdrawn, the Insurance Commissioner shall give the health maintenance organization written notice of the reasons for disapproval and in the notice shall inform the health maintenance organization that within thirty (30) days of receipt of the notice the health maintenance organization may request a hearing. A hearing shall be conducted within thirty (30) days after the Insurance Commissioner has received the request for hearing.
Credits
Laws 2003, c. 197, § 8, eff. Nov. 1, 2003; Laws 2016, c. 68, § 1, eff. Nov. 1, 2016.
36 Okl. St. Ann. § 6908, OK ST T. 36 § 6908
Current with emergency effective legislation through Chapter 257 of the Second Regular Session of the 59th Legislature (2024). Some sections may be more current, see credits for details.
End of Document |