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§ 4419. Short-term, limited-duration insurance policies--Limitations on benefits provided

Oklahoma Statutes AnnotatedTitle 36. InsuranceEffective: November 1, 2019

Oklahoma Statutes Annotated
Title 36. Insurance (Refs & Annos)
Chapter 1. Insurance Code (Refs & Annos)
Article 44. Individual Accident and Health Insurance (Refs & Annos)
Effective: November 1, 2019
36 Okl.St.Ann. § 4419
§ 4419. Short-term, limited-duration insurance policies--Limitations on benefits provided
Currentness
A. For the purposes of this section “short-term, limited-duration insurance” or “STLDI” means individual health insurance coverage provided pursuant to a contract with an insurer that has an expiration date specified in the contract that is less than twelve (12) months after the original effective date of the contract and, taking into account renewals or extensions, has a duration of no longer than thirty-six (36) months in total.
B. An STLDI policy shall not be subject to the continuation provisions of the Health Insurance Portability and Accountability Act of 1996, and shall be exempt from medical loss ratio calculations associated with individual accident and health insurance issued within this state.
C. No STLDI policy shall be deemed to be included under the definition of group accident and health insurance issued or renewed inside or outside of this state and covering persons residing in this state.
D. The benefits provided by an STLDI policy may be limited as follows:
1. An STLDI policy shall not be required to contain one or more of the mandated accident and health insurance benefits otherwise required by Title 36 of the Oklahoma Statutes; and
2. An STLDI policy shall include the definitions of individual accident and health insurance with respect to major medical benefits and standard provisions or rights of coverage.
E. An applicant for an STLDI policy shall be provided, at the time of application and in addition to any notice required by applicable federal law or regulation, a written notice that one or more of the benefits mandated by Oklahoma law is not included in the STLDI policy.
1. The notice shall specify the essential health benefits that are included in the STLDI policy. For purposes of this subsection, “essential health benefits” means those benefits set forth in 42 U.S.C., Section 18022(b).
2. The notice shall specifically list the accident and health insurance benefits otherwise required to be covered by Title 36 of the Oklahoma Statutes that will not be covered.
3. The insurer shall retain a signed copy of this notice on file as a part of the original application as evidence that the insured has acknowledged such notice.
4. Such signed copy may be in original form, electronic file form or in any other reproducible file form as may be consistent with the insurer's method of retaining application copies.
F. An STLDI policy may offer various optional combinations of coverage at additional premiums for each optional benefit offered.
G. STLDI policies issued in Oklahoma shall be subject to the filing requirements of Section 4402 of Title 36 of the Oklahoma Statutes.
H. Any individual insured under an STLDI policy shall be issued an identification card which clearly indicates that the STLDI policy is a limited duration policy not subject to Affordable Care Act requirements.

Credits

Laws 2019, c. 418, § 1, eff. Nov. 1, 2019.
36 Okl. St. Ann. § 4419, OK ST T. 36 § 4419
Current with emergency effective legislation through Chapter 182 of the Second Regular Session of the 59th Legislature (2024). Some sections may be more current, see credits for details.
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