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OHCA Policies and Rules

OHCA Policies and Rules Main Page

317:45-5-2. Closure criteria for health plans

[Revised 09-01-16]

Eligibility for the carrier's benefit plans ends when:

(1) changes are made to the design of the benefit plan such that it no longer meets the requirements to be considered a qualified benefit plan. Carriers are required to report to OHCA any changes in health plans potentially affecting their qualification for participation in the program not less than 90 days prior to the effective date of such change(s).

(2) the carrier no longer meets the definition set forth in 317:45-1-3.

(3) the benefit plan is no longer an available product in the Oklahoma market.

(4) the benefit plan fails to meet or comply with all requirements for a qualified benefit plan as defined in 317:45-5-1.

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.

 

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Oklahoma Health Care Authority

4345 N Lincoln Blvd

Oklahoma City, OK 73105

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The Oklahoma Health Care Authority collects the personally identifiable data submitted and received in regard to applications for services, renewals, appeals, provision of health care and processing of claims. This data is treated as confidential and is stored securely in accordance with applicable law and regulations. OHCA may share this personally identifiable data with its authorized business associates, government agencies with jurisdiction over the OHCA, or as otherwise required or permitted by applicable law.