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Library: Policy

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

Revised 6-25-11

     Eligibility for the carrier's health plans ends when:

  • (1) changes are made to the design or benefits of the health plan such that it no longer meets the requirements to be considered a qualified health 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 OAC 317:45-1-3.

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

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