Oklahoma Administrative Code
Title 310 - Oklahoma State Department of Health
Chapter 657 - Certified Workplace Medical Plans
Subchapter 17 - Contracts and Service Explanations
Section 310:657-17-2 - Contents of the insurers' or insureds' contract

Universal Citation: OK Admin Code 310:657-17-2

Current through Vol. 42, No. 1, September 16, 2024

Each contract shall contain a clear statement of the following:

(1) Plan's name and address;

(2) Eligibility requirements;

(3) Medical and health services in the area;

(4) Emergency care services and procedures for authorizing emergency services by non-Plan providers;

(5) Out of area services;

(6) Limits and excluded items;

(7) Employee termination;

(8) Employee reinstatement;

(9) Claims procedures, if any;

(10) Dispute resolution and grievance procedures;

(11) Continuing coverage;

(12) Extension of benefits;

(13) Substitution of creditors;

(14) Geographic service area;

(15) Entire contract provision;

(16) Term of coverage;

(17) Renewing contract;

(18) Canceling contract;

(19) Reinstatement of contract;

(20) Grace period; and

(21) Conformity with state law.

Added at 12 Ok Reg 2977, eff 6-16-95 (emergency); Added at 13 Ok Reg 2127, eff 6-13-96; Amended at 23 Ok Reg 2404, eff 6-25-06

Disclaimer: These regulations may not be the most recent version. Oklahoma may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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