Okla. Admin. Code § 260:50-3-20

Current through Vol. 42, No. 8, January 2, 2025

Section 260:50-3-20 - Withdrawal from plan; termination or loss of coverage

(a)Withdrawal from plan. Those eligible entities participating on a voluntary basis that elect to withdraw cannot re-enter the Plan for one [1] year following the date of withdrawal except for extraordinary circumstances. Notice of the election to withdraw must be provided to EGID thirty [30] days prior to the actual withdrawal date.

(b)Termination of coverage due to insolvency of carrier. Any eligible entities who have withdrawn and purchased other coverage, then have been notified by their other health and/or group dental insurance carrier that coverage is being terminated due to insolvency of the carrier may re-enroll in the corresponding coverages within thirty [30] days after the loss of coverage by submitting a completed application form which must be approved by EGID prior to enrollment. Excepted Benefits do not qualify as other health coverage for purposes of this rule.

(c)Individual member withdrawal and re-enrollment. An individual employee who discontinues coverage on himself cannot re-enroll in any coverage for himself or his dependents for a period of twelve [12] months. Subsequent to the end of this twelve [12] month period, he may reapply for coverage offered by EGID provided that he is eligible through a participating entity. The orthodontic limitations will apply.

(d)Loss of other health, group dental or group life insurance coverage. The twelve [12] month requirement does not apply when the individual member has lost other health, group dental and/or group life insurance coverage and is seeking reinstatement pursuant to Rule 260:50-3-20(c). Excepted Benefits do not qualify as other health coverage for purposes of this rule.

Okla. Admin. Code § 260:50-3-20

Adopted by Oklahoma Register, Volume 31, Issue 24, September 2, 2014, eff. 9/12/2014

Amended by Oklahome Register, Volume 33, Issue 23, August 15, 2016, eff. 1/1/2017

Amended by Oklahoma Register, Volume 34, Issue 24, September 1, 2017, eff. 1/1/2018