Okla. Admin. Code § 365:40-5-41

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

Section 365:40-5-41 - Membership

(a) An HMO shall not expel or refuse to re-enroll any enrollee, nor refuse to enroll individual members of a group, or establish rules for eligibility that are based on health status factors, health care needs, or age of the enrollee or individual.

(b) An HMO shall not require an individual within a group to pay a higher premium or contribution than would a similarly situated individual, based on a health-status factor.

(c) Nothing in this Section prohibits an HMO from requiring that, as a condition of continued eligibility for enrollment, dependents of a subscriber, upon reaching a specified age, convert to non-group enrollment.

Okla. Admin. Code § 365:40-5-41

Added at 21 Ok Reg 77, eff 11-1-03 (emergency); Added at 21 Ok Reg 1672, eff 7-14-04