Okla. Admin. Code § 317:45-9-7

Current through Vol. 42, No. 7, December 16, 2024

Section 317:45-9-7 - Closure

(a) Employer and employee eligibility are tied together. If the employer is no longer eligible, then the associated employees enrolled under that employer are also ineligible. Employees are mailed a notice 10 days prior to closure of eligibility.

(b) The employee's certification period may be terminated when:

(1) termination of employment, either voluntary or involuntary, occurs;

(2) the employee moves out-of-state;

(3) the covered employee dies;

(4) the employer ends its contract with the qualified benefit plan;

(5) the employer's eligibility ends;

(6) a review indicates a discrepancy that makes the employee or employer ineligible;

(7) the employer is terminated from the program;

(8) the employer fails to pay the premium;

(9) the qualified benefit plan or carrier no longer meets the requirements set forth in this Chapter;

(10) the employee becomes eligible for SoonerCare or Medicare;

(11) the employee or employer reports any change affecting eligibility;

(12) the employee is no longer listed as a covered person on the employer's benefit plan invoice;

(13) the employee requests closure; or

(14) the employee no longer meets the eligibility criteria set forth in this Chapter.

Okla. Admin. Code § 317:45-9-7

Added at 23 Ok Reg 278, eff 10-3-05 (emergency); Added at 23 Ok Reg 1407, eff 5-25-06; Amended at 24 Ok Reg 101, eff 8-2-06 (emergency); Amended at 24 Ok Reg 963, eff 5-11-07; Amended at 26 Ok Reg 2169, eff 6-25-09; Amended at 27 Ok Reg 2391, eff 7-1-10 (emergency); Amended at 28 Ok Reg 1574, eff 6-25-11

Amended by Oklahome Register, Volume 33, Issue 23, August 15, 2016, eff. 9/1/2016