OAC 310:657-17-2
Contents of the insurers' or insureds' contract
Cite as Okla. Admin. Code ยง 310:657-17-2
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.