{"data":{"id":"us-ok/okla.-stat.-tit.-36-36-4509.1","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 36, § 36-4509.1","heading":"Liability of prior carrier - Eligibility under","body":"succeeding carrier - Determination of benefits - Election of\n\ncoverage.\n\nA. This section applies to determination of the liability of a\n\ncarrier pursuant to a group or blanket accident or health insurance\n\nplan in those instances in which the contract of one carrier\n\nreplaces a plan of similar benefits of another carrier. As used in\n\nthis section, \"carrier\" means an insurer or other entity subject to\n\nthe provisions of Title 36 of the Oklahoma Statutes, and includes\n\nbut is not limited to a not-for-profit hospital service and medical\n\nindemnity corporation, a fraternal benefit society, a health\n\nmaintenance organization and a multiple employer welfare\n\narrangement.\n\nB. The prior carrier shall be liable only to the extent of its\n\naccrued liabilities and extensions of benefits. The position of the\n\nprior carrier shall be the same whether the group policyholder or\n\nother entity responsible for making payments or submitting\n\nsubscription charges to the carrier secures replacement coverage\n\nfrom a new carrier, self-insures, or foregoes the provision of\n\ncoverage.\n\nC. Each person who was covered by the plan of the prior carrier\n\nshall be covered by the plan of benefits of the succeeding carrier\n\nconditioned only upon the payment of the premium.\n\nD. The succeeding carrier, in applying any deductibles or\n\nwaiting periods in its plan, including but not limited to waiting\n\nperiods for preexisting conditions, shall give credit for the\n\nsatisfaction or partial satisfaction of the same or similar\n\nprovisions under a prior plan providing similar benefits and shall\n\nnot impose any additional waiting periods for coverage for any\n\nperson who was covered by the plan of the prior carrier. In the\n\ncase of deductible provisions, the credit shall apply for the same\n\nor overlapping benefit periods and shall be given for expenses\n\nactually incurred and applied against the deductible provisions of\n\nthe prior plan during the ninety (90) days preceding the effective\n\ndate of the succeeding plan but only to the extent these expenses\n\nare recognized under the terms of the plan of the succeeding carrier\n\nand are subject to similar deductible provision.\n\nE. If a determination of the benefits of the prior plan is\n\nrequired and requested by the succeeding carrier, upon receiving\n\nsuch request, the prior carrier shall furnish a statement of the\n\nbenefits available or pertinent information sufficient either to\n\npermit verification of the benefits available under the prior plan\n\nor to permit the determination of the benefits by the succeeding\n\ncarrier. For the purposes of this subsection, benefits of the prior\n\nplan shall be determined in accordance with all of the definitions,\n\nconditions, and covered expense provisions of the prior plan and\n\nshall not be subject to the definitions, conditions, and covered\n\nexpense provisions of the succeeding plan. The benefit\n\ndetermination shall be made as if coverage had not been replaced by\n\nthe succeeding carrier.\n\nF. Nothing in this section shall prevent an individual from\n\nelecting not to be covered under the plan of benefits of the\n\nsucceeding carrier.","path":["OK Code","Title 36"],"source_url":"https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os36.pdf","current_through":"2026-08-14","vintage":"open-us-law v2026.08, retrieved 2026-09-14","retrieved_at":"2026-09-14T18:32:36Z","sha256":"c720af4c3180d0bcbce269b9f2847f10f644380ba098c3645324480de4f7b715","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-36-36-4509","next":"us-ok/okla.-stat.-tit.-36-36-4509.2"},"notice":"GroundRules: Original legal text. Not legal advice."}