§36-6060.22. Exemption for health benefit plans from autism
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/ok/title-36-insurance/36-6060-22·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
spectrum disorder coverage.
A. 1. A health benefit plan that, at the end of its base period, experiences a greater than one percent (1%) increase in premium costs pursuant to providing applied behavior analysis for treatment of autism spectrum disorders shall be exempt from the provisions of this act.
2. To calculate base-period-premium costs, the health benefit plan shall subtract from premium costs incurred during the base period, both the premium costs incurred during the period immediately preceding the base period and any premium cost increases
attributable to factors unrelated to benefits for treatment of autism spectrum disorders.
3. a. To claim the exemption provided for in subsection A of
this section a health benefit plan shall provide to
the Insurance Commissioner a written request signed by
an actuary stating the reasons and actuarial
assumptions upon which the request is based.
b. The Commissioner shall verify the information provided
and shall approve or disapprove the request within
thirty
(30)days of receipt.
c. If, upon investigation, the Commissioner finds that
any statement of fact in the request is found to be
knowingly false, the health benefit plan may be
subject to suspension or loss of license or any other
penalty as determined by the Commissioner, or the
State Commissioner of Health with regard to health
maintenance organizations. Added by Laws 2016, c. 230, § 4, eff. Nov. 1, 2016.