OHCA Policies and Rules

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Chapter 45INSURE OKLAHOMA
SubChapter 1GENERAL PROVISIONS
317:45-1-1.Purpose and general program provisions
317:45-1-2.Program limitations
317:45-1-3.Definitions
317:45-1-4.Reimbursement for out-of-pocket expenses
SubChapter 3INSURE OKLAHOMA CARRIERS
317:45-3-1.Carrier eligibility
317:45-3-2.Reviews
317:45-3-3.Carrier rate structure requirements
SubChapter 5INSURE OKLAHOMA QUALIFIED BENEFIT PLANS
317:45-5-1.Qualified Benefit Plan requirements
317:45-5-2.Closure criteria for health plans
317:45-5-3.Health plan rate structure requirements
SubChapter 7INSURE OKLAHOMA ESI EMPLOYER ELIGIBILITY
317:45-7-1.Employer application and eligibility requirements for Insure Oklahoma ESI
317:45-7-2.Employer eligibility determination
317:45-7-3.Employer cost sharing
317:45-7-4.Qualifying Event
317:45-7-5.Reimbursement
317:45-7-6.Credits and adjustments
317:45-7-7.Reviews
317:45-7-8.Closure
SubChapter 9INSURE OKLAHOMA ESI EMPLOYEE ELIGIBILITY
317:45-9-1.Employee eligibility requirements
317:45-9-2.Employee eligibility period
317:45-9-3.Qualifying Event
317:45-9-4.Employee cost sharing
317:45-9-5.Reimbursement for out-of-pocket medical expenses [REVOKED]
317:45-9-6.Reviews
317:45-9-7.Closure
317:45-9-8.Appeals
SubChapter 11INSURE OKLAHOMA IP
Part 1INDIVIDUAL PLAN PROVIDERS
317:45-11-1.Insure Oklahoma Individual Plan providers
317:45-11-2.Insure Oklahoma IP provider payments
Part 3INSURE OKLAHOMA IP MEMBER HEALTH CARE BENEFITS
317:45-11-10.Insure Oklahoma IP adult benefits
317:45-11-11.Insure Oklahoma IP adult non-covered services
317:45-11-12.Insure Oklahoma IP children benefits [REVOKED]
317:45-11-13.Insure Oklahoma IP children non-covered services [REVOKED]
Part 5INSURE OKLAHOMA IP MEMBER ELIGIBILITY
317:45-11-20.Insure Oklahoma IP eligibility requirements
317:45-11-21.Dependent eligibility
317:45-11-21.1.Certification of newborn child deemed eligible [REVOKED]
317:45-11-22.PCP choices
317:45-11-23.Member eligibility period
317:45-11-24.Member cost sharing
317:45-11-25.Premium payment
317:45-11-26.Reviews
317:45-11-27.Closure
317:45-11-28.Appeals
SubChapter 13INSURE OKLAHOMA DENTAL SERVICES
317:45-13-1.Dental services requirements and benefits [REVOKED]

Disclaimer. The OHCA rules found on this Web site are unofficial. The official rules are published by the Oklahoma Secretary of State Office of Administrative Rules as Title 317 of the Oklahoma Administrative Code. To order an official copy of these rules, contact the Office of Administrative Rules at (405) 521-4911.