Oklahoma Code § 36-6148

Title 36. Insurance: Policy for membership coverage
Open in Lexace · Ask the AI about this section
A.  Every member in a prepaid dental plan shall be issued a
membership coverage policy by the prepaid dental plan organization.

B.  No policy for membership coverage or amendment to said
policy shall be issued or delivered to any person in this state
until a copy of the policy for membership coverage or amendment to
said policy has been filed with and approved by the Commissioner.
C.  A policy for membership coverage shall contain a statement
of:
1.  The prepaid dental services or other benefits to which the
member is entitled under the prepaid dental plan; and
2.  Any limitations of the services or benefits to be provided,
including any deductible or co-payment feature; and
3.  Information as to how services may be obtained; and
4.  The obligation of the member for charges for the prepaid
dental plan.
D.  Any member in a prepaid dental plan shall be free to select
any licensed dental practitioner to provide dental services and
prepayment or reimbursement determinations shall be made without
regard to whether the provider is a participating or
nonparticipating member of the plan.  This provision shall be
printed on the policy for membership coverage.
E.  Membership coverage shall contain no provisions or
statements which are unjust, unfair, untrue, inequitable,
misleading, deceptive, or which encourage misrepresentation as
determined by the Commissioner.
F.  The Commissioner shall approve any policy of membership
coverage if the requirements of this section are complied with and
the prepaid dental plan, in the judgment of the Commissioner, is
able to meet its financial obligations for the membership coverage.
It shall be unlawful for a prepaid dental plan organization to issue
a policy until approved.  If the Commissioner does not disapprove
any such policy within thirty (30) days after filing, said policy
shall be deemed approved.  If the Commissioner disapproves a policy
of membership coverage, the Commissioner shall notify the prepaid
dental plan organization, specifying the reasons for disapproval.
The Commissioner shall grant a hearing on such disapproval within
thirty (30) days after a request in writing for a hearing is
received by the Commissioner from the prepaid dental plan
organization.

‹ Prev All Oklahoma sections Next ›


Lexace provides legal information, not legal advice, and no attorney–client relationship is created. Statute text is provided for general information and may not reflect the most recent amendments; verify against the official state code.