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Oklahoma – Health Insurance Premium Rate Review Laws

If you buy health insurance on the individual market, without help from an employer, you may want to know what Oklahoma is doing to protect you from unfair and unnecessary premium rate increases. Here’s a summary of the Oklahoma laws that govern rate increases.

If you buy health insurance on the individual market, without help from an employer, you may want to know what Oklahoma is doing to protect you from unfair and unnecessary premium rate increases.  Here’s a summary of the Oklahoma laws that govern rate increases.

  • Oklahoma has prior approval authority to approve or reject rates before they go into effect for HMOs only. OK Ins. Code § 6916. 
  • Rate increases for commercial accident and health policies may be used as soon as they are filed with the state.  OK. Ins. Code § 4402.
  • For nonprofit insurers, premium rates are filed and deemed approved if they are not disapproved by the Insurance Commissioner 60 days after filing.  Ok Ins. Code § 2606.
  • For HMOs, premium rates may not be “excessive, inadequate, or unfairly discriminatory.”  HMO rates are deemed approved if they are not disapproved by the Insurance Commissioner 30 days after filing.  Ok Ins. Code § 6916.  These rates are “confidential and not subject to public disclosure.”  Ok Ins. Code § 6916(A).
  • Rate increases for “standard health benefit plans,” must be filed for informational purposes only.  A “standard health benefit plan” is an accident and health insurance policy issued to individuals under age 40 that does not provide state-mandated health benefits, but does provide creditable coverage.  Ok Ins. Code § 4415.
IssuesHealth