Oklahoma law provides individuals with some rights to purchase a conversion or state continuation policy when certain events occur. A conversion policy is an individual policy sold by the insurer that provided your prior coverage. Conversion policies may be more expensive than your prior coverage and may not contain the same benefits. A continuation policy provides you with the ability to buy into the group policy that covered you before.
- If you lose coverage through an HMO because you become unemployed, your spouse dies, you divorce your spouse, or any other reason beyond your control, you can obtain a conversion policy from the HMO. You will not be able to get a conversion policy if you are eligible for or already have comparable coverage, the group contract under which you were covered is terminated (with some exceptions), your coverage was terminated for cause, or you fail to exercise your conversion rights within 31 days.
- Non-HMO fully insured group health plans are not required to offer conversion coverage. However, if the plan chooses to offer a conversion option to the covered person, then it must also offer a conversion policy to the covered person’s spouse at divorce, the death of the covered person, or when the covered person becomes unemployed.
- If your family members lost coverage through your non-HMO individual health insurance policy for reasons other than nonpayment of premiums or the expiration of the term the policy was issued for, the insurer must offer them a conversion policy or a continuation policy. The insurer is not required to offer them coverage if they are eligible for other coverage.
