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§36-6060.4.
§36-6060.4.
A. A health benefit plan delivered, issued for delivery or renewed on
or after January 1, 1998, that provides benefits for the dependents of
an insured individual shall provide coverage for each child of the
insured, from birth through the date such child is eighteen (18) years
of age for:
1. Immunization against:
a. diphtheria,
b. hepatitis B,
c. measles,
d. mumps,
e. pertussis,
f. polio,
g. rubella,
h. tetanus,
i. varicella,
j. haemophilus influenzae type B, and
k. hepatitis A; and
2. Any other immunization subsequently required for children by the
State Board of Health.
B. Benefits required pursuant to subsection A of this section shall
not be subject to a deductible, copayment, or coinsurance requirement.
C. 1. For purposes of this section, "health benefit plan" means a plan
that:
a. provides benefits for medical or surgical expenses incurred as a
result of a health condition, accident, or sickness, and
b. is offered by any insurance company, group hospital service
corporation, the Oklahoma Employees Group Insurance Program, the
Oklahoma Medicaid Program, or health maintenance organization that
delivers or issues for delivery an individual, group, blanket, or
franchise insurance policy or insurance agreement, a group hospital
service contract, or an evidence of coverage, or, to the extent
permitted by the Employee Retirement Income Security Act of 1974, 29
U.S.C., Section 1001 et seq., by a multiple employer welfare
arrangement as defined in Section 3 of the Employee Retirement Income
Security Act of 1974, or any other analogous benefit arrangement.
2. The term "health benefit plan" shall not include:
a. a plan that provides coverage:
(1) only for a specified disease,
(2) only for accidental death or dismemberment,
(3) for wages or payments in lieu of wages for a period during which
an employee is absent from work because of sickness or injury, or
(4) as a supplement to liability insurance,
b. a Medicare supplemental policy as defined by Section 1882(g)(1) of
the Social Security Act (42 U.S.C., Section 1395ss),
c. worker's compensation insurance coverage,
d. medical payment insurance issued as part of a motor vehicle
insurance policy, or
e. a long-term care policy, including a nursing home fixed indemnity
policy, unless a determination is made that the policy provides
benefit coverage so comprehensive that the policy meets the definition
of a health benefit plan.
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