(a) Members are mailed a notice 10 days prior to closure of eligibility.
(b) The employer and employees' eligibility are tied together. If the employer no longer meets the requirements for Insure Oklahoma/O-EPIC then eligibility for the associated employees enrolled under that employer are also ineligible.
(c) The employee's certification period may be terminated when:
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(1) the member requests closure;
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(2) the member moves out-of-state;
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(3) the covered member dies;
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(4) the employer's eligibility ends;
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(5) an audit indicates a discrepancy that makes the member or employer ineligible;
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(6) the employer is terminated from Insure Oklahoma/O-EPIC;
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(7) the member fails to pay the amount due within 60 days of the date on the bill;
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(8) the QHP or carrier is no longer qualified;
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(9) the member begins receiving SoonerCare benefits; or
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(10) the member or employer reports to the OHCA or the TPA any change affecting eligibility.
(d) This subsection applies to applicants eligible according to OAC 317:45-11-20(a) through (c) and 317:45-11-20(f) through (h). The member's certification period may be terminated when:
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(1) the member requests closure;
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(2) the member moves out-of-state;
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(3) the covered member dies;
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(4) the employer's eligibility ends;
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(5) an audit indicates a discrepancy that makes the member or employer ineligible;
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(6) the member fails to pay the amount due within 60 days of the date on the bill;
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(7) the member becomes eligible for SoonerCare/Medicare; or
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(8) the member or employer reports to the OHCA or the TPA any change affecting eligibility.