Okla. Stat. tit. 36, § 36-6411 — OK Code / Title 36 / Section 36-6411
Short title
Status: in_force

Sections 44 through 55 of this act shall constitute a part of

the Oklahoma Insurance Code and shall be known and may be cited as

the "Market Assistance Association Act".
Okla. Stat. tit. 36, § 36-7121 — OK Code / Title 36 / Section 36-7121
Cemetery Merchandise Trust Act
Status: in_force

Sections 7121 through 7135 of this title shall be known and may

be cited as the "Cemetery Merchandise Trust Act".
Okla. Stat. tit. 36, § 36-1100 — OK Code / Title 36 / Section 36-1100
Short title - Purpose and effect
Status: in_force

Oklahoma Statutes - Title 36. Insurance Page 245

A. Sections 1100 through 1120 of Title 36 of the Oklahoma

Statutes shall be known and may be cited as the "Unauthorized

Insurers and Surplus Lines Insurance Act".

B. The purpose and effect of the Unauthorized Insurers and

Surplus Lines Insurance Act shall relate back to the effective date

of implementation of the Nonadmitted and Reinsurance Reform Act of

2010.
Okla. Stat. tit. 36, § 36-6816 — OK Code / Title 36 / Section 36-6816
Confidentiality
Status: in_force

A. Information included in an individual closed claim report

submitted by an insurer under Sections 12 and 13 of this act is

confidential and shall not be made available by the Department to

the public and shall not be subject to the Oklahoma Open Records

Act.

B. Information included in an individual closed claim report

may be examined only by the Commissioner and Department employees.
Okla. Stat. tit. 36, § 36-2728.1 — OK Code / Title 36 / Section 36-2728.1
Examination of domestic, foreign or alien societies
Status: in_force

A. The Insurance Commissioner, or a designee, may examine any

domestic, foreign or alien society transacting or applying for

admission to transact business in this state in the same manner as

authorized for examination of domestic, foreign or alien insurers.

Requirements of notice and an opportunity to respond before findings

are made public as provided in the laws regulating insurers shall

also be applicable to the examination of societies.

B. The expense of each examination and of each valuation,

including compensation and actual expense of examiners, shall be

paid by the society examined or whose certificates are valued, upon

statements furnished by the Commissioner.
Okla. Stat. tit. 36, § 36-3110 — OK Code / Title 36 / Section 36-3110
Inapplicability to attorneys and insurance, bonding or
Status: in_force

surety companies.

Nothing in this act shall apply to a duly authorized attorney-

at-law acting in the usual cause of his profession nor to any

insurance company, bonding company or surety company now or

hereafter duly and regularly licensed and doing business as such

under the laws of this state.
Okla. Stat. tit. 36, § 36-5102 — OK Code / Title 36 / Section 36-5102
Definitions
Status: in_force

As used in the Reinsurance Intermediary Act:

1. "Actuary" means a person who is a member in good standing of

the American Academy of Actuaries;

2. "Controlling person" means any person, firm, association or

corporation who directly or indirectly has the power to direct or

cause to be directed, the management, control or activities of the

reinsurance intermediary;

3. "Insurer" means any person, firm, association or corporation

duly licensed in this state pursuant to the applicable provisions of

the Oklahoma Insurance Code as an insurer;

4. "Licensed producer" means an agent, broker or reinsurance

intermediary licensed in this state pursuant to the applicable

provision of the Oklahoma Insurance Code;

5. "Reinsurance intermediary" means a reinsurance intermediary

broker or a reinsurance intermediary manager as these terms are

defined in this section;

6. "Reinsurance intermediary broker" (RB) means any person,

other than an officer or employee of the ceding insurer, firm,

association or corporation, who solicits, negotiates or places

reinsurance cessions or retrocessions on behalf of a ceding insurer

without the authority or power to bind reinsurance on behalf of such

insurer;

7. "Reinsurance intermediary manager" (RM) means any person,

firm, association or corporation that has authority to bind or

manages all or part of the assumed reinsurance business of a

reinsurer, including the management of a separate division,

department or underwriting office, and acts as an agent for such

reinsurer whether known as an RM, manager or other similar term.

The following persons shall not be considered RMs, with respect to a

reinsurer, for the purposes of the Reinsurance Intermediary Act:

a. an employee of the reinsurer,

b. a U.S. manager of the United States branch of an alien

reinsurer,

Oklahoma Statutes - Title 36. Insurance Page 1026

c. an underwriting manager which, pursuant to contract,

manages all the reinsurance operations of the

reinsurer, is under common control with the reinsurer,

subject to Article 16A of the Insurance Code, and

whose compensation is not based on the volume of

premiums written, or

d. the manager of a group, association, pool or

organization of insurers which engage in joint

underwriting or joint reinsurance and who are subject

to examination by the Insurance Commissioner of the

state in which the manager's principal business office

is located;

8. "Reinsurer" means any person, firm, association or

corporation duly licensed in this state pursuant to the applicable

provisions of the Oklahoma Insurance Code as an insurer with the

authority to assume reinsurance;

9. "To be in violation" means failure by the reinsurance

intermediary, insurer, reinsurer, or reinsurer for whom the

reinsurance intermediary was acting to substantially comply with the

provisions of the Reinsurance Intermediary Act; and

10. "Qualified United States financial institution" means an

institution that:

a. is organized or, in the case of a U.S. office of a

foreign banking organization, licensed under the laws

of the United States or any state thereof,

b. is regulated, supervised and examined by U.S. federal

or state authorities having regulatory authority over

banks and trust companies, and

c. has been determined by either the Commissioner, or the

Securities Valuation Office of the National

Association of Insurance Commissioners, to meet such

standards of financial condition and standing as are

considered necessary and appropriate to regulate the

quality of financial institutions.
Okla. Stat. tit. 36, § 36-3622 — OK Code / Title 36 / Section 36-3622
Binders
Status: in_force

A. Binders or other contracts for temporary insurance may be

made orally or in writing, and shall be deemed to include all the

usual terms of the policy as to which the binder was given together

with such applicable endorsements as are designated in the binder,

except as superseded by the clear and express terms of the binder.

B. No binder shall be valid beyond the issuance of the policy

with respect to which it was given, or beyond ninety (90) days from

its effective date, whichever period is the shorter.

C. If the policy has not been issued a binder may be extended

or renewed beyond such ninety (90) days with the written approval of

the Insurance Commissioner, or in accordance with such rules and

regulations relative thereto as the Commissioner may promulgate.

D. This section shall not apply to life or accident and health

insurances.
Okla. Stat. tit. 36, § 36-311A.8 — OK Code / Title 36 / Section 36-311A.8
Audited consolidated or combined financial statements
Status: in_force

Oklahoma Statutes - Title 36. Insurance Page 87

An insurer may make written application to the Insurance

Commissioner for approval to file audited consolidated or combined

financial statements in lieu of separate annual audited financial

statements if the insurer is part of a group of insurance companies

that utilizes a pooling or one hundred percent (100%) reinsurance

agreement that affects the solvency and integrity of the reserves of

the insurer and the insurer cedes all of its direct and assumed

business to the pool. In such cases, a columnar consolidating or

combining worksheet shall be filed with the report, as follows:

1. Amounts shown on the consolidated or combined audited

financial report shall be shown on the worksheet;

2. Amounts for each insurer subject to this section shall be

stated separately;

3. Noninsurance operations may be shown on the worksheet on a

combined or individual basis;

4. Explanations of consolidating and eliminating entries shall

be included; and

5. A reconciliation shall be included of any differences

between the amounts shown in the individual insurer columns of the

worksheet and comparable amounts shown on the annual statements of

the insurers.
Okla. Stat. tit. 36, § 36-6934 — OK Code / Title 36 / Section 36-6934
Services permitted to be provided
Status: in_force

Health maintenance organizations may provide any services

included in state or federal health care programs, such as state

employee benefits, the state basic health benefits program,

"Medicare", "Medicaid", "CHAMPUS" and Veterans Administrations and

other health programs provided in whole or in part by state or

federal funds, in accordance with the laws governing such programs.
Okla. Stat. tit. 36, § 36-2716.1 — OK Code / Title 36 / Section 36-2716.1
Benefits
Status: in_force

A. A society may provide the following contractual benefits in

any form:

1. Death benefits;

2. Endowment benefits;

3. Annuity benefits;

4. Temporary or permanent disability benefits;

5. Hospital, medical or nursing benefits;

6. Monument or tombstone benefits to the memory of deceased

members; and

7. Such other benefits as authorized for life insurers and

which are not inconsistent with this article.

B. A society shall specify in its rules those persons who may

be issued, or covered by, the contractual benefits in subsection A

of this section, consistent with providing benefits to members and

their dependents. A society may provide benefits on the lives of

children under the minimum age for adult membership upon application

of an adult person.
Okla. Stat. tit. 36, § 36-2901 — OK Code / Title 36 / Section 36-2901
"Reciprocal" insurance defined
Status: in_force

"Reciprocal" insurance is that resulting from an inter-exchange

among persons, known as "subscribers," of reciprocal agreement of

indemnity, the inter-exchange being effectuated through an

"attorney-in-fact" common to all such persons.
Okla. Stat. tit. 36, § 36-1533 — OK Code / Title 36 / Section 36-1533
Notices to insurers - When effective
Status: in_force

All notices by the Insurance Commissioner to an insurer which

may result in regulatory action hereunder shall be effective upon

Oklahoma Statutes - Title 36. Insurance Page 423

dispatch if transmitted by registered or certified mail, or in the

case of any other transmission shall be effective upon the insurer's

receipt of such notice.
Okla. Stat. tit. 36, § 36-2135 — OK Code / Title 36 / Section 36-2135
Mutual member's share of assets on liquidation
Status: in_force

A. Upon any liquidation of a domestic mutual insurer, its

assets remaining after discharge of its indebtedness, policy

obligations, repayment of contributed or borrowed surplus, if any,

and expenses of administration, shall be distributed to existing

persons who were its members at any time within thirty-six (36)

months next preceding the date such liquidation was authorized or

ordered, or date of last termination of the insurer's certificate of

authority, whichever date is the earliest.

B. The distributive share of each such member shall be in the

proportion that the aggregate premiums earned by the insurer on the

policies of the member during the combined periods of his membership

bear to the aggregate of all premiums so earned on the policies of

all such members. The insurer may make a reasonable classification

of its policies so held by such members and a formula based upon

such classification for determining the equitable distributive share

of each such member. Such classification and formula shall be

subject to the approval of the Commissioner.

C. Subsections A and B above shall not apply to any mutual

which, prior to July 1, 1957, has provided for any other method of

liquidation through its articles and bylaws, and which have been

approved by the then Insurance Commissioner.
Okla. Stat. tit. 36, § 36-954 — OK Code / Title 36 / Section 36-954
Reunderwriting and rerating of insured - Refund of
Status: in_force

overpayment.

If it is determined through the dispute resolution process set

forth in the federal Fair Credit Reporting Act, 15 USC 1681i(a)(5),

that the credit information of a current insured was incorrect or

incomplete and if the insurer receives notice of such determination

from either the consumer reporting agency or from the insured, the

insurer shall reunderwrite and rerate the consumer within thirty

(30) days of receiving the notice. After reunderwriting or rerating

the insured, the insurer shall make any adjustments necessary,

consistent with its underwriting and rating guidelines. If an

insurer determines that the insured has overpaid premium, the

insurer shall refund to the insured the amount of overpayment

calculated back to the shorter of either the last twelve (12) months

of coverage or the actual policy period.
Okla. Stat. tit. 36, § 36-6802v2 — OK Code / Title 36 / Section 36-6802v2
Definitions
Status: in_force

As used in the Oklahoma Telemedicine Act:

1. "Distant site" means a site at which a health care

professional licensed to practice in this state is located while

providing health care services by means of telemedicine;

2. a. "Health benefits plan" means any plan or arrangement

that:

(1) provides benefits for medical or surgical

expenses incurred as a result of a health

condition, accident or illness, and

(2) is offered by any insurance company, group

hospital service corporation or health

maintenance organization that delivers or issues

for delivery an individual, group, blanket or

Oklahoma Statutes - Title 36. Insurance Page 1364

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, whether the

payment is fixed or by indemnity,

b. Health benefits plan shall not include:

(1) a plan that provides coverage:

(a) only for a specified disease or diseases or

under an individual limited benefit policy,

(b) only for accidental death or dismemberment,

(c) only for dental or vision care,

(d) for a hospital confinement indemnity policy,

(e) for disability income insurance or a

combination of accident-only and disability

income insurance, or

(f) as a supplement to liability insurance,

(2) a Medicare supplemental policy as defined by

Section 1882(g)(1) of the Social Security Act (42

U.S.C., Section 1395ss),

(3) workers' compensation insurance coverage,

(4) medical payment insurance issued as part of a

motor vehicle insurance policy,

(5) 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 benefits plan,

(6) short-term health insurance issued on a

nonrenewable basis with a duration of six (6)

months or less, or

(7) a plan offered by the Employees Group Insurance

Division of the Office of Management and

Enterprise Services;

3. "Health care professional" means a physician or other health

care practitioner licensed, accredited or certified to perform

specified health care services consistent with state law;

4. "Insurer" means any entity providing an accident and health

insurance policy in this state including, but not limited to, a

licensed insurance company, a not-for-profit hospital service and

medical indemnity corporation, a fraternal benefit society, a

multiple employer welfare arrangement or any other entity subject to

regulation by the Insurance Commissioner;

Oklahoma Statutes - Title 36. Insurance Page 1365

5. "Originating site" means a site at which a patient is

located at the time health care services are provided to him or her

by means of telemedicine, which may include, but shall not be

restricted to, a patient's home, workplace or school;

6. "Remote patient monitoring services" means the delivery of

home health services using telecommunications technology to enhance

the delivery of home health care including monitoring of clinical

patient data such as weight, blood pressure, pulse, pulse oximetry,

blood glucose and other condition-specific data, medication

adherence monitoring and interactive video conferencing with or

without digital image upload;

7. "Store and forward transfer" means the transmission of a

patient's medical information either to or from an originating site

or to or from the health care professional at the distant site, but

does not require the patient being present nor must it be in real

time; and

8. "Telemedicine" or "telehealth" means technology-enabled

health and care management and delivery systems that extend capacity

and access, which includes:

a. synchronous mechanisms, which may include live

audiovisual interaction between a patient and a health

care professional or real-time provider-to-provider

consultation through live interactive audiovisual

means,

b. asynchronous mechanisms, which include store and

forward transfers, online exchange of health

information between a patient and a health care

professional and online exchange of health information

between health care professionals, but shall not

include the use of automated text messages or

automated mobile applications that serve as the sole

interaction between a patient and a health care

professional,

c. remote patient monitoring, and

d. other electronic means that support clinical health

care, professional consultation, patient and

professional health-related education, public health

and health administration.
Okla. Stat. tit. 36, § 36-1163 — OK Code / Title 36 / Section 36-1163
Exclusion from application for certain policies or
Status: in_force

coverage certificates.

The provisions of Section 40 of this act and amendments thereto

shall not apply to any policy or certificate providing coverage for

any specified disease, specified accident or accident-only coverage,

credit, dental, disability income, hospital indemnity, long-term

care, as defined by Article 44 of Title 36 of the Oklahoma Statutes

and any amendments thereto, Medicare supplement, as defined by the

Insurance Commissioner by rules and regulations, vision care, short-

term nonrenewable health policy or other limited-benefit

supplemental insurance, nor any coverage issued as a supplement to

any liability insurance, workers’ compensation or similar insurance,

or any insurance under which benefits are payable with or without

regard to fault, whether written on a group, blanket or individual

basis.
Okla. Stat. tit. 36, § 36-4025 — OK Code / Title 36 / Section 36-4025
Incontestability after reinstatement
Status: in_force

The reinstatement of any policy of life insurance or annuity

contract hereafter delivered or issued for delivery in this state

may be contested on account of fraud or misrepresentation of facts

material to the reinstatement only for the same period following

reinstatement and with the same conditions and exceptions as the

policy provides with respect to contestability after original

issuance.
Okla. Stat. tit. 36, § 36-1427 — OK Code / Title 36 / Section 36-1427
Renumbered as § 1435.30 of this title by Laws 2001, c
Status: in_force

156, § 35, eff. Nov. 1, 2001.
Okla. Stat. tit. 36, § 36-6835 — OK Code / Title 36 / Section 36-6835
Definitions
Status: in_force

As used in this act:

1. "Insurance compliance audit" means a voluntary internal

evaluation, review, assessment, audit, or investigation for the

purpose of identifying or preventing noncompliance with, or

promoting compliance with, laws, regulations, orders, or industry or

professional standards, which is conducted by or on behalf of a

company licensed or regulated under the Oklahoma Insurance Code, or

which involves an activity regulated under this Code. Once

initiated, an audit shall be completed within a reasonable period of

time. Nothing in this section shall be construed to authorize

uninterrupted or continuous auditing; and

2. "Insurance compliance self-evaluative audit document" means

documents prepared as a result of or in connection with an insurance

compliance audit. An insurance compliance self-evaluative audit

document may include, but is not limited to, as applicable, field

notes and records of observations, findings, opinions, suggestions,

conclusions, drafts, memoranda, drawings, photographs, exhibits,

computer-generated or electronically recorded information, phone

records, maps, charts, graphs, and surveys; provided, this

supporting information is collected or developed for the primary

purpose and in the course of an insurance compliance audit. An

insurance compliance self-evaluative audit document also includes,

but is not limited to, any of the following:

Oklahoma Statutes - Title 36. Insurance Page 1378

a. an insurance compliance audit report prepared by an

auditor, who may be an employee of the company or an

independent contractor, which may include the scope of

the audit, the information gained in the audit, and

conclusions and recommendations, with exhibits and

appendices,

b. memoranda and documents analyzing portions or all of

the insurance compliance audit report and discussing

potential implementation issues,

c. an implementation plan that addresses correcting past

noncompliance, improving current compliance, and

preventing future noncompliance, or

d. analytic data generated in the course of conducting

the insurance compliance audit.

Documents, communications, data, reports or other information

which are created as a result of a claim involving personal injury,

property damage or workers’ compensation made against an insurance

policy are not insurance compliance self-evaluative audit documents

and are admissible as evidence in civil, criminal or administrative

proceedings as otherwise provided by applicable rules of evidence or

civil procedure, subject to any applicable statutory or common-law

privilege.
Okla. Stat. tit. 36, § 36-3613.2 — OK Code / Title 36 / Section 36-3613.2
Restrictions on recording of birth or ultrasound
Status: in_force

prohibited.

A. No insurer which writes physicians' or hospitals'

professional liability insurance shall, in a policy of insurance or

in a rider, endorsement, or other amendment of or addition to a

policy of insurance or by any means, attempt to restrict, control,

or otherwise interfere with any agreement between a patient and a

hospital or between a patient and a physician regarding recording of

a birth or ultrasound on video tape or disc, or otherwise.

B. The Insurance Commissioner shall revoke or refuse to approve

or renew an insurer's certificate of authority for violation of any

provision of this subsection.
Okla. Stat. tit. 36, § 36-4605 — OK Code / Title 36 / Section 36-4605
Direct primary care membership agreement
Status: in_force

A. As used in this section, "direct primary care membership

agreement" means a contractual agreement between a primary care

provider and an individual patient, or his or her legal

representative, in which:

1. The provider agrees to provide primary care services to the

individual patient for an agreed-to fee over an agreed-to period of

time;

2. The direct primary care provider will not bill third parties

on a fee-for-service basis; and

3. Any per-visit charges under the agreement will be less than

the monthly equivalent of the periodic fee.

Oklahoma Statutes - Title 36. Insurance Page 1003

A "direct primary care provider" means an individual or legal

entity that is licensed, registered or otherwise authorized to

provide primary care services in this state and who chooses to enter

into a direct primary care membership agreement. This includes, but

is not limited to, an individual primary care provider or other

legal entity alone or with others professionally associated with the

individual or other legal entity.

B. A direct primary care membership agreement is not insurance

and is not subject to regulation by the Insurance Department.

C. Entering into a direct primary care membership agreement is

not the business of insurance and is not subject to regulations

under the Oklahoma Insurance Code.

D. A direct primary care provider or the agent of a direct

primary care provider is not required to obtain a certification of

authority or license under Title 36 of the Oklahoma Statutes to

market, sell or offer to sell a direct primary care agreement.

E. A direct primary care membership agreement is not a medical

discount plan, as defined by state law or regulation under the

Insurance Department and a direct primary care provider is not

required to register as a medical discount plan.

F. A direct primary care membership agreement shall:

1. Allow either party to terminate the agreement upon written

notice to the other party;

2. Provide that fees are not earned by the direct primary care

provider until the month paid by the periodic fee has been

completed; and

3. Provide that, upon termination of this agreement by the

individual patient, all unearned fees are to be returned to the

patient.
Okla. Stat. tit. 36, § 36-6513 — OK Code / Title 36 / Section 36-6513
Application of act to certain group health benefit plans
Status: in_force

A. Except as otherwise provided in this section and in Section

3 of this act, the Small Employer Health Insurance Reform Act shall

apply to any group health benefit plan that provides coverage to two

(2) or more eligible employees of a small employer in this state and

to individual health benefits plans providing coverage for the

eligible employees of a small employer which may include the

employer when three (3) or more of such individual plans are sold to

a small employer if any of the following conditions are met:

1. Any portion of the premium or benefits is paid by or on

behalf of the small employer;

Oklahoma Statutes - Title 36. Insurance Page 1277

2. An eligible employee or dependent is reimbursed, whether

through wage adjustments or otherwise, by or on behalf of the small

employer for any portion of the premium; or

3. The health benefit plan is treated by the employer or any of

the eligible employees or dependents as part of a plan or program

for the purposes of Section 162 or Section 106 of the United States

Internal Revenue Code.

B. 1. Except as provided in paragraph 2 of this subsection,

for the purposes of the Small Employer Health Insurance Reform Act,

carriers that are affiliated companies or that are eligible to file

a consolidated tax return shall be treated as one carrier and any

restrictions or limitations imposed by the Small Employer Health

Insurance Reform Act shall apply as if all health benefit plans

issued to small employers in this state by such affiliated carriers

were issued by one carrier, unless on or before July 1, 1992, the

respective affiliate carriers operated with separate books of

business as insurers of health benefit plans in which event each

such affiliate carrier shall be treated as a separate carrier.

2. An affiliated carrier that is a health maintenance

organization granted a certificate of authority by the Insurance

Commissioner pursuant to the provisions of Sections 6901 through

6951 of Title 36 of the Oklahoma Statutes may be considered to be a

separate carrier for the purposes of the Small Employer Health

Insurance Reform Act.
Okla. Stat. tit. 36, § 36-2902 — OK Code / Title 36 / Section 36-2902
"Reciprocal insurer" defined
Status: in_force

A "reciprocal insurer" means an unincorporated aggregation of

subscribers operating individually and collectively through an

attorney-in-fact to provide reciprocal insurance among themselves.
Okla. Stat. tit. 36, § 36-4080 — OK Code / Title 36 / Section 36-4080
Enforcement of compliance
Status: in_force

A. If the Insurance Commissioner or an independent hearing

examiner finds that a violation of this act has occurred, the

Insurance Commissioner shall enforce compliance with this act by

sending a letter by certified mail, return receipt requested,

demanding that the charitable organization comply with this act. If

the charitable organization fails to comply with the demand within

thirty (30) days of receipt of the letter, the charitable

organization may be censured by the Insurance Commissioner or may be

subject to a civil fine of not less than One Thousand Dollars

($1,000.00) but not more than Ten Thousand Dollars ($10,000.00)

until such time as the charitable organization brings itself into

compliance with this act.

B. If the Insurance Commissioner or an independent hearing

examiner finds that the violation or threatened violation of this

act is willful and is substantially injurious to the public, the

Commissioner may file an action in district court to prevent,

restrain or enjoin such violation or threatened violation.

C. The failure of a charitable organization to comply with the

requirements of this act does not prevent a charitable gift annuity

from otherwise being a charitable gift annuity under the Internal

Revenue Code.

Oklahoma Statutes - Title 36. Insurance Page 916
Okla. Stat. tit. 36, § 36-1161 — OK Code / Title 36 / Section 36-1161
Definitions
Status: in_force

As used in this act:

1. “Adverse tier placement” means being subject to the rates of

any tier with less coverage or higher premiums than the tier within

which the insured is currently insured;

2. “Federal government-sponsored health insurance program”

means the TriCare program providing coverage for civilian dependents

of military personnel;

3. “Health plan” means any insurance company or health

maintenance organization which issues individual coverage to a

resident of this state;

Oklahoma Statutes - Title 36. Insurance Page 268

4. “Individual coverage” means health insurance or health

maintenance organization coverage issued on other than a group or

blanket basis, including an individual coverage containing coverage

for a spouse, dependent, or both;

5. “Insureds” means persons enrolled under individual coverage

issued by a health plan. Insureds include persons covered under a

policy of personal insurance; and

6. “Personal insurance” means private passenger automobile,

motorcycle, mobile homeowners, homeowners, renters and

noncommercial-dwelling fire insurance policies and boat, personal

watercraft, snowmobile and recreational vehicle policies.
Okla. Stat. tit. 36, § 36-1907 — OK Code / Title 36 / Section 36-1907
Grounds for conservation of foreign insurers
Status: in_force

The Insurance Commissioner may apply to the court for an order

appointing him as receiver or ancillary receiver, and directing him

to conserve the assets within this state of a foreign insurer upon

any of the following grounds:

1. Upon any of the grounds specified in sections 1805 or 1806

of this article, or

2. Upon the ground that its property has been sequestrated in

its domiciliary sovereignty or in any other sovereignty.
Okla. Stat. tit. 36, § 36-2681 — OK Code / Title 36 / Section 36-2681
Nonliability
Status: in_force

A dental service corporation shall not be liable for injuries

resulting from negligence or malpractice on the part of any

participating or other dentist or supplier of services to any

subscriber. A participating dentist shall not be liable for any

wrongful or negligent conduct by a dental service corporation or any

of its officers, directors or agents.
Okla. Stat. tit. 36, § 36-2809 — OK Code / Title 36 / Section 36-2809
Incidental expenses
Status: in_force

The bylaws shall provide for sufficient assessment to pay for

stationery, blanks, printing, postage, viewing and appraising

losses, and such other incidental expenses as may be necessary to

conduct the business of such association.
Okla. Stat. tit. 36, § 36-2014 — OK Code / Title 36 / Section 36-2014
Scope of covered claims
Status: in_force

Oklahoma Statutes - Title 36. Insurance Page 586

A covered claim shall not include any claim filed with the

Association after the final date set by the court for the filing of

claims against the liquidator or receiver of an insolvent insurer.
Okla. Stat. tit. 36, § 36-309.5 — OK Code / Title 36 / Section 36-309.5
Examiner's conflict of interest
Status: in_force

A. No examiner may be appointed by the Insurance Commissioner

if such examiner, either directly or indirectly, has a conflict of

interest or is affiliated with the management of or owns a pecuniary

interest in any person subject to examination under Sections 309.1

through 309.7 of this title. This section shall not be construed to

automatically preclude an examiner from being:

1. A policyholder or claimant under an insurance policy;

2. A grantor of a mortgage or similar instrument on such

examiner's residence to a regulated entity if done under customary

terms and in the ordinary course of business;

3. An investment owner in shares of regulated diversified

investment companies; or

4. A settlor or beneficiary of a blind trust into which any

otherwise impermissible holdings have been placed.

B. Notwithstanding the requirements of this section, the

Commissioner may retain from time to time, on an individual basis,

qualified actuaries, an accounting firm or individual holding a

permit to practice public accounting in this state, or other similar

individuals who are independently practicing their professions, even

though said persons may from time to time be similarly employed or

retained by persons subject to examination under this act. An

examiner shall disclose to the Commissioner in writing any prior or

existing personal or business relationship with any company to be

examined by that examiner.
Okla. Stat. tit. 36, § 36-6713 — OK Code / Title 36 / Section 36-6713
Limited lines travel insurance producer license
Status: in_force

A. The Insurance Commissioner may issue a limited lines travel

insurance producer license to an individual or business entity that

has filed with the Commissioner an application for such license in a

form and manner prescribed by the Commissioner. The limited lines

travel insurance producer shall be licensed to sell, solicit or

negotiate travel insurance through a licensed insurer. No person

may act as a limited lines travel insurance producer or travel

insurance retailer unless properly licensed or registered,

respectively.

B. A travel retailer may offer and disseminate travel insurance

under a limited lines travel insurance producer business entity

license only if:

1. The limited lines travel insurance producer or travel

retailer provides to purchasers of travel insurance:

a. a description of the material terms or the actual

material terms of the insurance coverage,

b. a description of the process for filing a claim,

c. a description of the review or cancellation process

for the travel insurance policy, and

d. the identity and contact information of the insurer

and limited lines travel insurance producer;

2. At the time of licensure, the limited lines travel insurance

producer shall establish and maintain a register on a form

prescribed by the Commissioner of each travel retailer that offers

travel insurance on behalf of the limited lines travel insurance.

The register shall be maintained and updated by the limited lines

travel insurance producer and shall include the name, address and

contact information of the travel retailer and an officer or person

who directs or controls the operations of the travel retailer and

the federal tax identification number of the travel retailer. The

limited lines travel insurance producer shall submit the register to

the Insurance Department upon reasonable request. The limited lines

travel insurance producer shall also certify that the registered

travel retailer complies with 18 U.S.C., Section 1033. The grounds

for the suspension, revocation and the penalties applicable to

resident insurance producers, pursuant to Section 1435.13 of this

title, shall be applicable to the limited lines travel insurance

producers and travel retailers;

3. The limited lines travel insurance producer has designated

one of its employees, a designated responsible producer, who is a

licensed individual producer as the person responsible for the

compliance with the travel insurance laws and regulations applicable

to the limited lines travel insurance producer and its registrants;

4. The designated responsible producer, president, secretary,

treasurer and any other officer or person who directs or controls

the limited lines travel insurance producer’s insurance operations

Oklahoma Statutes - Title 36. Insurance Page 1350

comply with the fingerprinting requirements applicable to insurance

producers in the resident state of the limited lines travel

insurance producer;

5. The limited lines travel insurance producer has paid all

applicable insurance producer licensing fees as set forth in Section

1435.23 of this title; and

6. The limited lines travel insurance producer requires each

employee and authorized representative of the travel retailer whose

duties include offering and disseminating travel insurance to

receive a program of instruction or training, which is subject to

the discretion of the Commissioner to review and approve. The

training material shall, at a minimum, contain adequate instructions

on the types of insurance offered, ethical sales practices and

required disclosures to prospective customers.

C. Any travel retailer offering or disseminating travel

insurance shall make available to prospective purchasers brochures

or other written materials that have been approved by the travel

insurer. Such materials shall include information which, at a

minimum:

1. Provides the identity and contact information of the insurer

and the limited lines travel insurance producer;

2. Explains that the purchase of travel insurance is not

required in order to purchase any other product or service from the

travel retailer; and

3. Explains that an unlicensed travel retailer is permitted to

provide only general information about the insurance offered by the

travel retailer, including a description of the coverage and price,

but is not qualified or authorized to answer technical questions

about the terms and conditions of the insurance offered by the

travel retailer or to evaluate the adequacy of the customer’s

existing insurance coverage.

D. A travel retailer employee or authorized representative who

is not licensed as an insurance producer may not:

1. Evaluate or interpret the technical terms, benefits and

conditions of the offered travel insurance coverage;

2. Evaluate or provide advice concerning existing insurance

coverage for a prospective purchaser; or

3. Hold himself, herself or itself out as a licensed insurer,

licensed producer or insurance expert.

E. Notwithstanding any other provision in law, a travel

retailer whose insurance-related activities, and those of its

employees and authorized representatives, are limited to offering

and disseminating travel insurance on behalf of and under the

direction of a limited lines travel insurance producer meeting the

conditions stated in the Travel Insurance Act, is authorized to

receive related compensation, upon registration by the limited lines

Oklahoma Statutes - Title 36. Insurance Page 1351

travel insurance producer as described in paragraph 2 of subsection

B of this section.

F. As the insurer designee, the limited lines travel insurance

producer is responsible for the acts of the travel retailer and

shall use reasonable means to ensure compliance by the travel

retailer with the Travel Insurance Act.

G. Any person licensed as an insurance producer with a line of

authority set forth in paragraphs 1 through 4, 6 and 7 of subsection

A of Section 1435.8 of this title is authorized to sell, solicit and

negotiate travel insurance. The producer is not required to be

appointed by an insurer in order to sell, solicit or negotiate the

travel insurance.
Okla. Stat. tit. 36, § 36-3613.1 — OK Code / Title 36 / Section 36-3613.1
Policies and claims - Fraud warning
Status: in_force

Oklahoma Statutes - Title 36. Insurance Page 783

Every insurance policy or application and every insurance claim

form shall contain a statement that clearly indicates in substance

the following: "WARNING: Any person who knowingly, and with intent

to injure, defraud or deceive any insurer, makes any claim for the

proceeds of an insurance policy containing any false, incomplete or

misleading information is guilty of a felony." The absence of such

a statement shall not constitute a defense in any prosecution.
Okla. Stat. tit. 36, § 36-4005 — OK Code / Title 36 / Section 36-4005
Application and policy as entire contract; statements in
Status: in_force

application as representations.

There shall be a provision that the policy, or the policy and

the application therefor if a copy of such application is endorsed

upon or attached to the policy when issued, shall constitute the

entire contract between the parties, and that all statements

contained in the application shall, in the absence of fraud, be

deemed representations and not warranties.
Okla. Stat. tit. 36, § 36-4522 — OK Code / Title 36 / Section 36-4522
Definitions
Status: in_force

As used in the Employer Health Insurance Purchasing Group Act:

1. "Commissioner" means the Oklahoma Insurance Commissioner;

2. "Eligible employee" means an employee or individual who

works the number of hours per week designated by the employer as

full-time employment and is qualified to enroll in a health benefit

plan offered through a HIPG;

3. "Eligible employer" means an employer employing no more than

one hundred eligible employees;

4. "Employer", "employee", and "dependent", unless otherwise

defined in this section, shall have the meaning applied to the terms

with respect to the coverage under the laws of the state relating to

the coverage and the issuer;

5. "Full time" shall be defined by the employer, but in no

event shall it be less than twenty-four (24) hours per week;

6. "Health benefits plan" means a group plan, group policy, or

group contract for health care services, issued or delivered by a

HIPG health carrier, excluding plans, policies, or contracts

providing health care benefits or health care services pursuant to

the Workers’ Compensation Laws and mandatory liability laws;

7. "Health insurer" means any entity which provides health

insurance in this state. For the purposes of the Employer Health

Insurance Purchasing Group Act, “health insurer” includes a licensed

insurance company, not-for-profit hospital service or medical

indemnity corporation, or a health maintenance organization;

8. "HIPG" means a Health Insurance Purchasing Group meeting the

requirements of this act;

9. "HIPG health carrier" means a health insurer as defined in

this act;

Oklahoma Statutes - Title 36. Insurance Page 994

10. "Large group" means a combination of two or more eligible

employers belonging to a HIPG;

11. "Limited benefit contract" means, for the purposes of this

act, a policy or certificate that does not contain state-mandated

health benefits;

12. "Member" means an individual enrolled for health benefits

coverage in a HIPG;

13. "Purchaser" means an eligible employer that has contracted

with a HIPG for the purchase of health benefits coverage;

14. a. "State-mandated health benefits" means coverages for

health care services or benefits, required by state

law or state regulations, requiring the reimbursement

or utilization related to a specific illness, injury,

or condition of the covered person, or inclusion of a

specific category of licensed health care practitioner

to be provided to the covered person in a health

benefits plan for a health-related condition of a

covered person. Provided, that for the purposes of

the options provided by this act, state-mandated

health benefits which may be excluded in whole or in

part shall not include any health care services or

benefits which were mandated by federal law, and

b. "State-mandated health benefits" does not mean

standard provisions or rights required to be present

in a health benefit plan pursuant to state law or

state regulations unrelated to a specific illness,

injury or condition of the insured, including, but not

limited to, those related to continuation of benefits

found in Article 45 of the Oklahoma Insurance Code;

and

15. "Total eligible employees" means two hundred or more

eligible employees.
Okla. Stat. tit. 36, § 36-1250.6 — OK Code / Title 36 / Section 36-1250.6
Property and casualty insurer - Acknowledging receipt
Status: in_force

of claim - Commissioner's inquiry - Other communications - Claim

forms, instructions and assistance.

A. Every property and casualty insurer, within thirty (30) days

after receiving notification of a claim, shall acknowledge the

receipt of such notification unless payment is made within such

period of time. If an acknowledgement is made by means other than

writing, an appropriate notation of such acknowledgement shall be

made in the claim file of the property and casualty insurer, and

dated. Notification given to an agent of a property and casualty

insurer shall be notification to the insurer.

B. Every property and casualty insurer, upon receiving

notification of a claim, promptly shall provide necessary claim

forms, instruction, and reasonable assistance so that first party

claimants can comply with the policy conditions and the reasonable

requirements of the property and casualty insurer. Compliance with

this paragraph within thirty (30) days after notification of a claim

shall constitute compliance with subsection A of this section.Oklahoma Statutes - Title 36. Insurance Page 9
Okla. Stat. tit. 36, § 36-3641 — OK Code / Title 36 / Section 36-3641
Short title
Status: in_force

Oklahoma Statutes - Title 36. Insurance Page 819

Sections 1 through 9 of this act shall be known and may be cited

as the "Life, Accident and Health Insurance Policy Language

Simplification Act".
Okla. Stat. tit. 36, § 36-2516 — OK Code / Title 36 / Section 36-2516
Foreign and alien companies
Status: in_force

No corporation, company, association or society organized under

the laws of any other state or territory of the United States, or

the District of Columbia, or foreign country shall transact business

under the provisions of this article until it has received from the

Insurance Commissioner a certificate of authority to do business in

this state, a duplicate of which shall be filed in his office. The

Insurance Commissioner shall annually issue to such foreign

corporation, company or association renewal certificates of

authority to continue business, if it shall have fully complied with

the provisions of this article, and if the Insurance Commissioner

shall be of the opinion that any such corporation, company or

association is not entitled to a renewal of a certificate of

authority, he shall cite the same to appear, giving reasons

Oklahoma Statutes - Title 36. Insurance Page 681

therefor, and to show cause why the certificate of authority should

be renewed, and unless the certificate of authority shall be renewed

within thirty days after such hearing, such foreign corporation,

company or association shall cease to do business in this state. No

foreign corporation, company, association or society shall be

authorized to transact any business authorized by this article

within this state, unless it can furnish evidence satisfactory to

the Insurance Commissioner that it has a reserve or emergency fund

equal in amount to that required by this article, and the same is

held for the benefit of policyholders only, and invested as required

by the insurance laws of its home state.
Okla. Stat. tit. 36, § 36-6596 — OK Code / Title 36 / Section 36-6596
Application of Section 9.1 of Title 23 to cause of action
Status: in_force

brought under act.

Subparagraph c of paragraph 2 of subsection C of Section 9.1 of

Title 23 of the Oklahoma Statutes shall not apply to any cause of

action brought under the Managed Health Care Reform and

Accountability Act.
Okla. Stat. tit. 36, § 36-4603 — OK Code / Title 36 / Section 36-4603
Enrollment in health insurance programs of uninsured individuals and individuals not
Status: in_force

Oklahoma Statutes - Title 36. Insurance Page 28individuals and individuals not covered by Medicaid.

A. The Insurance Commissioner in collaboration with the

Oklahoma Health Care Authority shall initiate a program to encourage

enrollment of individuals, not covered by insurance or Medicaid in

health insurance programs.

B. Upon treatment of an uninsured individual or an individual

not covered by Medicaid, a health care provider shall refer the

individual to the HUB established in Section 2 of this act to begin

the enrollment process in a certified insurance plan or the premium

Oklahoma Statutes - Title 36. Insurance Page 1002

assistance program established in Section 1010.1 of Title 56 of the

Oklahoma Statutes, if eligible.
Okla. Stat. tit. 36, § 36-1118 — OK Code / Title 36 / Section 36-1118
Legal process against surplus line insurer
Status: in_force

A. Every surplus lines insurer issuing or delivering a surplus

line policy through a surplus lines licensee or broker in this state

shall conclusively be deemed thereby to have irrevocably appointed

the Insurance Commissioner as its attorney for acceptance of service

Oklahoma Statutes - Title 36. Insurance Page 259

of all legal process, other than a subpoena, issued in this state in

any action or proceeding under or arising out of the policy, and

service of process upon the Insurance Commissioner shall be lawful

personal service upon the surplus lines or nonadmitted insurer.

B. Each surplus line policy shall contain a provision stating

the substance of subsection A of this section, and designating the

person to whom the Insurance Commissioner shall mail process as

provided in subsection C of this section.

C. Triplicate copies of legal process against such an insurer

shall be served upon the Insurance Commissioner, and at time of

service the plaintiff shall pay to the Insurance Commissioner Twenty

Dollars ($20.00), taxable as costs in the action. The Insurance

Commissioner shall immediately mail one copy of the process so

served to the person designated by the insurer in the policy for the

purpose, by mail with return receipt requested. The surplus lines

or nonadmitted insurer shall have forty (40) days after the date of

mailing within which to plead, answer, or otherwise defend the

action.
Okla. Stat. tit. 36, § 36-1255 — OK Code / Title 36 / Section 36-1255
Renumbered as § 1250.6 of this title by Laws 1994, c
Status: in_force

342, § 20, eff. Sept. 1, 1994.
Okla. Stat. tit. 36, § 36-115 — OK Code / Title 36 / Section 36-115
Particular provisions prevail
Status: in_force

Provisions of this Code relative to a particular kind of

insurance or a particular type of insurer or to a particular matter

shall prevail over provisions relating to insurance in general or

insurers in general or to such matter in general.
Okla. Stat. tit. 36, § 36-1676 — OK Code / Title 36 / Section 36-1676
Powers of Commissioner or receiver - Civil actions
Status: in_force

A. 1. If the Commissioner believes that the controlling

producer or any other person has not materially complied with the

Business Transacted with Producer Controlled Insurer Act, or any

regulation or order promulgated hereunder, after notice and

opportunity to be heard, the Commissioner may order the controlling

producer to cease placing business with the controlled insurer; and

2. If it was found that because of such material noncompliance

that the controlled insurer or any policyholder thereof has suffered

any loss or damage, the Commissioner may maintain a civil action or

intervene in an action brought by or on behalf of the insurer or

policyholder for recovery of compensatory damages for the benefit of

the insurer or policyholder or other appropriate relief.

B. If an order for liquidation or rehabilitation of the

controlled insurer has been entered pursuant to Section 1903 of

Title 36 of the Oklahoma Statutes, and the receiver appointed under

that order believes that the controlling producer or any other

person has not materially complied with this act, or any regulation

or order promulgated hereunder, and the insurer suffered any loss or

damage therefrom, the receiver may maintain a civil action for

recovery of damages or other appropriate sanctions for the benefit

of the insurer.

C. Nothing contained in this section shall affect the right of

the Commissioner to impose any other penalties provided for in the

Insurance Code.

Oklahoma Statutes - Title 36. Insurance Page 499

D. Nothing contained in this section is intended to or shall in

any manner alter or affect the rights of policyholders, claimants,

creditors or other third parties.
Okla. Stat. tit. 36, § 36-4216 — OK Code / Title 36 / Section 36-4216
Title of policy
Status: in_force

There shall be a title on the face of each such policy briefly

describing its form.

Oklahoma Statutes - Title 36. Insurance Page 934
Okla. Stat. tit. 36, § 36-6475.6 — OK Code / Title 36 / Section 36-6475.6
Form of external review requests
Status: in_force

A. 1. Except for a request for an expedited external review as

set forth in Section 6475.9 of this title, all requests for external

review shall be made in writing to the Insurance Commissioner.

2. The Commissioner may prescribe by rule the form and content

of external review requests required to be submitted under this

section.

B. A covered person or the covered person's authorized

representative may make a request for an external review of an

adverse determination or final adverse determination.
Okla. Stat. tit. 36, § 36-2719.1 — OK Code / Title 36 / Section 36-2719.1
Benefit contract - Standard provision requirements
Status: in_force

A. Every society authorized to do business in this state shall

issue to each owner of a benefit contract a certificate specifying

the amount of benefits provided thereby. The certificate, together

with any riders or endorsements attached thereto, the laws of the

Oklahoma Statutes - Title 36. Insurance Page 724

society, the application for membership, the application for

insurance and declaration of insurability, if any, signed by the

applicant, and all amendments to each, shall constitute the benefit

contract, as of the date of issuance, between the society and the

owner, and the certificate shall so state. A copy of the

application for insurance and declaration of insurability, if any,

shall be endorsed upon or attached to the certificate. All

statements on the application shall be representations and not

warranties. Any waiver of this provision shall be void.

B. Any changes, additions or amendments to the laws of the

society duly made or enacted subsequent to the issuance of the

certificate shall bind the owner and the beneficiaries, and shall

govern and control the benefit contract in all respects the same as

though such changes, additions or amendments had been made prior to

and were in force at the time of the application for insurance,

except that no change, addition or amendment shall destroy or

diminish benefits which the society contracted to give the owner as

of the date of issuance.

C. Any person upon whose life a benefit contract is issued

prior to attaining the age of majority shall be bound by the terms

of the application and certificate and by all the laws and rules of

the society to the same extent as though the age of majority had

been attained at the time of application.

D. A society shall provide in its laws that if its reserves as

to all or any class of certificates become impaired, its board of

directors or corresponding body may require that there shall be paid

by the owner of the certificate to the society the amount of the

owner's equitable proportion of the deficiency as ascertained by its

board, and that if the payment is not made, either:

1. It shall stand as an indebtedness against the certificate

and draw interest not to exceed the rate specified for certificate

loans under the certificates; or

2. In lieu of or in combination with the provisions of

paragraph 1 of this subsection, the owner may accept a proportionate

reduction in benefits under the certificate.

The society may specify the manner of the election and which

alternative is to be presumed if no election is made.

E. Copies of any of the documents mentioned in this section,

certified by the secretary or corresponding officer of the society,

shall be received as evidence of the terms and conditions thereof.

F. No certificate shall be delivered or issued for delivery in

this state unless a copy of the form has been filed with and

approved by the Insurance Commissioner in the manner provided for

like policies issued by life insurers in this state. Every life,

accident, health, or disability insurance certificate and every

annuity certificate issued on or after one (1) year from the

effective date of this act shall meet the standard contract

Oklahoma Statutes - Title 36. Insurance Page 725

provision requirements not inconsistent with this article for like

policies issued by life insurers in this state, except that a

society may provide for a grace period for payment of premiums of

one (1) full month in its certificates. The certificate shall also

contain a provision stating the amount of premiums which are payable

under the certificate and a provision reciting or setting forth the

substance of any sections of the society's laws or rules in force at

the time of issuance of the certificate which, if violated, will

result in the termination or reduction of benefits payable under the

certificate. If the laws of the society provide for expulsion or

suspension of a member, the certificate shall also contain a

provision that any member so expelled or suspended, except for

nonpayment of a premium or within the contestable period for

material misrepresentation in the application for membership or

insurance, shall have the privilege of maintaining the certificate

in force by continuing payment of the required premium.

G. Benefit contracts issued on the lives of persons below the

society's minimum age for adult membership may provide for transfer

of control or ownership to the insured at an age specified in the

certificate. A society may require approval of an application for

membership in order to effect this transfer, and may provide in all

other respects for the regulation, government and control of such

certificates and all rights, obligations and liabilities incident

thereto and connected therewith. Ownership rights prior to such

transfer shall be specified in the certificate.

H. A society may specify the terms and conditions on which

benefit contracts may be assigned.
Okla. Stat. tit. 36, § 36-998 — OK Code / Title 36 / Section 36-998
Appeals from Commissioner
Status: in_force

Appeals from Commissioner.

A. Any party aggrieved by an order or decision of the

Commissioner may, within thirty (30) days after receiving the

Commissioner's notice, make written request for a hearing.

B. Any order, decision or act of the Commissioner pursuant to

the Property and Casualty Competitive Loss Cost Rating Act is

subject to judicial review upon petition of any person aggrieved.

The appeal shall be in accordance with the Administrative Procedures

Act.

Oklahoma Statutes - Title 36. Insurance Page 242
Okla. Stat. tit. 36, § 36-941.2 — OK Code / Title 36 / Section 36-941.2
Motor vehicle liability policies – Provision relating to
Status: in_force

financial responsibility limits of another state or province.

Every motor vehicle liability insurance policy approved by the

Insurance Commissioner shall include a provision providing that the

financial responsibility limits of another state or province shall

be met if so required by the other state and if the financial

responsibility limits of the other state or province are higher than

those required by the state where the motor vehicle is principally

garaged. The policy does not have to contain the exact wording of

this section or any other exact wording. Language which is

substantially similar to this section shall be considered to be in

compliance with this section.
Okla. Stat. tit. 36, § 36-6103.9 — OK Code / Title 36 / Section 36-6103.9
Service of process
Status: in_force

A. 1. Service of process on a person as defined in Section

6103.3 of this title in a civil suit for injunctive relief under

Section 6103.3 of this title or to recover a civil penalty under

Section 6103.7 of this title shall be made by serving the Secretary

of State as agent of the person.

2. Service of process shall be made pursuant to Section 2004 of

Title 12 of the Oklahoma Statutes. The Insurance Commissioner shall

not pay a fee. Persons served under the provisions of Sections

6103.1 through 6103.11 of this title shall not be considered foreign

insurance companies.

B. Nothing contained in this section shall limit or abridge the

right to serve any process upon any person in any other manner now

or hereafter permitted by law.

Oklahoma Statutes - Title 36. Insurance Page 1136
Okla. Stat. tit. 36, § 36-1424.16 — OK Code / Title 36 / Section 36-1424.16
Renumbered as § 1435.36 of this title by Laws 2001, c
Status: in_force

156, § 35, eff. Nov. 1, 2001.
Okla. Stat. tit. 36, § 36-1801 — OK Code / Title 36 / Section 36-1801
Legislative findings and purposes
Status: in_force

A. The Legislature finds that:

1. Existing provisions of law and present procedures are

sometimes not adequate nor appropriate under all circumstances

inorder to remedy the financial condition and the management of

certain insurers;

2. Present laws are not adequate for the rehabilitation of

insurers who voluntarily requestrehabilitation;

3. A void exists in the laws with respect to those insurers

most susceptible to rehabilitation or the regaining of solvency;

Oklahoma Statutes - Title 36. Insurance Page 523

4. The placing of an insurer in receivership often destroys or

diminishes, or is likely to destroy ordiminish, one or more of the

following values or assets:

a. the value of the insurance account or in-force

business of the insurer,

b. the value of the insurer as a going concern,

c. the value of its agency force, and

d. the value of other of its assets;

5. Such values and assets should be preserved if the

circumstances of the insurer's financial condition warrant an

attempt to conserve or rehabilitate such insurer and such

rehabilitation or conservation is otherwise feasible;

6. In the event receivership ultimately becomes necessary,

preliminary supervision and conservatorship is preventive of a

dissipation of assets and will thus benefit policyholders, creditors

and owners;

7. Insurer delinquency, or the state's inability to properly

proceed in a threatened delinquency, directly or indirectly affects

other insurers by creating a lack of public confidence in insurance

and in insurance companies and are destructive of public confidence

in the capacity of the state to regulate insurers, and these and

other harmful results of insurer delinquency are properly minimized

by a further enactment designed to protect and in aid of insureds,

creditors and owners; and

8. It is a proper concern of this state to attempt to correct

or remedy insurer misconduct, ineptness or misfortune.

B. It is the purpose of this act to:

1. Provide for rehabilitation and conservation of insurers by

authorizing and requiring the additional facility of supervision and

conservatorship by the Insurance Commissioner, authorize action to

resolve whether an attempt be made to rehabilitate and conserve an

insurer, and avoid, if possible and feasible, the necessity of

temporary or permanent receivership;

2. Provide for protection of the assets of an insurer pending

determination of whether or not an insurer can be successfully

rehabilitated; and

3. Provide a facility and direction for attempting the

rehabilitation without immediate resort to the harsher remedy of

receivership.

C. The substance and procedure of this act is, therefore,

declared to be the public policy of this state and necessary to the

public welfare. Such policy and welfare require the availability of

the remedies provided by this law whenever circumstances warrant,

and it is a condition of doing an insurance business in this state.
Okla. Stat. tit. 36, § 36-2706.1 — OK Code / Title 36 / Section 36-2706.1
Laws or rules required
Status: in_force

A. A society shall specify in its laws or rules:

1. Eligibility standards for each and every class of

membership; provided, if benefits are provided on the lives of

children, the minimum age for adult membership shall be set at not

less than age fifteen (15) nor greater than age twenty-one (21);

2. The process for admission to membership for each membership

class; and

3. The rights and privileges of each membership class;

provided, only benefit members shall have the right to vote on the

management of the insurance affairs of the society.

Oklahoma Statutes - Title 36. Insurance Page 714

B. A society may also admit social members who shall have no

voice or vote in the management of the insurance affairs of the

society.

C. Membership rights in the society are personal to the member

and are not assignable.
Okla. Stat. tit. 36, § 36-4525 — OK Code / Title 36 / Section 36-4525
Filing of forms and plan – Notice required on face page
Status: in_force

of policy and certificate.

A. Each Health Insurance Purchasing Group (HIPG) shall file

forms as may be described by rules and regulations of the

Commissioner.

B. Each HIPG health carrier shall file the health benefits plan

to be issued to a HIPG pursuant to Article 36 of the Oklahoma

Insurance Code.

C. Each HIPG health carrier, which develops or offers a health

benefits plan for a HIPG that is a limited benefit plan not subject

to state-mandated health benefits, shall specify on the face page of

the policy and certificate, printed in ten-point or larger type, a

statement that clearly indicates in substance the following:

“IMPORTANT NOTICE: This policy is a limited benefit contract

which has been established by a Health Insurance Purchasing Group

(HIPG). It may not contain mandated benefits found under Oklahoma

Insurance Laws. READ YOUR POLICY CAREFULLY.”
Okla. Stat. tit. 36, § 36-1697 — OK Code / Title 36 / Section 36-1697
Receivership – Amounts recoverable
Status: in_force

A. Notwithstanding any contrary provision in the Oklahoma

Insurance Code, the rules promulgated under the Oklahoma Insurance

Code or any other applicable law or rule, upon placement under

administrative supervision or upon any order of conservation,

rehabilitation or liquidation of a protected cell company, the

receiver shall be bound to deal with the protected cell company's

assets and liabilities, including protected cell assets and

protected cell liabilities, in accordance with the requirements set

forth in the Protected Cell Companies Act.

B. With respect to amounts recoverable under a protected cell

company insurance securitization, the amount recoverable by the

receiver shall not be reduced or diminished as a result of the

placement under administrative supervision or entry of an order of

conservation, rehabilitation or liquidation with respect to the

protected cell company or any of its protected cells,

notwithstanding any provisions to the contrary in the contracts or

other documentation governing the protected cell company insurance

securitization.
Okla. Stat. tit. 36, § 36-2905 — OK Code / Title 36 / Section 36-2905
Name; suits
Status: in_force

A reciprocal insurer shall:

Oklahoma Statutes - Title 36. Insurance Page 742

1. Have and use a business name. The name shall include the

word "reciprocal," or "interinsurer," or "inter-insurance," or

"exchange," or "underwriters," or "underwriting."

2. Sue and be sued in its own name.
Okla. Stat. tit. 36, § 36-3643 — OK Code / Title 36 / Section 36-3643
Definitions
Status: in_force

As used in the Life, Accident and Health Insurance Policy

Language Simplification Act:

1. "Policy" or "policy form" means any policy, contract, plan

or agreement of life insurance, health and accident insurance, or

subscriber certificates of medical care corporations, health care

corporations, hospital service associations, or health care

maintenance organizations, delivered or issued for delivery in this

state by any company subject to the Life, Accident and Health

Insurance Policy Language Simplification Act; any certificate,

contract or policy issued by a fraternal benefit society; any

certificate issued pursuant to a group insurance policy delivered or

issued for delivery in this state; and any evidence of coverage

issued by a health maintenance organization.

2. "Company" or "insurer" means any entity authorized to do the

business of life insurance, accident and health insurance; a

fraternal benefit society; a medical care corporation; a health care

corporation; a hospital service association; or a health maintenance

organization.
Okla. Stat. tit. 36, § 36-612 — OK Code / Title 36 / Section 36-612
Additional kinds of insurance - Requirments
Status: in_force

Oklahoma Statutes - Title 36. Insurance Page 130

A. An insurance company which incorporates or is authorized

initially to transact the business of insurance in Oklahoma after

the effective date of this act may transact all kinds of insurance

with no additional capital or surplus requirements.

B. An insurance company which incorporated or was initially

authorized to transact the business of insurance in Oklahoma prior

to the effective date of this act and which is otherwise qualified

therefor may be authorized to transact combinations of kinds of

insurance (other than the life and accident and health combination

shown in Section 610 of this article) while possessing and

maintaining thereafter additional surplus in regard to policyholders

not less in amount than that determined in subsection C of this

section.

C. For any lawful combination add One Hundred Thousand Dollars

($100,000.00) for each additional kind of insurance included in the

combination, to the amount required under Section 610 of this

article for that one kind of insurance in the combination for which

the largest amount is required under said Section 610, except:

1. Vehicle and accident and health insurance may be combined

with casualty, and in any combination including casualty, without

funds in addition to those required because of casualty.

2. An insurer, if otherwise qualified therefor, may be

authorized to transact all kinds of insurance except life and title

insurance.

3. The amount of such surplus in regard to policyholders shall

not in any event be less than would be required if the insurer

proposed to transact in Oklahoma all those kinds of insurance which

it is transacting elsewhere.
Okla. Stat. tit. 36, § 36-6475.15 — OK Code / Title 36 / Section 36-6475.15
Written records
Status: in_force

A. 1. An independent review organization assigned pursuant to

Section 6475.8, 6475.9, or 6475.10 of this title to conduct an

external review shall maintain written records in the aggregate by

state and by health carrier on all requests for external review for

which it conducted an external review during a calendar year and,

upon request, submit a report to the Insurance Commissioner, as

required under paragraph 2 of this subsection.

2. Each independent review organization required to maintain

written records on all requests for external review pursuant to

paragraph 1 of this subsection for which it was assigned to conduct

an external review shall submit to the Commissioner, upon request, a

report in the format specified by the Commissioner.

3. The report shall include in the aggregate by state, and for

each health carrier:

a. the total number of requests for external review,

b. the number of requests for external review resolved

and, of those resolved, the number resolved upholding

the adverse determination or final adverse

determination and the number resolved reversing the

adverse determination or final adverse determination,

c. the average length of time for resolution,

Oklahoma Statutes - Title 36. Insurance Page 1270

d. a summary of the types of coverages or cases for which

an external review was sought, as provided in the

format required by the Commissioner,

e. the number of external reviews pursuant to subsection

G of Section 6475.8 of this title that were terminated

as the result of a reconsideration by the health

carrier of its adverse determination or final adverse

determination after the receipt of additional

information from the covered person or the covered

person's authorized representative, and

f. any other information the Commissioner may request or

require.

4. The independent review organization shall retain the written

records required pursuant to this subsection for at least three (3)

years.

B. 1. Each health carrier shall maintain written records in

the aggregate, by state and for each type of health benefit plan

offered by the health carrier on all requests for external review

that the health carrier receives notice of from the Commissioner

pursuant to this act.

2. Each health carrier required to maintain written records on

all requests for external review pursuant to paragraph 1 of this

subsection shall submit to the Commissioner, upon request, a report

in the format specified by the Commissioner.

3. The report shall include in the aggregate, by state, and by

type of health benefit plan:

a. the total number of requests for external review,

b. from the total number of requests for external review

reported under subparagraph a of this paragraph, the

number of requests determined eligible for a full

external review, and

c. any other information the Commissioner may request or

require.

4. The health carrier shall retain the written records required

pursuant to this subsection for at least three (3) years.
Okla. Stat. tit. 36, § 36-6060.5a — OK Code / Title 36 / Section 36-6060.5a
Biomarker testing
Status: in_force

A. As used in this section:

1. "Biomarker" means a biological molecule found in blood,

other body fluids, or tissues that is a sign of a normal or abnormal

Oklahoma Statutes - Title 36. Insurance Page 1094

process, or of a condition or disease. A biomarker may be used to

see how well the body responds to a treatment for a disease or

condition or for other purposes. Biomarkers shall include but are

not limited to gene mutation or protein expression;

2. "Biomarker testing" means the analysis of a patient’s

tissue, blood, or other biospecimen for the presence of a biomarker.

Biomarker testing shall include but not be limited to single-analyte

tests, multiplex panel tests, gene or protein expression, and whole

exome, whole genome, and whole transcriptome sequencing;

3. "Clinical utility" means the test result provides

information that is used in the formulation of a treatment or

monitoring strategy that informs a patient's outcome and impacts the

clinical decision. The most appropriate test may include both

information that is actionable and some information that cannot be

immediately used in the formulation of a clinical decision;

4. "Consensus statement" means a statement that:

a. is developed by an independent, multidisciplinary

panel of experts that use a transparent methodology

and reporting structure that includes a conflict of

interest policy,

b. is based on the best available evidence for the

purpose of optimizing clinical care outcomes, and

c. is aimed at specific clinical circumstances;

5. "Health benefit plan" means a plan as defined pursuant to

Section 6060.4 of Title 36 of the Oklahoma Statutes; and

6. "Nationally recognized clinical practice guidelines" means

evidence-based clinical practice guidelines that:

a. are developed by independent organizations or medical

professional societies using a transparent methodology

and reporting structure and a conflict of interest

policy, and

b. establish standards of care that are informed by a

systemic review of evidence and an assessment of the

benefits and costs of alternative care options that

includes recommendations intended to optimize patient

care.

B. Any health benefit plan, including the Oklahoma Employees

Insurance Plan, that is offered, issued, or renewed in this state on

or after the effective date of this act shall provide coverage for

biomarker testing. A contract provided with a health benefit plan

under this section shall include biomarker testing for the purpose

of diagnosis, treatment, appropriate management, or ongoing

monitoring of an insured’s disease or condition to guide treatment

decisions when the biomarker test provides clinical utility as

demonstrated by medical and scientific evidence including, but not

limited to:

Oklahoma Statutes - Title 36. Insurance Page 1095

1. Labeled indications for tests that are approved or cleared

by the United States Food and Drug Administration;

2. Indicated tests for a drug that is approved by the United

States Food and Drug Administration;

3. Warnings and precautions on United States Food and Drug

Administration-approved drug labels;

4. Centers for Medicare and Medicaid Services national coverage

determinations or Medicare administrative contractor local coverage

determinations; or

5. Nationally recognized clinical practice guidelines and

consensus statements.

C. A health benefit plan shall ensure that coverage is provided

in a manner that limits disruptions in care, including the need for

multiple biopsies and biospecimen samples.

D. An insured and a prescribing practitioner shall have access

to a clear, readily available, and convenient process to request an

exception to a coverage policy of a health benefit plan under this

subsection. The process shall be readily accessible on the plan’s

website. This subsection shall not be construed to require a

separate process if the health benefit plan’s existing process

complies with this subsection.
Okla. Stat. tit. 36, § 36-4404 — OK Code / Title 36 / Section 36-4404
Form of policy
Status: in_force

A. No policy of individual accident and health insurance shall

be delivered or issued for delivery to any person in this state

unless:

1. the entire money and other considerations therefor are

expressed therein;

2. the time at which the insurance takes effect and terminates

is expressed therein;

3. it purports to insure only one person, except that a policy

may insure, originally or by subsequent amendment, upon the

application of an adult member of a family who shall be deemed the

policyholder, any two or more eligible members of that family,

including husband, wife, dependent children or any children under a

specified age which shall not exceed twenty-two (22) years and any

other person dependent upon the policyholder;

4. the style, arrangement and overall appearance of the policy

give no undue prominence to any portion of the text, and unless

every printed portion of the text of the policy and of any

endorsement or attached papers is plainly printed in lightfaced type

of a style in general use, the size of which shall be uniform and

not less than ten-point with a lowercase unspaced alphabet length

not less than one hundred twenty points (the "text" shall include

all printed matter except the name and address of the insurer, name

or title of the policy, the brief description if any, and captions

and subcaptions); when a policy is renewable only at the option of

the company, such fact shall be made known in prominent lettering on

the face of the policy;

5. the exceptions and reductions of indemnity are set forth in

the policy and, except those which are set forth in Section 4405 of

this article, are printed, at the insurer's option, either included

with the benefit provision to which they apply, or under an

appropriate caption such as "Exceptions," or "Exceptions and

Reductions," provided that if an exception or reduction specifically

applies only to a particular benefit of the policy, a statement of

such exception or reduction shall be included with the benefit

provision to which it applies;

6. each such form, including riders and endorsements, shall be

identified by a form number in the lower left-hand corner of the

first page thereof;

7. it contains no provision purporting to make any portion of

the charter, rules, constitution, or bylaws of the insurer a part of

the policy unless such portion is set forth in full in the policy,

except in the case of the incorporation of, or reference to, a

statement of rates or classification of risks, or short rate table

filed with the Insurance Commissioner; and

Oklahoma Statutes - Title 36. Insurance Page 939

8. in such policies, except accident insurance only policies,

in which the insurer reserves the right to refuse renewal on an

individual basis, it shall provide, in substance, in a provision

thereof or in an endorsement thereon or in a rider attached thereto,

that, subject to the right to terminate the policy upon nonpayment

of premium when due, such right to refuse renewal may not be

exercised so as to take effect before the renewal date occurring on,

or after and nearest, each anniversary (or in the case of lapse and

reinstatement at the renewal date occurring on, or after and

nearest, each anniversary of the last reinstatement) and that any

refusal of renewal shall be without prejudice to any claim

originating while the policy is in force. (The parenthetic

reference to lapse and reinstatement may be omitted at the option of

the insurer.)

B. If the terms of any individual or franchise accident and

health insurance policy cover services within the lawful scope of

practice of a licensed psychologist then:

1. such services may be performed by any person licensed to do

so under the "Psychologists Licensing Act," Title 59 of the Oklahoma

Statutes, Sections 1351 through 1375.

2. selection of a licensed psychologist may be made by the

insured at his option and, provided other conditions of the policy

are met, reimbursement shall not be denied when service is rendered

by a person so licensed.

3. the provisions of this act shall apply to the policies and

contracts of insurance, which are delivered, amended, ratified, or

issued for delivery in Oklahoma after this act takes effect.

4. any provision, exclusion, or limitation of a policy that

denies an insured the privilege of selecting a licensed psychologist

shall, to the extent of the denial, be void, but such void provision

shall not affect the validity of the other provisions of the policy.

C. If any policy is issued by an insurer domiciled in this state

for delivery to a person residing in another state, and if the

official having responsibility for the administration of the

insurance laws of such other state shall have advised the Insurance

Commissioner that any such policy is not subject to approval or

disapproval by such official, the Insurance Commissioner may by

ruling require that such policy meet the standards set forth in

subsection A of this section and in Section 4405.
Okla. Stat. tit. 36, § 36-2914 — OK Code / Title 36 / Section 36-2914
Action on bond
Status: in_force

Action on the attorney's bond or to recover against any such

deposit made in lieu thereof may be brought at any time by one or

more subscribers suffering loss through a violation of its

conditions, or by a receiver or liquidator of the insurer. Amounts

recovered on the bond shall be deposited in and become part of the

insurer's funds. The total aggregate liability of the surety shall

be limited to the amount of the penalty of such bond.
Okla. Stat. tit. 36, § 36-4903 — OK Code / Title 36 / Section 36-4903
Bail bond surety companies - Reserve funds
Status: in_force

All surety companies which execute undertakings of bail shall

keep any moneys collected from agents licensed pursuant to Section

1303 of Title 59 of the Oklahoma Statutes as buildup or reserve

funds in segregated interest-bearing trust accounts within this

state in an entity which is insured either by the Federal Deposit

Insurance Corporation or the Federal Savings and Loan Insurance

Corporation.

The interest-bearing trust accounts shall not be pledged or

offered as collateral.

The moneys in the interest-bearing trust accounts shall be used

to satisfy the unfulfilled obligations of the undertakings of bail

written by the agents from whom the moneys have been collected and

to otherwise satisfy the unfulfilled obligations which may be owing

to the surety by such agents.
Okla. Stat. tit. 36, § 36-108 — OK Code / Title 36 / Section 36-108
"Insurance Department" defined
Status: in_force

Oklahoma Statutes - Title 36. Insurance Page 43

Unless the context otherwise requires, "Insurance Department" or

"Department" means the Insurance Department established by Section

301, Article 3 of this Code.
Okla. Stat. tit. 36, § 36-6203 — OK Code / Title 36 / Section 36-6203
Persons not deemed adjusters or required to obtain
Status: in_force

license.

The definition of an insurance adjuster shall not be deemed to

include, and a license as an insurance adjuster shall not be

required of, the following:

1. A licensed agent or general agent of an insurer who

processes undisputed or uncontested losses for the insurers solely

pursuant to the provisions of policies issued by the agent, or his

Oklahoma Statutes - Title 36. Insurance Page 1162

agency, if the agent or general agent receives no extra compensation

for such services;

2. A person engaged in investigating, adjusting, negotiating,

or processing claims arising pursuant to the provisions of life

insurance, annuity, or accident and health insurance contracts;

3. A nonresident who occasionally is in this state to adjust a

single loss or losses arising pursuant to the provisions of a policy

of marine insurance;

4. A salaried employee of a licensed insurer whose primary

duties are not adjusting, investigating, or supervising insurance

claims;

5. A licensed attorney in the State of Oklahoma who adjusts

insurance losses from time to time, incidental to the practice of

law, and who does not advertise or represent that he is an adjuster;

6. A person employed solely for the purpose of furnishing

technical assistance to a licensed adjuster, including but not

limited to photographers, appraisers, estimators, private

detectives, engineers, handwriting experts, and attorneys-at-law;

7. A person who performs clerical duties for a licensed insurer

or organization that handles claims and who does not negotiate

disputed or contested claims for the insurer or organization that

handles claims;

8. A nonresident insurance adjuster who is actively licensed in

another state and who is in this state no more than once a year for

the purpose of adjusting a single loss or who is acting as a

temporary substitute for a licensed adjuster; or

9. An individual who collects claim information from, or

furnishes claim information to, insured customers or claimants, and

who conducts data entry including entering data into an automated

claims adjudication system, provided that the individual is an

employee of a licensed independent adjuster or an affiliate where no

more than twenty-five persons are under the supervision of one

licensed independent adjuster or licensed agent. A licensed agent

acting as a supervisor pursuant to this paragraph is not required to

be licensed as an adjuster.
Okla. Stat. tit. 36, § 36-1256 — OK Code / Title 36 / Section 36-1256
Renumbered as § 1250.7 of this title by Laws 1994, c
Status: in_force

342, § 20, eff. Sept. 1, 1994.
Okla. Stat. tit. 36, § 36-4526 — OK Code / Title 36 / Section 36-4526
Services for members – Contracts with third-party
Status: in_force

administrators – Information to be disseminated to members –

Administrative charges.

A. Each Health Insurance Purchasing Group (HIPG) may provide

administrative services for its members. The services may include,

but are not limited to, accounting, billing, enrollment information,

and employee coverage status reports.

B. The HIPG may delegate or contract its billing and other

administrative duties to a third-party administrator as defined

under Article 14B of the Oklahoma Insurance Code.

C. 1. Nothing in this section shall be construed as preventing

a HIPG from serving as an administrative service organization to any

entity.

Oklahoma Statutes - Title 36. Insurance Page 999

2. Each HIPG shall collect and disseminate or arrange for the

collection and dissemination of consumer-oriented information on the

scope, cost, and enrollee satisfaction of all coverage options

offered through the HIPG to its members.

3. The information shall be defined by the HIPG and shall be in

a manner appropriate to the type of coverage offered.

4. To the extent practicable, the information shall include

information on provider performance, locations, and hours of

operation of providers, outcomes, and similar matters.

5. Nothing in this section shall be construed as preventing the

dissemination of the information or other information by the HIPG or

by the health care insurer through electronic or other means.

D. The contract between a HIPG and a HIPG health carrier shall

provide that the HIPG may collect premiums on behalf of the issuer

for coverage, less a predetermined administrative charge negotiated

by the HIPG and the issuer.
Okla. Stat. tit. 36, § 36-6059 — OK Code / Title 36 / Section 36-6059
Adopted children - Coverage
Status: in_force

A. All individual and group health insurance policies providing

coverage on an expense incurred, fixed, or capitated basis, and all

individual and group insurance policies, certificates, service or

indemnity type contracts issued by insurance companies, health

maintenance organizations, nonprofit corporations, charitable and

benevolent corporations established for the purposes of operating a

nonprofit hospital service or indemnity plan and/or a nonprofit

medical or indemnity, fixed, or capitated plan, and all self-

insurers which provide coverage for a family member of the insured

or subscriber shall, as to such family member's coverage, also

provide that the health insurance benefits applicable for any

natural child of the insured or subscriber shall be payable with

respect to any adopted child of the insured or subscriber from the

date of placement of the child in the custody of the insured or

subscriber, provided the insurer is notified within thirty-one (31)

days in writing. Coverage shall include the necessary care and

treatment of medical conditions existing prior to the date of

placement of the child in the custody of the insured or subscriber.

Nothing in this section shall be construed to require coverage of

costs incurred for such medical conditions prior to the date of

placement of the child in the custody of the insured or subscriber.

B. Subject to the terms and conditions of the policy, contract

or agreement, coverage shall also include the actual and documented

medical costs associated with the birth of an adopted child who is

eighteen (18) months of age or younger. If requested, the insured

shall provide copies of medical bills and records associated with

the birth of the adopted child and proof that the insured paid or is

responsible for payment of the medical bills associated with the

birth and that the cost of the birth was not covered by another

health care plan including Medicaid. Any reference to the name of

the natural parents of the adopted child shall be deleted from the

records so provided. The coverage required by this subsection shall

be subject to the same annual deductibles and coinsurance as may be

deemed appropriate and as are consistent with those established for

other covered benefits. The coverage shall also be subject to the

terms of the insurers contract, if any, with hospitals and

physicians.

C. As used in this section, "placement" means the assumption by

the insured or subscriber of the physical custody of the adopted

Oklahoma Statutes - Title 36. Insurance Page 1082

child and the financial responsibility for the support and care of

the adopted child.

D. For purposes of this section, a child who is in the custody

of the insured, pursuant to an interlocutory decree issued under

Section 7505-6.1 of Title 10 of the Oklahoma Statutes vesting

temporary care of the child in the insured, is an adopted child

during the pendency of the adoption proceeding, regardless of

whether a final decree of adoption is ultimately issued.
Okla. Stat. tit. 36, § 36-6570.59 — OK Code / Title 36 / Section 36-6570.59
Application to Oklahoma Medicaid State Plan
Status: in_force

This act shall apply to the Oklahoma Medicaid State Plan.
Okla. Stat. tit. 36, § 36-976 — OK Code / Title 36 / Section 36-976
Strengthen Oklahoma Homes Revolving Fund
Status: in_force

A. There is hereby created in the State Treasury a revolving

fund for the Insurance Department, to be designated the "Strengthen

Oklahoma Homes Revolving Fund". The fund shall be a continuing

fund, not subject to fiscal year limitations, and shall consist of

any monies deposited to the fund from the receipt of federal grants

or funds or from other sources of grants or funds. All monies

accruing to the credit of the fund are hereby appropriated and may

be budgeted and expended by the Department for the purpose of

assisting the Strengthen Oklahoma Homes (SOH) Program in performing

all acts that relate to the function and purpose of the SOH Program.

Warrants for expenditures from the revolving fund shall be drawn by

the State Treasurer, based on claims signed by an authorized

employee or employees of the Insurance Department, and filed with

the Director of the Office of Management and Enterprise Services.

B. Monies collected pursuant to this act shall be deposited in

the Strengthen Oklahoma Homes Revolving Fund. Monies shall not

lapse, unless otherwise specified under federal funding or federal

grant, or a grant or funds from another source, or be transferred to

the State Insurance Commissioner Revolving Fund or other state funds

and shall not be redistributed.

C. Notwithstanding any other provision of law, the Insurance

Commissioner may transfer from the State Insurance Commissioner

Revolving Fund to the Strengthen Oklahoma Homes Revolving Fund up to

fifty percent (50%), but in an amount not to exceed Ten Million

Dollars ($10,000,000.00), of the balance remaining in the State

Oklahoma Statutes - Title 36. Insurance Page 228

Insurance Commissioner Revolving Fund at the end of each fiscal year

beginning with the fiscal year ending on June 30, 2024.
Okla. Stat. tit. 36, § 36-3624.5 — OK Code / Title 36 / Section 36-3624.5
Limiting payments by insurer based upon eligibility for
Status: in_force

medical assistance prohibited.

Any clause of an insurance contract, plan or agreement

administered by an insurer that limits or excludes payments if the

individual is eligible for medical assistance is void.
Okla. Stat. tit. 36, § 36-3107 — OK Code / Title 36 / Section 36-3107
Solicitation for unlicensed companies prohibited
Status: in_force

No person shall solicit, or aid in the solicitation of, another

person to purchase a service contract issued by a company not duly

licensed under the terms of this act.
Okla. Stat. tit. 36, § 36-307.4 — OK Code / Title 36 / Section 36-307.4
Use of grant - Audited annually
Status: in_force

A. The Insurance Commissioner may solicit, accept and authorize

the use of any grant made to the Insurance Department as long as the

terms of the grant are carried out and the Insurance Commissioner

holds the funds in trust for the purposes of carrying out the terms

of the grant.

Oklahoma Statutes - Title 36. Insurance Page 60

B. The Insurance Commissioner must annually account to the

State Auditor and Inspector for all monies or property received or

extended by virtue of this section. The account shall state:

1. The source of the monies or property received with the

actual date of its receipt;

2. The particular use or place for which it was expended; and

3. The balance on hand showing the place of deposit of the

unexpended balance.
Okla. Stat. tit. 36, § 36-1435.2 — OK Code / Title 36 / Section 36-1435.2
Definitions
Status: in_force

As used in the Oklahoma Producer Licensing Act:

1. "Commissioner" means the Insurance Commissioner;

2. "Business entity" means a corporation, association,

partnership, limited liability company, limited partnership, or

other legal entity;

3. "Customer service representative" means an individual who is

required to be licensed as an insurance producer under the laws of

this state and assists the insurance producer, broker, or agency in

transacting the business of insurance from the office of the

insurance producer, broker, or agency;

4. "Home state" means the District of Columbia and any state or

territory of the United States in which an insurance producer

maintains the producer's principal place of residence or principal

place of business and is licensed to act as an insurance producer;

5. "Insurance" means any of the lines of authority in this

title including workers' compensation insurance. Any insurer

approved to offer workers' compensation insurance may appoint

insurance producers. All producers appointed for workers'

compensation insurance products must be licensed as insurance

producers by the Oklahoma Insurance Department;

6. "Insurance consultant" means an individual or legal entity

who is required to be licensed as an insurance producer under the

laws of this state and, for a fee, is held out to the public as

engaged in the business of offering any advice, counsel, opinion or

service with respect to the benefits, advantages, or disadvantages

promised under any policy of insurance that could be issued or

delivered in this state;

7. "Insurance producer" means a person required to be licensed

under the laws of this state to sell, solicit or negotiate insurance

and includes a customer service representative and an insurance

consultant. Any person not duly licensed as an insurance producer,

surplus lines insurance broker, or limited lines producer who

solicits a policy of insurance on behalf of an insurer shall be

deemed to be acting as an insurance agent within the meaning of the

Oklahoma Statutes - Title 36. Insurance Page 331

Oklahoma Producer Licensing Act, and shall thereby become liable for

all the duties, requirements, liabilities, and penalties to which an

insurance producer of the company is subject, and the company by

issuing the policy of insurance shall thereby accept and acknowledge

the person as its agent in the transaction. For purposes of the

laws of this state and the Oklahoma Insurance Code, the term

"insurance agent" means an insurance producer properly appointed by

an insurance carrier to act as an agent for that insurance carrier,

pursuant to Section 1435.15 of this title;

8. "Insurer" has the meaning set out in Section 103 of this

title;

9. "License" means a document issued by the Insurance

Commissioner of this state authorizing a person to act as an

insurance producer for the lines of authority specified in the

document. The license itself does not create any authority, actual,

apparent or inherent, in the holder to represent or commit an

insurance carrier;

10. "Limited line credit insurance" includes credit life,

credit disability, credit property, credit unemployment, involuntary

unemployment, mortgage life, mortgage guaranty, mortgage disability,

guaranteed automobile protection insurance, known as "gap"

insurance, and any other form of insurance offered in connection

with an extension of credit that is limited to partially or wholly

extinguishing that credit obligation that the Insurance Commissioner

determines should be designated a form of limited line credit

insurance;

11. "Limited line credit insurance producer" means a person who

sells, solicits or negotiates one or more forms of limited line

credit insurance coverage to individuals through a master,

corporate, group or individual policy;

12. "Limited lines insurance" means limited line credit and

those lines of insurance defined in Section 1435.20 of this title or

any other line of insurance the Insurance Commissioner deems

necessary to recognize for the purposes of complying with subsection

E of Section 1435.9 of this title;

13. "Limited lines producer" means a person who is authorized

by the Commissioner to sell, solicit or negotiate limited lines

insurance. For purposes of the laws of this state and the Oklahoma

Insurance Code, the term "limited insurance representative" shall

have the same meaning as the term "limited lines producer";

14. "Managing general agent" means an individual or legal

entity appointed, as an independent contractor, by one or more

insurers to exercise general supervision over the business of the

insurer in this state, with authority to appoint insurance producers

for the insurer, and to terminate appointments for the insurer;

15. "Negotiate" means the act of conferring directly with or

offering advice directly to a purchaser or prospective purchaser of

Oklahoma Statutes - Title 36. Insurance Page 332

a particular contract of insurance concerning any of the substantive

benefits, terms or conditions of the contract, provided that the

person engaged in that act either sells insurance or obtains

insurance from insurers for purchaser;

16. "Person" means an individual or a business entity;

17. "Sell" means to exchange a contract of insurance, by any

means, for money or its equivalent, on behalf of an insurance

company;

18. "Solicit" means attempting to sell insurance or asking or

urging a person to apply for a particular kind of insurance from a

particular company;

19. "Surplus lines insurance broker" means an individual or

legal entity who solicits, negotiates, or procures a policy of

insurance in an insurance company not licensed to transact business

in this state which cannot be procured from insurers licensed to do

business in this state. All transactions under such license shall

be subject to Article 11 of the Oklahoma Insurance Code;

20. "Terminate" means the cancellation of the relationship

between an insurance producer and the insurer or the termination of

a producer's authority to transact insurance;

21. "Uniform Business Entity Application" means the current

version of the National Association of Insurance Commissioners

(NAIC) Uniform Business Entity Application for resident and

nonresident business entities; and

22. "Uniform Application" means the current version of the NAIC

Uniform Application for resident and nonresident producer licensing.
Okla. Stat. tit. 36, § 36-1474 — OK Code / Title 36 / Section 36-1474
Written contract with insurer required - Minimum
Status: in_force

provisions.

No person acting in the capacity of a managing general agent

shall place business with an insurer unless there is in force a

written contract between the parties which sets forth the

responsibilities of each party, and where both parties share

Oklahoma Statutes - Title 36. Insurance Page 379

responsibility for a particular function, specifies the division of

such responsibilities, and which contains the following minimum

provisions:

1. The insurer may terminate the contract for cause upon thirty

(30) days' written notice to the managing general agent and the

Insurance Commissioner. The insurer may suspend the underwriting

authority of the managing general agent during the pendency of any

dispute regarding the cause for termination;

2. The managing general agent shall render accounts to the

insurer detailing all transactions and shall remit all funds due

under the contract to the insurer on not less than a monthly basis;

3. All funds collected for the account of an insurer shall be

held by the managing general agent in a fiduciary capacity in a bank

which is a member of the Federal Reserve System. This account shall

be used for all payments on behalf of the insurer. The managing

general agent may retain no more than three (3) months' estimated

claims payment and allocated loss adjustment expenses;

4. Separate records of business written by the managing general

agent shall be maintained. The insurer shall have access to and the

right to copy all accounts and records related to its business in a

form usable by the insurer. The Insurance Commissioner shall have

access to all books, bank accounts and records of the managing

general agent in a form usable to the Commissioner. Such records

shall be retained according to the provisions of subsection E of

Section 1435.13 of this title;

5. The contract may not be assigned in whole or part by the

managing general agent;

6. The contract shall contain appropriate underwriting

guidelines including:

a. the maximum annual premium volume,

b. the basis of the rates to be charged,

c. the types of risks which may be written,

d. maximum limits of liability,

e. applicable exclusions,

f. territorial limitations,

g. policy cancellation provisions, and

h. the maximum policy period;

7. The insurer shall have the right to cancel or not renew any

policy of insurance subject to applicable laws and regulations;

8. If the contract permits the managing general agent to settle

claims on behalf of the insurer:

a. all claims must be reported to the company in a timely

manner,

b. a copy of the claim file shall be sent to the insurer

at its request or as soon as it becomes known that the

claim:

Oklahoma Statutes - Title 36. Insurance Page 380

(1) has the potential to exceed a threshold

determined by the Insurance Commissioner or

exceeds the limit set by the company, whichever

is less,

(2) involves a coverage dispute,

(3) may exceed the managing general agent's claims

settlement authority,

(4) is open for more than six (6) months, or

(5) is closed by payment of an amount set by the

Insurance Commissioner or an amount set by the

company, whichever is less,

c. all claim files will be the joint property of the

insurer and managing general agent. However, upon an

order of liquidation of the insurer, such files shall

become the sole property of the insurer or its estate

and the managing general agent shall have reasonable

access to and the right to copy the files on a timely

basis,

d. any settlement authority granted to the managing

general agent may be terminated for cause upon the

insurer's written notice to the managing general agent

or upon the termination of the contract. The insurer

may suspend the settlement authority during the

pendency of any dispute regarding the cause for

termination, and

e. nothing in this section shall be construed to give the

Insurance Commissioner authority to settle or adjust

claims on behalf of the insurer;

9. Where electronic claim files are in existence, the contract

shall address the timely transmission of the data;

10. If the contract provides for a sharing of interim profits

by the managing general agent, and the managing general agent has

the authority to determine the amount of the interim profits by

establishing loss reserves or controlling claim payments, or in any

other manner, interim profits will not be paid to the managing

general agent on the lines of business written by the managing

general agent until at least ninety-seven percent (97%) of the

ultimate loss has been developed for those lines of business, based

on an opinion of the actuary who certifies the adequacy of the loss

reserves for the insurer;

11. The managing general agent shall not:

a. bind reinsurance or retrocessions on behalf of the

insurer, except that the managing general agent may

bind facultative reinsurance contracts pursuant to

obligatory facultative agreements if the contract with

the insurer contains reinsurance underwriting

Oklahoma Statutes - Title 36. Insurance Page 381

guidelines including, for both reinsurance assumed and

ceded:

(1) a list of reinsurers with which such automatic

agreements are in effect,

(2) the coverages and amounts or percentages that may

be reinsured, and

(3) commission schedules,

b. commit the insurer to participate in insurance or

reinsurance syndicates,

c. appoint any agent or broker without assuring that the

agent or broker is lawfully licensed to transact the

type of insurance for which he is appointed,

d. without prior approval of the insurer, pay or commit

the insurer to pay a claim over a specified amount,

net of reinsurance, which shall not exceed one percent

(1%) of the insurer's policyholder's surplus as of

December 31 of the last completed calendar year,

e. collect any payment from a reinsurer or commit the

insurer to any claim settlement with a reinsurer

without prior approval of the insurer. If prior

approval is given, a report shall be promptly

forwarded to the insurer,

f. permit its sub-agent or sub-broker to serve on the

insurer's board of directors,

g. jointly employ an individual who is employed with the

insurer, or

h. appoint a sub-managing general agent.
Okla. Stat. tit. 36, § 36-2737.1 — OK Code / Title 36 / Section 36-2737.1
Penalties
Status: in_force

A. Any person who willfully makes a false or fraudulent

statement in or relating to an application for membership or for the

purpose of obtaining money from or a benefit in any society, upon

conviction, shall be guilty of a misdemeanor, punishable by a fine

of not less than One Hundred Dollars ($100.00) nor more than One

Thousand Dollars ($1,000.00) or by imprisonment in the county jail

for not less than thirty (30) days nor more than one (1) year, or

both.

Oklahoma Statutes - Title 36. Insurance Page 735

B. Any person who willfully makes a false or fraudulent

statement in any verified report or declaration under oath required

or authorized by this article, or of any material fact or thing

contained in a sworn statement concerning the death or disability of

a member for the purpose of procuring payment of a benefit named in

the certificate, is guilty of the felony of perjury, a Class D3

felony offense, and shall be punished by imprisonment as provided

for in subsections B through F of Section 20P of Title 21 of the

Oklahoma Statutes.

C. Any person who solicits membership for, or in any manner

assists in procuring membership in, any society not licensed to do

business in this state, upon conviction, shall be fined not less

than Fifty Dollars ($50.00) nor more than Five Hundred Dollars

($500.00).

D. Any person guilty of a willful violation of, or neglect of

or refusal to comply with, the provisions of this article for which

a penalty is not otherwise prescribed, shall, upon conviction, be

subject to a fine not exceeding One Thousand Dollars ($1,000.00).
Okla. Stat. tit. 36, § 36-630 — OK Code / Title 36 / Section 36-630
Failure to make payments timely - Penalties
Status: in_force

Failure to make such payments timely shall subject the insurance

company to a penalty of ten percent (10%) of the tax due and said

tax and penalty shall be further subject to interest at the rate of

six percent (6%) per annum, from the date said payment should have

been paid, until the tax, penalty and interest are paid.
Okla. Stat. tit. 36, § 36-6947 — OK Code / Title 36 / Section 36-6947
Foreign health maintenance organizations
Status: in_force

A. 1. A foreign health maintenance organization shall, upon

the written request of the Insurance Commissioner, submit to the

Commissioner a Risk-Based Capital (RBC) report as of the end of the

calendar year just ended the later of:

a. the date an RBC report would be required to be filed

by a domestic health maintenance organization under

this act, or

b. fifteen (15) days after the request is received by the

foreign health maintenance organization.

2. A foreign health maintenance organization shall, at the

written request of the Commissioner, promptly submit to the

Commissioner a copy of any RBC plan that is filed with the Insurance

Commissioner of any other state.

B. In the event of a Company Action Level Event, Regulatory

Action Level Event or Authorized Control Level Event with respect to

a foreign health maintenance organization, as determined under the

RBC statute applicable in the state of domicile of the health

maintenance organization or, if no RBC statute is in force in that

state, under the provisions of this act, if the Insurance

Commissioner of the state of domicile of the foreign health

maintenance organization fails to require the foreign health

maintenance organization to file an RBC plan in the manner specified

Oklahoma Statutes - Title 36. Insurance Page 1427

under that state’s RBC statute or, if no RBC statute is in force in

that state, under the provisions of Section 40 of this act, the

Commissioner may require the foreign health maintenance organization

to file an RBC plan with the Commissioner. In such event, the

failure of the foreign health maintenance organization to file an

RBC plan with the Commissioner shall be grounds to order the health

maintenance organization to cease and desist from writing new

insurance business in this state.

C. In the event of a Mandatory Control Level Event with respect

to a foreign health maintenance organization, if no domiciliary

receiver has been appointed for the foreign health maintenance

organization under the rehabilitation and liquidation statute

applicable in the state of domicile of the foreign health

maintenance organization, the Commissioner may make application to

the District Court of Oklahoma County as permitted under Article 19

of the Insurance Code with respect to the liquidation of property of

foreign health maintenance organizations found in this state, and

the occurrence of the Mandatory Control Level Event shall be

considered adequate grounds for the application.
Okla. Stat. tit. 36, § 36-6754 — OK Code / Title 36 / Section 36-6754
Service contracts - Content
Status: in_force

A. Service contracts marketed, sold, offered for sale, issued,

made, proposed to be made, or administered in this state shall be

written, printed, or typed in clear, understandable language that is

easy to read, and shall disclose the requirements set forth in this

section, as applicable. Each service contract provider shall, upon

initial registration and at renewal of its registration, file a copy

of each of its current contracts issued in this state for

informational purposes. The provider shall update a filing any time

a change is made to the service contract that materially affects the

rights or obligations of a contract holder or upon written request

by the Department.

B. Service contracts insured under an insurance policy pursuant

to paragraph 3 of subsection C of Section 6753 of this title shall

contain a statement in substantially the following form:

"Obligations of the provider under this service contract are insured

under a service contract reimbursement insurance policy." The

service contract shall also state the name and address of the

insurer.

C. Service contracts not insured under an insurance policy

pursuant to paragraph 3 of subsection C of Section 6753 of this

title shall contain a statement in substantially the following form:

"Obligations of the provider under this service contract are backed

by the full faith and credit of the provider."

D. Service contracts shall state the name and address of the

provider, and shall identify any administrator if different from the

provider, the service contract seller, and the service contract

holder to the extent that the name of the service contract holder

Oklahoma Statutes - Title 36. Insurance Page 1361

has been furnished by the service contract holder. The identities

of such parties are not required to be preprinted on the service

contract and may be added to the service contract at the time of

sale.

E. Service contracts shall state the total purchase price and

the terms under which service contract is sold. The purchase price

is not required to be preprinted on the service contract and may be

negotiated at the time of sale with the service contract holder.

F. Service contracts shall state the existence of any trade

service fee, if applicable.

G. Service contracts shall specify the merchandise and services

to be provided and any limitations, exceptions, or exclusions.

H. Service contracts shall state any restrictions governing the

transferability of the service contract, if applicable.

I. Service contracts shall state the terms, restrictions or

conditions governing cancellation of the service contract.

J. Service contracts shall set forth all of the obligations and

duties of the service contract holder, such as the duty to protect

against any further damage and any requirement to follow the owner's

manual.

K. Service contracts shall state whether or not the service

contract provides for or excludes consequential damages or

preexisting conditions, if applicable. Service contracts may, but

are not required to, cover damage resulting from rust, corrosion or

damage caused by a noncovered part or system.

L. If prior approval of repair work is required, a service

contract shall state the procedure for obtaining prior approval and

for making a claim, including a toll-free telephone number for claim

service and a procedure for obtaining emergency repairs performed

outside of normal business hours.
Okla. Stat. tit. 36, § 36-6057.2 — OK Code / Title 36 / Section 36-6057.2
Penalties
Status: in_force

For any violation of the Health Care Freedom of Choice Act, the

Insurance Commissioner may, after notice and opportunity hearing,

subject an insurer or practitioner to an administrative penalty of

Oklahoma Statutes - Title 36. Insurance Page 1076

not less than One Hundred Dollars ($100.00) nor more than Five

Thousand Dollars ($5,000.00) for each occurrence. Such

administrative penalty may be enforced in the same manner in which

civil judgments may be enforced. The penalties collected shall be

placed in the Insurance Commissioner’s Revolving Fund.
Okla. Stat. tit. 36, § 36-607.1 — OK Code / Title 36 / Section 36-607.1
Certain entities considered insurers - Audited financial
Status: in_force

reports - Actuarial opinions.

A. An entity organized pursuant to the Interlocal Cooperation

Act (an "Interlocal Entity") for the purpose of transacting

insurance that insures an Oklahoma educational institution shall be

considered an insurer for all kinds of insurance that the entity

transacts. Such an entity shall hold a certificate of authority to

transact insurance in this state.

B. Any entity organized pursuant to the Interlocal Cooperation

Act that insures an Oklahoma educational institution and has within

a twelve-month period received premiums or contributions of any

amount for any kind of insurance that the Interlocal Entity

transacts shall have an annual audit by an independent certified

public accountant and shall file an audited financial report by an

independent certified public accountant with the Insurance

Commissioner within one hundred eighty (180) days immediately

following the close of the Interlocal Entity's fiscal year. The

annual audited financial report shall be presented in conformity

with accounting principles generally accepted in the United States

of America and include:

1. The report of an independent certified public accountant in

accordance with accounting principles generally accepted in the

United States of America;

2. A balance sheet reporting assets, liabilities and equity;

3. A statement of operations;

4. A statement of cash flows;

5. A statement of changes in assets, liabilities and equity;

6. Footnotes to financial statements; and

7. An unqualified opinion from the certified public accountant

that the audited financial report represents a fair presentation of

the Interlocal Entity's financial position in conformity with

Oklahoma Statutes - Title 36. Insurance Page 126

accounting principles generally accepted in the United States of

America.

C. Any entity subject to the provisions of subsection B of this

section, except those entities which purchase full insurance

coverage as determined by the Commissioner, shall file with the

Insurance Commissioner an actuarial opinion prepared by a qualified

actuary within one hundred eighty (180) days immediately following

the close of the Interlocal Entity's fiscal year. The actuarial

opinion should certify the amount and adequacy of the Interlocal

Entity's reserves for loss and loss adjustment expenses, including

amounts for Incurred But Not Reported (IBNR) Claims, and the

adequacy of the Interlocal Entity's premiums. The actuarial opinion

shall be consistent with the appropriate Actuarial Standards of

Practice (ASOP) as promulgated by the Actuarial Standards Board.

As used in this section, "qualified actuary" means an individual

who is a member of the American Academy of Actuaries and who has met

the Qualification Standards for Actuaries Issuing Statements of

Actuarial Opinions in the United States promulgated by the American

Academy of Actuaries.

D. Extensions of the filing date may be granted by the

Commissioner for thirty-day periods upon a showing by the Interlocal

Entity and its independent certified public accountant or qualified

actuary of the reasons for requesting an extension and determination

by the Commissioner of good cause for an extension. The request for

extension must be submitted in writing not less than ten (10) days

prior to the due date in sufficient detail to permit the

Commissioner to make an informed decision with respect to the

requested extension.

E. The Commissioner may assess a fine for failure to file the

required annual audit or actuarial opinion in an amount of not more

than Five Hundred Dollars ($500.00) per day.

F. The audited financial reports and actuarial opinions

required herein are subject to public inspection pursuant to the

Oklahoma Open Records Act.

G. The Insurance Commissioner shall, if there is substantial

reason to believe that any insurer subject to this section is

insolvent, or if any such insurer's condition is such as to render

the continuance of its business hazardous to the public or to

holders of its policies or certificates of insurance, or it has

exceeded its powers, or it has failed to comply with the law, or if

such insurer gives its consent:

1. Notify the insurer and its participating members of the

Commissioner's determination;

2. Require the insurer to file with the Insurance Commissioner

a written plan of action to abate the Commissioner's determination

within thirty (30) days of notification; and

Oklahoma Statutes - Title 36. Insurance Page 127

3. If the Commissioner makes a further determination to

supervise, notify the insurer that it is under supervision pursuant

to this section.

H. An insurer subject to subsection G of this section shall

comply with the lawful requirements of the Commissioner and, if

placed under supervision, shall have ninety (90) days from the date

of notice within which to comply with the requirements of the

Commissioner unless the Commissioner designates a lesser or greater

period of time or unless the Commissioner determines at any time

during or after the ninety-day period of time that judicial or

administrative proceedings should be initiated to place such insurer

in conservation, rehabilitation or liquidation proceedings or other

delinquency proceedings, pursuant to Sections 1801 through 1920 of

this title. If such insurer does not comply with such requirements,

such supervision may continue until such requirements are remedied

or until the Commissioner approves or completes pursuit of

additional options as provided in the Insurance Code.

I. The Commissioner may assess a fine for failure to timely

file a written plan of action required under subsection G of this

section in an amount of not more than Five Hundred Dollars ($500.00)

per day.

J. The Insurance Commissioner may promulgate rules to implement

the provisions of this section.
Okla. Stat. tit. 36, § 36-1926 — OK Code / Title 36 / Section 36-1926
Fraudulent transfers or transactions - Avoidance
Status: in_force

A. Every transfer made or suffered to be made and every

obligation incurred by an insurer within one (1) year prior to the

filing of a successful petition for rehabilitation or liquidation

under the Insurance Code is fraudulent as to then existing and

future creditors if made or incurred without fair consideration or

with actual intent to hinder, delay or defraud either existing or

future creditors. A transfer made or an obligation incurred by an

insurer ordered to be rehabilitated or liquidated under the

Insurance Code, which is fraudulent under this section, may be

Oklahoma Statutes - Title 36. Insurance Page 550

avoided by the receiver, except as to a person who in good faith is

a purchaser, lienor, or obligee for a present fair equivalent value,

and except that any purchaser, lienor or obligee, who in good faith

has given a consideration less than fair for such transfer, lien, or

obligation, may retain the property, lien or obligation as security

for repayment. The court may, on due notice, order any such

transfer or obligation to be preserved for the benefit of the

estate, and in that event, the receiver shall succeed to and may

enforce the rights of the purchaser, lienor, or obligee.

B. Every director, officer, employee, stockholder, member,

agent, subscriber, and any other person acting on behalf of such

insurer who shall be concerned in any such act or deed and every

person receiving thereby any property of such insurer or the benefit

thereof shall be personally liable therefor and shall be bound to

account to the Insurance Commissioner.

C. The Insurance Commissioner as receiver in any proceeding

under this article may avoid any transfer of or lien upon the

property of an insurer which any creditor, stockholder, subscriber

or member of such insurer might have avoided and may recover the

property so transferred unless such person was a bona fide holder

for value prior to the date of the granting of an order to show

cause under this article. Such property or its value may be

recovered from anyone who has received it except a bona fide holder

for value as herein specified.

D. Any transaction of the insurer with a reinsurer shall be

deemed fraudulent and may be avoided by the receiver under this

section if:

1. The transaction consists of the termination, adjustment or

settlement of a reinsurance contract in which the reinsurer is

released from any part of its duty to pay the originally specified

share of losses that had occurred prior to the time of the

transactions, unless the reinsurer gives a present fair equivalent

value for the release; and

2. Any part of the transaction took place within one (1) year

prior to the date of filing of the petition through which the

receivership was commenced.

E. Notwithstanding subsection A of this section, or any other

provision of this chapter, no receiver shall avoid any transfer of,

or any obligation to transfer, money or any other property arising

under or in connection with any Federal Home Loan Bank security

agreement, or any pledge, security, collateral or guarantee

agreement or any other similar arrangement or credit enhancement

relating to such Federal Home Loan Bank security agreement.

However, a transfer may be avoided under this section if it was made

with actual intent to hinder, delay or defraud either existing or

future creditors.

Oklahoma Statutes - Title 36. Insurance Page 551
Okla. Stat. tit. 36, § 36-1810 — OK Code / Title 36 / Section 36-1810
Rehabilitation
Status: in_force

A conservator shall serve for such time as is necessary to

accomplish the purposes of conservatorship under this act. If

rehabilitated, the insurer shall be returned to the management or

new management under such conditions as determined by the

Commissioner.
Okla. Stat. tit. 36, § 36-4055.10 — OK Code / Title 36 / Section 36-4055.10
Contracts within two years of issuance of insurance
Status: in_force

policy or certificate - Requests for verification of coverage or

transfer of policy.

A. It is a violation of the Viatical Settlements Act of 2008

for any person to enter into a viatical settlement contract at any

time prior to the application or issuance of a policy which is the

subject of viatical settlement contract or within a two-year period

commencing with the date of issuance of the insurance policy or

certificate unless the viator certifies to the viatical settlement

Oklahoma Statutes - Title 36. Insurance Page 891

provider that one or more of the following conditions have been met

within the two-year period:

1. The policy was issued upon the viator’s exercise of

conversion rights arising out of a group or individual policy,

provided the total of the time covered under the conversion policy

plus the time covered under the prior policy is at least twenty-four

(24) months. The time covered under a group policy shall be

calculated without regard to any change in insurance carriers,

provided the coverage has been continuous and under the same group

sponsorship; or

2. The viator submits independent evidence to the viatical

settlement provider that one or more of the following conditions

have been met within the two-year period:

a. the viator or insured is terminally or chronically

ill,

b. the viator’s spouse dies,

c. the viator divorces his or her spouse,

d. the viator retires from full-time employment,

e. the viator becomes physically or mentally disabled and

a physician determines that the disability prevents

the viator from maintaining full-time employment,

f. a final order, judgment or decree is entered by a

court of competent jurisdiction, on the application of

a creditor of the viator, adjudicating the viator

bankrupt or insolvent, or approving a petition seeking

reorganization of the viator or appointing a receiver,

trustee or liquidator to all or a substantial part of

the viator’s assets, or

g. the viator involuntarily experiences a significant

decrease in income that is unexpected and that also

reasonably impairs the reasonable ability of the

viator to pay the policy premiums.

B. Copies of the independent evidence described in paragraph 2

of subsection A of this section and documents required by subsection

A of Section 9 of this act shall be submitted to the insurer when

the viatical settlement provider or other party entering into a

viatical settlement contract with a viator submits a request to the

insurer for verification of coverage. The copies shall be

accompanied by a letter of attestation from the viatical settlement

provider that the copies are true and correct copies of the

documents received by the viatical settlement provider.

C. If the viatical settlement provider submits to the insurer a

copy of the owner or insured’s certification described in and the

independent evidence required by paragraph 2 of subsection A of this

section when the provider submits a request to the insurer to effect

the transfer of the policy or certificate to the viatical settlement

provider, the copy shall be deemed to conclusively establish that

Oklahoma Statutes - Title 36. Insurance Page 892

the viatical settlement contract satisfies the requirements of this

section and the insurer shall timely respond to the request.

D. No insurer may, as a condition of responding to a request

for verification of coverage or effecting the transfer of a policy

pursuant to a viatical settlement contract, require that the viator,

insured, viatical settlement provider or viatical settlement broker

sign any forms, disclosures, consent or waiver form that has not

been expressly approved by the Insurance Commissioner for use in

connection with viatical settlement contracts in this state.

E. Upon receipt of a properly completed request for change of

ownership or beneficiary of a policy, the insurer shall respond in

writing within thirty (30) calendar days with written

acknowledgement confirming that the change has been effected or

specifying the reasons why the requested change cannot be processed.

The insurer shall not unreasonably delay effecting change of

ownership or beneficiary and shall not otherwise seek to interfere

with any viatical settlement contract lawfully entered into in this

state.
Okla. Stat. tit. 36, § 36-6057 — OK Code / Title 36 / Section 36-6057
Denial under policy coverage as void – Compliance with
Status: in_force

act.

A. Any provision, exclusion or limitation in an accident and

health insurance policy which:

1. Denies an insured, or the insured's parent or guardian if

the insured is a minor, the free choice of any practitioner or the

use of any hospital, home care agency or ambulatory surgical center

where the practitioner is authorized to practice, doctor's office or

clinic; or

Oklahoma Statutes - Title 36. Insurance Page 1075

2. Otherwise conflicts with any provision of the Health Care

Freedom of Choice Act,

shall, to the extent of the denial or conflict, be void, but such

voidance shall not affect the validity of the other provisions of

the policy.

B. Any policy form presently approved for use containing any

provision, exclusion or limitation determined by the Insurance

Commissioner to be in conflict with any provision of the Health Care

Freedom of Choice Act shall be brought into compliance with the act

by the filing of a rider, an endorsement, or a new or revised policy

form approved by the Commissioner.
Okla. Stat. tit. 36, § 36-2129 — OK Code / Title 36 / Section 36-2129
Mutualization of stock insurer
Status: in_force

A. A domestic stock insurer other than a life or title insurer

may become a domestic mutual insurer pursuant to such plan and

procedure as may be approved in advance by the Insurance

Commissioner.

B. The Commissioner shall not approve any such plan, procedure,

or mutualization unless:

1. It is equitable to both stockholders and policyholders;

2. It is subject to approval by a vote of the holders of not

less than three-fourths (3/4) of the insurer's capital stock having

voting rights and by a vote of not less than two-thirds (2/3) of the

insurer's policyholders who vote on such plan in person, by proxy or

by mail pursuant to such notice and procedure as may be approved by

the Commissioner;

3. Mutualization will result in retirement of shares of the

insurer's capital stock at a price not in excess of the fair market

value thereof as determined by competent disinterested appraisers;

4. The plan provides for the purchase of the shares of any

nonconsenting stockholder in accordance with the provisions of the

Oklahoma General Corporation Act, and such nonconsenting

stockholders shall have all the rights and restrictions applicable

under said act to stockholders of a private corporation who do not

consent to the agreed manner of converting the shares of stock of

such private corporation upon proposal for consolidation;

5. The plan provides for definite conditions to be fulfilled by

a designated early date upon which such mutualization will be deemed

effective; and

6. The mutualization leaves the insurer with surplus funds

reasonably adequate for the security of its policyholders and to

continue successfully in business in the states in which it is then

authorized to transact insurance, and for the kinds of insurance

included in its certificate of authority.

C. This section shall not apply to mutualization under order of

court pursuant to rehabilitation or reorganization of an insurer

under Article 18, (Rehabilitation and Liquidation).
Okla. Stat. tit. 36, § 36-2708.1 — OK Code / Title 36 / Section 36-2708.1
No personal liability - Indemnification and
Status: in_force

reimbursement - Insurance.

A. The officers and members of the supreme governing body or

any subordinate body of a society shall not be personally liable for

any benefits provided by a society.

B. Any person may be indemnified and reimbursed by any society

for expenses reasonably incurred by, and liabilities imposed upon,

Oklahoma Statutes - Title 36. Insurance Page 715

such person in connection with or arising out of any action, suit or

proceeding, whether civil, criminal, administrative or

investigative, or threat thereof, in which the person may be

involved by reason of the fact that he or she is or was a director,

officer, employee or agent of the society or of any firm,

corporation or organization which he or she served in any capacity

at the request of the society. A person shall not be so indemnified

or reimbursed:

1. In relation to any matter in such action, suit or proceeding

as to which he or she shall finally be adjudged to be or have been

guilty of breach of a duty as a director, officer, employee or agent

of the society; or

2. In relation to any matter in such action, suit or

proceeding, or threat thereof, which has been made the subject of a

compromise settlement,

unless in either such case the person acted in good faith for a

purpose the person reasonably believed to be in or not opposed to

the best interests of the society and, in a criminal action or

proceeding, in addition, had no reasonable cause to believe that his

or her conduct was unlawful. The determination whether the conduct

of such person met the standard required in order to justify

indemnification and reimbursement in relation to any matter

described in paragraph 1 or 2 of this subsection may only be made by

the supreme governing body or board of directors by a majority vote

of a quorum consisting of persons who were not parties to such

action, suit or proceeding or by a court of competent jurisdiction.

The termination of any action, suit or proceeding by judgment,

order, settlement, conviction, or upon a plea of no contest, as to

such person shall not in itself create a conclusive presumption that

the person did not meet the standard of conduct required in order to

justify indemnification and reimbursement. The foregoing right of

indemnification and reimbursement shall not be exclusive of other

rights to which such person may be entitled as a matter of law and

shall inure to the benefit of his or her heirs, executors and

administrators.

C. A society shall have power to purchase and maintain

insurance on behalf of any person who is or was a director, officer,

employee or agent of the society, or who is or was serving at the

request of the society as a director, officer, employee or agent of

any other firm, corporation, or organization against any liability

asserted against such person and incurred by him or her in any such

capacity or arising out of his or her status as such, whether or not

the society would have the power to indemnify the person against

such liability under this section.
Okla. Stat. tit. 36, § 36-335 — OK Code / Title 36 / Section 36-335
Conflicts of interest - Exceptions
Status: in_force

No employee of the Insurance Department shall be financially

interested, directly or indirectly, in any insurer, agency or

insurance transaction except as a policyholder or claimant under a

policy; except, that as to such matters wherein a conflict of

interest does not exist on the part of any such individual, the

Insurance Commissioner may employ from time to time insurance

actuaries or other technicians who are independently practicing

their professions even though similarly employed by insurers and

others. This section shall not be deemed to prohibit employment by

the Insurance Commissioner of retired or pensioned personnel of

insurers or insurance organizations. In addition, this section

shall not be deemed to prohibit employees of the Insurance

Department from investing in mutual funds that may own stock in

insurance companies, or from having an interest in retirement or

pension plans, other than self-directed plans, that may own stock in

insurance companies.
Okla. Stat. tit. 36, § 36-1692 — OK Code / Title 36 / Section 36-1692
Purpose of act
Status: in_force

The Protected Cell Companies Act is adopted to provide a basis

for the creation of protected cells by a domestic insurer as a means

of accessing alternative sources of capital and achieving the

benefits of insurance securitization or effectuating insurance

business transfers in accordance with the Insurance Business

Transfer Act. Investors in fully funded insurance securitization

transactions provide funds that are available to pay the insurer's

insurance obligations or to repay investors or both. The creation

of protected cells is intended to be a means to achieve more

efficiencies in conducting insurance securitizations or insurance

business transfers.
Okla. Stat. tit. 36, § 36-5109 — OK Code / Title 36 / Section 36-5109
Duties of reinsurer
Status: in_force

A. A reinsurer shall not engage the services of any person,

firm, association or corporation to act as an RM on its behalf

unless such person is licensed as required by the Reinsurance

Intermediary Act.

B. The reinsurer shall annually obtain a copy of statements of

the financial condition of each RM which such reinsurer has engaged,

prepared by an independent certified accountant in a form acceptable

to the Commissioner.

C. If an RM establishes loss reserves, the reinsurer annually

shall obtain the opinion of an actuary attesting to the adequacy of

loss reserves established for losses incurred and outstanding on

business produced by the RM. This opinion shall be in addition to

any other required loss reserve certification.

D. Binding authority for all retrocessional contracts or

participation in reinsurance syndicates shall rest with an officer

of the reinsurer who shall not be affiliated with the RM.

E. Within thirty (30) days of termination of a contract with an

RM, the reinsurer shall provide written notification of such

termination to the Commissioner.

F. A reinsurer shall not appoint to its board of directors, any

officer, director, employee, controlling shareholder or subproducer

of its RM. This subsection shall not apply to relationships

governed by Article 16A of the Insurance Code or, if applicable, the

Business Transacted with Producer Controlled Insurer Act.
Okla. Stat. tit. 36, § 36-615.2 — OK Code / Title 36 / Section 36-615.2
Biographical affidavit
Status: in_force

All domestic insurers and health maintenance organizations are

required to keep biographical information current. Domestic

insurers and health maintenance organizations are required to

provide Biographical Affidavits within thirty (30) days of any

change in officers, directors, key management or any person

acquiring ten percent (10%) or more controlling interest in a

domestic insurer. The information shall be on the National

Association of Insurance Commissioners (NAIC) UCAA Biographical

Affidavit Form. The Biographical Affidavit is to be certified by an

independent third party acceptable to the Insurance Commissioner

that has conducted a comprehensive review of the background of the

applicant and has indicated that the Biographical Affidavit has no

significantly inaccurate or conflicting information and is accepted

as the Business Character Report. As used in this section,

"independent third party" is one that has no affiliation with the

applicant and is in the business of providing background checks or

investigations. The Business Character Report must be current and

shall not be older than six (6) months.

Oklahoma Statutes - Title 36. Insurance Page 134
Okla. Stat. tit. 36, § 36-6978 — OK Code / Title 36 / Section 36-6978
Conditions for issuance of certificate of authority
Status: in_force

A. Issuance of a certificate of authority for a prepaid vision

plan organization shall be granted by the Insurance Commissioner if

the Commissioner is satisfied that the following conditions are met:

1. The requirements of Section 6 of this act have been

fulfilled;

2. The persons, organization, or entity responsible for

conducting the business affairs of the prepaid vision plan

organization are competent, trustworthy, and professionally capable

of providing or arranging for the provision of services offered;

3. The prepaid vision plan organization constitutes an

appropriate mechanism to achieve an effective prepaid vision plan;

4. The prepaid vision plan organization has filed with the

Commissioner a fidelity bond that is in its own name on its officers

and employees in an amount not less than Fifty Thousand Dollars

($50,000.00) and is subject to the approval of the Commissioner;

5. The financial structure of the prepaid vision plan

organization may reasonably be expected to meet obligations for

payment of services for enrollees and prospective enrollees. In

making this determination, the Commissioner may consider:

a. the financial soundness of the arrangements made

pursuant to the provisions of the prepaid vision plan

for services and the schedule of charges used,

b. any agreement with an insurer, hospital, medical

service corporation, or any other organization for

ensuring the payment of prepaid vision services,

c. provisions in the plan for automatic coverage of

vision services if the prepaid plan is discontinued,

and

Oklahoma Statutes - Title 36. Insurance Page 1454

d. the sufficiency of the agreement for prepaid vision

services with providers of vision services; and

6. The Commissioner has not made a determination that the

prepaid vision plan organization is incompetent, untrustworthy, or

financially irresponsible, and the organization has not had any

insurance license denied for cause by any state.

B. A certificate of authority shall expire at midnight on June

30 following the date of issuance or the most recent renewal date,

and annually on June 30 thereafter. If the prepaid vision plan

organization remains in compliance with the provisions of this act

and pays a renewal fee of One Hundred Dollars ($100.00), the

certificate of authority may be renewed.

C. Every prepaid vision plan organization, upon receipt of any

inquiry from the Insurance Commissioner, shall furnish the

Commissioner with an adequate response to the inquiry within twenty

(20) days from the receipt of inquiry.
Okla. Stat. tit. 36, § 36-2691.10 — OK Code / Title 36 / Section 36-2691.10
Annual statement; examinations; expenses
Status: in_force

A. Each chiropractic service corporation shall annually, on or

before the last day of March, file in the office of the Insurance

Commissioner a full, true and complete statement of the condition of

the corporation on December 31 of the preceding year in such form as

shall be prescribed by the Insurance Commissioner, and which shall

be verified under oath by at least two (2) of the principal officers

of the corporation.

B. Whenever the Insurance Commissioner deems it pertinent or

necessary, and at least once in each period of three (3) years, the

Insurance Commissioner shall personally, or by his authorized

representative, visit each corporation and thoroughly inspect and

examine its financial condition, its ability to fulfill its

obligations, whether it has complied with the provisions of the law,

and any other facts relative to its business methods, management and

the equity of its dealings with its members. The Insurance

Commissioner may summon and administer the oath to and examine as

witnesses the directors, officers, trustees, agents, representatives

and members of any corporation and any other person or persons

relative to its affairs, transactions and condition. Any

corporation so examined shall pay the proper charges for the per

diem, travel and other necessary expenses in connection therewith.
Okla. Stat. tit. 36, § 36-2501 — OK Code / Title 36 / Section 36-2501
Organization authorized; purpose
Status: in_force

Any number of persons, not less than five, a majority of whom

being citizens and residents of the State of Oklahoma, may associate

themselves and form a company, for the purpose of making insurance

on the lives of individuals, with a stipulated premium, as defined

and regulated herein, and may write life insurance and/or accident

and health insurance.
Okla. Stat. tit. 36, § 36-6661 — OK Code / Title 36 / Section 36-6661
Application and construction of act
Status: in_force

The Vehicle Protection Product Act applies to all vehicle

protection products sold or offered for sale on or after the

effective date of this act. The failure of any person to comply

with the Vehicle Protection Product Act prior to its effective date

shall not be admissible in any court proceeding, administrative

proceeding, arbitration, or alternative dispute resolution

proceeding and may not otherwise be used to prove that the action of

any person or the affected vehicle protection product was unlawful

or otherwise improper. The adoption of the Vehicle Protection

Product Act does not imply that a vehicle protection product

warranty was insurance prior to the effective date of this act.

Nothing in this section shall be construed to require the

application of the penalty provisions where this section is not

applicable.
Okla. Stat. tit. 36, § 36-711 — OK Code / Title 36 / Section 36-711
Allowance for credit or increase in amount at risk –
Status: in_force

Contract requirements.

A. 1. No credit shall be allowed, as an admitted asset or as a

deduction from liability, to any ceding insurer for reinsurance nor

Oklahoma Statutes - Title 36. Insurance Page 195

increase the amount it is authorized to have at risk unless the

reinsurance contract provides, in substance, that in the event of

the insolvency of the ceding insurer, the reinsurance shall be

payable under a contract or contracts reinsured by the assuming

insurer on the basis of reported claims allowed by the liquidation

court, without diminution because of the insolvency of the ceding

insurer. Such payments shall be made directly to the ceding insurer

or to its domiciliary liquidator, except:

a. if the contract or other written agreement

specifically provides another payee of such

reinsurance in the event of the insolvency of the

ceding insurer, or

b. if the assuming insurer, with the consent of the

direct insureds, has assumed such policy obligations

of the ceding insurer as direct obligations of the

assuming insurer to the payees under such policies and

in substitution for the obligations of the ceding

insurer to such payees.

2. The reinsurance agreement may provide that the domiciliary

liquidator of an insolvent ceding insurer shall give written notice

to the assuming insurer of the pendence of a claim against such

ceding insurer on the contract reinsured within a reasonable time

after such claim is filed in the liquidation proceeding. During the

pendence of such claim, any assuming insurer may investigate such

claim and interpose, at its own expense, in the proceeding where

such claim is to be adjudicated, any defenses which it deems

available to the ceding insurer, or its liquidator. Such expense

may be filed as a claim against the insolvent ceding insurer to the

extent of a proportionate share of the benefit which may accrue to

the ceding insurer solely as a result of the defense undertaken by

the assuming insurer. If two or more assuming insurers are involved

in the same claim and a majority in interest elect to interpose one

or more defenses to such claim, the expense shall be apportioned in

accordance with the terms of the reinsurance agreement as though

such expense had been incurred by the ceding insurer.

B. This section shall not apply to insurance of ocean marine

risks or marine protection and indemnity risks.
Okla. Stat. tit. 36, § 36-6033 — OK Code / Title 36 / Section 36-6033
Limitation on compensation, fees or commissions
Status: in_force

It shall be unlawful for any person, firm, or corporation to pay

or to receive more than fifteen per cent (15%) of the price received

or paid for the equity security of any insurer as compensation for

services, fees or commissions related directly or indirectly to the

organization and promotion of the insurer and for the issuance or

sale of the equity security of the insurer. In addition to any

other penalty which may be applicable thereto, either under the

Insurance Code or otherwise, violation of this section shall

constitute a misdemeanor and shall be punishable as such where no

greater penalty is provided therefor. In addition thereto, any

person, firm or corporation that pays or receives in excess of the

Oklahoma Statutes - Title 36. Insurance Page 1062

said fifteen per cent (15%) for such purposes shall be liable to the

insurer for an amount double such excess. Suit to recover such

excess may be instituted at law or in equity in any court of

competent jurisdiction by the insurer or by the owner of any equity

security of the insurer in the name and in behalf of the insurer if

the insurer shall fail or refuse to bring such suit within sixty

days after request or shall fail diligently to prosecute the same

thereafter. If no suit to recover such profit is so filed within

six months following the date such profit was realized or accrued or

if at any time such suit is not diligently prosecuted, the Insurance

Commissioner may file or prosecute such suit for and on behalf of

the insurer at the expense of the insurer.
Okla. Stat. tit. 36, § 36-6972 — OK Code / Title 36 / Section 36-6972
Definitions
Status: in_force

As used in this act:

1. “Contractual discount” means a reduction from a provider’s

usual and customary rate for covered services and materials required

under a prepaid vision plan agreement with a provider;

2. “Covered materials” means materials for which reimbursement

from the insurer, vision plan, or vision care discount plan is

provided to a vision care provider by an enrollee’s plan contract,

or for which a reimbursement would be available but for the

application of the enrollee’s contractual limitations of

deductibles, copayments, or coinsurance;

3. “Covered services” means services eligible for reimbursement

from the insurer or vision plan to a provider, or services that

would be eligible for reimbursement but for the application of the

enrollee’s contractual plan limitations of deductibles, copayments,

or coinsurance, regardless of how the benefits are listed in the

explanation of benefits provided in the vision plan of the enrollee;

4. “Enrollee” means any individual enrolled in a health care

plan, vision plan, or vision care discount plan provided by a group,

employer, or other entity that purchases or supplies coverage for a

vision plan;

Oklahoma Statutes - Title 36. Insurance Page 1448

5. “Extrapolation” means a mathematical process or technique

used by a vision plan in the process of auditing a vision care

provider to estimate audit results for a larger batch of group

claims not reviewed in the audit by the plan;

6. “Health benefit plan” means a health benefit plan as defined

pursuant to Section 6060.4 of Title 36 of the Oklahoma Statutes;

7. “Materials” means ophthalmic devices including but not

limited to lenses, devices containing lenses, artificial intraocular

lenses, ophthalmic frames and other lens mounting apparatus, prisms,

lens treatments and coatings, contact lenses, and prosthetic devices

to correct, relieve, or treat defects or abnormal conditions of the

human eye or its adnexa, or any material allowed to be utilized by

the Board of Examiners in Optometry and optometry’s scope of

practice as provided by law;

8. “Net equity” means the excess of total assets over total

liabilities, excluding liabilities which have been subordinated in a

manner acceptable to the Insurance Commissioner;

9. “Prepaid vision plan” means any contractual agreement

whereby any prepaid vision plan organization undertakes to provide

full payment or a discount of vision services directly, to arrange

for prepaid vision services, or to pay or make reimbursement for any

vision service not provided for by other insurance;

10. “Prepaid vision plan organization” means any person who, or

organization or entity that, undertakes to conduct one or more

prepaid vision plans providing only vision services;

11. “Services” means the professional work performed by a

vision care provider;

12. “Subcontractor” means any company, group, or third-party

entity including agents, servants, partially or wholly owned

subsidiaries, and controlled organizations contracted by the

insurer, vision plan, or vision care discount plan to supply

services or materials for a vision care provider or enrollee to

fulfill the benefit plan of an insurer, vision plan, or vision care

discount plan;

13. “Tangible net equity” means net equity reduced by the value

assigned to intangible assets including, but not limited to,

goodwill, going concern value, organizational expenses, start-up

costs, long-term prepayments of deferred charges, nonreturnable

deposits, and obligations of officers, directors, owners, or

affiliates, except short-term obligations of affiliates for goods or

services arising in the normal course of business that are payable

on the same term as equivalent transactions with nonaffiliates and

that are not past due;

14. “Uncovered expense” means the cost of health care services

that are the obligation of a prepaid vision plan organization for

which:

Oklahoma Statutes - Title 36. Insurance Page 1449

a. an enrollee may be liable in the event of the

insolvency of the organization, and

b. alternative arrangements acceptable to the

Commissioner have not been made to cover the costs;

and

15. “Vision care provider” or “provider” means a licensed

doctor of optometry or a licensed medical or osteopathic doctor

practicing under the authority of the applicable provisions of Title

59 of the Oklahoma Statutes.
Okla. Stat. tit. 36, § 36-1937 — OK Code / Title 36 / Section 36-1937
Immunity or indemnity of receivers and employees
Status: reserved

A. For the purposes of this section the persons entitled to

protection under this section are:

1. The receiver, assistant receiver, and retained counsel

responsible for the conduct of a delinquency proceeding under

Article 19 of the Insurance Code, including present and former

receivers; and

2. Their employees meaning all present and former assistant

receivers and attorneys for the receiver appointed by the Insurance

Commissioner and all persons whom the Commissioner, assistant

receiver or retained counsel have employed to assist in a

delinquency proceeding under Article 19 of the Insurance Code.

Attorneys, accountants, auditors and other professional persons or

Oklahoma Statutes - Title 36. Insurance Page 565

firms, who are retained by the receiver as independent contractors

and their employees shall not be considered employees of the

receiver for purposes of this section.

B. If any legal action is commenced against the receiver or any

employee, whether against him personally or in his official

capacity, alleging property damage, property loss, personal injury

or other civil liability caused by or resulting from any alleged

act, error or omission of the receiver or any employee arising out

of or by reason of their duties or employment, the receiver and any

employee shall be indemnified from the assets of the insurer for all

expenses, attorneys' fees, judgments, settlements, decrees or

amounts due and owing or paid in satisfaction of or incurred in the

defense of such legal action unless it is determined upon a final

adjudication on the merits that the alleged act, error or omission

of the receiver or employee giving rise to the claim did not arise

out of or by reason of his duties or employment, or was caused by

intentional or willful and wanton misconduct.

1. Attorneys' fees and any and all related expenses incurred in

defending a legal action for which immunity or indemnity is

available under this section shall be paid from the assets of the

insurer, as they are incurred, in advance of the final disposition

of such action upon receipt of an undertaking by or on behalf of the

receiver or employee to repay the attorneys' fees and expenses if it

shall ultimately be determined upon a final adjudication on the

merits that the receiver or employee is not entitled to immunity or

indemnity under this section.

2. Any indemnification for expense payments, judgments,

settlements, decrees, attorneys' fees, surety bond premiums or other

amounts paid or to be paid from the insurer's assets pursuant to

this section shall be an administrative expense of the insurer.

3. In the event of any actual or threatened litigation against

a receiver or any employee for which immunity or indemnity may be

available under this section, a reasonable amount of funds which in

the judgment of the Insurance Commissioner may be needed to provide

immunity or indemnity shall be segregated and reserved from the

assets of the insurer as security for the payment of indemnity until

such time as all applicable statutes of limitation shall have run

and all actual or threatened actions against the receiver or any

employee have been completely and finally resolved, and all

obligations of the insurer and the Commissioner under this section

shall have been satisfied.

4. In lieu of segregation and reserving of funds, the Insurance

Commissioner shall have the discretion to obtain a surety bond or

make other arrangements which shall enable the Commissioner to fully

secure the payment of all obligations under this section.

C. If any legal action against an employee for which indemnity

may be available under this section is settled prior to final

Oklahoma Statutes - Title 36. Insurance Page 566

adjudication on the merits, the insurer must pay the settlement

amount on behalf of the employee, or indemnify the employee for the

settlement amount, unless the Insurance Commissioner determines:

1. That the claim did not arise out of or by reason of the

employee's duties or employment; or

2. That the claim was caused by the intentional or willful and

wanton misconduct of the employee.

D. In any legal action in which the receiver is a defendant,

that portion of any settlement relating to the alleged act, error or

omission of the receiver shall be subject to the approval of the

court before which the delinquency proceeding is pending. The court

shall not approve that portion of the settlement if it determines:

1. That the claim did not arise out of or by reason of the

receiver's duties or employment; or

2. That the claim was caused by the intentional or willful and

wanton misconduct of the receiver.

E. Nothing contained or implied in this section shall operate,

or be construed or applied to deprive the receiver or any employee

of any immunity, indemnity, benefits of law, rights or any defense

otherwise available.

F. 1. No legal action shall lie against the receiver or any

employee based in whole or in part on any alleged act, error or

omission which took place prior to September 1, 1992, unless suit is

filed and valid service of process is obtained prior to September 1,

1993.

2. Subsections B, C, and D of this section shall apply to any

suit which is pending on or filed after September 1, 1992, without

regard to when the alleged act, error or omission took place.
Okla. Stat. tit. 36, § 36-4606.1 — OK Code / Title 36 / Section 36-4606.1
State-based Exchange Revolving Fund
Status: in_force

A. There is hereby created in the State Treasury a revolving

fund for the Insurance Department, to be designated the "State-based

Exchange Revolving Fund". The fund shall be a continuing fund, not

Oklahoma Statutes - Title 36. Insurance Page 1004

subject to fiscal year limitations, and shall consist of any monies

deposited to the fund for the creation, implementation,

administration, and operation of the State-based Exchange as

authorized in subsection A of Section 1 of this act. All monies

accruing to the credit of the fund are hereby appropriated and may

be budgeted and expended by the Department for the creation,

implementation, administration, and operation of the State-based

Exchange. Warrants for expenditures from the revolving fund shall

be drawn by the State Treasurer, based on claims signed by an

authorized employee or employees of the Insurance Department, and

filed with the Director of the Office of Management and Enterprise

Services.

B. Notwithstanding any law to the contrary, all monies,

including but not limited to user fees, paid to or collected by the

Insurance Commissioner in relation to the State-based Exchange shall

be deposited in the State-based Exchange Revolving Fund. Monies

shall not lapse, unless otherwise specified under federal funding or

federal grant, or a grant or funds from another source, or be

transferred to the State Insurance Commissioner Revolving Fund or

other state funds and shall not be redistributed.
Okla. Stat. tit. 36, § 36-2921 — OK Code / Title 36 / Section 36-2921
Subscriber's liability
Status: in_force

A. The liability of each subscriber, other than as to a

nonassessable policy, for the obligations of the reciprocal insurer

shall be an individual, several, and proportionate liability, and

not joint.

B. Except as to a nonassessable policy each subscriber shall

have a contingent assessment liability, in the amount provided for

in the power of attorney or in the subscribers' agreement, for

payment of actual losses and expenses incurred while his policy was

in force. Such contingent liability may be at the rate of not less

than one nor more than ten times the premium or premium deposit

stated in the policy, and the maximum aggregate thereof shall be

computed in the manner set forth in section 2925 of this article.

C. Each assessable policy issued by the insurer shall contain a

statement of the contingent liability, set in type of the same

prominence as the insuring clause.
Okla. Stat. tit. 36, § 36-6002 — OK Code / Title 36 / Section 36-6002
Approval by Insurance Commissioner
Status: in_force

No form or plan of insurance covering any group or combination

of persons or risks shall be written or delivered within or outside

Oklahoma Statutes - Title 36. Insurance Page 1059

of this state to cover Oklahoma persons or risks at any preferred

rate or form other than that offered to persons not in such group,

and the public generally, unless such form, plan or policy and the

rates or premiums to be charged therefor have been submitted to and

filed or approved by the Insurance Commissioner.
Okla. Stat. tit. 36, § 36-2020.1 — OK Code / Title 36 / Section 36-2020.1
Joining other state associations — Efficient
Status: in_force

coordination and cooperation with receivers - Uniform Data

Standards.

A. The Oklahoma Property and Casualty Insurance Guaranty

Association may join one or more organizations of other state

associations of similar purposes, to further the purposes and

administer the powers and duties of the Association. The

Association may designate one or more of these organizations to act

as a liaison for the Association and, to the extent the Association

authorizes, to bind the Association in agreements or settlements

with receivers of insolvent insurance companies or their designated

representatives.

Oklahoma Statutes - Title 36. Insurance Page 588

B. The Oklahoma Property and Casualty Insurance Guaranty

Association, in cooperation with other obligated or potentially

obligated guaranty associations, or their designated

representatives, shall make all reasonable efforts to coordinate and

cooperate with receivers, or their designated representatives, in

the most efficient and uniform manner, including the use of Uniform

Data Standards as promulgated or approved by the National

Association of Insurance Commissioners.
Okla. Stat. tit. 36, § 36-6558 — OK Code / Title 36 / Section 36-6558
Information required to be submitted by private review
Status: in_force

agents.

In conjunction with an application for a certificate, the

private review agent shall submit information that the Insurance

Commissioner requires, including, but not limited to:

1. A utilization review plan that includes:

a. an adequate summary description of review standards,

protocol and procedures to be used in evaluating

proposed or delivered hospital and medical care,

b. assurances that the standards and criteria to be

applied in review determinations are established with

input from health care providers representing major

areas of specialty and certified by the boards of the

various American medical specialties. The entity

Oklahoma Statutes - Title 36. Insurance Page 1302

shall provide the Commissioner with a list of such

representatives and their major areas of specialty

upon request, and

c. the provisions by which patients or health care

providers may seek reconsideration or appeal of

adverse decisions by the private review agent;

2. The type and qualifications of the personnel either employed

or under contract to perform the utilization review;

3. The procedures and policies to ensure that a representative

of the private review agent is reasonably accessible, if domiciled

in this state, to patients and health care providers five (5) days a

week during normal business hours, such procedures and policies to

include as a requirement a toll-free telephone number to be

available during said business hours; provided, in the alternative,

the out-of-state private review agent shall be available or make

staff available by toll-free telephone for at least forty (40) hours

per week during normal business hours and shall have a telephone

system which is capable of accepting or recording incoming telephone

calls during other than normal hours, and shall respond to such

calls within two (2) working days, if sufficient information is

provided to whomever accepts the call or on a recorded message;

4. The policies and procedures to ensure that all applicable

state and federal laws to protect the confidentiality of individual

medical records are followed;

5. The policies and procedures to verify the identity and

authority of personnel performing utilization review by telephone;

6. A copy of the materials designed to inform applicable

patients and health care providers of the requirements of the

utilization review plan;

7. A list of the third party payors for which the private

review agent is performing utilization review in this state. Said

list may be deemed confidential by the Commissioner for the purpose

of protecting competition between agents;

8. The procedures for receiving and handling complaints by

patients and health care providers concerning utilization review;

and

9. Procedures to ensure that after a request for medical

evaluation, treatment, or procedures has been rejected in whole or

in part and in the event a copy of the report on said rejection is

requested, a copy of the report of a private review agent concerning

the rejection shall be mailed by the insurer, postage prepaid, to

the ill or injured person, the treating health care provider or to

the person financially responsible for the patient's bill within

fifteen (15) days after receipt of the request for the report.
Okla. Stat. tit. 36, § 36-2514 — OK Code / Title 36 / Section 36-2514
Relinquishment of business
Status: in_force

When any such corporation, company or association shall desire

to relinquish its business in this state, the Insurance Commissioner

shall, on application of such corporation under oath of its

president or principal officer and secretary or actuary, give notice

of such intention at least twice in a newspaper of general

circulation published at the state capital. After such publication

he shall deliver up to said corporation the securities, or any

portion thereof, held by the State Treasurer belonging to such

corporation upon being satisfied that all debts and liabilities of

every kind are paid or provided for.
Okla. Stat. tit. 36, § 36-350 — OK Code / Title 36 / Section 36-350
Electronic format filing requirement
Status: in_force

Notwithstanding any other provision of law that requires a

particular form and associated payment to be filed with the

Insurance Department in paper form, or to be mailed or hand-

delivered to the Insurance Department, the Insurance Commissioner

may, by appropriate order, require that all filings of that specific

type be filed or delivered in an electronic format. Electronic

filings shall include payment of any transaction, filing, or other

applicable fees.
Okla. Stat. tit. 36, § 36-4215 — OK Code / Title 36 / Section 36-4215
Conversion
Status: in_force

There may be a provision in the case of industrial policies

granting to the insured, upon proper written request and upon

presentation of evidence of insurability satisfactory to the

insurer, the privilege of converting any industrial insurance policy

to any form of life insurance with less frequent premium payments

regularly issued by the insurer, in accordance with terms and

conditions agreed upon with the insurer. The privilege of making

such conversion need be granted only if the insurer's industrial

policies on the life insured, in force as premium paying insurance

and on which conversion is requested, grant benefits in event of

death, exclusive of additional accidental death benefits and

exclusive of any dividend additions, in an amount not less than the

minimum amount of such insurance with less frequent premium payments

issued by the insurer at the age of the insured on the plan of

industrial or ordinary insurance desired.
Okla. Stat. tit. 36, § 36-2691.9 — OK Code / Title 36 / Section 36-2691.9
Practicing chiropractors as members, meetings; voting;
Status: in_force

officers.

Every participating chiropractor under contract with a

chiropractic service corporation created under this article shall be

a member of such corporation. Annually the members in person or by

proxy shall meet to conduct the business of the corporation. At

each such annual meeting, or at any special meeting properly called

as provided for in the bylaws of the corporation, each person who is

a member shall have one vote and may exercise the privilege of

voting on all matters brought before the membership. A simple

majority of the votes cast shall be sufficient to carry all matters

brought before the membership. If a majority of the directors at

any time so decides, a matter may be submitted to a special meeting

of the members of the corporation following such procedure as the

Oklahoma Statutes - Title 36. Insurance Page 709

corporation may provide for in its bylaws. At each annual meeting,

the members shall vote to elect one-third of the directors of the

corporation. The directors shall be elected for terms of three (3)

years in office. The directors shall elect the officers, who shall

serve for one (1) year in office and thereafter until their

successors are designated by the directors.
Okla. Stat. tit. 36, § 36-6060.3 — OK Code / Title 36 / Section 36-6060.3
Maternity benefits - Postpartum care
Status: in_force

A. Every health benefit plan issued, amended, renewed or

delivered in this state on or after July 1, 1996, that provides

maternity benefits shall provide for coverage of:

1. A minimum of forty-eight (48) hours of inpatient care at a

hospital, or a birthing center licensed as a hospital, following a

vaginal delivery, for the mother and newborn infant after

childbirth, except as otherwise provided in this section;

2. A minimum of ninety-six (96) hours of inpatient care at a

hospital following a delivery by caesarean section for the mother

and newborn infant after childbirth, except as otherwise provided in

this section; and

3. a. Postpartum home care following a vaginal delivery if

childbirth occurs at home or in a birthing center that

is not licensed as a hospital but that is accredited

as a freestanding birth center by the Commission for

the Accreditation of Birth Centers. The coverage

shall provide for one home visit within forty-eight

(48) hours of childbirth by a licensed health care

provider whose scope of practice includes providing

postpartum care. Visits shall include, at a minimum:

(1) physical assessment of the mother and the newborn

infant,

(2) parent education, to include, but not be limited

to:

(a) the recommended childhood immunization

schedule,

(b) the importance of childhood immunizations,

and

(c) resources for obtaining childhood

immunizations,

(3) training or assistance with breast or bottle

feeding, and

(4) the performance of any medically necessary and

appropriate clinical tests.

Oklahoma Statutes - Title 36. Insurance Page 1088

b. At the discretion of the mother, visits may occur at

the facility of the plan or the provider.

B. Inpatient care shall include, at a minimum:

1. Physical assessment of the mother and the newborn infant;

2. Parent education, to include, but not be limited to:

a. the recommended childhood immunization schedule,

b. the importance of childhood immunizations, and

c. resources for obtaining childhood immunizations;

3. Training or assistance with breast or bottle feeding; and

4. The performance of any medically necessary and appropriate

clinical tests.

C. A plan may limit coverage to a shorter length of hospital

inpatient stay for services related to maternity and newborn infant

care provided that:

1. In the sole medical discretion or judgment of the attending

physician licensed by the State Board of Medical Licensure and

Supervision or the State Board of Osteopathic Examiners or the

certified nurse midwife licensed by the Oklahoma Board of Nursing

providing care to the mother and to the newborn infant, it is

determined prior to discharge that an earlier discharge of the

mother and newborn infant is appropriate and meets medical criteria

contained in the most current treatment standards of the American

Academy of Pediatrics and the American College of Obstetricians and

Gynecologists that determine the appropriate length of stay based

upon:

a. evaluation of the antepartum, intrapartum and

postpartum course of the mother and newborn infant,

b. the gestational age, birth weight and clinical

condition of the newborn infant,

c. the demonstrated ability of the mother to care for the

newborn infant post-discharge, and

d. the availability of post-discharge follow-up to verify

the condition of the newborn infant in the first

forty-eight (48) hours after delivery.

A plan shall adopt these guidelines by July 1, 1996; and

2. The plan covers one home visit, within forty-eight (48)

hours of discharge, by a licensed health care provider whose scope

of practice includes providing postpartum care. The visits shall

include, at a minimum:

a. physical assessment of the mother and the newborn

infant,

b. parent education, to include, but not be limited to:

(1) the recommended childhood immunization schedule,

(2) the importance of childhood immunizations, and

(3) resources for obtaining childhood immunizations,

c. training or assistance with breast or bottle feeding,

and

Oklahoma Statutes - Title 36. Insurance Page 1089

d. the performance of any medically necessary and

clinical tests.

At the mother’s discretion, visits may occur at the facility of

the plan or the provider.

D. The plan shall include, but is not limited to, notice of the

coverage required by this section in the evidence of coverage of the

plan, and shall provide additional written notice of the coverage to

the insured or an enrollee during the course of the prenatal care of

the insured or enrollee.

E. In the event the coverage required by this section is

provided under a contract that is subject to a capitated or global

rate, the plan shall be required to provide supplementary

reimbursement to providers for any additional services required by

that coverage if it is not included in the capitation or global

rate.

F. No health benefit plan subject to the provisions of this

section shall terminate the services of, reduce capitation payments

for, refuse payment for services, or otherwise discipline a licensed

health care provider who orders care consistent with the provisions

of this section.

G. As used in this section:

1. “Birthing center” has the same meaning as provided by

Section 1-701 of Title 63 of the Oklahoma Statutes; and

2. “Health benefit plan” means any plan or arrangement as

defined in subsection C of Section 6060.4 of this title.

H. The Insurance Commissioner shall promulgate any rules

necessary to implement the provisions of this section.
Okla. Stat. tit. 36, § 36-2505 — OK Code / Title 36 / Section 36-2505
Valuation of outstanding policies; computation
Status: in_force

Each and every company incorporated transacting business under

the provisions of this article shall annually make valuations of all

outstanding policies of life insurance as of December 31st of each

year, computed upon a calculation which shall show a value not less

than that shown in accordance with the one-year preliminary term

method, based upon the American Experience Table of Mortality and

three and one-half percent (3 1/2%) per annum, assuming an average

risk exposure of six (6) months on all new policies issued within

each calendar year.
Okla. Stat. tit. 36, § 36-907.1 — OK Code / Title 36 / Section 36-907.1
Monitoring and examination of rates
Status: in_force

A. The Insurance Commissioner shall monitor and examine the

adequacy of rates of any insurer and advisory organization in this

state. In so doing, the Commissioner shall:

1. Utilize existing relevant information, analytical systems

and other sources; or

2. Cause or participate in the development of new relevant

information, analytical systems and other sources.

B. The Commissioner may require the maintenance and submission

of records, memoranda or information relating to rates from such

insurers and advisory organizations. The Commissioner or any

authorized representative of the Commissioner may examine any such

record, memoranda or information concerning rates. The application

for the acceptance of any license or permit issued pursuant to the

provision of this title shall be deemed consent for the inspection

and examination of such records, memoranda or information.

C. The Commissioner shall conduct such monitoring and

examination required pursuant to this section within the Insurance

Department, at the place of business of such insurers and advisory

organizations, in cooperation with other state insurance

departments, through outside contractors or in any other appropriate

manner.

D. The cost of such examination and monitoring shall be

assessed against insurers and advisory organizations on an equitable

and practical basis established, after hearing, in a rule

promulgated by the Commissioner.

Oklahoma Statutes - Title 36. Insurance Page 205

E. The monitoring and examinations required pursuant to the

provisions of this section, shall be conducted in a reasonably

economical manner.
Okla. Stat. tit. 36, § 36-4030.6 — OK Code / Title 36 / Section 36-4030.6
Minimum present value at commencement of benefits
Status: in_force

Any paid-up annuity benefit available under a contract shall be

such that its present value on the date annuity payments are to

commence is at least equal to the minimum nonforfeiture amount on

that date. Present value shall be computed using the mortality

table, if any, and the interest rate specified in the contract for

determining the minimum paid-up annuity benefits guaranteed in the

contract.
Okla. Stat. tit. 36, § 36-2036 — OK Code / Title 36 / Section 36-2036
Assets of impaired or insolvent insurer - Association as
Status: in_force

creditor - Payment of policies and contractual obligations.

Oklahoma Statutes - Title 36. Insurance Page 619

A. For the purpose of carrying out its obligations under the

Oklahoma Life and Health Insurance Guaranty Association Act, the

Oklahoma Life and Health Insurance Guaranty Association shall be

deemed to be a creditor of the impaired or insolvent insurer to the

extent of assets attributable to covered policies reduced by any

amounts to which the Association is entitled as subrogee pursuant to

subsection K of Section 2028 of this title. Assets of the impaired

or insolvent insurer attributable to covered policies shall be used

to continue all covered policies and pay all contractual obligations

of the impaired or insolvent insurer as required by the Oklahoma

Life and Health Insurance Guaranty Association Act. Assets

attributable to covered policies or contracts, as used in this

subsection, are that proportion of the assets that the reserves

which should have been established for such policies or contracts

bear to the reserves which should have been established for all

policies of insurance or health benefit plans written by the

impaired or insolvent insurer.

B. As a creditor of the impaired or insolvent insurer as

established in subsection A of this section and consistent with

Section 1927.1 of this title, the Association and other similar

associations shall be entitled to receive a disbursement of assets

out of the marshaled assets, from time to time as the assets become

available to reimburse it, as a credit against contractual

obligations under this act. If the liquidator has not, within one

hundred twenty (120) days of a final determination of insolvency of

a member insurer by the receivership court, made an application to

the court for the approval of a proposal to disburse assets out of

marshaled assets to guaranty associations having obligations because

of the insolvency, then the Association shall be entitled to make

application to the receivership court for approval of its own

proposal to disburse these assets.
Okla. Stat. tit. 36, § 36-6060.3a — OK Code / Title 36 / Section 36-6060.3a
Annual obstetrical/gynecological examinations
Status: in_force

A. Any health benefit plan, including the State and Education

Employees Group Health Insurance plan, that is offered, issued or

renewed in this state on or after January 1, 2005, that provides

medical and surgical benefits shall provide coverage for routine

annual obstetrical/gynecological examinations.

B. The benefit required to be provided by this section shall in

no way diminish or limit diagnostic benefits otherwise allowable

under a health benefit plan.

C. Nothing in this section shall be construed as requiring such

routine annual examination to be performed by an obstetrician,

gynecologist, or obstetrician/gynecologist.

D. As used in this section, “health benefit plan” means any

plan or arrangement as defined in subsection C of Section 6060.4 of

this title, except that the term “health benefit plan” does not

Oklahoma Statutes - Title 36. Insurance Page 1090

include policies or certificates issued to individuals or groups

with fewer than fifty employees.

E. The provisions of this section shall not apply to policies

or certificates issued to individuals or groups with fewer than

fifty employees.
Okla. Stat. tit. 36, § 36-634 — OK Code / Title 36 / Section 36-634
Valid license required - Exempt entities
Status: in_force

A. It is unlawful to operate, maintain or establish a MEWA

unless the MEWA has a valid license issued by the Insurance

Commissioner. Any MEWA operating in this state without a valid

license is an unauthorized insurer.

B. This act shall not apply to:

1. A MEWA that offers or provides benefits that are fully

insured by an authorized insurer;

Oklahoma Statutes - Title 36. Insurance Page 156

2. A MEWA that is exempt from state insurance regulation in

accordance with the Employee Retirement Income Security Act of 1974

(ERISA) (Public Law 93-406);

3. Any plan that has no more than two employer members which

share substantial common support other than income generated by

their respective similar business classification;

4. A plan that has no more than two employer members, which

together have a combined net worth of more than Five Million Dollars

($5,000,000.00) and each of such member employers participated in

the continuous sponsorship and maintenance of such MEWA for the

benefit of their employees for a period of more than ten (10) years

next preceding the effective date of this act; or

5. A nonprofit professional trade association pursuant to

Section 501(c)(3) of the Internal Revenue Code, 26 U.S.C., Section

501(c)(3), which has maintained either a self-funded plan or a fully

insured plan of coverage for the payment of expenses to or for

members of the association for a period of ten (10) or more

consecutive years and, if self-funded, which coverage is provided to

at least five hundred covered participants.

C. Any entity which claims to be exempt from state regulation

pursuant to subsection B of this section shall provide to the

Commissioner strict proof establishing such exemption.
Okla. Stat. tit. 36, § 36-1515 — OK Code / Title 36 / Section 36-1515
Information for valuation of securities
Status: in_force

It shall be the duty of every domestic insurance company holding

securities valued under Sections 1511 or 1512 which do not have an

established market value to furnish the Commissioner of Insurance,

within thirty (30) days of his request, sufficient financial

information concerning the issuing corporation, so as to enable him

to arrive at a proper value of the security so held. Failure to

furnish such information as specified herein shall result in the

security being ineligible as a deduction from liabilities.