Okla. Stat. tit. 36, § 36-4055.2 — OK Code / Title 36 / Section 36-4055.2
Definitions
Status: in_force

As used in the Viatical Settlements Act of 2008:

1. “Advertising” means any written, electronic or printed

communication or any communication by means of recorded telephone

messages or transmitted on radio, television, the Internet or

similar communications media, including film strips, motion pictures

and videos, published, disseminated, circulated or placed directly

before the public, in this state, for the purpose of creating an

interest in or inducing a person to sell, assign, devise, bequest or

transfer the death benefit or ownership of a life insurance policy

pursuant to a viatical settlement contract;

2. “Business of viatical settlements” means an activity

involved in, but not limited to, the offering, soliciting,

negotiating, procuring, effectuating, purchasing, investing,

financing, monitoring, tracking, underwriting, selling,

transferring, assigning, pledging, hypothecating or in any other

manner acquiring an interest in a life insurance policy by means of

a viatical settlement contract;

3. “Chronically ill” means:

a. being unable to perform at least two activities of

daily living, including, but not limited to, eating,

Oklahoma Statutes - Title 36. Insurance Page 865

toileting, transferring, bathing, dressing or

continence,

b. requiring substantial supervision to protect the

individual from threats to health and safety due to

severe cognitive impairment, or

c. having a level of disability similar to that described

in subparagraph a of this paragraph as determined by

the Secretary of Human Services;

4. “Commissioner” means the Insurance Commissioner of the State

of Oklahoma;

5. “Financing entity” means an underwriter, placement agent,

lender, purchaser of securities, purchaser of a policy or

certificate from a viatical settlement provider, credit enhancer, or

any entity that has a direct ownership in a policy or certificate

that is the subject of a viatical settlement contract, but:

a. whose principal activity related to the transaction is

providing funds to effect the viatical settlement or

purchase of one or more viaticated policies, and

b. who has an agreement in writing with one or more

licensed viatical settlement providers to finance the

acquisition of viatical settlement contracts.

Financing entity does not include a nonaccredited investor or a

viatical settlement purchaser;

6. “Financing transaction” means a transaction in which a

licensed provider obtains financing from a financing entity,

including, without limitation, any secured or unsecured financing,

any securitization transaction, or any securities offering which

either is registered or exempt from registration under federal and

state securities law;

7. “Fraudulent viatical settlement act” includes:

a. acts or omissions committed by any person who,

knowingly and with intent to defraud, for the purpose

of depriving another of property or for pecuniary

gain, commits, or permits its employees or its agents

to engage in acts including:

(1) presenting, causing to be presented or preparing

with knowledge or belief that it will be

presented to or by a viatical settlement

provider, viatical settlement broker, viatical

settlement purchaser, financing entity, insurer,

insurance producer or any other person, false

material information, or concealing material

information, as part of, in support of or

concerning a fact material to one or more of the

following:

Oklahoma Statutes - Title 36. Insurance Page 866

(a) an application for the issuance of a

viatical settlement contract or insurance

policy,

(b) the underwriting of a viatical settlement

contract or insurance policy,

(c) a claim for payment or benefit pursuant to a

viatical settlement contract or insurance

policy,

(d) premiums paid on an insurance policy,

(e) payments and changes in ownership or

beneficiary made in accordance with the

terms of a viatical settlement contract or

insurance policy,

(f) the reinstatement or conversion of an

insurance policy,

(g) in the solicitation, offer, effectuation or

sale of a viatical settlement contract or

insurance policy,

(h) the issuance of written evidence of viatical

settlement contract or insurance, or

(i) a financing transaction,

(2) intentionally failing to disclose to the insurer

when requested by the insurer that the

prospective insured has knowingly undergone a

life expectancy evaluation by any person or

entity other than the insured or its authorized

representatives in connection with the issuance

of the policy,

(3) in the solicitation, application or issuance of a

life insurance policy, employing any device,

scheme or artifice in violation of Section 3604

of Title 36 of the Oklahoma Statutes, and

(4) employing any plan, financial structure, device,

scheme, or artifice to defraud related to

viaticated policies,

b. in the furtherance of a fraud or to prevent the

detection of a fraud any person commits or permits its

employees or its agents to:

(1) remove, conceal, alter, destroy or sequester from

the Commissioner the assets or records of a

licensee or other person engaged in the business

of viatical settlements,

(2) misrepresent or conceal the financial condition

of a licensee, financing entity, insurer or other

person,

(3) transact the business of viatical settlements in

violation of laws requiring a license,

Oklahoma Statutes - Title 36. Insurance Page 867

certificate of authority or other legal authority

for the transaction of the business of viatical

settlements, or

(4) file with the Commissioner or the equivalent

chief insurance regulatory official of another

jurisdiction a document containing false

information or otherwise conceals information

about a material fact from the Commissioner,

c. embezzlement, theft, misappropriation or conversion of

monies, funds, premiums, credits or other property of

a viatical settlement provider, insurer, insured,

viator, insurance policyowner or any other person

engaged in the business of viatical settlements or

insurance,

d. recklessly entering into, negotiating, brokering,

otherwise dealing in a viatical settlement contract,

the subject of which is a life insurance policy that

was obtained by presenting false information

concerning any fact material to the policy or by

concealing, for the purpose of misleading another,

information concerning any fact material to the

policy, where the person or the persons intended to

defraud the policy’s issuer, the viatical settlement

provider or the viator. Recklessly means engaging in

the conduct in conscious and clearly unjustifiable

disregard of a substantial likelihood of the existence

of the relevant facts or risks, such disregard

involving a gross deviation from acceptable standards

of conduct,

e. stranger-originated life insurance,

f. facilitating the change of state of ownership of a

policy or certificate or the state of residency of a

viator to a state or jurisdiction that does not have a

law similar to this act for the express purposes of

evading or avoiding the provisions of the Viatical

Settlements Act of 2008, or

g. attempting to commit, assisting, aiding or abetting in

the commission of, or conspiracy to commit the acts or

omissions specified in this paragraph;

8. “Life insurance producer” means any person licensed in this

state as a resident or nonresident insurance producer who has

received qualification or authority for life insurance coverage or a

life line of coverage pursuant to the Oklahoma Producer Licensing

Act;

9. “Person” means a natural person or a legal entity,

including, without limitation, an individual, partnership, limited

liability company, association, trust, or corporation;

Oklahoma Statutes - Title 36. Insurance Page 868

10. “Policy” means an individual or group policy, group

certificate, contract or arrangement of life insurance owned by a

resident of this state, regardless of whether delivered or issued

for delivery in this state;

11. “Related provider trust” means a titling trust or other

trust established by a licensed viatical settlement provider or a

financing entity for the sole purpose of holding the ownership or

beneficial interest in purchased policies in connection with a

financing transaction. The trust shall have a written agreement

with the licensed viatical settlement provider under which the

licensed viatical settlement provider is responsible for ensuring

compliance with all statutory and regulatory requirements and under

which the trust agrees to make all records and files related to

viatical settlement transactions available to the Commissioner as if

those records and files were maintained directly by the licensed

viatical settlement provider;

12. “Special purpose entity” means a corporation, partnership,

trust, limited liability company or other similar entity formed

solely to provide either directly or indirectly access to

institutional capital markets:

a. for a financing entity or licensed viatical settlement

provider, or

b. (1) in connection with a transaction in which the

securities in the special purposes entity are

acquired by the viator or by “qualified

institutional buyers” as defined in Rule 144

promulgated under the Federal Securities Act of

1933, as amended, or

(2) the securities pay a fixed rate of return

commensurate with established asset-backed

institutional capital markets;

13. “Stranger-originated life insurance” means a practice or

plan to initiate a life insurance policy for the benefit of a third-

party investor who, at the time of policy origination, has no

insurable interest in the insured. Stranger-originated life

insurance practices include, but are not limited to, cases in which

life insurance is purchased with resources or guarantees from or

through a person or entity who, at the time of policy inception,

could not lawfully initiate the policy, and where, at the time of

policy inception, there is an arrangement or agreement, whether

verbal or written, to directly or indirectly transfer the ownership

of the policy or the policy benefits to a third party. Trusts that

are created to give the appearance of insurable interest and are

used to initiate policies for investors violate Section 3604 of

Title 36 of the Oklahoma Statutes and the prohibition against

wagering on human life. Stranger-originated life insurance

Oklahoma Statutes - Title 36. Insurance Page 869

arrangements do not include the practices provided in subparagraph b

of paragraph 15 of this section;

14. “Terminally ill” means having an illness or sickness that

can reasonably be expected to result in death in twenty-four (24)

months or less;

15. “Viatical settlement broker” means a person, including a

life insurance producer as provided for in Section 3 of Enrolled

Senate Bill No. 1980 of the 2nd Session of the 51st Oklahoma

Legislature, who working exclusively on behalf of a viator and for a

fee, commission or other valuable consideration, offers or attempts

to negotiate viatical settlement contracts between a viator and one

or more viatical settlement providers or one or more viatical

settlement brokers. Notwithstanding the manner in which the

viatical settlement broker is compensated, a viatical settlement

broker is deemed to represent only the viator, and not the insurer

or the viatical settlement provider, and owes a fiduciary duty to

the viator to act according to the viator’s instructions and in the

best interest of the viator. The term does not include an attorney,

certified public accountant or a financial planner accredited by a

nationally recognized accreditation agency, who is retained to

represent the viator and whose compensation is not paid directly or

indirectly by the viatical settlement provider or purchaser;

16. “Viatical settlement contract” means a written agreement

between a viator and a viatical settlement provider or any affiliate

of the viatical settlement provider establishing the terms under

which compensation or anything of value is or will be paid, which

compensation or value is less than the expected death benefits of

the policy, in return for the viator’s present or future assignment,

transfer, sale, devise or bequest of the death benefit or ownership

of any portion of the insurance policy or certificate of insurance.

Viatical settlement contract also means the transfer for

compensation or value of ownership or beneficial interest in a trust

or other entity that owns such policy if the trust or other entity

was formed or availed of for the principal purpose of acquiring one

or more life insurance contracts, which life insurance contracts

insure the life of a person residing in this state.

a. Viatical settlement contract includes a premium

finance loan made for a life insurance policy by a

lender to viator on, before or less than two (2) years

after the date of issuance of the policy where:

(1) the viator or the insured receives on the date of

the premium finance loan a guarantee of a future

viatical settlement value of the policy, or

(2) the viator or the insured agrees on the date of

the premium finance loan to sell the policy or

any portion of its death benefit on any date

following the issuance of the policy.

Oklahoma Statutes - Title 36. Insurance Page 870

b. Viatical settlement contract does not include:

(1) a policy loan or accelerated death benefit made

by the insurer pursuant to the policy’s terms,

(2) loan proceeds that are used solely to pay:

(a) premiums for the policy, and

(b) the costs of the loan, including, without

limitation, interest, arrangement fees,

utilization fees and similar fees, closing

costs, legal fees and expenses, trustee fees

and expenses, and third-party collateral

provider fees and expenses, including fees

payable to letter of credit issuers,

(3) a loan made by a bank or other licensed financial

institution in which the lender takes an interest

in a life insurance policy solely to secure

repayment of a loan or, if there is a default on

the loan and the policy is transferred, the

transfer of such a policy by the lender, provided

that neither the default on the loan nor the

transfer of the policy in connection with the

default is pursuant to an agreement or

understanding with any other person for the

purpose of evading regulation under this act,

(4) a loan made by a lender that does not violate

Sections 4-101 through 4-304 of Title 14A of the

Oklahoma Statutes, provided that the premium

finance loan is not described in this

subparagraph,

(5) an agreement where all the parties:

(a) are closely related to the insured by blood

or law, or

(b) have a lawful substantial economic interest

in the continued life, health and bodily

safety of the person insured, or are trusts

established primarily for the benefit of

such parties,

(6) any designation, consent or agreement by an

insured who is an employee of an employer in

connection with the purchase by the employer, or

trust established by the employer, of life

insurance on the life of the employee,

(7) a bona fide business succession planning

arrangement:

(a) between one or more shareholders in a

corporation or between a corporation and one

or more of its shareholders or one or more

trusts established by its shareholders,

Oklahoma Statutes - Title 36. Insurance Page 871

(b) between one or more partners in a

partnership or between a partnership and one

or more of its partners or one or more

trusts established by its partners, or

(c) between one or more members in a limited

liability company or between a limited

liability company and one or more of its

members or one or more trusts established by

its members,

(8) an agreement entered into by a service recipient,

or a trust established by the service recipient,

and a service provider, or a trust established by

the service provider, who performs significant

services for the service recipient’s trade or

business, or

(9) any other contract, transaction or arrangement

exempted from the definition of viatical

settlement contract by the Commissioner based on

a determination that the contract, transaction or

arrangement is not of the type intended to be

regulated by the Viatical Settlements Act of

2008;

17. “Viatical settlement provider” means a person, other than a

viator, that enters into or effectuates a viatical settlement

contract with a viator resident in this state. Viatical settlement

provider does not include:

a. a bank, savings bank, savings and loan association,

credit union or other licensed lending institution

that takes an assignment of a life insurance policy

solely as collateral for a loan,

b. a premium finance company making premium finance loans

and exempted by the Commissioner from the licensing

requirement under the premium finance laws that takes

an assignment of a life insurance policy solely as

collateral for a loan,

c. the issuer of the life insurance policy,

d. an authorized or eligible insurer that provides stop

loss coverage or financial guaranty insurance to a

viatical settlement provider, purchaser, financing

entity, special purpose entity or related provider

trust,

e. a natural person who enters into or effectuates no

more than one agreement in a calendar year for the

transfer of life insurance policies for any value less

than the expected death benefit,

f. a financing entity,

g. a special purpose entity,

Oklahoma Statutes - Title 36. Insurance Page 872

h. a related provider trust,

i. a viatical settlement purchaser, or

j. any other person that the Commissioner determines is

not the type of person intended to be covered by the

definition of viatical settlement provider;

18. “Viatical settlement purchaser” means a person who provides

a sum of money as consideration for a life insurance policy or an

interest in the death benefits of a life insurance policy, or a

person who owns or acquires or is entitled to a beneficial interest

in a trust that owns a viatical settlement contract or is the

beneficiary of a life insurance policy that has been or will be the

subject of a viatical settlement contract, for the purpose of

deriving an economic benefit. Viatical settlement purchaser does

not include:

a. a licensee under the Viatical Settlements Act of 2008,

b. an accredited investor or qualified institutional

buyer as defined, respectively, in Rule 501(a) or Rule

144A promulgated under the Federal Securities Act of

1933, as amended,

c. a financing entity,

d. a special purpose entity, or

e. a related provider trust;

19. “Viaticated policy” means a life insurance policy or

certificate that has been acquired by a viatical settlement provider

pursuant to a viatical settlement contract; and

20. “Viator” means the owner of a life insurance policy or a

certificate holder under a group policy who resides in this state

and enters or seeks to enter into a viatical settlement contract.

For the purposes of the Viatical Settlements Act of 2008, a viator

shall not be limited to an owner of a life insurance policy or a

certificate holder under a group policy insuring the life of an

individual with a terminal or chronic illness or condition except

where specifically addressed. If there is more than one viator on a

single policy and the viators are residents of different states, the

transaction shall be governed by the law of the state in which the

viator having the largest percentage ownership resides or, if the

viators hold equal ownership, the state of residence of one viator

agreed upon in writing by all the viators. Viator does not include:

a. a licensee under the Viatical Settlements Act of 2008,

including a life insurance producer acting as a

viatical settlement broker pursuant to the Viatical

Settlements Act of 2008,

b. qualified institutional buyer as defined,

respectively, in Rule 144A promulgated under the

Federal Securities Act of 1933, as amended,

c. a financing entity,

d. a special purpose entity, or

Oklahoma Statutes - Title 36. Insurance Page 873

e. a related provider trust.
Okla. Stat. tit. 36, § 36-1610 — OK Code / Title 36 / Section 36-1610
Public structure or improvement obligations
Status: in_force

Oklahoma Statutes - Title 36. Insurance Page 432

An insurer may invest in bonds, notes, certificates of

indebtedness, warrants, or other evidences of indebtedness, which

are payable from revenues or earnings specifically pledged therefor

of any public structure or improvement owned by any state,

incorporated city, or legally-constituted public corporation or

commission or trust, all within the United States, for the payment

of the principal and interest if no default on the part of the

issuer in payment of principal or interest has occurred on any of

its bonds, notes, warrants, or other securities within five (5)

years prior to the date of investment therein, or, if such

obligations were issued less than five (5) years prior to the date

of investment, no default in payment of principal or interest has

occurred on the obligations to be purchased or on any other

obligation of the issuer within five (5) years of such investment.
Okla. Stat. tit. 36, § 36-7500 — OK Code / Title 36 / Section 36-7500
Anesthesia coverage
Status: in_force

A. As used in this section:

Oklahoma Statutes - Title 36. Insurance Page 1506

1. “Anesthesia time” means the period beginning when an

anesthesia practitioner begins to prepare the patient for anesthesia

services in the operating room or an equivalent area and ends when

the anesthesia practitioner is no longer furnishing anesthesia

services to the patient. In counting anesthesia time for services

furnished, the anesthesia practitioner may include blocks of time

around an interruption in anesthesia time provided the anesthesia

practitioner is furnishing continuous anesthesia care within the

time periods around the interruption;

2. “Payments for anesthesia service” means the prevailing

medical coding and billing standards in the professional medical

billing community including, but not limited to, current AMA CPT

Codebook, Medicare Claims Processing Manual, and American Society of

Anesthesiologists guidance. Payment for anesthesia services is

based on base plus time unit together multiplied by an anesthesia

conversion factor. Anesthesia time units are recognized in

appropriate time intervals that must add up to the duration of the

anesthesia time; and

3. “Insurer” shall have the same meaning as defined in Section

1250.2 of Title 36 of the Oklahoma Statutes.

B. No insurer shall establish, implement, or enforce any

policy, practice, or procedure which:

1. Imposes a time limit on the amount of covered anesthesia

services provided during a medical or surgical procedure; or

2. Restricts or excludes coverage or payment of anesthesia

time.
Okla. Stat. tit. 36, § 36-6211 — OK Code / Title 36 / Section 36-6211
Form of license - Contents
Status: in_force

The license of an adjuster shall be in a form prescribed by the

Insurance Commissioner. The license shall contain:

1. The name and mailing address of the adjuster;

2. Indication as to whether the adjuster is licensed as an

insurance adjuster or as a public adjuster;

3. The date of issuance and the date of expiration of the

license;

4. The classes of business the license is to cover; and

5. Other information which the Commissioner deems necessary.
Okla. Stat. tit. 36, § 36-903.2 — OK Code / Title 36 / Section 36-903.2
Workplace safety plans - Expenses of implementation
Status: in_force

No insurance company shall request and the Insurance

Commissioner shall not approve an increase for the expense portion

of insurance company rate filings based upon the requirements of

Section 6701 of this title.
Okla. Stat. tit. 36, § 36-624.3 — OK Code / Title 36 / Section 36-624.3
Refund of adverse economically targeted and home office
Status: in_force

credit deductions.

A. As used in this section:

1. “Economically targeted credits” means any credit against the

insurance premium tax other than the home office credits;

2. “Home office credits” means the credits against insurance

premium tax authorized pursuant to Section 625.1 of this title;

3. “Insurance premium tax” means those levies imposed pursuant

to Sections 624 and 628 of this title; and

4. “Insurance premium tax liabilities” means the total

liability of any insurance company created by the insurance premium

tax.

B. Any taxpayer adversely affected by a requirement of the

Oklahoma Insurance Department for deducting home office credits

after the deduction of economically targeted credits in computation

of the taxpayer’s insurance premium tax liabilities for the period

January 2003, through December 2006, shall be granted a refund,

pursuant to the provisions of Section 624.2 of this title, for the

difference between the insurance premium tax liability as it would

have been computed had the home office credit been deducted prior to

economically targeted credits and the insurance premium tax

liability as it was actually computed for such periods.

C. The provisions of this section shall be deemed sufficient

grounds for the granting of a refund claim pursuant to subsection C

of Section 624.2 of this title.

D. No refund otherwise payable pursuant to the provisions of

this section shall be paid to a claimant prior to July 1, 2007.

E. Refunds paid on or after July 1, 2007, pursuant to the

provisions of this section shall only be paid from those insurance

premium taxes and fees that would be apportioned to the General

Revenue Fund of the State Treasury. No refund otherwise payable

Oklahoma Statutes - Title 36. Insurance Page 143

pursuant to the provisions of this section shall be paid from

insurance premium taxes or fees that would be apportioned to the

Oklahoma Firefighters Pension and Retirement Fund, the Oklahoma

Police Pension and Retirement System or the Law Enforcement

Retirement Fund.

F. Any and all premium tax credits to be utilized or recovered

in a subsequent year are fully admitted as an asset to the insurer

owning or generating said credits.
Okla. Stat. tit. 36, § 36-1934 — OK Code / Title 36 / Section 36-1934
Publication and service of assessment order
Status: in_force

The Insurance Commissioner shall cause a notice of such

assessment order, setting forth a brief summary of the contents of

such order, to be (1) published in such manner as shall be directed

by the court, and (2) enclosed in a sealed envelope, addressed and

mailed postage prepaid, to each member or subscriber liable

thereunder at his last-known address as it appears on the records of

the insurer, at least twenty (20) days before the return day of the

order to show cause provided for in section 1833 of this article.
Okla. Stat. tit. 36, § 36-6519 — OK Code / Title 36 / Section 36-6519
Basic and standard health benefit plans - Condition of
Status: in_force

transacting business - Filing with Commissioner - Required

compliance with certain provisions - Exceptions.

A. 1. As a condition of transacting business in this state

with small employers, every small employer carrier shall actively

offer to small employers the health benefit plans currently being

marketed by the small employer carrier.

2. a. A small employer carrier shall issue a health benefit

plan to any eligible small employer that applies for a

plan and agrees to make the required premium payments

and to satisfy the other reasonable provisions of the

Oklahoma Statutes - Title 36. Insurance Page 1284

health benefit plan not inconsistent with Section 6511

et seq. of this title.

b. In the case of a small employer carrier that

establishes more than one class of business pursuant

to Section 6514 of this title, the small employer

carrier shall maintain and issue to eligible small

employers all health benefit plans currently being

marketed in each class of business so established. A

small employer carrier may apply reasonable criteria

to determine the class of business applicable to any

small employer, provided that:

(1) the criteria are not intended to discourage or

prevent acceptance of small employers applying

for a health benefit plan,

(2) the criteria are not related to the health status

or claim experience of the small employer,

(3) the criteria are applied consistently to all

small employers applying for coverage in the

class of business, and

(4) the small employer carrier provides for the

acceptance of all eligible small employers into

one or more classes of business.

The provisions of this subparagraph shall not apply to

a class of business into which the small employer

carrier is no longer enrolling new small businesses.

3. A small employer is eligible under paragraph 2 of this

subsection if it employed at least two or more eligible employees

within this state on at least fifty percent (50%) of its working

days during the preceding calendar quarter. This also includes

family businesses where employees of the business may be related.

The fact that the employees are related shall have no effect on the

eligibility for coverage of the small employer.

4. A small employer carrier that offers a health benefit plan

in the small employer market only through one or more bona fide

association health plans is not required to offer that health

benefit plan to any small employer that is not a member of the bona

fide association sponsoring the bona fide association health plan.

B. 1. A small employer carrier shall file with the

Commissioner, in a format and manner prescribed by the Commissioner,

all health benefit plans to be used by the carrier. A health

benefit plan filed pursuant to this paragraph may be used by a small

employer carrier beginning sixty (60) days after it is filed unless

the Commissioner disapproves its use.

2. Except as otherwise set forth in this title, the

Commissioner at any time may, after providing notice and an

opportunity for a hearing to the small employer carrier, disapprove

the continued use by a small employer carrier of any health benefit

Oklahoma Statutes - Title 36. Insurance Page 1285

plan on the grounds that the plan does not meet the requirements of

the Small Employer Health Insurance Reform Act.

C. Health benefit plans covering small employers shall comply

with the following provisions:

1. A health benefit plan shall not deny, exclude or limit

benefits for a covered individual for losses incurred more than

twelve (12) months following the effective date of the individual's

coverage due to a preexisting condition. A health benefit plan

shall not define a preexisting condition more restrictively than:

a. a condition that would have caused an ordinarily

prudent person to seek medical advice, diagnosis, care

or treatment during the six (6) months immediately

preceding the effective date of coverage, orOklahoma Statutes - Title 36. Insurance Page 35e (12) months following the effective date of the individual's

coverage due to a preexisting condition. A health benefit plan

shall not define a preexisting condition more restrictively than:

a. a condition that would have caused an ordinarily

prudent person to seek medical advice, diagnosis, care

or treatment during the six (6) months immediately

preceding the effective date of coverage, or

b. a condition for which medical advice, diagnosis, care

or treatment was recommended or received during the

six (6) months immediately preceding the effective

date of coverage;

2. A health benefit plan may exclude coverage for late

enrollees for the greater of eighteen (18) months or for an

eighteen-month preexisting condition exclusion; provided that if

both a period of exclusion from coverage and a preexisting condition

exclusion are applicable to a late enrollee, the combined period

shall not exceed eighteen (18) months from the date the individual

enrolls for coverage under the health benefit plan;

3. a. Except as provided in subparagraph d of this

paragraph, requirements used by a small employer

carrier will be limited to requirements for minimum

participation of eligible employees and minimum

employer contributions. These requirements shall be

applied uniformly among all small employers with the

same number of eligible employees applying for

coverage or receiving coverage from the small employer

carrier.

b. A small employer carrier may vary application of

minimum participation requirements and minimum

employer contribution requirements only by the size of

the small employer group.

c. (1) Except as provided in division (2) of this

subparagraph, in applying minimum participation

requirements with respect to a small employer, a

small employer carrier shall not consider

employees or dependents who have qualifying

existing coverage in determining whether the

applicable percentage of participation is met.

(2) With respect to a small employer, a small

employer carrier may consider employees or

dependents who have coverage under another health

Oklahoma Statutes - Title 36. Insurance Page 1286

benefit plan sponsored by a small employer in

applying minimum participation requirements.

d. A small employer carrier shall not increase any

requirement for minimum employee participation or any

requirement for minimum employer contribution

applicable to a small employer at any time after the

small employer has been accepted for coverage; and

4. a. If a small employer carrier offers coverage to a small

employer, the small employer carrier shall offer

coverage to all of the eligible employees of a small

employer and their dependents. A small employer

carrier shall not offer coverage to only certain

individuals in a small employer group or to only part

of the group, except in the case of late enrollees as

provided in paragraph 2 of this subsection.

b. Except as permitted under paragraphs 1 and 2 of this

subsection, a small employer carrier shall not modify

a health benefit plan with respect to a small employer

or any eligible employee or dependent, through riders,

endorsements or otherwise, to restrict or exclude

coverage or benefits for specific diseases, medical

conditions or services otherwise covered by the plan.

D. The Commissioner shall develop, by rule, a uniform health

questionnaire for use by small employers applying for health

insurance coverage under group health plans offered by small

employer carriers. Small employer carriers shall be required to

accept and use the uniform health questionnaire not more than six

(6) months after the rules adopting the questionnaire become

effective.

E. 1. A small employer carrier shall not be required to offer

coverage or accept applications pursuant to subsection A of this

section in the case of the following:

a. to a small employer, where the small employer is not

physically located in the established geographic

service area of the carrier,

b. to an employee, when the employee does not work or

reside within the established geographic service area

of the carrier, or

c. within an area where the small employer carrier

reasonably anticipates, and demonstrates to the

satisfaction of the Commissioner, that it will not

have the capacity within its established geographic

service area to deliver service adequately to the

members of such groups because of its obligations to

existing group policyholders and enrollees.

2. A small employer carrier that cannot offer coverage pursuant

to subparagraph c of paragraph 1 of this subsection may not offer

Oklahoma Statutes - Title 36. Insurance Page 1287

coverage in the applicable area to new cases of employer groups with

more than fifty (50) eligible employees or to any small employer

groups until the later of one hundred eighty (180) days following

each refusal or the date on which the carrier notifies the

Commissioner that it has regained capacity to deliver services to

small employer groups.

F. A bona fide association health plan established pursuant to

this title to provide benefits to a particular trade, business,

profession or industry or their subsidiaries shall not issue

coverage to a group or individual that is not in the same trade,

business, profession or industry as that covered by the bona fide

association health plan. The bona fide association health plan

shall accept all employer groups in the same trade, business,

profession or industry or their subsidiaries that apply for coverage

under the arrangement and that meet the requirements for membership

in the arrangement. For purposes of this subsection, the

requirements for membership in a bona fide association health plan

shall not include any requirements that relate to the actual or

expected health status of the prospective enrollee.
Okla. Stat. tit. 36, § 36-1930 — OK Code / Title 36 / Section 36-1930
Time to file claims
Status: in_force

If upon commencement of delinquency proceedings under this

article or at any time during the proceedings the insurer shall not

be clearly solvent, the court shall, after such notice and hearing

as it deems proper, make an order declaring the insurer to be

insolvent. Thereupon, regardless of any prior notice which may have

been given to creditors, the Insurance Commissioner shall notify all

persons who may have claims against the insurer and who have not

filed proper proofs thereof to present the same to the Commissioner,

at a place specified in the notice, within four (4) months from the

date of entry of the order, or within a longer time prescribed by

the court not to exceed one hundred eighty (180) days which shall be

specified in the notice. The notice shall be given in a manner

determined by the court.

Oklahoma Statutes - Title 36. Insurance Page 562

Only upon application of the liquidator, the receivership court

may allow alternative procedures and requirements for the filing of

proofs of claim or for allowing or proving claims. Upon

application, if the court dispenses with the requirements of filing

a proof of claim by a person, class, or group of persons, a proof of

claim for such a person, class, or group shall be deemed as having

been filed for all purposes, except that the receivership court's

waiver of proof-of-claim requirements shall not impact a guaranty

association's proof-of-claim filing requirement or coverage

determinations to the extent that the guaranty fund statute or

filing requirements are inconsistent with the court's waiver of

proof.

Proofs of claim may be filed after the date specified in the

notice, but no such claim shall share in the distribution of the

assets until all allowed claims, proofs of which have been filed

before that date, have been paid in full with interest.
Okla. Stat. tit. 36, § 36-6592 — OK Code / Title 36 / Section 36-6592
Definitions
Status: in_force

For purposes of this act:

1. "Enrollee" means an individual who is enrolled in a health

care plan, including covered dependents;

2. "Health care plan" means any arrangement whereby any person

undertakes to provide, arrange for, pay for, or reimburse any part

of the costs of any health care services for an enrollee;

Oklahoma Statutes - Title 36. Insurance Page 1324

3. "Health care provider" means a physician, hospital,

pharmaceutical company, pharmacy, pharmacist, laboratory, or other

state-licensed or state-recognized provider of health care services;

4. "Health insurance carrier" means an insurance company that

issues policies of accident and health insurance and is or should be

licensed to sell insurance in this state;

5. "Health maintenance organization" means an organization

which is or should be licensed by the State Department of Health

pursuant to Section 2501 et seq. of Title 63 of the Oklahoma

Statutes;

6. "Managed care entity" means any entity which is a health

care plan, health insurance carrier or health maintenance

organization as defined in this section, but does not include an

employer that sponsors or participates in a health care plan or

purchases coverage or assumes risk on behalf of or for the benefit

of its employees or the employees of one or more subsidiaries or

affiliates of the employer; and

7. "Medically necessary” means services or supplies provided by

a health care provider that are:

a. appropriate for the symptoms and diagnosis or

treatment of the enrollee’s condition, illness,

disease, or injury,

b. in accordance with standards of good medical practice,

c. not primarily for the convenience of the enrollee or

the enrollee’s health care provider, and

d. the most appropriate supply or level of service that

can safely be provided to the enrollee.
Okla. Stat. tit. 36, § 36-6057.1 — OK Code / Title 36 / Section 36-6057.1
Examination and enforcement by Commissioner –
Status: in_force

Attorneys’ fees.

A. In order to enforce the provisions of the Health Care

Freedom of Choice Act, the Insurance Commissioner may conduct an

examination of insurers’ and preferred provider organizations’

claims files pursuant to the procedure set forth in Section 1250.4

of this title.

B. The Commissioner, upon finding an insurer in violation of

any provision of the Health Care Freedom of Choice Act, may issue a

cease and desist order to the insurer directing the insurer to stop

such unlawful practices. If the insurer refuses or fails to comply

with the order, the Commissioner shall have the authority to revoke

or suspend the insurer’s certificate of authority. The Commissioner

shall use the authority specified in this subsection to the extent

deemed necessary to obtain the insurer’s compliance with the order.

The Attorney General shall offer assistance if requested by the

Commissioner to enforce the Commissioner’s orders.

C. Reasonable attorney fees shall be awarded to the

Commissioner if judicial action is necessary for the enforcement of

the orders. Such fees shall be based upon those prevailing in the

community. Fees collected by the Commissioner without the

assistance of the Attorney General shall be credited to the

Insurance Commissioner’s Revolving Fund. Fees collected by the

Attorney General shall be credited to the Attorney General’s

Revolving Fund.
Okla. Stat. tit. 36, § 36-1443 — OK Code / Title 36 / Section 36-1443
Written agreement required - Examination, audit and
Status: in_force

inspection of records.

A. No person shall act as an administrator without a written

agreement between that person and an insurer. The written agreement

shall be retained as part of the official records of both the

insurer and the administrator for the duration of the agreement and

for five (5) years thereafter.

B. The written agreement required by the provisions of

subsection A of this section shall contain provisions stating any of

the requirements of the Third-party Administrator Act which apply to

the functions performed by the administrator.

C. If a policy is issued to a trustee, a copy of the trust

agreement and any amendments to the agreement shall be furnished to

the insurer by the administrator and shall be retained as part of

the official records of both the insurer and the administrator for

the duration of the policy and for five (5) years thereafter.

D. Every administrator shall maintain at the principal

administrative office of the administrator for the duration of the

agreement and for five (5) years thereafter the written agreement

required by the provisions of this section and records of all

transactions among the administrator, insurers or trusts, and

insured persons.

E. 1. For the purposes of examination, audit, and inspection,

the Insurance Commissioner or any other person in the course of

examination, audit and inspection shall have access to books and

records maintained by the administrator. Any trade secrets

contained in these books and records, including the identity and

addresses of policyholders and certificate holders, shall be

confidential.

2. All work papers, recorded information, documents and copies

thereof produced or obtained by or disclosed to the Commissioner or

other person in the course of examination, audit and inspection made

pursuant to this section, or in the course of analysis by the

Commissioner or other person in the course of examination, audit and

inspection, shall be given confidential treatment by the

Commissioner and may not be made public by the Commissioner or any

other person who obtained the information in the course of the

examination, audit and inspection, except to the extent provided in

this section. Access may be granted to the National Association of

Insurance Commissioners. The parties shall agree in writing prior

to receiving the information to provide to it the same confidential

treatment as required by this section, unless the prior written

Oklahoma Statutes - Title 36. Insurance Page 370

consent of the company to which it pertains has been obtained. The

confidentiality and protection from discovery by subpoena provided

for in this paragraph shall not be construed to be extended to

identical, similar or other related documents or information or to

the work papers that are not deemed to be in the possession, custody

or control of the Commissioner.

3. The Commissioner may use this information in any proceedings

instituted against the administrator.

F. The insurer or trust shall have the right of continuing

access to books and records maintained by the administrator

sufficient to permit the insurer or trust to fulfill all of its

contractual obligations to insured persons, subject to any

restriction in the written agreement between the insurer or trust

and the administrator concerning the proprietary rights of the

parties to said books and records.

G. The agreement required by the provisions of this section

shall include provisions stating the underwriting standards or other

standards pertaining to the business underwritten by the insurer or

trust.
Okla. Stat. tit. 36, § 36-1250.5 — OK Code / Title 36 / Section 36-1250.5
Acts by an insurer constituting an unfair claim
Status: in_force

settlement practice.

Any of the following acts by an insurer, if committed in

violation of Section 1250.3 of this title, constitutes an unfair

claim settlement practice exclusive of paragraph 16 of this section

which shall be applicable solely to health benefit plans:

1. Failing to fully disclose to first-party claimants,

benefits, coverages, or other provisions of any insurance policy or

insurance contract when the benefits, coverages or other provisions

are pertinent to a claim;

2. Knowingly misrepresenting to claimants pertinent facts or

policy provisions relating to coverages at issue;

3. Failing to adopt and implement reasonable standards for

prompt investigations of claims arising under its insurance policies

or insurance contracts;

4. Not attempting in good faith to effectuate prompt, fair and

equitable settlement of claims submitted in which liability has

become reasonably clear;

5. Failing to comply with the provisions of Section 1219 of

this title;

6. Denying a claim for failure to exhibit the property without

proof of demand and unfounded refusal by a claimant to do so;

7. Except where there is a time limit specified in the policy,

making statements, written or otherwise, which require a claimant to

give written notice of loss or proof of loss within a specified time

limit and which seek to relieve the company of its obligations if

the time limit is not complied with unless the failure to comply

with the time limit prejudices the rights of an insurer. Any policy

that specifies a time limit covering damage to a roof due to wind or

hail must allow the filing of claims after the first anniversary but

no later than twenty-four (24) months after the date of the loss, if

the damage is not evident without inspection;

8. Requesting a claimant to sign a release that extends beyond

the subject matter that gave rise to the claim payment;

9. Issuing checks, drafts or electronic payment in partial

settlement of a loss or claim under a specified coverage which

contain language releasing an insurer or its insured from its total

liability;

10. Denying payment to a claimant on the grounds that services,

procedures, or supplies provided by a treating physician, hospital,

or person or entity licensed or otherwise authorized to provide

health care services were not medically necessary unless the health

insurer or administrator, as defined in Section 1442 of this title,

first obtains an opinion from any provider of health care licensed

by law and preceded by a medical examination or claim review, to the

effect that the services, procedures or supplies for which payment

is being denied were not medically necessary. In the event that

Oklahoma Statutes - Title 36. Insurance Page 309

claims for mental health or substance use disorder treatments and

services are under review, the reviewing health care provider shall

have appropriate, qualified, and specialized credentials with

respect to the services and treatments. Upon written request of a

claimant, treating physician, hospital, or authorized person or

entity, the opinion shall be set forth in a written report, prepared

and signed by the reviewing physician. The report shall detail

which specific services, procedures, or supplies were not medically

necessary, in the opinion of the reviewing physician, and an

explanation of that conclusion. A copy of each report of a

reviewing physician shall be mailed by the health insurer, or

administrator, postage prepaid, to the claimant, treating physician,

hospital, or authorized person or entity requesting same within

fifteen (15) days after receipt of the written request. As used in

this paragraph, “physician” means a person holding a valid license

to practice medicine and surgery, osteopathic medicine, podiatric

medicine, dentistry, chiropractic, or optometry, pursuant to the

state licensing provisions of Title 59 of the Oklahoma Statutes;

11. Compensating a reviewing physician, as defined in paragraph

10 of this section, on the basis of a percentage of the amount by

which a claim is reduced for payment;

12. Violating the provisions of the Health Care Fraud

Prevention Act;

13. Compelling, without just cause, policyholders to institute

suits to recover amounts due under its insurance policies or

insurance contracts by offering substantially less than the amounts

ultimately recovered in suits brought by them, when the

policyholders have made claims for amounts reasonably similar to the

amounts ultimately recovered;

14. Failing to maintain a complete record of all complaints

which it has received during the preceding three (3) years or since

the date of its last financial examination conducted or accepted by

the Commissioner, whichever time is longer. This record shall

indicate the total number of complaints, their classification by

line of insurance, the nature of each complaint, the disposition of

each complaint, and the time it took to process each complaint. For

the purposes of this paragraph, “complaint” means any written

communication primarily expressing a grievance;

15. Requesting a refund of all or a portion of a payment of a

claim made to a claimant more than six (6) months or a health care

provider more than twelve (12) months after the payment is made.

This paragraph shall not apply:

a. if the payment was made because of fraud committed by

the claimant or health care provider, or

b. if the claimant or health care provider has otherwise

agreed to make a refund to the insurer for overpayment

of a claim;

Oklahoma Statutes - Title 36. Insurance Page 310

16. Failing to pay, or requesting a refund of a payment, for

health care services covered under the policy if a health benefit

plan, or its agent, has provided a preauthorization or

precertification and verification of eligibility for those health

care services. This paragraph shall not apply if:

a. the claim or payment was made because of fraud

committed by the claimant or health care provider,

b. the subscriber had a preexisting exclusion under the

policy related to the service provided, or

c. the subscriber or employer failed to pay the

applicable premium and all grace periods and

extensions of coverage have expired;

17. Denying or refusing to accept an application for life

insurance, or refusing to renew, cancel, restrict or otherwise

terminate a policy of life insurance, or charge a different rate

based upon the lawful travel destination of an applicant or insured

as provided in Section 4024 of this title; or

18. As a health insurer that provides pharmacy benefits or a

pharmacy benefits manager that administers pharmacy benefits for a

health plan, failing to include any amount paid by an enrollee or on

behalf of an enrollee by another person when calculating the

enrollee’s total contribution to an out-of-pocket maximum,

deductible, copayment, coinsurance or other cost-sharing

requirement.

However, if, under federal law, application of this paragraph

would result in health savings account ineligibility under Section

223 of the federal Internal Revenue Code, as amended, this

requirement shall apply only for health savings accounts with

qualified high-deductible health plans with respect to the

deductible of such a plan after the enrollee has satisfied the

minimum deductible, except with respect to items or services that

are preventive care pursuant to Section 223(c)(2)(C) of the federal

Internal Revenue Code, as amended, in which case the requirements of

this paragraph shall apply regardless of whether the minimum

deductible has been satisfied.
Okla. Stat. tit. 36, § 36-1537 — OK Code / Title 36 / Section 36-1537
Discretion of insurer or insurance group over responses
Status: in_force

A. The insurer or insurance group shall have discretion over

the responses to the Corporate Governance Annual Disclosure (CGAD)

inquiries, provided the CGAD shall contain the material information

necessary to permit the Insurance Commissioner to gain an

understanding of the insurer's or group's corporate governance

structure, policies, and practices. The Commissioner may request

additional information that he or she deems material and necessary

to provide a clear understanding of the corporate governance

policies, the reporting or information system or controls

implementing those policies.

B. Notwithstanding subsection A of this section, the CGAD shall

be prepared consistent with any regulation created to support this

act. Documentation and supporting information shall be maintained

and made available upon examination or upon request of the

Commissioner.
Okla. Stat. tit. 36, § 36-7110 — OK Code / Title 36 / Section 36-7110
Violations - Punishment
Status: in_force

Any person, firm or corporation violating any of the provisions

of the Perpetual Care Fund Act shall, upon conviction, be deemed

guilty of a misdemeanor and shall be subject to a fine of not less

than One Hundred Dollars ($100.00) nor more than Two Thousand Five

Hundred Dollars ($2,500.00).
Okla. Stat. tit. 36, § 36-4055.4 — OK Code / Title 36 / Section 36-4055.4
Denial, suspension, revocation or nonrenewal of license
Status: in_force

- Hearing.

A. The Insurance Commissioner may refuse to issue, suspend,

revoke or refuse to renew the license of a viatical settlement

provider or viatical settlement broker if the Commissioner finds

that:

1. There was any material misrepresentation in the application

for the license;

2. The licensee or any officer, partner, member or key

management personnel has been convicted of fraudulent or dishonest

Oklahoma Statutes - Title 36. Insurance Page 876

practices, is subject to a final administrative action or is

otherwise shown to be untrustworthy or incompetent;

3. The viatical settlement provider demonstrates a pattern of

unreasonable payments to viators;

4. The licensee or any officer, partner, member or key

management personnel has been found guilty of, or has pleaded guilty

or nolo contendere to, any felony, or to a misdemeanor involving

fraud or moral turpitude, regardless of whether a judgment of

conviction has been entered by the court;

5. The viatical settlement provider has entered into any

viatical settlement contract that has not been approved pursuant to

the Viatical Settlements Act of 2008;

6. The viatical settlement provider has failed to honor

contractual obligations set out in a viatical settlement contract;

7. The licensee no longer meets the requirements for initial

licensure;

8. The viatical settlement provider has assigned, transferred

or pledged a viaticated policy to a person other than a viatical

settlement provider licensed in this state, viatical settlement

purchaser, an accredited investor or qualified institutional buyer

as defined respectively in Rule 501(a) or Rule 144A promulgated

under the Federal Securities Act of 1933, as amended, financing

entity, special purpose entity, or related provider trust; or

9. The licensee or any officer, partner, member or key

management personnel has violated any provision of the Viatical

Settlements Act of 2008.

B. The Commissioner may suspend, revoke or refuse to renew the

license of a viatical settlement broker or a life insurance producer

operating as a viatical settlement broker pursuant to the Viatical

Settlements Act of 2008 if the Commissioner finds that the viatical

settlement broker or life insurance producer has violated the

provisions of the Viatical Settlements Act of 2008 or has otherwise

engaged in bad-faith conduct with one or more viators.

C. If the Commissioner denies a license application or

suspends, revokes or refuses to renew the license of a viatical

settlement provider, viatical settlement broker or suspends,

revokes, or refuses to renew a license of a life insurance producer

operating as a viatical settlement broker pursuant to the Viatical

Settlements Act of 2008 the Commissioner shall conduct a hearing in

accordance with the Administrative Procedures Act.
Okla. Stat. tit. 36, § 36-2502 — OK Code / Title 36 / Section 36-2502
Designation as corporators; articles of agreement;
Status: in_force

contents; approval by insurance commissioner; filing and recording.

Oklahoma Statutes - Title 36. Insurance Page 676

The persons mentioned in Section 2501 shall be designated as

corporators, and such persons shall associate themselves by articles

of agreement in writing, duly signed and acknowledged, setting

forth:

First: The corporate name of the proposed corporation, which

shall not be the name of any corporation heretofore incorporated or

doing business in this state for similar purposes, or any such

imitation of such name calculated to mislead the public.

Second: The name of the city, town or county in which the

principal office is located.

Third: The amount of the capital stock of the corporation,

which shall not be less than Fifty Thousand Dollars ($50,000.00),

the number of shares into which it is divided, and the par value

thereof, that the same has been bona fide subscribed, and actually

paid up in lawful money of the United States, and is in the custody

of persons named as the first board of directors, the name and place

of the several shareholders and the number of shares subscribed by

each.

Fourth: The number of the board of directors or managers, which

shall be not less than five, their powers and duties, and the names

agreed upon for the first year.

Fifth: The number of years the corporation is to continue.

Sixth: A statement that the company is formed for the purpose

of carrying on the business of insurance under the provisions of

this article. Said articles of agreement shall be submitted to the

Insurance Commissioner, and if they are found to comply with the

provisions of this article, he shall approve the same. When

approved they shall be filed and recorded in the office of the

Secretary of State, who shall issue a certificate of incorporation,

upon the receipt of which such persons shall be a body corporate and

politic, under the laws of this state.
Okla. Stat. tit. 36, § 36-1435.13 — OK Code / Title 36 / Section 36-1435.13
Suspension, revocation or refusal to issue or renew
Status: in_force

license – Probation and censure – Grounds – Notice – Fines.

A. The Insurance Commissioner may place on probation, censure,

suspend, revoke or refuse to issue or renew a license issued

pursuant to the Oklahoma Producer Licensing Act or may levy a civil

penalty in accordance with subsection D of this section or any

combination of actions, for any one or more of the following causes:

1. Providing incorrect, misleading, incomplete or materially

untrue information in the license application;

2. Violating any insurance laws, or violating any regulation,

subpoena or order of the Insurance Commissioner or of another

state’s Insurance Commissioner;

3. Obtaining or attempting to obtain a license through

misrepresentation or fraud;

Oklahoma Statutes - Title 36. Insurance Page 344

4. Improperly withholding, misappropriating or converting any

monies or properties received in the course of doing insurance

business;

5. Intentionally misrepresenting the terms of an actual or

proposed insurance contract or application for insurance;

6. Having been convicted of a felony;

7. Having admitted or been found to have committed any

insurance unfair trade practice or fraud;

8. Using fraudulent, coercive or dishonest practices, or

demonstrating incompetence, untrustworthiness or financial

irresponsibility in the conduct of business in this state or

elsewhere;

9. Having an insurance producer license, or its equivalent,

denied, suspended, censured, placed on probation or revoked in any

other state, province, district or territory;

10. Forging another’s name to an application for insurance or

to any document related to an insurance transaction;

11. Improperly using notes or any other reference material to

complete an examination for an insurance license;

12. Knowingly accepting insurance business from an individual

who is not licensed;

13. Failing to comply with an administrative or court order

imposing a child support obligation;

14. Failing to pay state income tax or comply with any

administrative or court order directing payment of state income tax;

15. Failing to respond to an inquiry from the Department as

required in Section 1250.4 of this title; or

16. Any cause for which an original issuance of a license could

have been refused.

B. In the event that the action by the Insurance Commissioner

is to nonrenew or to deny an application for a license, the

Insurance Commissioner shall notify the applicant or licensee and

advise the applicant or licensee, in writing, of the reason for the

denial or nonrenewal of the applicant’s or licensee’s license. The

applicant or licensee may make written demand upon the Insurance

Commissioner within thirty (30) days of the date of notification of

the notification by the Insurance Commissioner for a hearing before

the Insurance Commissioner or an independent hearing examiner to

determine the reasonableness of the Insurance Commissioner’s action.

The hearing shall be heard within a reasonable time period and shall

be held pursuant to the Oklahoma Administrative Procedures Act.

C. The license of a business entity may be suspended, revoked

or refused if the Insurance Commissioner finds, after opportunity

for hearing, that an individual licensee’s violation was known or

should have been known by one or more of the partners, officers or

managers acting on behalf of the partnership or corporation and the

Oklahoma Statutes - Title 36. Insurance Page 345

violation was neither reported to the Insurance Commissioner nor

corrective action taken.

D. In addition to or in lieu of any applicable denial,

probation, censure, suspension or revocation of a license, a person

may, after opportunity for hearing, be subject to a civil fine of

not more than One Thousand Dollars ($1,000.00) for each occurrence.

The penalty may be enforced in the same manner in which civil

judgments may be enforced.

E. Every licensee licensed pursuant to the provisions of the

Oklahoma Producer Licensing Act shall keep at the licensee’s place

of business the usual and customary records pertaining to

transactions authorized by the license. All records as to any

particular transactions shall be kept available and open to the

inspection of the Commissioner at any time during business hours

during the three (3) years immediately following the date of

completion of the transaction. The Commissioner may require a

financial or market conduct examination during any investigation of

a licensee. The cost of such examination shall be apportioned among

all of the appointing insurers of the licensee.

F. The Insurance Commissioner shall retain the authority to

enforce the provisions of and impose any penalty or remedy

authorized by the Oklahoma Producer Licensing Act and this title

against any person who is under investigation for or charged with a

violation of the Oklahoma Producer Licensing Act or this title even

if the person’s license or registration has been surrendered or has

lapsed by operation of law.

G. Files pertaining to investigations or legal matters which

contain information concurring a current and ongoing investigation

of allegations of violations of the Oklahoma Insurance Code by a

licensed agent shall not be available for public inspection without

proper judicial authorization; however, a licensee under

investigation for alleged violations of the Oklahoma Insurance Code,

or against whom an action for alleged violations of the Oklahoma

Insurance Code has been commenced, may view evidence and complaints

pertaining to the investigation, other than privileged information,

at reasonable times at the Commissioner’s office. All qualification

examination materials, booklets and answers for any license

authorized to be issued by the Commissioner under any statute shall

not be available for public inspection. The residence address,

residence telephone number, birth date and Social Security number of

a licensee shall not be available for public inspection. A separate

business or mailing address provided by the licensee shall be

considered a public record. If the residence and business addresses

or residence and business telephone numbers are the same, such

addresses or telephone numbers shall be considered a public record.

H. The Commissioner shall promptly notify all appointing

insurers, where applicable, and the licensee regarding any censure,

Oklahoma Statutes - Title 36. Insurance Page 346

suspension, revocation or termination of license by the

Commissioner.

I. Upon suspension, revocation or termination of the license of

a resident or nonresident of this state, the Commissioner shall

notify the Central Office of the National Association of Insurance

Commissioners, or its appropriate nonprofit affiliates and the

Insurance Commissioner of each state for whom the Commissioner has

executed a certificate of licensure status.

J. The Commissioner may issue a duplicate license for any lost,

stolen or destroyed license issued pursuant to the Oklahoma Producer

Licensing Act upon an affidavit of the licensee prescribed by the

Commissioner concerning the facts of such loss, theft or

destruction.
Okla. Stat. tit. 36, § 36-6475.12 — OK Code / Title 36 / Section 36-6475.12
Approval of independent review organizations
Status: in_force

Oklahoma Statutes - Title 36. Insurance Page 1265

A. The Insurance Commissioner shall approve independent review

organizations eligible to be assigned to conduct external reviews

under the Uniform Health Carrier External Review Act.

B. In order to be eligible for approval by the Commissioner

under this section to conduct external reviews under the Uniform

Health Carrier External Review Act an independent review

organization:

1. Except as otherwise provided in this section, shall be

accredited by a nationally recognized private accrediting entity

that the Commissioner has determined has independent review

organization accreditation standards that are equivalent to or

exceed the minimum qualifications for independent review

organizations established under Section 6475.13 of this title; and

2. Shall submit an application for approval in accordance with

subsection D of this section.

C. The Commissioner shall develop an application form by rule

for initially approving and for reapproving independent review

organizations to conduct external reviews.

D. 1. Any independent review organization wishing to be

approved to conduct external reviews under this act shall submit the

application form and include with the form all documentation and

information necessary for the Commissioner to determine if the

independent review organization satisfies the minimum qualifications

established under Section 6475.13 of this title.

2. a. Subject to subparagraph b of this paragraph, an

independent review organization is eligible for

approval under this section only if it is accredited

by a nationally recognized private accrediting entity

that the Commissioner has determined has independent

review organization accreditation standards that are

equivalent to or exceed the minimum qualifications for

independent review organizations under Section 6475.13

of this title.

b. The Commissioner may approve independent review

organizations that are not accredited by a nationally

recognized private accrediting entity if there are no

acceptable nationally recognized private accrediting

entities providing independent review organization

accreditation.

3. The Commissioner may charge an application fee that

independent review organizations shall submit to the Commissioner

with an application for approval and reapproval.

E. 1. An approval is effective for two (2) years, unless the

Commissioner determines before its expiration that the independent

review organization is not satisfying the minimum qualifications

established under Section 6475.14 of this title.

Oklahoma Statutes - Title 36. Insurance Page 1266

2. Whenever the Commissioner determines that an independent

review organization has lost its accreditation or no longer

satisfies the minimum requirements established under Section 6475.14

of this title, the Commissioner shall terminate the approval of the

independent review organization and remove the independent review

organization from the list of independent review organizations

approved to conduct external reviews under the Uniform Health

Carrier External Review Act that is maintained by the Commissioner

pursuant to subsection F of this section.

F. The Commissioner shall maintain and periodically update a

list of approved independent review organizations.

G. The Commissioner may promulgate rules to carry out the

provisions of this section.
Okla. Stat. tit. 36, § 36-6570.57 — OK Code / Title 36 / Section 36-6570.57
Continuity of prior authorizations during health plan
Status: in_force

changes.

Oklahoma Statutes - Title 36. Insurance Page 1321

A. On receipt of information documenting a prior authorization

from the enrollee or from the enrollee's health care provider, a

utilization review entity shall honor a prior authorization granted

to an enrollee from a previous utilization review entity for at

least the initial sixty (60) days of an enrollee's coverage under a

new health plan.

B. During the time period described in subsection A of this

section, a utilization review entity may perform its own review to

grant a prior authorization or make an adverse determination.

C. A utilization review entity shall continue to honor a prior

authorization it has granted to an enrollee when the enrollee

changes products under the same health insurance company for the

initial sixty (60) days of an enrollee's coverage under the new

product unless the service is no longer a covered service under the

new product.

D. During the time period described in subsection C of this

section, a utilization review entity may simultaneously perform a

review to grant a prior authorization or to make an adverse

determination.

E. Provided the provisions of this section do not violate any

applicable law, regulation, or the Oklahoma Medicaid State Plan.
Okla. Stat. tit. 36, § 36-990 — OK Code / Title 36 / Section 36-990
Challenge and review of application of rating system
Status: in_force

Challenge and Review of Application of Rating System.

A. Every advisory organization and every insurer subject to the

Property and Casualty Competitive Loss Cost Rating Act which makes

its own rates shall provide within this state reasonable means

whereby any insured aggrieved by the application of its rating

system may, upon that insured's written request, be heard in person

or by the insured's authorized representative to review the manner

in which such rating system has been applied in connection with the

insurance afforded the aggrieved insurer.

B. An insurer or any party affected by the action of an

advisory organization may, within thirty (30) days after written

notice of that action, make application, in writing, for an appeal

to the Commissioner, setting forth the basis for the appeal and the

grounds to be relied upon by the applicant.

Oklahoma Statutes - Title 36. Insurance Page 238

C. Within thirty (30) days, the Commissioner shall review the

application and, if the Commissioner finds that the application is

made in good faith and that it sets forth on its face grounds which

reasonably justify holding a hearing, the Commissioner shall conduct

a hearing held not less than ten (10) days after written notice to

the applicant and to the advisory organization or insurer. The

Commissioner, after a hearing, shall affirm or reverse the action of

the advisory organization or insurer.
Okla. Stat. tit. 36, § 36-3612 — OK Code / Title 36 / Section 36-3612
Standard provisions
Status: in_force

A. Insurance contracts shall contain such standard provisions

as are required by the applicable provisions of this Code pertaining

to contracts of particular kinds of insurance. The Insurance

Commissioner may waive the required use of a particular standard

provision in a particular insurance policy form if:

1. The Commissioner finds such provision unnecessary for the

protection of the insured and inconsistent with the purpose of the

policy; and

2. The policy is otherwise approved.

B. No policy shall contain any provision inconsistent with or

contradictory to any standard provision used or required to be used,

but the Insurance Commissioner may approve any substitute provision

which is not less favorable in any particular to the insured or

beneficiary than the standard provisions or optional standard

provisions otherwise required.

C. In lieu of the standard provisions required by the

provisions of this Code for contracts for particular kinds of

insurance, substantially similar standard provisions required by the

law of the domicile of a foreign or alien insurer may be used when

approved by the Insurance Commissioner.

D. This section does not apply with respect to the Oklahoma

standard fire insurance policy.
Okla. Stat. tit. 36, § 36-2001 — OK Code / Title 36 / Section 36-2001
Short title
Status: in_force

This act shall be known and may be cited as the Oklahoma

Property and Casualty Insurance Guaranty Association Act.
Okla. Stat. tit. 36, § 36-1105 — OK Code / Title 36 / Section 36-1105
Attorney fees
Status: in_force

In any action against a surplus lines insurer pursuant to

Section 1103 of this title, if the insurer has failed for thirty

(30) days after demand prior to the commencement of the action to

make payment in accordance with the terms of the contract of

insurance or in accordance with Section 1115 of this title, and it

appears to the court that the refusal was vexatious and without

reasonable cause, the court may allow to the plaintiff or an

aggrieved agency of this state a reasonable attorney fee and include

the fee in any judgment that may be rendered in the action. The fee

Oklahoma Statutes - Title 36. Insurance Page 251

shall not exceed one-third (1/3) of the amount which the court or

jury finds the plaintiff is entitled to recover against the insurer,

but in no event shall a fee be less than One Hundred Dollars

($100.00). Failure of an insurer to defend any action shall be

deemed prima facie evidence that its failure to make payment was

vexatious and without reasonable cause.
Okla. Stat. tit. 36, § 36-3606 — OK Code / Title 36 / Section 36-3606
Capacity to contract for insurance; Minors
Status: in_force

A. Any person of competent legal capacity may contract for

insurance.

B. A minor not less than sixteen (16) years of age as at

nearest birthday may, notwithstanding such minority and with signed

parental or guardian consent, contract for life or accident and

health insurance on his or her own life or body or the life or body

of any person in whom he or she has an insurable interest, for his

or her own benefit or for the benefit of his or her father or

mother, spouse, child, brother, sister or grandparents. Such a

minor shall, notwithstanding such minority, be deemed competent to

exercise all rights and powers with respect to or under any contract

of life or accident and health insurance on his or her own life or

body or with respect to or under any contract such minor effected on

the life or body of any person in whom he or she has an insurable

interest, as though of full legal age, and may surrender his or her

interest therein and give a valid discharge for any benefit accruing

or money payable thereunder. The minor shall not, by reason of his

or her minority, be entitled to rescind, avoid or repudiate the

contract, nor to rescind, avoid or repudiate any exercise of a right

or privilege thereunder, except that such minor, not otherwise

emancipated, shall not be bound by any unperformed agreement to pay,

by promissory note or otherwise, any premium on any such insurance

contract.

C. A minor not less than sixteen (16) years of age may,

notwithstanding such minority and with signed parental or guardian

consent, contract for insurance on other subjects of insurance in

which he or she has an insurable interest. A minor shall be bound

by any settlement made in connection with any insurance contract so

issued. The minor shall not, by reason of his or her minority, be

entitled to rescind, avoid or repudiate the contract, nor to

rescind, avoid or repudiate any exercise of a right or privilege

thereunder, except that such minor, not otherwise emancipated, shall

not be bound by any unperformed agreement to pay, by promissory note

or otherwise, any premium on any such insurance contract.

D. Liability for failure to obtain signed parental or guardian

consent under subsections B and C of this section shall not rest

upon the insurance agent from whom the insurance policy was

purchased.
Okla. Stat. tit. 36, § 36-7122 — OK Code / Title 36 / Section 36-7122
Definitions
Status: in_force

As used in the Cemetery Merchandise Trust Act:

1. "Cemetery merchandise" means markers, memorials, vases,

memorial vases, monuments, equipment, crypts, niches or outer

enclosures. Cemetery merchandise shall not include the sale of

lands or interests therein as grave lots or grave spaces; burial or

interment rights; and delivered or installed crypts, niches or outer

enclosures;

2. "Purchase price" means the gross amount to be paid for

cemetery merchandise under the provisions of a prepaid cemetery

merchandise contract. Purchase price shall not include finance

charges, sales tax, charges for real property interests or charges

for credit life insurance;

Oklahoma Statutes - Title 36. Insurance Page 1488

3. "Prepaid cemetery merchandise contract" means any agreement

for the sale of cemetery merchandise by an organization which

requires payment of the purchase price, in whole or in part, prior

to delivery of the cemetery merchandise, which agreement is entered

into from and after November 1, 1989;

4. "Minimum funding requirement" means that portion of the

purchase price equal to one hundred ten percent (110%) of the

wholesale cost, plus delivery charges, of the cemetery merchandise

covered in a prepaid cemetery merchandise contract;

5. "Organization" means any individual, firm, partnership,

trust, corporation, association or entity. Organization shall not

include state, county, municipal, township, rural community,

religious, fraternal or nonprofit entities, free community burial

grounds, county cemetery associations, Indian tribal cemeteries on

tribal land and charitable or eleemosynary institutions operating

cemeteries in this state;

6. "Outer enclosure" means a grave liner, grave box, or grave

vault;

7. "Lawn crypt" means a subsurface permanent outer enclosure

installed before need in multiple units for the purpose of interring

human remains;

8. "Financial institution" means a federally insured bank,

trust company, or savings and loan association which is authorized

to do business in this state;

9. "Commissioner" or “Insurance Commissioner” means the

Insurance Commissioner of the State of Oklahoma; and

10. “Wholesale cost” means an amount determined on the basis of

such standard quotations and price lists as are published by the

vendor of the cemetery merchandise, without regard to any discounts

that may be available to the organization.
Okla. Stat. tit. 36, § 36-301 — OK Code / Title 36 / Section 36-301
Insurance Department
Status: in_force

The Insurance Department of the State of Oklahoma is hereby

created. The Insurance Commissioner shall be the chief executive

officer of the Insurance Department. The powers and duties of the

Insurance Commissioner shall be those created by the Oklahoma

Oklahoma Statutes - Title 36. Insurance Page 52

Insurance Code. The Insurance Department shall be situated in one

area in the State Capitol or some other location conveniently

accessible to the general public subject to the provisions of

Sections 63 and 94 of Title 74 of the Oklahoma Statutes and Section

580:20-13-5 of the Oklahoma Administrative Code.
Okla. Stat. tit. 36, § 36-6207 — OK Code / Title 36 / Section 36-6207
Insurance adjuster or public adjuster
Status: in_force

A. The Commissioner may issue a license to an insurance

adjuster or a public adjuster in accordance with the provisions of

the Insurance Adjusters Licensing Act.

B. A firm, association, company, or corporation shall be

licensed only as an adjuster. In the case of a firm each general

partner and each other individual to act for the firm pursuant to

the license, and in the case of a corporation, association, or

company each individual to act for the corporation, association, or

company pursuant to the license, shall be named in the license and

shall qualify therefor as though an individual licensee. The

Commissioner shall charge a full license fee for each firm,

association, company, or corporation and a full additional license

fee for each individual acting for the firm, association, company,

or corporation.
Okla. Stat. tit. 36, § 36-2103 — OK Code / Title 36 / Section 36-2103
"Mutual" insurer defined
Status: in_force

A "mutual" insurer is an incorporated insurer without capital

stock or shares, and is owned by its policyholders.
Okla. Stat. tit. 36, § 36-6946 — OK Code / Title 36 / Section 36-6946
Application of act - Rules for implementation of act
Status: in_force

A. The provisions of the Risk-based Capital (RBC) for Health

Maintenance Organizations Act of 2003 are supplemental to any other

provisions of the laws of this state, and shall not preclude or

limit any other powers or duties of the Insurance Commissioner under

such laws including, but not limited to, Articles 18 and 19 of the

Insurance Code and promulgated rules related to health maintenance

organizations in hazardous financial condition.

B. The Commissioner may adopt reasonable rules necessary for

the implementation of this act.

C. The Commissioner may exempt from the application of this act

a domestic health maintenance organization that:

1. Writes direct business only in this state; and

2. Assumes no reinsurance in excess of five percent (5%) of

direct premium written.
Okla. Stat. tit. 36, § 36-3009 — OK Code / Title 36 / Section 36-3009
Division of profits
Status: in_force

Oklahoma Statutes - Title 36. Insurance Page 753

No profits shall accrue to an underwriter, except upon the basis

of his actual investment in cash or securities, disregarding any

obligation or subscription to pay in additional cash or securities

at a later date.
Okla. Stat. tit. 36, § 36-4423 — OK Code / Title 36 / Section 36-4423
Application of act
Status: in_force

A. The requirements of the Long-Term Care Insurance Act shall

apply to policies, other than life care community policies delivered

or issued for delivery in this state on or after November 1, 1987.

The requirements of the Long-Term Care Insurance Act shall apply to

life care community policies delivered or issued for delivery in

this state on or after November 1, 1989.

B. Notwithstanding any other provision, the Long-Term Care

Insurance Act shall not apply to the following:

1. Residential care homes licensed pursuant to the Oklahoma

Residential Care Act;

2. Assisted living centers and continuum of care facilities

licensed pursuant to the Oklahoma Continuum of Care and Assisted

Living Act; or

3. Facilities licensed pursuant to the Oklahoma Nursing Home

Care Act.

C. The Long-Term Care Insurance Act is not intended to

supersede the obligations of entities subject to said act to comply

with the substance of other applicable insurance laws insofar as

Oklahoma Statutes - Title 36. Insurance Page 964

they do not conflict with the Long-Term Care Insurance Act, except

that laws and regulations designed and intended to apply to Medicare

supplement insurance policies shall not apply to long-term care

insurance. A policy which is not advertised, marketed or offered as

long-term care insurance need not meet the requirements of the Long-

Term Care Insurance Act. The Long-Term Care Insurance Act is not

intended to require life care communities to be licensed insurers.

Life care communities which are not licensed insurers shall not be

subject to the provisions of the Insurance Code or the jurisdiction

of the Insurance Commissioner, except as provided in the Long-Term

Care Insurance Act.
Okla. Stat. tit. 36, § 36-2680 — OK Code / Title 36 / Section 36-2680
Annual statement - Examinations - Expenses
Status: in_force

A. Each dental 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 Commissioner, and which shall be verified

under oath by at least two 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 five (5) years, the

Commissioner shall personally, or by 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 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.

Oklahoma Statutes - Title 36. Insurance Page 704
Okla. Stat. tit. 36, § 36-1204.1 — OK Code / Title 36 / Section 36-1204.1
Availability of loss runs and claims histories
Status: in_force

Property and casualty insurers and advisory board or advisory

organizations shall make loss runs or claims history available to

current and former policyholders within thirty (30) days upon a

written request by the policyholder.
Okla. Stat. tit. 36, § 36-612.2 — OK Code / Title 36 / Section 36-612.2
Workers' compensation insurance - Required capital and
Status: in_force

surplus.

After November 1, 1987, no insurer who requests to write

workers' compensation insurance in this state shall be permitted to

transact the business of workers' compensation insurance in this

Oklahoma Statutes - Title 36. Insurance Page 131

state unless the insurer possesses and maintains a surplus as

regards policyholders, as defined in Section 610 of Title 36 of the

Oklahoma Statutes, in excess of Five Million Dollars

($5,000,000.00). Should the surplus as regards policyholders fall

below Five Million Dollars ($5,000,000.00), the insurer shall not be

permitted to write any additional workers' compensation insurance

until the surplus meets the statutory requirements as established in

this section.
Okla. Stat. tit. 36, § 36-1928 — OK Code / Title 36 / Section 36-1928
Offsets
Status: in_force

A. In all cases of mutual debts or mutual credits between the

insurer and another person, whether arising out of one or more

Oklahoma Statutes - Title 36. Insurance Page 560

contracts between the insurer and another person, in connection with

any action or proceeding under this article, such credits and debts

shall be offset and the balance only shall be allowed or paid,

except as provided in subsection B of this section.

B. No offset shall be allowed if:

1. The obligation of the insurer would not, at the date of the

entry of any liquidation order or otherwise as provided in Section

1925 of this title, entitle the claimant to share in the assets of

the insurer;

2. The obligation of the insurer was purchased by or

transferred to the claimant to be used as an offset;

3. The obligation is to pay an assessment levied against the

members of a mutual insurer, or against the subscribers of a

reciprocal insurer, or to pay a balance upon the subscription to the

capital stock of a stock insurer;

4. The obligation of the insurer is owed to an affiliate of

such person, or any other entity or association other than the

person;

5. The obligation of the person is owed to an affiliate of the

insurer, or any other entity or association other than the insurer;

or

6. The obligation between the person and the insurer arises

from business where either the person or the insurer has assumed

risks and obligations from the other party and then has ceded back

to that party substantially the same risks and obligations.
Okla. Stat. tit. 36, § 36-311A.7 — OK Code / Title 36 / Section 36-311A.7
Qualified independent certified public accountants
Status: in_force

A. The Insurance Commissioner shall not recognize a person or

firm as a qualified independent certified public accountant if the

person or firm:

1. Is not in good standing with the AICPA and in all states in

which the accountant is licensed to practice, or, for a Canadian or

British company, that is not a chartered accountant; or

2. Has either directly or indirectly entered into an agreement

of indemnity or release from liability, collectively referred to as

indemnification, with respect to the audit of the insurer.

B. Except as otherwise provided in the Oklahoma Annual

Financial Report Act, the Commissioner shall recognize an

independent certified public accountant as qualified as long as the

accountant conforms to the standards of the profession, as contained

in the Code of Professional Ethics of the AICPA and Rules and

Regulations and Code of Ethics and Rules of Professional Conduct of

the Oklahoma Board of Public Accountancy, or similar code.

C. A qualified independent certified public accountant may

enter into an agreement with an insurer to have disputes relating to

an audit resolved by mediation or arbitration. However, in the

event of a delinquency proceeding commenced against the insurer

under Article 19 of the Oklahoma Insurance Code, the mediation or

arbitration provisions shall operate at the option of the statutory

successor.

D. 1. The lead or coordinating audit partner having primary

responsibility for the audit may not act in that capacity for more

than five (5) consecutive years. The person shall be disqualified

from acting in that or a similar capacity for the same company or

its insurance subsidiaries or affiliates for a period of five (5)

consecutive years. An insurer may make application to the

Commissioner for relief from the above rotation requirement on the

basis of unusual circumstances. This application should be made at

least thirty (30) days before the end of the calendar year. The

Commissioner may consider the following factors in determining if

the relief should be granted:

a. number of partners, expertise of the partners, or the

number of insurance clients in the currently

registered firm,

b. premium volume of the insurer, or

Oklahoma Statutes - Title 36. Insurance Page 84

c. number of jurisdictions in which the insurer transacts

business.

2. The insurer shall file, with its annual statement filing,

the approval for relief from paragraph 1 of this subsection with the

states that it is licensed in or doing business in and with the

NAIC. If the nondomestic state accepts electronic filing with the

NAIC, the insurer shall file the approval in an electronic format

acceptable to the NAIC.

E. The Commissioner shall neither recognize as a qualified

independent certified public accountant, nor accept an annual

audited financial report, prepared in whole or in part by, a natural

person who:

1. Has been convicted of fraud, bribery, a violation of the

Racketeer Influenced and Corrupt Organizations Act, 18 U.S.C.

Sections 1961 to 1968, or any dishonest conduct or practices under

federal or state law;

2. Has been found to have violated the insurance laws of this

state with respect to any previous reports submitted under the

Oklahoma Annual Financial Report Act; or

3. Has demonstrated a pattern or practice of failing to detect

or disclose material information in previous reports filed under the

provisions of the Oklahoma Annual Financial Report Act.

F. The Commissioner may hold a hearing to determine whether an

independent certified public accountant is qualified and,

considering the evidence presented, may rule that the accountant is

not qualified for purposes of expressing the opinion of the

accountant on the financial statements in the annual audited

financial report made pursuant to the Oklahoma Annual Financial

Report Act and require the insurer to replace the accountant with

another whose relationship with the insurer is qualified within the

meaning of the Oklahoma Annual Financial Report Act.

G. 1. The Commissioner shall not recognize as a qualified

independent certified public accountant, nor accept an annual

audited financial report, prepared in whole or in part by an

accountant who provides to an insurer, contemporaneously with the

audit, the following non-audit services:

a. bookkeeping or other services related to the

accounting records or financial statements of the

insurer,

b. financial information systems design and

implementation,

c. appraisal or valuation services, fairness opinions, or

contribution-in-kind reports,

d. actuarially oriented advisory services involving the

determination of amounts recorded in the financial

statements. The accountant may assist an insurer in

understanding the methods, assumptions, and inputs

Oklahoma Statutes - Title 36. Insurance Page 85

used in the determination of amounts recorded in the

financial statement only if it is reasonable to

conclude that the services provided will not be

subject to audit procedures during an audit of the

financial statements of the insurer. The actuary of

an accountant may also issue an actuarial opinion or

certification on the reserves of an insurer if the

following conditions have been met:

(1) neither the accountant nor the actuary of the

accountant has performed any management functions

or made any management decisions,

(2) the insurer has competent personnel or engages a

third-party actuary to estimate the reserves for

which management takes responsibility, and

(3) the actuary of the accountant tests the

reasonableness of the reserves after the

management of the insurer has determined the

amount of the reserves,

e. internal audit outsourcing services,

f. management functions or human resources,

g. broker or dealer, investment adviser, or investment

banking services,

h. legal services or expert services unrelated to the

audit, or

i. any other services that the Commissioner determines,

by rule, are impermissible.

2. In general, the principles of independence with respect to

services provided by the qualified independent certified public

accountant are largely predicated on three basic principles,

violations of which would impair the independence of the accountant.

The principles are that the accountant cannot function in the role

of management, cannot audit the own work of the accountant, and

cannot serve in an advocacy role for the insurer.

H. Insurers having direct written and assumed premiums of less

than One Hundred Million Dollars ($100,000,000.00) in any calendar

year may request an exemption from paragraph 1 of subsection G of

this section. The insurer shall file with the Commissioner a

written statement discussing the reasons why the insurer should be

exempt from these provisions. If the Commissioner finds, upon

review of the statement, that compliance with the Oklahoma Annual

Financial Report Act would constitute a financial or organizational

hardship upon the insurer, an exemption may be granted.

I. A qualified independent certified public accountant who

performs the audit may engage in other non-audit services, including

tax services, that are not described in paragraph 1 of subsection G

of this section or that do not conflict with paragraph 2 of

subsection G of this section, only if the activity is approved in

Oklahoma Statutes - Title 36. Insurance Page 86

advance by the audit committee, in accordance with subsection J of

this section.

J. All auditing services and non-audit services provided to an

insurer by the qualified independent certified public accountant of

the insurer shall be preapproved by the audit committee. The

preapproval requirement is waived with respect to non-audit services

if the insurer is a SOX Compliant Entity or a direct or indirect

wholly-owned subsidiary of a SOX Compliant entity or:

1. The aggregate amount of all such non-audit services provided

to the insurer constitutes not more than five percent (5%) of the

total amount of fees paid by the insurer to its qualified

independent certified public accountant during the fiscal year in

which the non-audit services are provided;

2. The services were not recognized by the insurer at the time

of the engagement to be non-audit services; and

3. The services are promptly brought to the attention of the

audit committee and approved prior to the completion of the audit by

the audit committee or by one or more members of the audit committee

who are the members of the board of directors to whom authority to

grant such approvals has been delegated by the audit committee.

K. The audit committee may delegate to one or more designated

members of the audit committee the authority to grant the

preapprovals required by subsection J of this section. The

decisions of any member to whom this authority is delegated shall be

presented to the full audit committee at each of its scheduled

meetings.

L. 1. The Commissioner shall not recognize an independent

certified public accountant as qualified for a particular insurer if

a member of the board, president, chief executive officer,

controller, chief financial officer, chief accounting officer, or

any person serving in an equivalent position for that insurer, was

employed by the independent certified public accountant and

participated in the audit of that insurer during the one-year period

preceding the date that the most current statutory opinion is due.

This subsection shall only apply to partners and senior managers

involved in the audit. An insurer may make application to the

Commissioner for relief from the above requirement on the basis of

unusual circumstances.

2. The insurer shall file, with its annual statement filing,

the approval for relief from paragraph 1 of this subsection with the

states that it is licensed in or doing business in and the NAIC. If

the nondomestic state accepts electronic filing with the NAIC, the

insurer shall file the approval in an electronic format acceptable

to the NAIC.
Okla. Stat. tit. 36, § 36-1147 — OK Code / Title 36 / Section 36-1147
Suspension or revocation of license - Commissioner
Status: in_force

authority - Procedure.

A. The Insurance Commissioner may suspend the license of any

advisory organization which fails to comply with an order of the

Commissioner within the time limit established by such order, or any

extension thereof which the Commissioner may grant. The

Commissioner shall not suspend the license of any advisory

organization for failure to comply with an order until the time

prescribed for judicial review has expired or if an action for

judicial review has been commenced, until the order has been

affirmed or the action has been dismissed. The Commissioner may

determine when a suspension of license shall become effective and

when it shall terminate, unless it modifies or rescinds the

suspension, or until the order upon which the suspension is based is

modified, rescinded or reversed.

B. No license shall be suspended or revoked except upon a

written order of the Commissioner, stating its findings of fact and

conclusions of law, made after a hearing held upon not less than ten

(10) days' written notice, to the person or legal entity, specifying

the alleged violation.
Okla. Stat. tit. 36, § 36-122 — OK Code / Title 36 / Section 36-122
Electronic filing of documents
Status: in_force

A. The Commissioner shall have the authority to require any

entity obligated to submit or file documents with the Insurance

Department to file the documents electronically.

B. The documents referred to in subsection A of this section

include, but are not limited to, forms for compliance, rate filings,

or annual, quarterly, or other financial statements.

C. The Commissioner may promulgate reasonable and necessary

rules concerning the implementation of this section.
Okla. Stat. tit. 36, § 36-4055.15 — OK Code / Title 36 / Section 36-4055.15
Violation of act - Deceptive trade practice
Status: in_force

A violation of the Viatical Settlements Act of 2008, including

the commission of a fraudulent viatical settlement act, shall be

Oklahoma Statutes - Title 36. Insurance Page 903

considered a deceptive trade practice under Sections 1201 through

1219 of Title 36 of the Oklahoma Statutes subject to the penalties

contained in those sections.
Okla. Stat. tit. 36, § 36-2603 — OK Code / Title 36 / Section 36-2603
Certificate of authority; requirements
Status: in_force

The Insurance Commissioner shall issue a certificate of

authority authorizing the applicant to issue contracts to its

subscribers when it is shown to the satisfaction of the Commissioner

that:

1. The applicant is established as a bona fide not-for-profit

hospital service or indemnity corporation and/or a not-for-profit

medical or indemnity corporation;

2. The contracts between the applicant and the participating

hospitals, physicians, or other health care providers, if any,

obligate each hospital, physician, or other health care provider

executing the same to render service to which each subscriber may be

entitled under the terms of the contract to be issued to the

subscribers;

3. The amounts provided as working capital of the corporation

are repayable, without interest, out of operating expenses;

4. The amount of money actually available for working capital

is sufficient to carry on the plan for a period of six (6) months

from the date of issuance of the certificate of authority; and

5. The applicant has secured contracts of participation from

sufficient hospitals, physicians, or other health care providers to

provide ample protection for its subscribers within the area

proposed to be served by the applicant.
Okla. Stat. tit. 36, § 36-6452 — OK Code / Title 36 / Section 36-6452
Operation of act
Status: in_force

The Oklahoma Risk Retention Act shall regulate the formation and

operation of risk retention groups in this state formed pursuant to

the provisions of the federal Liability Risk Retention Act of 1986.
Okla. Stat. tit. 36, § 36-5113 — OK Code / Title 36 / Section 36-5113
Date for compliance with act
Status: in_force

No insurer or reinsurer shall continue to utilize the services

of a reinsurance intermediary on and after September 1, 1992, unless

utilization is in compliance with the provisions of the Reinsurance

Intermediary Act.
Okla. Stat. tit. 36, § 36-6570.4 — OK Code / Title 36 / Section 36-6570.4
Appeals to be reviewed by physician or licensed mental
Status: in_force

health professional.

A utilization review entity shall ensure that all appeals are

reviewed by a physician or licensed mental health professional. The

physician or licensed mental health professional shall:

1. Possess a current and valid unrestricted license in any

United States jurisdiction;

2. Be of the same or similar specialty as a physician or

licensed mental health professional who typically manages the

medical condition or disease, which means that the physician either

maintains board certification for the same or similar specialty as

the medical condition in question or whose training and experience:

a. includes treating the condition,

b. includes treating complications that may result from

the service or procedure, and

c. is sufficient for the physician or licensed mental

health professional to determine if the service or

procedure is medically necessary or clinically

appropriate,

Oklahoma Statutes - Title 36. Insurance Page 1311

except for appeals coming from a licensed mental health

professional, which may be conducted by another licensed mental

health professional as opposed to a physician;

3. Not have been directly involved in making the adverse

determination;

4. Not have any financial interest in the outcome of the

appeal; and

5. Consider all known clinical aspects of the health care

service under review, including, but not limited to, a review of

those medical records which are pertinent and relevant to the active

condition provided to the utilization review entity by the

enrollee's health care provider, or a health care facility, and any

pertinent medical literature provided to the utilization review

entity by the health care provider.
Okla. Stat. tit. 36, § 36-4209 — OK Code / Title 36 / Section 36-4209
Nonforfeiture benefits
Status: in_force

There shall be provisions for nonforfeiture benefits and cash

surrender values as required by Section 4029 of Article 40 (Life

Insurance and Annuities).
Okla. Stat. tit. 36, § 36-6943 — OK Code / Title 36 / Section 36-6943
Mandatory control level event - Definition - Duties of
Status: in_force

Insurance Commissioner.

A. “Mandatory Control Level Event” means any of the following

events:

1. The filing of an RBC report which indicates that the health

maintenance organization’s total adjusted capital is less than its

Mandatory Control Level RBC;

2. Notification by the Commissioner to the health maintenance

organization of an adjusted RBC report that indicates a Mandatory

Control Level Event specified in paragraph 1 of this subsection,

provided the health maintenance organization does not challenge the

adjusted RBC report under Section 44 of this act; or

3. If, pursuant to the provisions of Section 44 of this act,

the health maintenance organization challenges an adjusted RBC

report that indicates the event in paragraph 1 of this subsection,

notification by the Commissioner to the health maintenance

organization that the Commissioner has, after a hearing, rejected

the health maintenance organization’s challenge.

B. In the event of a Mandatory Control Level Event, the

Commissioner shall take such actions as are necessary to place the

health maintenance organization under regulatory control pursuant to

the provisions of Articles 18 and 19 of the Insurance Code. In that

Oklahoma Statutes - Title 36. Insurance Page 1423

event, the Mandatory Control Level Event shall be deemed sufficient

grounds for the Commissioner to take action pursuant to the

provisions of Articles 18 and 19 of the Insurance Code, and the

Commissioner shall have the rights, powers and duties with respect

to the health maintenance organization as provided in Articles 18

and 19 of the Insurance Code. Notwithstanding any of the preceding

provisions, the Commissioner may forego action for up to ninety (90)

days after the Mandatory Control Level Event if the Commissioner

finds there is a reasonable expectation that the Mandatory Control

Level Event may be eliminated within the ninety-day period.
Okla. Stat. tit. 36, § 36-941 — OK Code / Title 36 / Section 36-941
Certain cancellation, refusal to renew or increase of
Status: in_force

premium rate for motor vehicle liability or collision insurance

policies prohibited - Exemptions.

A. No insurance carrier who issues motor vehicle insurance

policies in this state shall assign driving record points, cancel,

refuse to issue or renew, or charge a higher premium rate for any

motor vehicle liability or collision insurance policy for the reason

that the insured has been involved in a motor vehicle collision and

was not at fault.

B. No insurance carrier who issues motor vehicle insurance

policies in this state shall cancel, refuse to issue or renew, or

charge a higher premium for any motor vehicle liability or collision

insurance policy for the reason that the insured had lower liability

limits with a previous insurer without actuarial justification.

This prohibition includes using prior limits for company or tier

placement unless the insurer provides actuarial justification.

C. This section shall not apply to an insured who has been

convicted of:

1. Homicide or assault arising out of the operation of any

motor vehicle; or

2. A violation of Section 11-902 or 761 of Title 47 of the

Oklahoma Statutes as being impaired by or under the influence of

alcohol or intoxicating liquor or who was under the influence of any

Oklahoma Statutes - Title 36. Insurance Page 211

substance included in the Uniform Controlled Dangerous Substances

Act.
Okla. Stat. tit. 36, § 36-4103 — OK Code / Title 36 / Section 36-4103
Schedule of premium rates - Required provisions
Status: reserved

A. No policy of group life insurance shall be delivered in this

state unless it contains in substance the following provisions, or

provisions which are more favorable to the persons insured, or at

least as favorable to the persons insured and more favorable to the

policyholder; provided, however, that:

1. Paragraphs 6 through 10 of this section shall not apply to

policies issued to a creditor to insure debtors of such creditor;

2. That the standard provisions required for individual life

insurance policies shall not apply to group life insurance policies;

and

3. That if the group life insurance policy is on a plan of

insurance other than the term plan, it shall contain a nonforfeiture

provision or provisions which is or are equitable to the insured

persons and to the policyholder, but nothing herein shall be

construed to require that group life insurance policies contain the

same nonforfeiture provisions as are required for individual life

insurance policies:

B. A provision that the policyholder is entitled to a grace

period of thirty-one (31) days for the payment of any premium due

except the first, during which grace period the death benefit

coverage shall continue in force, unless the policyholder shall have

given the insurer written notice of discontinuance in advance of the

date of discontinuance and in accordance with the terms of the

policy. The policy may provide that the policyholder shall be

liable to the insurer for the payment of a pro rata premium for the

time the policy was in force during such grace period.

C. A provision that the validity of the policy shall not be

contested, except for nonpayment of premiums, after it has been in

force for two (2) years from its date of issue, and that no

statement made by any person insured under the policy relating to

his or her insurability shall be used in contesting the validity of

the insurance with respect to which such statement was made after

such insurance has been in force prior to the contest for a period

of two (2) years during such person's lifetime nor unless it is

contained in a written instrument signed by him or her.

D. A provision that a copy of the application, if any, of the

policyholder shall be attached to the policy when issued, that all

statements made by the policyholder or by the persons insured shall

be deemed representations and not warranties, and that no statement

made by any person insured shall be used in any contest unless a

copy of the instrument containing the statement is or has been

furnished to such person or to his or her beneficiary.

Oklahoma Statutes - Title 36. Insurance Page 925

E. A provision setting forth the conditions, if any, under

which the insurer reserves the right to require a person eligible

for insurance to furnish evidence of individual insurability

satisfactory to the insurer as a condition to part or all of his or

her coverage.

F. A provision specifying an equitable adjustment of premiums

or of benefits or of both to be made in the event the age of a

person insured has been misstated, such provision to contain a clear

statement of the method of adjustment to be used.

G. A provision that any sum becoming due by reason of the death

of the person insured shall be payable to the beneficiary designated

by the person insured, subject to the provisions of the policy in

the event there is no designated beneficiary as to all or any part

of such sum, living at the death of the person insured, and subject

to any right reserved by the insurer in the policy and set forth in

the certificate to pay at its option a part of such sum not

exceeding Five Hundred Dollars ($500.00) to any person appearing to

the insurer to be equitably entitled thereto by reason of having

incurred funeral or other expenses incident to the last illness or

death of the person insured.

H. A provision that the insurer will issue to the policyholder

for delivery to each person insured an individual certificate

setting forth a statement as to the insurance protection to which he

is entitled, to whom the insurance benefits are payable, and the

rights and conditions set forth in paragraphs 8, 9 and 10 of this

section.

I. A provision that if the insurance, or any portion of it, on

a person covered under the policy ceases because of termination of

employment or of membership in the class or classes eligible for

coverage under the policy, such person shall be entitled to have

issued to him or her by the insurer, without evidence of

insurability, an individual policy of life insurance without

disability or other supplementary benefits, provided an application

for the individual policy shall be made, and the first premium paid

to the insurer, within thirty-one (31) days after such termination,

and provided further that:

a. the individual policy shall, at the option of such

person, be on any one of the forms, except term

insurance, then customarily issued by the insurer at

the age and for the amount applied for,

b. the individual policy shall be in an amount not in

excess of the amount of life insurance which ceases

because of such termination, less, in the case of a

person whose membership in the class or classes

eligible for coverage terminates but who continues in

employment in another class, the amount of any life

insurance for which such person is or becomes eligible

Oklahoma Statutes - Title 36. Insurance Page 926

within thirty-one (31) days after such termination

under any other group policy; provided that any amount

of insurance which shall have matured on or before the

date of such termination as an endowment payable to

the person insured, whether in one sum or in

installments or in the form of an annuity, shall not,

for the purposes of this subparagraph, be included in

the amount which is considered to cease because of

such termination, and

c. the premium on the individual policy shall be at the

insurer's then customary rate applicable to the form

and amount of the individual policy, to the class of

risk to which such person then belongs, and to his or

her age attained on the effective date of the

individual policy.

J. A provision that if the group policy terminates or is

amended so as to terminate the insurance of any class of insured

persons, every person insured thereunder at the date of such

termination whose insurance terminates and who has been so insured

for at least five (5) years prior to such termination date shall be

entitled to have issued to him or her by the insurer an individual

policy of life insurance, subject to the same conditions and

limitations as are provided by paragraph 8 of this section, except

that the group policy may provide that the amount of such individual

policy shall not exceed the smaller of:

a. the amount of the person's life insurance protection

ceasing because of the termination or amendment of the

group policy, less the amount of any life insurance

for which he or she is or becomes eligible under any

group policy issued or reinstated by the same or

another insurer within thirty-one (31) days after such

termination, and

b. Ten Thousand Dollars ($10,000.00).

K. A provision that if a person insured under the group policy

dies during the period within which he or she would have been

entitled to have an individual policy issued to him or her in

accordance with paragraph I or J of this section and before such an

individual policy shall have become effective, the amount of life

insurance which he or she would have been entitled to have issued to

him or her under such individual policy shall be payable as a claim

under the group policy, whether or not application for the

individual policy or the payment of the first premium therefor has

been made.

L. In the case of a policy issued to a creditor to insure

debtors of such creditor, a provision that the insurer will furnish

to the policyholder for delivery to each debtor insured under the

policy a form which shall contain a statement that the life of the

Oklahoma Statutes - Title 36. Insurance Page 927

debtor is insured under the policy and that any death benefit paid

thereunder by reason of his or her death shall be applied to reduce

or extinguish the indebtedness.
Okla. Stat. tit. 36, § 36-6657 — OK Code / Title 36 / Section 36-6657
Use of certain terms and names restricted - Vehicle protection product purchase as
Status: in_force

Oklahoma Statutes - Title 36. Insurance Page 38protection product purchase as condition of financing prohibited.

Oklahoma Statutes - Title 36. Insurance Page 1335

A. Unless licensed as an insurance company, a vehicle

protection product warrantor shall not use in its name, contracts,

or literature, any of the words “insurance”, “casualty”, “surety”,

“mutual”, or any other words descriptive of the insurance, casualty,

or surety business or deceptively similar to the name or description

of any insurance or surety corporation, or any other vehicle

protection product warrantor. A warrantor may use the term

“guaranty” or similar word in the warrantor’s name.

B. A vehicle protection product seller or warrantor may not

require as a condition of financing that a retail purchaser of a

motor vehicle purchase a vehicle protection product.
Okla. Stat. tit. 36, § 36-6457 — OK Code / Title 36 / Section 36-6457
Exemptions
Status: in_force

A purchasing group and its insurer or insurers shall be subject

to all applicable laws of this state, except that a purchasing group

and its insurer or insurers shall be exempt, in regard to liability

insurance for the purchasing group, from any law of this state that

would:

1. Prohibit the establishment of a purchasing group;

2. Make unlawful an insurer providing advantages to a

purchasing group or its members based on the loss and expense

experience of the group or its members including but not limited to

Oklahoma Statutes - Title 36. Insurance Page 1204

advantages on rates, policy forms and coverage, that is not afford

to other persons or entities;

3. Prohibit a purchasing group or its members from purchasing

insurance on a group basis described in paragraph 1 of this section;

4. Prohibit a purchasing group from obtaining insurance on a

group basis because the group has not been in existence for a

minimum period of time or because any member has not belonged to the

group for a minimum period of time;

5. Require that a purchasing group must have a minimum number

of members, common ownership or affiliation, or certain legal form;

6. Require that a certain percentage of a purchasing group must

obtain insurance on a group basis;

7. Otherwise discriminates against a purchasing group or any of

its members; or

8. Require that any insurance policy issued to a purchasing

group or any of its members be countersigned by an insurance agent

or broker residing in this state.

A purchasing group shall be subject to all other applicable laws

of this state.
Okla. Stat. tit. 36, § 36-1435.5 — OK Code / Title 36 / Section 36-1435.5
When license not required
Status: in_force

A. Nothing in the Oklahoma Producer Licensing Act shall be

construed to require an insurer to obtain an insurance producer

license. In this section, the term "insurer" does not include an

insurer's officers, directors, employees, subsidiaries or

affiliates.

B. A license as an insurance producer shall not be required of

the following:

1. An officer, director or employee of an insurer or of an

insurance producer, provided that the officer, director or employee

does not receive any commission on policies written or sold to

insure risks residing, located or to be performed in this state,

and:

a. the officer, director or employee's activities are

executive, administrative, managerial, clerical or a

combination of these, and are only indirectly related

to the sale, solicitation or negotiation of insurance,

or

b. the officer, director or employee's function relates

to underwriting, loss control, inspection or the

processing, adjusting, investigating or settling of a

claim on a contract of insurance, or

c. the officer, director or employee is acting in the

capacity of a special agent or agency supervisor

assisting insurance producers where the person's

activities are limited to providing technical advice

and assistance to licensed insurance producers and do

not include the sale, solicitation or negotiation of

insurance;

2. A person who secures and furnishes information for the

purpose of group life insurance, group property and casualty

insurance, group annuities, group or blanket accident and health

insurance; or for the purpose of enrolling individuals under plans,

issuing certificates under plans or otherwise assisting in

administering plans; or performs administrative services related to

mass-marketed property and casualty insurance, where no commission

is paid to the person for the service;

3. An employer or association or its officers, directors,

employees, or the trustees of an employee trust plan, to the extent

that the employers, officers, employees, director or trustees are

engaged in the administration or operation of a program of employee

benefits for the employer's or association's own employees or the

employees of its subsidiaries or affiliates, which program involves

the use of insurance issued by an insurer, as long as the employers,

Oklahoma Statutes - Title 36. Insurance Page 335

associations, officers, directors, employees or trustees are not in

any manner compensated, directly or indirectly, by the company

issuing the contracts;

4. Employees of insurers or organizations employed by insurers

who are engaging in the inspection, rating or classification of

risks, or in the supervision of the training of insurance producers

and who are not individually engaged in the sale, solicitation or

negotiation of insurance;

5. A person whose activities in this state are limited to

advertising without the intent to solicit insurance in this state

through communications in printed publications or other forms of

electronic mass media whose distribution is not limited to residents

of the state, provided that the person does not sell, solicit or

negotiate insurance that would insure risks residing, located or to

be performed in this state;

6. A person who is not a resident of this state who sells,

solicits or negotiates a contract of insurance for commercial

property and casualty risks to an insured with risks located in more

than one state insured under that contract, provided that that

person is otherwise licensed as an insurance producer to sell,

solicit or negotiate that insurance in the state where the insured

maintains its principal place of business and the contract of

insurance insures risks located in that state;

7. A salaried full-time employee who counsels or advises his or

her employer relative to the insurance interests of the employer or

of the subsidiaries or business affiliates of the employer, provided

that the employee does not sell or solicit insurance or receive a

commission; or

8. A volunteer counselor assisting Medicare beneficiaries with

enrollment in Medicare Part D plans pursuant to the Federal Medicare

Prescription Drug, Improvement and Modernization Act of 2003, Pub.

Law No. 108-173, provided that the volunteer counselor does not

receive commissions or other valuable consideration from any person

or plan for the enrollment, that the volunteer counselor has

received education that is acceptable to the Insurance Commissioner

on enrollment of Medicare beneficiaries in Medicare Part D, that the

volunteer counselor is providing volunteer services as part of a

sponsoring agency or organization acceptable to the Commissioner,

and that supporting documentation and/or verification is provided to

the Commissioner as set out by rule.
Okla. Stat. tit. 36, § 36-1607 — OK Code / Title 36 / Section 36-1607
United States government obligations
Status: in_force

An insurer may invest any of its funds in:

1. Bonds or other evidences of indebtedness of the United

States of America or of any of its agencies or instrumentalities

when such obligations are guaranteed as to principal and interest by

the United States of America or any agency or instrumentality

thereof.

2. Bonds or other evidences of indebtedness which are

guaranteed as to principal and interest by the United States of

America or by any agency or instrumentality of the United States of

America.

3. Bonds, debentures or other securities of the following

agencies of the government of the United States, whether or not such

obligations are quaranteed by such government:

(a) Commodity credit corporation.

(b) Federal national mortgage association and stock thereof when

acquired in connection with sale of mortgage loans to such

association.

Oklahoma Statutes - Title 36. Insurance Page 431

(c) Federal land banks, issued under provisions of the Act of

Congress entitled the "Federal Farm Loan Act" and approved July 17,

1916, and any acts amendatory or supplementary to that Act.

(d) Any federal home loan bank, issued under provisions of the

Act of Congress entitled "Federal Home Loan Bank Act" and approved

July 22, 1932.

(e) The Home Owners' Loan Corporation, created by the Act of

Congress entitled "Home Owners' Loan Act of 1933" and approved June

13, 1933.

(f) Federal intermediate credit banks, created by the Act of

Congress entitled "Agricultural Credits Act of March 4, 1923."

(g) Central bank for cooperatives and regional banks for

cooperatives organized under the Farm Credit Act of 1933, or by any

of such banks.

(h) Any other similar agency of the government of the United

States and of similar financial quality.
Okla. Stat. tit. 36, § 36-2015 — OK Code / Title 36 / Section 36-2015
Prohibited acts
Status: in_force

No person, including an insurer, agent or affiliate of an

insurer shall make, publish, disseminate, circulate or place before

the public, or cause, directly or indirectly, to be made, published,

disseminated, circulated or placed before the public, in any

newspaper, magazine or other publication, or in the form of a

notice, circular, pamphlet, letter or poster, or over any radio

station or television station, or in any other way, any

advertisement, announcement or statement which uses the existence of

the Oklahoma Property and Casualty Insurance Guaranty Association

for the purpose of sales, solicitation or inducement to purchase any

form of insurance covered by the Oklahoma Property and Casualty

Insurance Guaranty Association Act. This section shall not apply to

the Oklahoma Property and Casualty Insurance Guaranty Association or

to any other entity which does not sell or solicit insurance.
Okla. Stat. tit. 36, § 36-6475.17 — OK Code / Title 36 / Section 36-6475.17
Description of external review procedures
Status: in_force

A. 1. Each health carrier shall include a description of the

external review procedures in or attached to the policy,

certificate, membership booklet, outline of coverage or other

evidence of coverage it provides to covered persons.

2. The disclosure required by paragraph 1 of this subsection

shall be in a format prescribed by the Insurance Commissioner.

B. The description required under subsection A of this section

shall include a statement that informs the covered person of the

right of the covered person to file a request for an external review

of an adverse determination or final adverse determination with the

Commissioner. The statement shall explain that external review is

available when the adverse determination or final adverse

determination involves an issue of medical necessity,

appropriateness, health care setting, level of care or

effectiveness. The statement shall include the telephone number and

address of the Commissioner.

C. In addition to subsection B of this section, the statement

shall inform the covered person that, when filing a request for an

external review, the covered person will be required to authorize

the release of any medical records of the covered person that may be

required to be reviewed for the purpose of reaching a decision on

the external review.
Okla. Stat. tit. 36, § 36-2691.17 — OK Code / Title 36 / Section 36-2691.17
Conflicting laws
Status: in_force

Nothing in this article shall be construed to supersede the

provisions of Sections 161 through 168 of Title 59 of the Oklahoma

Statutes. In the event of the conflict of any of the provisions of

this article with any of the above-cited sections, then such cited

section shall take precedence over this article, and this article

shall be construed accordingly.
Okla. Stat. tit. 36, § 36-6553 — OK Code / Title 36 / Section 36-6553
Private review agents - Certification required -
Status: in_force

Exemptions.

A. A private review agent who approves or denies payment or who

recommends approval or denial of payment for hospital or medical

services or whose review results in approval or denial of payment

for hospital or medical services on a case-by-case basis shall not

conduct utilization review in this state unless the Insurance

Commissioner has granted the private review agent a certificate.

B. Except as provided in Section 9 of this act, the Hospital

and Medical Services Utilization Review Act shall not apply to any

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

indemnity plan licensed by the Commissioner to transact insurance in

this state. If the insurer contracts outside the company for any or

all utilization review services, the entity with whom the insurance

company contracts shall be subject to all of the provisions of the

Hospital and Medical Services Utilization Review Act.

C. The State and Education Employees Group Insurance Board

shall be exempt from the provisions of the Hospital and Medical

Services Utilization Review Act and regulated accordingly as

provided for in the State and Education Employees Group Insurance

Act. In addition, the Board shall comply with the provisions of

Section 17 of this act. If the State and Education Employees Group

Insurance Board contracts for utilization review services instead of

having utilization review services be performed by employees of the

Board, the entity with whom the Board contracts shall be subject to

all of the provisions of the Hospital and Medical Services

Utilization Review Act.
Okla. Stat. tit. 36, § 36-2115 — OK Code / Title 36 / Section 36-2115
Membership in mutuals
Status: in_force

A. Each holder of one or more insurance policies or contracts

issued by a domestic mutual insurer, other than a contract or

reinsurance, is a member of the insurer with all the rights and

obligations of such membership, and each such policy or contract so

issued shall so specify.

B. Any person, government or governmental agency, state or

political estate, trustee or fiduciary may be a member of a

domestic, foreign or alien mutual insurer.

C. The insurer shall be entitled to charge and collect initial

membership and/or policy fees, in addition to the premiums.
Okla. Stat. tit. 36, § 36-4024 — OK Code / Title 36 / Section 36-4024
Limit of liability - Life insurance policy application
Status: in_force

denial.

A. No policy of life insurance shall be delivered or issued for

delivery in this state if it contains a provision which excludes or

restricts liability for death caused in a certain specified manner

or occurring while the insured has a specified status, except that a

policy may contain provisions excluding or restricting coverage as

specified therein in the event of death under any one or more of the

following circumstances:

1. Death as a result of a declared war or military action.

2. Death resulting from violations of the conditions of the

policy relating to service, travel, or flight in any species of

aircraft, other than as a fare-paying passenger in a licensed

passenger aircraft, piloted by a licensed passenger pilot on a

regular passenger route between definitely established airports.

3. Death within two (2) years from the date of issue of the

policy as a result of suicide, while sane or insane; provided, that

in the event of death as a result of suicide within two (2) years

from the date of issue of the policy the insurer shall return the

amount of all premiums paid.

B. A policy which contains any exclusion or restriction

pursuant to paragraphs 1 and 2 of subsection A of this section shall

also provide that in the event of death under the circumstances to

which any such exclusion or restriction is applicable, the insurer

Oklahoma Statutes - Title 36. Insurance Page 834

will pay an amount not less than a reserve determined according to

the reserve valuation method and upon the basis of the mortality

table and interest rate specified in the policy for the calculation

of nonforfeiture benefits (or if the policy provides for no such

benefits, computed according to a mortality table and interest rate

determined by the insurer and specified in the policy) with

adjustment for indebtedness or dividend credit.

C. A life insurance company doing business within this state

shall not deny or refuse to accept an application for life insurance

or refuse to renew, cancel, restrict, or otherwise terminate a

policy of life insurance, or charge a different rate for the same

life insurance coverage, based upon the lawful travel destinations

of the applicant or the insured. Nothing in this subsection shall

prohibit a life insurance company from denying an application for

life insurance, or restricting or charging a different premium or

rate for coverage under such a policy based on a specific travel

destination where the denial, restriction, or rate differential is

based upon sound actuarial principles or is related to actual or

anticipated experience. A violation of this subsection shall be an

unfair trade practice pursuant to Section 1250.5 of this title. The

provisions of this subsection shall apply to any life insurance

policy issued on or after the effective date of this act.

D. This section shall not apply to group life insurance,

accident and health insurance, reinsurance, or annuities, or to any

provision in a life insurance policy relating to disability benefits

or to additional benefits in the event of death by accident or

accidental means, except as provided in subsection C of this

section.
Okla. Stat. tit. 36, § 36-3006 — OK Code / Title 36 / Section 36-3006
Reserves for liabilities and losses
Status: in_force

Underwriters at a Lloyd's are required to compute reserve

liabilities for all outstanding business and for all incurred losses

upon the same basis required for stock insurance companies doing the

same class and character of business in Oklahoma.
Okla. Stat. tit. 36, § 36-2604 — OK Code / Title 36 / Section 36-2604
Deposit for protection of members
Status: in_force

A. Corporations governed by this article shall at all times

have on deposit with the Insurance Commissioner sums as follows:

1. If newly formed under this article, the sum of Fifteen

Thousand Dollars ($15,000.00); or

2. If formed under prior law, such sum as was so required under

such prior law.

Every such corporation shall deposit with the Commissioner, not

later than the first day of each February, an amount equal to two

percent (2%) of the gross subscriptions collected during the

preceding calendar year, until the deposit of such corporation

reaches a total of Twenty-five Thousand Dollars ($25,000.00). All

such deposits shall be held by the Commissioner in trust for the

benefit and protection of the subscribers of the corporation making

the deposit.

B. The deposit prescribed by this section shall be subject to

withdrawal in whole or in part on the order of and as directed by

Oklahoma Statutes - Title 36. Insurance Page 684

the Insurance Commissioner, but may, with the approval of the

Commissioner, be invested in bonds of the United States or of the

State of Oklahoma, or any political subdivision thereof, or state

warrants, which shall be assigned to the Commissioner and held by

the Commissioner as provided for original deposits. The securities

may, with the approval of the Commissioner, be exchanged for similar

securities or cash of equal amount. Interest on securities so

deposited shall be payable to the corporation depositing the same.

C. An unsettled final judgment, arising upon a certificate of

participation against such a corporation, shall be a lien on the

deposit prescribed by this section, subject to execution after

thirty (30) days from the entry of final judgment. If the deposit

is reduced thereby, it shall be replenished within ninety (90) days.

D. Upon the liquidation or dissolution of such corporation and

the satisfaction of all its liabilities, any balance remaining in

the deposit in the hands of the Commissioner and any other assets of

the insurer shall be distributed to the holders of certificates of

participation in good standing at the time proceedings for the

liquidation or dissolution of the corporation were commenced,

prorated according to the gross amount of subscriptions which have

been paid on such certificates up to the time such proceedings were

commenced.
Okla. Stat. tit. 36, § 36-1425.6 — OK Code / Title 36 / Section 36-1425.6
Renumbered as § 1435.26 of this title by Laws 2001, c
Status: in_force

156, § 35, eff. Nov. 1, 2001.
Okla. Stat. tit. 36, § 36-3651 — OK Code / Title 36 / Section 36-3651
“Actual charge” and “actual fee” defined - Application
Status: in_force

A. As used in an individual or group specified disease

insurance policy, “actual charge” or “actual fee” means the amount

actually paid by or on behalf of the insured and accepted by a

provider for services provided. Insurance policies that use these

terms must use them as defined in this section.

B. Except as provided by subsection C of this section, the

change in law made by this section applies only to insurance

policies delivered, issued for delivery, or renewed on or after the

effective date of this act. An insurance policy delivered, issued

for delivery, or renewed before the effective date of this act is

governed by the law in effect immediately before that date, and that

law is continued in effect for that purpose.

C. This section applies to an insurance policy in effect on the

effective date of this act only if the policy does not define

“actual charge” or “actual fee”.
Okla. Stat. tit. 36, § 36-2801 — OK Code / Title 36 / Section 36-2801
Organization authorized – Purposes – Power to make
Status: in_force

assessments.

Any fifty or more persons of lawful age, who shall be resident,

bona fide farmers, and collectively shall own property of not less

than Twenty-five Thousand Dollars ($25,000.00), which they desire to

have insured, may associate themselves together for the purpose of

insuring any or all property located in this state, as provided in

this article, against loss by fire, lightning, tornado, and theft,

and against property and liability loss and to provide extended

coverage, and they may assess upon and collect from each other such

sums of money as from time to time may be necessary to pay losses,

occurring from fire, lightning, tornado, and theft, property and

liability loss and protection for the events provided by extended

coverage insurance, to insured members of such associations. The

assessment and collection of such sums of money shall be prescribed

and regulated by the bylaws of such association. Such associations

shall comply with all provisions of the Insurance Code not

inconsistent with the provisions of this article.
Okla. Stat. tit. 36, § 36-3011 — OK Code / Title 36 / Section 36-3011
Deposit required of foreign Lloyd's in home state as
Status: in_force

condition to permit.

In case underwriters at a Lloyd's who are nonresidents of

Oklahoma, or who maintain their principal office outside of

Oklahoma, apply to the Insurance Commissioner for a permit to do

business in Oklahoma, such permit shall not be granted unless such

underwriters have on deposit with the Insurance Commissioner of

their home states net assets in the amount of at least Two Hundred

Thousand Dollars ($200,000.00).
Okla. Stat. tit. 36, § 36-2920 — OK Code / Title 36 / Section 36-2920
Subscribers' advisory committee
Status: in_force

A. The advisory committee of a domestic reciprocal insurer

exercising the subscribers' rights shall be selected under such

rules as the subscribers adopt.

B. Not less than two-thirds (2/3) of such committee shall be

subscribers other than the attorney, or any person employed by,

representing, or having a financial interest in the attorney.

C. The committee shall:

1. Supervise the finances of the insurer;

2. Supervise the insurer's operations to such extent as to

assure conformity with the subscribers' agreement and power of

attorney;

3. Procure the audit of the accounts and records of the insurer

and of the attorney at the expense of the insurer;

4. Have such additional powers and functions as may be

conferred by the subscribers' agreement.
Okla. Stat. tit. 36, § 36-4104 — OK Code / Title 36 / Section 36-4104
Right to individual policy; notice of right; time for
Status: in_force

exercising right.

If any individual insured under a group life insurance policy

hereafter delivered in this state becomes entitled under the terms

of such policy to have an individual policy of life insurance issued

to him without evidence of insurability, subject to making of

application and payment of the first premium within the period

specified in such policy, and if such individual is not given notice

of the existence of such right at least fifteen (15) days prior to

the expiration date of such period, then, in such event the

individual shall have an additional period within which to exercise

such right, but nothing herein contained shall be construed to

continue any insurance beyond the period provided in such policy.

This additional period shall expire fifteen (15) days next after the

individual is given such notice but in no event shall such

additional period extend beyond sixty (60) days next after the

expiration date of the period provided in such policy. Written

notice presented to the individual or mailed by the policyholder to

the last-known address of the individual or mailed by the insurer to

the last-known address of the individual as furnished by the

policyholder shall constitute notice for the purpose of this

paragraph.
Okla. Stat. tit. 36, § 36-6811 — OK Code / Title 36 / Section 36-6811
Time for filing closed claim report
Status: in_force

A. The Insurance Commissioner may require that an insuring

entity or self-insured entity shall file a closed claim report.

These reports shall be filed within thirty (30) days after the

Commissioner's request and shall include data for all claims closed

in the preceding calendar year and other information required by the

Commissioner.

B. Any violation by an insurer of the Medical Professional

Liability Insurance Closed Claim Reports Act shall subject the

insurer to discipline including a civil penalty of not less than

Five Thousand Dollars ($5,000.00).

C. A closed claim that is covered under a primary policy and

one or more excess policies shall be reported only by the insuring

entity that issued the primary policy. The insuring entity that

issued the primary policy shall report the total amount, if any,

paid with respect to the closed claim, including any amount paid

under an excess policy, any amount paid by the facility or provider,

and any amount paid by any other person on behalf of the facility or

provider.

D. If a claim is not covered by an insuring entity or self-

insurer, the facility or provider named in the claim shall report it

to the Commissioner after a final claim disposition has occurred due

to a court proceeding or a settlement by the parties. Instances in

which a claim may not be covered by an insuring entity or self-

insurer include situations in which:

1. The facility or provider did not buy insurance or maintained

a self-insured retention that was larger than the final judgment or

settlement;

2. The claim was denied by an insuring entity or self-insurer

because it did not fall within the scope of the insurance coverage

agreement; or

Oklahoma Statutes - Title 36. Insurance Page 1370

3. The annual aggregate coverage limits had been exhausted by

other claim payments.

E. If a claim is covered by an insuring entity or self-insurer

that fails to report the claim to the Commissioner, the facility or

provider named in the claim shall report it to the Commissioner

after a final claim disposition has occurred due to a court

proceeding or a settlement by the parties.

1. If a facility or provider is insured by a risk retention

group and the risk retention group refuses to report closed claims

and asserts that the federal Liability Risk Retention Act (95 Stat.

949; 15 U.S.C. Sec. 3901 et seq.) preempts state law, the facility

or provider shall report all data required by the Medical

Professional Liability Insurance Closed Claim Reports Act on behalf

of the risk retention group.

2. If a facility or provider is insured by an unauthorized

insurer and the unauthorized insurer refuses to report closed claims

and asserts a federal exemption or other jurisdictional preemption,

the facility or provider shall report all data required by the

Medical Professional Liability Insurance Closed Claim Reports Act on

behalf of the unauthorized insurer.

3. If a facility or provider is insured by a captive insurer

and the captive insurer refuses to report closed claims and asserts

a federal exemption or other jurisdictional preemption, the facility

or provider shall report all data required by the Medical

Professional Liability Insurance Closed Claim Reports Act on behalf

of the captive insurer.
Okla. Stat. tit. 36, § 36-4428 — OK Code / Title 36 / Section 36-4428
Investment of life care community policy funds
Status: in_force

Any funds received pursuant to a life care community policy

shall be invested only in assets enumerated in Section 1607 of Title

36 of the Oklahoma Statutes.
Okla. Stat. tit. 36, § 36-2009 — OK Code / Title 36 / Section 36-2009
Powers and duties of Commissioner
Status: in_force

A. The Commissioner shall:

1. Notify the Oklahoma Property and Casualty Insurance Guaranty

Association Executive Director of the existence of an insolvent

insurer as soon as possible but not later than three (3) days after

notice of the determination is received. The Association shall be

entitled to a copy of a complaint seeking an order of liquidation

with a finding of insolvency against a member company at the same

time that the complaint is filed with a court of competent

jurisdiction; and

2. Provide the Association with a statement of the net direct

written premiums of each member insurer upon the request of the

board of directors.

B. The Commissioner may:

1. Suspend or revoke, after the notice and hearing, the

certificate of authority to transact insurance in this state of any

member insurer which fails to pay an assessment when due or fails to

comply with the plan of operation. As an alternative, the

Commissioner may levy a fine on any member insurer which fails to

pay an assessment when due. The fine shall not exceed five percent

(5%) of the unpaid assessment per month, except that no fine shall

be less than One Hundred Dollars ($100.00) per month;

2. Revoke the designation of any servicing facility if the

Commissioner finds claims are being handled unsatisfactorily; or

Oklahoma Statutes - Title 36. Insurance Page 583

3. Examine or audit the Association.

C. Any final action or order of the Commissioner under the

Oklahoma Property and Casualty Insurance Guaranty Association Act

shall be subject to judicial review in a court of competent

jurisdiction.
Okla. Stat. tit. 36, § 36-311A.14 — OK Code / Title 36 / Section 36-311A.14
Audit committee - Membership - Duties
Status: in_force

A. This section shall not apply to foreign or alien insurers

licensed in this state or an insurer that is a SOX Compliant Entity

or a direct or indirect wholly-owned subsidiary of a SOX Compliant

Entity.

B. The audit committee shall be directly responsible for the

appointment, compensation, and oversight of the work of any

accountant, including resolution of disagreements between management

Oklahoma Statutes - Title 36. Insurance Page 91

and the accountant regarding financial reporting, for the purpose of

preparing or issuing the audited financial report or related work

pursuant to the Oklahoma Annual Financial Report Act. Each

accountant shall report directly to the audit committee.

C. The audit committee of an insurer or group of insurers shall

be responsible for overseeing the insurer's internal audit function

and granting the person or persons performing the function suitable

authority and resources to fulfill their responsibilities if

required by Section 311A.14 of this title.

D. Each member of the audit committee shall be a member of the

board of directors of the insurer or a member of the board of

directors of an entity elected pursuant to subsection G of this

section and paragraph 3 of Section 311A.3 of this title.

E. In order to be considered independent for purposes of this

section, a member of the audit committee may not, other than in the

capacity as a member of the audit committee, the board of directors,

or any other board committee, accept any consulting, advisory, or

other compensatory fee from the entity or be an affiliated person of

the entity or subsidiary thereof. However, if law requires board

participation by otherwise non-independent members, that law shall

prevail and such members may participate in the audit committee and

be designated as independent for audit committee purposes, unless

they are an officer or employee of the insurer or one of its

affiliates.

F. If a member of the audit committee ceases to be independent

for reasons outside the reasonable control of the member, that

person, with notice by the responsible entity to the state, may

remain an audit committee member of the responsible entity until the

earlier of the next annual meeting of the responsible entity or one

(1) year from the occurrence of the event that caused the member to

be no longer independent.

G. To exercise the election of the controlling person to

designate the audit committee for purposes of the Oklahoma Annual

Finance Report Act, the ultimate controlling person shall provide

written notice to the Insurance Commissioner of the affected

insurers. Notification shall be made timely prior to the issuance

of the statutory audit report and include a description of the basis

for the election. The election can be changed through notice to the

Commissioner by the insurer, which shall include a description of

the basis for the change. The election shall remain in effect for

perpetuity, until rescinded.

H. 1. The audit committee shall require the accountant that

performs for an insurer any audit required by the Oklahoma Annual

Financial Report Act to timely report to the audit committee in

accordance with the requirements of SAS 61, Communication with Audit

Committees, or its replacement, including:

Oklahoma Statutes - Title 36. Insurance Page 92

a. all significant accounting policies and material

permitted practices,

b. all material alternative treatments of financial

information within statutory accounting principles

that have been discussed with management officials of

the insurer, ramifications of the use of the

alternative disclosures and treatments, and the

treatment preferred by the accountant, and

c. other material written communications between the

accountant and the management of the insurer, such as

any management or schedule of unadjusted differences.

2. If an insurer is a member of an insurance holding company

system, the reports required by paragraph 1 of this subsection may

be provided to the audit committee on an aggregate basis for

insurers in the holding company system, provided that any

substantial differences among insurers in the system are identified

to the audit committee.

I. The proportion of independent audit committee members shall

meet or exceed the following criteria set out in paragraphs 1, 2 and

3 of this subsection:

1. No Minimum Requirements. There are no minimum requirements

for insurers with prior calendar year direct written and assumed

premiums of Three Hundred Million Dollars ($300,000,000.00) or less;

2. Majority of Members. Fifty percent (50%) or more of members

of the independent audit committee for insurers with prior calendar

year direct written and assumed premiums of between Three Hundred

Million Dollars ($300,000,000.00) and Five Hundred Million Dollars

($500,000,000.00); or

3. Supermajority of Members. Seventy-five percent (75%) or

more of members of the independent audit committee for insurers with

prior calendar year direct written and assumed premiums of over Five

Hundred Million Dollars ($500,000,000.00).

J. The Commissioner may require improvements to the

independence of the audit committee membership of any insurer if the

insurer is in a RBC action level event, meets one or more of the

standards of an insurer deemed to be in hazardous financial

condition, or otherwise exhibits qualities of a troubled insurer.

K. For purposes of this section, prior calendar year direct

written and assumed premiums shall be the combined total of direct

premiums and assumed premiums from non-affiliates for the reporting

entities.

L. An insurer with direct written and assumed premium,

excluding premiums reinsured with the Federal Crop Insurance

Corporation and Federal Flood Program, of less than Five Hundred

Million Dollars ($500,000,000.00) may make application to the

Commissioner for a waiver from the requirements of this section

based upon hardship. The insurer shall file, with its annual

Oklahoma Statutes - Title 36. Insurance Page 93

statement filing, the approval for relief from this section with the

states that it is licensed in or doing business in and the National

Association of Insurance Commissioners (NAIC). If the nondomestic

state accepts electronic filing with the NAIC, the insurer shall

file the approval in an electronic format acceptable to the NAIC.
Okla. Stat. tit. 36, § 36-2127 — OK Code / Title 36 / Section 36-2127
Management and exclusive agency contracts
Status: in_force

A. No domestic stock or mutual insurer shall make any contract

whereby any person or persons is granted or is to enjoy in fact the

management of the insurer, or to have the controlling or preemptive

right to produce substantially all insurance business for the

insurer for an amount which will equal or exceed five percent (5%)

of the insurer's net written premium, unless such contract is filed

with the Commissioner and be subject to his approval. The contract

shall be deemed approved unless disapproved by the Commissioner

within twenty (20) days after date of filing, subject to such

reasonable extension of time as the Commissioner may require by

notice given within such twenty (20) days. Any disapproval shall be

delivered to the insurer in writing, stating the grounds therefor.

Oklahoma Statutes - Title 36. Insurance Page 651

B. The Commissioner shall disapprove any such contract if he

finds that it:

1. Subjects the insurer to excessive charges; or

2. Is to extend for an unreasonable length of time; or

3. Does not contain fair and adequate standards of performance;

or

4. Contains other inequitable provisions or provisions which

impair the proper interests of stockholders or members of the

insurer.
Okla. Stat. tit. 36, § 36-6526 — OK Code / Title 36 / Section 36-6526
Rulemaking
Status: in_force

The Insurance Commissioner may promulgate rules in accordance

with Article I of the Administrative Procedures Act, Sections 250.2

through 323 of Title 75 of the Oklahoma Statutes, for the

implementation and administration of the Small Employer Health

Insurance Reform Act.
Okla. Stat. tit. 36, § 36-1210 — OK Code / Title 36 / Section 36-1210
Judicial review by intervenor
Status: in_force

If the final order of the Insurance Commissioner does not charge

a violation of this article, then any intervenor in the proceedings

may, within thirty (30) days after the service of such order, cause

an action for judicial review to be filed in the district court of

Oklahoma County for a review of such order. Upon such review, the

court shall have authority to issue appropriate orders and decrees

in connection therewith, including, if the court finds that it is to

the interest of the public, orders enjoining and restraining the

continuance of any method of competition, act or practice which it

finds, notwithstanding such order of the Commissioner, constitutes a

violation of this article.
Okla. Stat. tit. 36, § 36-6559 — OK Code / Title 36 / Section 36-6559
Information required to be submitted relating to in-house
Status: in_force

review.

A. Insurance companies and not-for-profit hospital services and

medical indemnity plans licensed by the Commissioner that perform

in-house utilization review shall submit to the Commissioner the

following information regarding utilization review:

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, and

c. the provisions by which patients or health care

providers may seek reconsideration or appeal of

adverse decisions concerning requests for medical

evaluation, treatment or procedures;

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

is reasonably accessible 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 case of

insurance companies, if the personnel performing utilization review

are out-of-state, the personnel 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 for response

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. The procedures for receiving and handling complaints by

patients, hospitals and health care providers concerning utilization

review; and

8. Procedures to ensure that after a request for medical

evaluation, treatment, or procedures has been rejected in whole or

Oklahoma Statutes - Title 36. Insurance Page 1304

in part and in the event a copy of the report on said rejection is

requested, a copy of the report of the personnel performing

utilization review concerning the rejection shall be mailed by the

insurer, postage prepaid, to the ill or injured person, the treating

health care provider, hospital or to the person financially

responsible for the patient's bill within fifteen (15) days after

receipt of the request for the report.

B. Insurance companies that provide for in-house utilization

review shall pay an annual fee to the Insurance Commissioner of Five

Hundred Dollars ($500.00).
Okla. Stat. tit. 36, § 36-1108 — OK Code / Title 36 / Section 36-1108
Recognized surplus lines
Status: in_force

If a particular insurance coverage or type, class, or kind of

coverage is not readily procurable from authorized insurers in

Oklahoma, a surplus lines licensee or broker may place the coverage

with a nonadmitted insurer or surplus lines insurer as defined in

the Unauthorized Insurers and Surplus Lines Insurance Act.
Okla. Stat. tit. 36, § 36-6817 — OK Code / Title 36 / Section 36-6817
Designated statistical agent - Definition
Status: in_force

STATISTICAL DATA COLLECTION

As used in Sections 19 and 20 of this act, “designated

statistical agent” means an organization designated or contracted

with by the Commissioner pursuant to Section 19 of this act.
Okla. Stat. tit. 36, § 36-7203 — OK Code / Title 36 / Section 36-7203
Access payment on paid claims
Status: in_force

A. From the effective date of this act until January 1, 2015,

all health carriers shall pay to the Insurance Commissioner an

access payment of one percent (1.0%) on all claims paid.

B. If a health carrier is contractually entitled to withhold

certain amounts from payments due to providers of health and medical

services for the purpose of ensuring that providers fulfill any

financial obligations under a managed care risk arrangement, the

full amounts due to the providers before the application of the

contractual withholdings shall be reflected in the calculation of

claims paid.
Okla. Stat. tit. 36, § 36-2128 — OK Code / Title 36 / Section 36-2128
Impairment of capital or assets
Status: in_force

A. If the capital stock or expendable surplus of a domestic

stock insurer is impaired to an extent of less than twenty percent

(20%) of the required capital stock or expendable surplus, or the

net surplus of a domestic mutual insurer is impaired to an extent of

less than twenty percent (20%) of the minimum amount of surplus

required of it by this Code for authority to transact the kinds of

insurance being transacted, the Commissioner shall serve notice upon

the insurer to make good the deficiency within sixty (60) days after

service of such notice.

B. The deficiency may be made good in cash or in assets

eligible under this code for the investment of the insurer's funds;

or if a stock insurer by reduction of the insurer's capital to an

amount not below the minimum required for the kinds of insurance

thereafter to be transacted; or if a mutual insurer, by amendment of

its certificate of authority to cover only such kind or kinds of

insurance for which the insurer has on deposit sufficient surplus.

C. If the deficiency is not made good and proof thereof filed

with the Commissioner within such sixty-day period, the insurer

shall be deemed insolvent and the Commissioner may institute

delinquency proceedings against it as authorized by this code. If

such deficiency exists because of increased loss reserves required

by the Insurance Commissioner, or because of disallowance by the

Commissioner of certain assets or reduction of the value at which

carried in the insurer's accounts, the Commissioner may in his

discretion and upon application and good cause shown, extend for not

more than an additional sixty (60) days the period within which such

deficiency may be so made good and such proof thereof so filed.

D. If the Commissioner finds that the capital stock or

expendable surplus of a domestic stock insurer is impaired to an

extent of more than twenty percent (20%) of the required capital

stock or expendable surplus, or that the net surplus of a domestic

mutual insurer is impaired to an extent of more than twenty percent

(20%) of the minimum amount of surplus required of it by this code

for authority to transact the kinds of insurance being transacted,

Oklahoma Statutes - Title 36. Insurance Page 652

the insurer shall be deemed insolvent and the Commissioner shall

forthwith institute delinquency proceedings.
Okla. Stat. tit. 36, § 36-6125 — OK Code / Title 36 / Section 36-6125
Deposit and investment of funds – Transfer of funds - Types of contracts – Net value of
Status: in_force

contract – Interest - Withdrawal of funds – Disbursement statement – Bond – Administrative fee –Types of contracts – Net value of contract – Interest - Withdrawal

of funds – Disbursement statement – Bond – Administrative fee –

Acceptance of funds – Violations.

A. 1. The organization may retain from the first funds

collected, the first ten percent (10%) of the purchase price of all

contracts issued pursuant to paragraph 1 of subsection B of this

section. Thereafter, one hundred percent (100%) of all funds

collected pursuant to the provisions of contracts for prepaid

funeral benefits, except for outer enclosures as defined by the

Funeral Services Licensing Act, shall be placed in investments

authorized by Article 16 of the Insurance Code, except to the extent

the Insurance Commissioner may determine that a particular asset may

be inappropriate for investment for prepaid funeral benefits.

2. For outer enclosures at the option of the organization the

first thirty-five percent (35%) of the retail price of the outer

enclosures collected may be retained by the organization. The

remaining sixty-five percent (65%) of the retail price collected for

the outer enclosures shall be invested as otherwise provided by this

subsection pursuant to the provisions of contracts for prepaid

funeral benefits.

3. The funds required to be deposited pursuant to paragraphs 1

and 2 of this subsection shall be deposited within ten (10) days

after the collection of the funds and shall be held in a trust fund

in this state for the use, benefit, and protection of purchasers of

contracts for prepaid funeral benefits. Nothing contained within

this section shall be construed to prohibit an organization

authorized to accept prepaid funds from transferring the funds held

in trust from one trust depository to another if notice of the

transfer is given to the Insurance Commissioner within ten (10) days

before the transfer and the organization transferring the funds

remains the designated trustor. This subsection shall not affect

funds invested prior to November 1, 1988.

B. An organization authorized to accept prepaid funds shall be

authorized to provide purchasers with a choice of either of the

following types of contracts:

Oklahoma Statutes - Title 36. Insurance Page 1143

1. A contract for Specific and Described Funeral Merchandise

and Service at a Guaranteed Price. The provisions of this type of

contract shall provide that interest paid by the organization upon

monies deposited in trust shall be added to the principal and that

principal and interest shall become available for disbursement to

the organization upon the death of the beneficiary and if withdrawal

of monies occurs prior to death, the net value, plus the amount

withheld pursuant to paragraph 1 of subsection A of this section,

shall be paid to the purchaser. Net value of the contract for

purposes of this section shall be determined by adding the amount of

all principal paid in pursuant to the provisions of the contract

plus all interest payable pursuant to subsection D of this section

less taxes and administrative fees;

2. A contract establishing a fund for prepaid funeral benefits.

The provisions of this type of contract shall require an initial

minimum deposit of Twenty-five Dollars ($25.00) and shall grant the

purchaser the right to add to the fund at the discretion of the

purchaser. The provisions of this contract shall provide that the

funds accumulated shall apply to the cost of the funeral services

and merchandise selected and that any funds remaining unused shall

be refunded to the purchaser or to the personal representative or

designated beneficiary of the purchaser and if withdrawal of monies

occurs prior to death, the organization may retain from the

interest, all interest incurred in excess of the minimum amount

payable pursuant to subsection D of this section less taxes and

administrative fees. This type of contract shall also bear upon it

the language: "Exact Funeral Merchandise and Services to be Selected

at Time of Death";

3. Notwithstanding the provisions of this section, at no time

shall the purchaser of a contract for Specific and Described Funeral

Merchandise and Service at a Guaranteed Price receive upon any

withdrawal or transfer a sum less than the original principal

collected; or

4. Notwithstanding the provisions of this section, at no time

shall the purchaser of a contract for Exact Funeral Merchandise and

Services to be Selected at Time of Death receive upon any full

withdrawal or transfer prior to death a sum less than the original

principal collected available at death, with the exception of those

accounts which bear principal reduced by previously made cash

withdrawals.

C. If an organization other than the organization with which

the purchaser contracted provides funeral merchandise and services

upon the death of the beneficiary of the contract, the organization

with whom the purchaser contracted shall forward, upon receipt of

request in writing from the purchaser or the personal representative

of the purchaser, the net value of the contract plus the amount

withheld pursuant to paragraph 1 of subsection A of this section to

Oklahoma Statutes - Title 36. Insurance Page 1144

the organization which provided the merchandise and services or to

the purchaser or the personal representative of the purchaser.

D. Funds deposited in trust pursuant to the provisions of

either type of contract authorized by the provisions of this section

shall earn for the account of the purchaser a rate of interest which

is not less than the minimum rate of interest offered by the

qualified investments specified in subsection A of this section to

the savings customers of the qualified investments having interest-

bearing accounts. The organization, in a nondiscriminatory manner,

may pay or accrue interest for the accounts of purchasers at any

rate greater than the minimum rate that the organization desires;

provided, however, that the organization may retain from the

interest all interest incurred in excess of the minimum amount

payable pursuant to this subsection.

E. A purchaser of either of the types of contracts authorized

by the provisions of this section may withdraw the net value of the

contract by signing a statement requesting the withdrawal. The

organization shall retain in its files a copy of the statement

requesting the withdrawal. Withdrawal of funds deposited pursuant

to the provisions of a contract authorized by the provisions of

paragraph 1 of subsection B of this section shall void the

obligation of the contracting organization to provide funeral

merchandise and services at a guaranteed price. Withdrawal forms

shall be retained on file for at least six (6) years by the

organization.

F. Following the death of a beneficiary for whom a contract has

been purchased, the organization shall prepare a statement,

acknowledged by the purchaser if the purchaser is not the

beneficiary, or by the personal representative of the purchaser if

the purchaser is the beneficiary, setting forth the use of the funds

deposited and the party to whom any unused funds were disbursed. A

copy of this statement shall remain in the files of the organization

for at least six (6) years and a copy shall be delivered to the

trust depository and the purchaser.

G. After thirty (30) days, a contract of either type authorized

by the provisions of this section may become irrevocable and not

subject to withdrawal prior to the death of the beneficiary if the

purchaser signs an election making the contract irrevocable. This

election shall not become effective until thirty (30) days after

signing the original contract.

H. In no event shall more funds be withdrawn or paid pursuant

to the provisions of one contract than were deposited with the

organization and which were accumulated as interest. All funds

deposited pursuant to the provisions of a contract authorized by the

provisions of this section and deposited pursuant to the terms of

this section and the interest earned on the funds shall be exempt

from attachment, garnishment, execution, and the claims of

Oklahoma Statutes - Title 36. Insurance Page 1145

creditors, receivers, or trustees in bankruptcy, until the time the

funds have been withdrawn from the trust account and paid to the

organization or refunded to the purchaser.

I. Each organization subject to the provisions of this section

shall furnish a bond in the form of a cash bond, letter of credit,

or fidelity bond, to be approved by the Insurance Commissioner, in

the amount of Three Hundred Thousand Dollars ($300,000.00) or

fifteen percent (15%) of all funds collected for prepaid funeral

benefits, whichever is less.

J. Organizations contracting with purchasers for prepaid

funeral benefits pursuant to paragraphs 1 and 2 of subsection B of

this section shall be entitled to deduct from the principal and

interest allocable to the contracts an administrative fee which

shall not exceed the product of .001146 times the total contract

fund including accrued interest per month or any major portion

thereof.

K. No organization holding a permit issued pursuant to the

provisions of Sections 6121 and 6124 of this title shall accept any

funds except pursuant to the provisions of a contract for prepaid

funeral or burial benefits authorized by the provisions of Sections

6121 through 6136.18 of this title, and no organization shall accept

funds from a purchaser in excess of the contracted price of prepaid

funeral or burial benefits purchased.

L. Any organization which knowingly commits any of the acts set

forth in the first sentence of Section 6121 of this title without

first having obtained a permit to engage in the stated activity from

the Insurance Commissioner, or any organization which commits the

acts while knowingly operating with an invalid or expired permit,

upon conviction, shall be guilty of a misdemeanor. Each separate

act performed without a valid permit shall be deemed a separate

offense. The punishment upon conviction for the offense shall be a

fine not to exceed One Thousand Dollars ($1,000.00) or imprisonment

in the county jail for not less than sixty (60) days nor more than

one (1) year, or both such fine and imprisonment.
Okla. Stat. tit. 36, § 36-3105 — OK Code / Title 36 / Section 36-3105
Appointment of agent – License - Fees
Status: in_force

A. Each motor service club operating in this state pursuant to

certificate of authority issued hereunder shall file with the

Commissioner, within ten (10) days of the date of employment, a

notice of appointment of any insurance producer or limited lines

producer, resident or nonresident, appointed by the automobile club

to sell memberships in the motor service club to the public. This

notification shall be upon such form as the Commissioner may

prescribe and shall contain the name, address, age, sex, and Social

Security number of such club producer, and shall also contain proof

satisfactory to the Commissioner that such applicant is not less

than eighteen (18) years of age, is of good reputation, and has

received training from the club or is otherwise qualified in the

field of motor service club service contracts and knowledgeable of

the laws of this state pertaining thereto.

Oklahoma Statutes - Title 36. Insurance Page 759

B. A licensing fee for insurance producers and limited lines

producers, resident or nonresident, shall be in accordance with

Section 1435.23 of this title.

C. Upon notice and hearing, the Commissioner may suspend,

censure, revoke, or refuse to renew any license of a producer if he

finds as to the licensee that any one or more of the following

causes exist:

1. Any violation of or noncompliance with any provision of this

act;

2. Obtaining or attempting to obtain any such license through

misrepresentation or fraud;

3. Oral or written misrepresentation of the terms, conditions,

benefits, or privileges of any motor service club service contract

issued or to be issued by the motor service club he represents or

any other motor service club;

4. Misappropriation or conversion to his own use or illegal

holding of monies, belonging to members or others, received in the

conduct of business under his license;

5. Pleading nolo contendere or guilty to a felony or conviction

by final judgment of a felony;

6. Demonstration of incompetence sufficient in the opinion of

the Commissioner to make the producer a source of injury and loss to

the public;

7. Fraudulent or dishonest practices;

8. Willful solicitation of membership from an individual who is

or has been a member of another motor service club by giving said

person credit for his years of membership with the other motor

service club;

9. Waiving the enrollment fee or otherwise reducing the usual

fees and charges for a new member when soliciting membership from an

individual who is or has been a member of another motor service

club.

D. In addition to the penalties provided for in this section, a

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

One Thousand Dollars ($1,000.00) for each occurrence may be levied.
Okla. Stat. tit. 36, § 36-6062 — OK Code / Title 36 / Section 36-6062
Application of insurance laws
Status: in_force

Except for Sections 4003, 4008, 4009, 4010, 4011, 4017, 4021,

4022, 4029, subsection 1 of 4103, 4106 and 4109, and except as

otherwise provided in this act, all pertinent provisions of the

insurance laws of this state shall apply to separate accounts and

contracts relating thereto, provided, that such individual contracts

delivered in this state shall contain grace, reinstatement and

nonforfeiture provisions appropriate to such contracts. Any group

variable life insurance contract delivered in this state shall

contain a grace provision appropriate to such contract.
Okla. Stat. tit. 36, § 36-6475.11 — OK Code / Title 36 / Section 36-6475.11
Binding power of external review decision
Status: in_force

A. An external review decision is binding on the health carrier

except to the extent the health carrier has other remedies available

under applicable state law.

B. An external review decision is binding on the covered person

except to the extent the covered person has other remedies available

under applicable federal or state law.

C. A covered person or the covered person’s authorized

representative shall not file a subsequent request for external

review involving the same adverse determination or final adverse

determination for which the covered person has already received an

external review decision pursuant to the Uniform Health Carrier

External Review Act.
Okla. Stat. tit. 36, § 36-6222 — OK Code / Title 36 / Section 36-6222
Report of administration actions against adjusters
Status: in_force

A. An adjuster shall report to the Insurance Commissioner any

administrative action taken against the adjuster in another

jurisdiction or by another governmental agency in this state within

thirty (30) days of the final disposition of the matter. This

Oklahoma Statutes - Title 36. Insurance Page 1180

report shall include a copy of the order, consent to order or other

relevant legal documents.

B. Within thirty (30) days of the initial pretrial hearing

date, an adjuster shall report to the Insurance Commissioner any

criminal prosecution of the adjuster taken in any jurisdiction. The

report shall include a copy of the initial complaint filed, the

order resulting from the hearing and any other relevant legal

documents.
Okla. Stat. tit. 36, § 36-6453 — OK Code / Title 36 / Section 36-6453
Definitions
Status: in_force

As used in the Oklahoma Risk Retention Act:

1. "Commissioner" means the Insurance Commissioner of this

state or the Commissioner, Director, or Superintendent of insurance

in any other state;

2. "Completed operations liability" means liability arising out

of the installation, maintenance, or repair of any product at a site

which is not owned or controlled by:

a. any person who performs that work, or

b. any person who hires an independent contractor to

perform that work,

and shall include liability for activities which are completed or

abandoned before the date of the occurrence giving rise to the

liability;

3. "Domicile", for purposes of determining the state in which a

purchasing group is domiciled, means:

Oklahoma Statutes - Title 36. Insurance Page 1192

a. for a corporation, the state in which the purchasing

group is incorporated, and

b. for an unincorporated entity, the state of its

principal place of business;

4. "Hazardous financial condition" means that, based on its

present or reasonably anticipated financial condition, a risk

retention group, although not yet financially impaired or insolvent,

is unlikely to be able:

a. to meet obligations to policyholders with respect to

known claims and reasonably anticipated claims, or

b. to pay other obligations in the normal course of

business;

5. "Insurance" means primary insurance, excess insurance,

reinsurance, surplus lines insurance, and any other arrangement for

shifting and distributing risk which is determined to be insurance

under the laws of this state;

6. "Liability":

a. means legal liability for damages, including but not

limited to, costs of defense, legal costs and fees,

and other claims expenses, because of injuries to

other persons, damage to their property, or other

damage or loss to such other persons resulting from or

arising out of:

(1) any for-profit or non-profit business, trade,

product, services, premises, or operations, or

(2) any activity of any state or local government, or

any agency or political subdivision thereof, and

b. does not include personal risk liability and the

liability of an employer to employees, other than

legal liability under the Federal Employers' Liability

Act, 45 U.S.C. 51 et seq.;

7. "Personal risk liability" means liability for damages

because of injury to any person, damage to property, or other loss

or damage resulting from any personal, familial, or household

responsibilities or activities rather than from responsibilities or

activities referred to in paragraph 6 of this section;

8. "Plan of operation or feasibility study" means an analysis

which presents the expected activities and results of a risk

retention group including, but not limited to:

a. for each state in which it intends to operate, the

coverages, deductibles, coverage limits, rates, and

rating classification systems for each line of

insurance the group intends to offer,

b. historical and expected loss experience of the

proposed members and national experience of similar

exposures to the extent that this experience is

reasonably available,

Oklahoma Statutes - Title 36. Insurance Page 1193

c. pro forma financial statements and projections,

d. appropriate opinions by a qualified independent

casualty actuary, as defined in paragraph 11 of this

section, including a determination of minimum premium

or participation levels required to commence

operations and to prevent a hazardous financial

condition,

e. identification of management procedures, underwriting

and claims procedures, marketing methods, managerial

oversight methods, investment policies, and

reinsurance agreements,

f. information sufficient to verify that its members are

engaged in businesses or activities similar or related

with respect to the liability to which such members

are exposed by virtue of any related, similar, or

common business, trade, product, services, premises,

or operations,

g. identification of each state in which the risk

retention group has obtained, or sought to obtain, a

charter and license, and a description of its status

in each such state, and

h. such other matters as may be prescribed by the

Commissioner, for liability insurance companies

authorized by the insurance laws of the state in which

the risk retention group is chartered;

9. "Product liability" means liability for damages because of

any personal injury, death, emotional harm, consequential economic

damage, or property damage, including but not limited to damages

resulting from the loss of use of property, arising out of the

manufacture, design, importation, distribution, packaging, labeling,

lease, or sale of a product, but does not include the liability of

any person for those damages if the product involved was in the

possession of such a person when the incident giving rise to the

claim occurred;

10. "Purchasing group" means any group which:

a. has as one of its purposes the purchase of liability

insurance on a group basis,

b. has as one of its purposes the purchase of liability

insurance on a group basis for its members to cover

their similar or related liability exposure,

c. is composed of members whose businesses or activities

are similar or related with respect to the liability

to which members are exposed by virtue of any related,

similar, or common business, trade, product, services,

premises, or operations, and

d. is domiciled in any state;

Oklahoma Statutes - Title 36. Insurance Page 1194

11. "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;

12. "Risk retention group" means any corporation or other

limited liability association:

a. whose primary activity consists of assuming and

spreading all or any portion of the liability exposure

of its group members,

b. which is organized for the primary purpose of

conducting the activity specified in subparagraph a of

this paragraph,

c. which is chartered and licensed as a liability

insurance company and authorized to engage in the

business of insurance under the laws of any state, or,

before January 1, 1985, was chartered or licensed and

authorized to engage in the business of insurance

under the laws of Bermuda or the Cayman Islands and,

before such date, had certified to the Insurance

Commissioner of at least one state that it satisfied

the capitalization requirements of such state, except

that any such group shall be considered to be a risk

retention group only if it has been engaged in

business continuously since such date and only for the

purpose of continuing to provide insurance to cover

product liability or completed operations liability,

as such terms were defined in the federal Product

Liability Risk Retention Act of 1981, before the date

of the enactment of the federal Liability Risk

Retention Act of 1986,

d. which does not exclude any person from membership in

the group solely to provide for members of such group

a competitive advantage over such person,

e. (1) which has as its owners only persons who comprise

the membership of the risk retention group, and

(2) has as its owners only persons who comprise the

membership of the risk retention group and who

are provided insurance by the group,

f. whose members are engaged in businesses or activities

similar or related with respect to the liability of

which such members are exposed by virtue of any

related, similar, or common business trade, product,

services, premises, or operations,

g. whose activities do not include the provision of

insurance other than:

Oklahoma Statutes - Title 36. Insurance Page 1195

(1) liability insurance for assuming and spreading

all or any portion of the liability of its group

members, and

(2) reinsurance with respect to the liability of any

other risk retention group, or any members of

such other group engaged in businesses or

activities so that the risk retention group or

individual members of the group meet the

requirements described in subparagraph f of this

paragraph because of membership in the risk

retention group that provides the reinsurance,

and

h. the name of which includes the phrase, "Risk Retention

Group"; and

13. "State" means any state of the United States or the

District of Columbia.
Okla. Stat. tit. 36, § 36-6710 — OK Code / Title 36 / Section 36-6710
Short title - Travel Insurance Act
Status: in_force

This act shall be known and may be cited as the "Travel

Insurance Act".
Okla. Stat. tit. 36, § 36-3614.4 — OK Code / Title 36 / Section 36-3614.4
Disclosure of genetic research studies
Status: in_force

A. This section shall be known and may be cited as the “Genetic

Research Studies Nondisclosure Act”.

B. For purposes of the Genetic Research Studies Nondisclosure

Act, “genetic research study or studies” shall mean those genetic

research studies approved by an institutional review board as

defined in 21 CFR, Section 50 or conducted subject to the

requirements of the federal common rule at 21 CFR, Section 50 and

Section 56, and 45 CFR, Section 46.

C. All research records of individual subjects in genetic

research studies shall be confidential, meaning the records shall

not be subject to subpoena or discovery in civil suits, except in

cases where the information in the records is the basis of the suit.

The records shall not be disclosed to employers or health insurers

without the informed consent of the subject.

D. Notwithstanding any language in this section to the

contrary, this section shall not apply to an insurer or to an

individual or third party dealing with an insurer in the ordinary

course of underwriting, conducting or administering the business of

life, disability income or long-term care insurance or in connection

with any judicial, legislative or administrative proceeding relating

to life, disability income or long-term care insurance. Nothing in

this section is intended to govern an insurer or to govern an

individual or third party dealing with an insurer in connection with

the obtaining, maintaining, use, disclosure or redisclosure of

genetic information or the results of a genetic test, including but

not limited to records of individual subjects in genetic research in

connection with life, disability income or long-term care insurance

or in connection with any judicial, legislative or administrative

proceeding relating to life, disability income or long-term care

insurance.

E. All stored tissues, including blood, that arise from

surgery, other diagnostic or therapeutic steps, or autopsy may be

disclosed for genetic or other research studies if informed consent

has been obtained. Informed consent may be included in a section of

the consent for treatment, admission to a hospital or clinic, or

permission for an autopsy and no other consent shall be required.

F. It shall be permissible to publish or otherwise use the

results of genetic research studies for research or educational

purposes if no individual subject is identified. If specific

informed consent from the individual has been obtained, the

individual may be identified.
Okla. Stat. tit. 36, § 36-3109 — OK Code / Title 36 / Section 36-3109
Contracts issued contrary to act as valid and binding on
Status: in_force

company.

Any service contract made, issued or delivered contrary to any

provision of this act shall nevertheless be valid and binding on the

company.
Okla. Stat. tit. 36, § 36-4806 — OK Code / Title 36 / Section 36-4806
Exclusion of loss caused by nuclear reaction, nuclear
Status: in_force

radiation or radioactive contamination.

Insurers issuing the standard form of fire insurance policy

provided in Section 4803, Article 48, Title 36, Oklahoma Session
Okla. Stat. tit. 36, § 36-994 — OK Code / Title 36 / Section 36-994
Advisory organizations - Filing requirements
Status: in_force

Oklahoma Statutes - Title 36. Insurance Page 239

Advisory Organizations; Filing Requirements.

Every advisory organization shall file with the Commissioner for

approval every statistical plan, all prospective loss costs,

provisions for special assessments and all supplementary rating

information and every change or amendment or modification of any of

the foregoing proposed for use in this state at least thirty (30)

days prior to its effective date. Such filings will be deemed

approved unless disapproved within the waiting period.
Okla. Stat. tit. 36, § 36-2724.1 — OK Code / Title 36 / Section 36-2724.1
Taxation
Status: in_force

Every society organized or licensed under this act is hereby

declared to be a charitable and benevolent institution, and all of

its funds shall be exempt from all and every state, county,

district, municipal and school tax other than taxes on real estate

and office equipment.