Okla. Stat. tit. 36, § 36-6954 — OK Code / Title 36 / Section 36-6954
Application for certificate of authority - Requirements
Status: in_force

The Insurance Commissioner may certify nonprofit health

maintenance organization corporations by issuing 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 nonprofit health

maintenance organization corporation;

2. The contracts between the applicant and the participating

physicians or other providers of health services obligate each

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 amount of required working capital of the corporation is

paid into the corporation and, if subject to repayment, can be

repaid only out of operating income, without endangering the

solvency or financial strength of the nonprofit health maintenance

organization corporation; and

4. The nonprofit corporation has met, or will be able to meet,

the requirements set forth in the Health Maintenance Organization

Act of 2003 and the risk-based capital for the Health Maintenance

Organization Act of 2003.
Okla. Stat. tit. 36, § 36-996 — OK Code / Title 36 / Section 36-996
Assigned risks
Status: in_force

Assigned Risks. A. Agreements may be made among insurers with

respect to the equitable apportionment among them of costs for

insurance which may be afforded applicants who are in good faith

entitled to, but who are unable to procure, such insurance through

ordinary methods, and such insurers may agree among themselves on

the use of reasonable rate modifications for such insurance, such

agreements and rate modifications to be subject to the approval of

the Insurance Commissioner.

B. The Oklahoma Automobile Insurance Plan is authorized to

issue policies of insurance in the name of the plan for the

applicants described in subsection A of this section and to act on

behalf of all participating members in connection with the policies.

The policies shall be considered proof of financial responsibility

in accordance with Section 7-600 of the Highway Safety Code.

C. The participating members shall be liable to the plan for

all costs, expenses and liabilities in proportion to its share of

voluntary market premium for the types of policies written under the

plan in this state.

D. The plan shall file an annual audited financial statement

with the Commissioner.

E. The Commissioner is authorized to establish rules and

regulations required to implement the purposes of this section.
Okla. Stat. tit. 36, § 36-1611 — OK Code / Title 36 / Section 36-1611
Obligations payable from public utility revenues
Status: in_force

An insurer may invest in the bonds, notes, certificates of

indebtedness, warrants, or other evidences of indebtedness which are

valid obligations issued, assumed, or guaranteed by the United

States or any state thereof or by any county, municipal corporation,

district, or political subdivision or civil division or public

instrumentality of any such government or unit thereof, if by

statute or other legal requirements such obligations are payable as

to both principal and interest from revenues or earnings from the

whole or any part of any utility supplying water, gas, sewage

disposal facility or electricity or any other public service.
Okla. Stat. tit. 36, § 36-2919 — OK Code / Title 36 / Section 36-2919
Who may be subscribers
Status: in_force

Individuals, partnerships, and corporations of this state may

make application, enter into agreement for and hold policies or

contracts in or with and be a subscriber of any domestic, foreign,

or alien reciprocal insurer. Any corporation now or hereafter

organized under the laws of this state shall, in addition to the

rights, powers, and franchises specified in its articles of

incorporation, have full power and authority as a subscriber to

exchange insurance contracts through such reciprocal insurance. The

right to exchange such contracts is hereby declared to be incidental

to the purposes for which such corporations are organized and to be

fully granted as the rights and powers expressly conferred upon such

corporations. Government or governmental agencies, state or

political subdivisions thereof, boards, associations, estates,

trustees or fiduciaries are authorized to exchange nonassessable

Oklahoma Statutes - Title 36. Insurance Page 747

reciprocal inter-insurance contracts with each other and with

individuals, partnerships, and corporations to the same extent that

individuals, partnerships and corporations are herein authorized to

exchange reciprocal inter-insurance contracts. Any officer,

representative, trustee, receiver, or legal representative of any

such subscriber shall be recognized as acting for or on its behalf

for the purpose of such contract but shall not be personally liable

upon such contract by reason of acting in such representative

capacity.
Okla. Stat. tit. 36, § 36-4029 — OK Code / Title 36 / Section 36-4029
Operative date of valuation manual - Nonforfeiture
Status: in_force

provisions - Life insurance.

A. Definitions. The term "operative date of the valuation

manual" means the January 1 of the first calendar year that the

valuation manual, as defined in the Section 1510 of this title, is

effective.

B. No policy of life insurance, except as set forth in

subsection M of this section, shall be delivered or issued for

delivery in this state unless it shall contain in substance the

following provisions, or corresponding provisions which are at least

as favorable to the defaulting or surrendering policyholder as are

the minimum requirements hereinafter specified and are essentially

in compliance with subsection L of this section:

1. That in the event of default in any premium payment, after

premiums have been paid for at least three (3) full years, the

insurer will grant, upon proper request not later than sixty (60)

days after the due date of the premium in default, a paid-up

nonforfeiture benefit on a plan stipulated in the policy, effective

as of such due date, of such amount as may be hereinafter specified.

In lieu of such stipulated paid-up nonforfeiture benefit, the

insurer may substitute, upon proper request not later than sixty

(60) days after the due date of the premium in default, an

Oklahoma Statutes - Title 36. Insurance Page 836

actuarially equivalent alternative paid-up nonforfeiture benefit

which provides a greater amount or longer period of death benefits

or, if applicable, a greater amount or earlier payment of endowment

benefits.

2. That upon surrender of the policy within sixty (60) days

after the due date of any premium payment in default after premiums

have been paid for at least three (3) full years in the case of

ordinary insurance, or five (5) full years in the case of industrial

insurance, the insurer will pay, in lieu of any paid-up

nonforfeiture benefit, a cash surrender value of such amount as may

be hereinafter specified.

3. That a specified paid-up nonforfeiture benefit shall become

effective as specified in the policy unless the person entitled to

make such election elects another available option not later than

sixty (60) days after the due date of the premium in default.

4. That if the policy shall have become paid up by completion

of all premium payments, or if it is continued under any paid-up

nonforfeiture benefit which became effective on or after the third

policy anniversary in the case of ordinary insurance, or the fifth

policy anniversary in the case of industrial insurance, the insurer

will pay, upon surrender of the policy within thirty (30) days after

any policy anniversary, a cash surrender value of such amount as may

be hereinafter specified.

5. In the case of policies which cause, on a basis guaranteed

in the policy, unscheduled changes in benefits or premiums, or which

provide an option for changes in benefits or premiums other than a

change to a new policy, a statement of the mortality table, interest

rate and method used in calculating cash surrender values and the

paid-up nonforfeiture benefits available under the policy. In the

case of all other policies, a statement of the mortality table and

interest rate used in calculating the cash surrender values and the

paid-up nonforfeiture benefits available under the policy, together

with a table showing the cash surrender value, if any, and paid-up

nonforfeiture benefit, if any, available under the policy on each

policy anniversary, either during the first twenty (20) policy years

or during the term of the policy, whichever is shorter, such values

and benefits to be calculated upon the assumption that there are no

dividends or paid-up additions credited to the policy and that there

is no indebtedness to the insurer on the policy.

6. An explanation of the manner in which the cash surrender

values and the paid-up nonforfeiture benefits are altered by the

existence of any paid-up additions credited to the policy or any

indebtedness to the insurer on the policy; if a detailed statement

of the method of computation of the values and benefits shown in the

policy is not stated therein, a statement that such method of

computation has been filed with the insurance supervisory official

of the state in which the policy is delivered; and a statement of

Oklahoma Statutes - Title 36. Insurance Page 837

the method to be used in calculating the cash surrender value and

paid-up nonforfeiture benefit available under the policy on any

policy anniversary beyond the last anniversary for which such values

and benefits are consecutively shown in the policy.

C. Any of the provisions or portions thereof set forth in

paragraphs 1 through 6 of subsection B of this section which are not

applicable by reason of the plan of insurance may, to the extent

inapplicable, be omitted from the policy. The insurer shall reserve

the right to defer the payment of any cash surrender value for a

period of six (6) months after demand therefor with surrender of the

policy.

D. Cash surrender value: The policy must comply with the

requirements of one of the following paragraphs:

1. Any cash surrender value available under the policy in the

event of default in the premium payment due on any policy

anniversary, whether or not required by subsection B of this

section, shall be at least equal to the reserve on the policy at

date of default and on any paid-up additions thereto, less a sum of

not more than two and one-half percent (2 1/2%) of the amount

insured by the policy and of the paid-up additions thereto, if any,

and less any existing indebtedness to the company on or secured by

the policy; the reserve on such policy to be computed in accordance

with the mortality table and the rate of interest specified in the

policy for the calculation of the cash value and by the net level

premium method of valuation unless a modified net premium method of

valuation be specified in the policy. No cash surrender value shall

be required in policies of term insurance of twenty (20) years or

less.

2. Any cash surrender value available under the policy in the

event of default in the premium payment due on any policy

anniversary, whether or not required by subsection B of this

section, shall be an amount not less than the excess, if any, of the

present value on such anniversary of the future guaranteed benefits

which would have been provided for by the policy, including any

existing paid-up additions if there had been no default over the sum

of (i) the then present value of the adjusted premiums as defined in

subsections G, H and I of this section, corresponding to premiums

which would have fallen due on and after such anniversary, and (ii)

the amount of any indebtedness to the insurer on account of or

secured by the policy.

3. Provided, however, that for any policy issued on or after

the operative date of paragraph 4 of subsection I of this section as

defined therein, which provides supplemental life insurance or

annuity benefits at the option of the insured and for an

identifiable additional premium by rider or supplemental policy

provision, the cash surrender value referred to in paragraph 2 of

this subsection shall be an amount not less than the sum of the cash

Oklahoma Statutes - Title 36. Insurance Page 838

surrender value as defined in such paragraph for an otherwise

similar policy issued at the same age without such rider or

supplemental policy provision and the cash surrender value as

defined in such paragraph for a policy which provides only the

benefits otherwise provided by such rider or supplemental policy

provision.

4. Provided, further, that for any family policy issued on or

after the operative date of paragraph 4 of subsection I of this

section as defined therein, which defines a primary insured and

provides term insurance on the life of the spouse of the primary

insured expiring before the spouse's age seventy-one (71) years, the

cash surrender value referred to in paragraph 2 of this subsection

shall be an amount not less than the sum of the cash surrender value

as defined in such paragraph for an otherwise similar policy issued

at the same age without such term insurance on the life of the

spouse and the cash surrender value as defined in such paragraph for

a policy which provides only the benefits otherwise provided by such

term insurance on the life of the spouse.

5. Any cash surrender value available within thirty (30) days

after any policy anniversary under any policy paid up by completion

of all premium payments, or any policy continued under any paid-up

nonforfeiture benefits, whether or not required by subsection B,

shall be an amount not less than the present value, on such

anniversary, of the future guaranteed benefits provided for by the

policy including any existing paid-up additions, decreased by any

indebtedness to the insurer on account of or secured by the policy.

The method described in paragraphs 2, 3, 4 and 5 of this subsection

may be referred to as the Standard Nonforfeiture Value Method.

E. Notification to policyholder of cash surrender value:

Within three (3) months after default of any premium payment on any

life insurance policy which has a cash surrender value, the insurer

shall notify the policyholder in writing of the cash surrender value

and of the policyholder's options as to the application of the cash

surrender value as provided in the policy.

F. Paid-up nonforfeiture benefits: Any paid-up nonforfeiture

benefit available under the policy in the event of default in the

premium payment due on any policy anniversary shall be such that its

present value as of such anniversary shall be at least equal to the

cash surrender value then provided for by the policy, or, if none is

provided for, that cash surrender value which would have been

required by this section in the absence of the condition that

premiums shall have been paid for at least a specified period.

G. The adjusted premium: This subsection shall not apply to

policies issued on or after the operative date of paragraph 4 of

subsection I of this section as defined therein. Except as provided

in paragraph 2 of subsection H of this section, the adjusted

premiums for any policy shall be calculated on an annual basis and

Oklahoma Statutes - Title 36. Insurance Page 839

shall be such uniform percentage of the respective premiums

specified in the policy for each policy year, excluding extra

premiums on a substandard policy, that the present value, at the

date of issue of the policy, of all such adjusted premiums shall be

equal to the sum of:

(i) the then present value of the future guaranteed

benefits provided for by the policy;

(ii) two percent (2%) of the amount of the insurance if the

insurance be uniform in amount, or of the equivalent

uniform amount, as hereinafter defined, if the amount

of insurance varies with the duration of the policy;

(iii) forty percent (40%) of the adjusted premium for the

first policy year; and

(iv) twenty-five percent (25%) of either the adjusted

premium for the first policy year or the adjusted

premium for a whole life policy of the same uniform or

equivalent uniform amount with uniform premiums for

the whole of life issued at the same age for the same

amount of insurance, whichever is less, provided,

however, that in applying the percentages specified in

clauses (iii) and (iv) above, no adjusted premiums

shall be deemed to exceed four percent (4%) of the

amount of insurance or uniform amount equivalent

thereto.

The date of issue of a policy for the purpose of this section

shall be the date as of which the rated age of the insured is

determined.

H. 1. This subsection shall not apply to policies issued on or

after the operative date of paragraph 4 of subsection I of this

section as defined therein. In the case of a policy providing an

amount of insurance varying with the duration of the policy, the

equivalent uniform amount thereof for the purpose of subsection G of

this section shall be deemed to be the uniform amount of insurance

provided by an otherwise similar policy, containing the same

endowment benefit or benefits, if any, issued at the same age and

for the same term, the amount of which does not vary with duration

and the benefits under which have the same present value at the date

of issue as the benefits under the policy, provided, however, that

in the case of a policy providing a varying amount of insurance

issued on the life of a child under age ten (10) years, the

equivalent uniform amount may be computed as though the amount of

insurance provided by the policy prior to the attainment of age ten

(10) years were the amount provided by such policy at age ten (10)

years.

2. The adjusted premiums for any policy providing term

insurance benefits by rider or supplemental policy provision shall

be equal to (a) the adjusted premiums for an otherwise similar

Oklahoma Statutes - Title 36. Insurance Page 840

policy issued at the same age without such term insurance benefits,

increased, during the period for which premiums for such term

insurance benefits are payable, by (b) the adjusted premiums for

such term insurance, the foregoing items (a) and (b) being

calculated separately and as specified in subsection G of this

section and paragraph 1 of this subsection except that, for the

purposes of clauses (ii), (iii) and (iv) of subsection G of this

section, the amount of insurance or equivalent uniform amount of

insurance used in the calculation of the adjusted premiums referred

to in (b) shall be equal to the excess of the corresponding amount

determined for the entire policy over the amount used in the

calculation of the adjusted premiums in (a).

I. 1. This paragraph shall not apply to policies issued on or

after the operative date of paragraph 4 of this subsection as

defined therein. For policies which comply with the requirements of

paragraph 2 of subsection D of this section and except as otherwise

provided in paragraphs 2 and 3 of this subsection, all adjusted

premiums and present values referred to in this section shall for

policies of ordinary insurance be calculated on the basis of the

Commissioners 1941 Standard Ordinary Mortality Table, provided that

for any category of ordinary insurance issued on female risks,

adjusted premiums and present values may be calculated according to

an age not more than three (3) years younger than the actual age of

the insured, and such calculations for all policies of industrial

insurance shall be made on the basis of the 1941 Standard Industrial

Mortality Table. All calculations shall be made on the basis of the

rate of interest, not exceeding three and one-half percent (3 1/2%)

per annum, specified in the policy for calculating cash surrender

values and paid-up nonforfeiture benefits, provided, however, that

in calculating the present value of any paid-up term insurance with

accompanying pure endowment, if any, offered as a nonforfeiture

benefit, the rates of mortality assumed may be not more than one

hundred thirty percent (130%) of the rates of mortality according to

such applicable table, provided further that for insurance issued on

a substandard basis, the calculation of any such adjusted premiums

and present values may be based on such other table of mortality as

may be specified by the insurer and approved by the Insurance

Commissioner.

2. This paragraph shall not apply to ordinary policies issued

on or after the operative date of paragraph 4 of this subsection as

defined therein. In the case of ordinary policies which comply with

the requirements of paragraph 2 of subsection D of this section

issued on or after July 1, 1962, all adjusted premiums and present

values referred to in this section may be calculated on the basis of

the Commissioners 1958 Standard Ordinary Mortality Table and the

rate of interest specified in the policy for calculating cash

surrender values and paid-up nonforfeiture benefits, provided that

Oklahoma Statutes - Title 36. Insurance Page 841

such rate of interest shall not exceed three and one-half percent (3

1/2%) per annum except that a rate of interest not exceeding four

percent (4%) per annum may be used for policies issued on or after

April 11, 1974, and prior to March 17, 1978, and rate of interest

not exceeding five and one-half percent (5 1/2%) per annum may be

used for policies issued on or after March 17, 1978, and provided

that for any category of ordinary insurance issued on female risks,

adjusted premiums and present values may be calculated according to

an age not more than six (6) years younger than the actual age of

the insured. Provided, however, that in calculating the present

value of any paid-up term insurance with accompanying pure

endowment, if any, offered as a nonforfeiture benefit, the rates of

mortality assumed may be not more than those shown in the

Commissioners 1958 Extended Term Insurance Table. Provided,

further, that for insurance issued on a substandard basis, the

calculation of any such adjusted premiums and present values may be

based on such other table of mortality as may be specified by the

company and approved by the Commissioner.

3. This paragraph shall not apply to industrial policies issued

on or after the operative date of paragraph 4 of this subsection as

defined therein. In the case of industrial policies, which comply

with the requirements of paragraph 2 of subsection D of this

section, all adjusted premiums and present values referred to in

this section may be calculated on the basis of the Commissioners

1961 Standard Industrial Mortality Table and the rate of interest

specified in the policy for calculating cash surrender values and

paid-up nonforfeiture benefits provided that such rate of interest

shall not exceed three and one-half percent (3 1/2%) per annum

except that a rate of interest not exceeding four percent (4%) per

annum may be used for policies issued on or after April 11, 1974,

and prior to March 17, 1978, and a rate of interest not exceeding

five and one-half percent (5 1/2%) per annum may be used for

policies issued on or after March 17, 1978. Provided, however, that

in calculating the present value of any paid-up term insurance with

accompanying pure endowment, if any, offered as a nonforfeiture

benefit, the rates of mortality assumed may be not more than those

shown in the Commissioners 1961 Industrial Extended Term Insurance

Table. Provided, further, that for insurance issued on a

substandard basis, the calculation of any such adjusted premiums and

present values may be based on such other table of mortality as may

be specified by the company and approved by the Commissioner.

4. (a) This paragraph shall apply to all policies issued on

or after the operative date of this paragraph as

defined herein. Except as provided in subparagraph

(g) of this paragraph, the adjusted premiums for any

policy shall be calculated on an annual basis and

shall be such uniform percentage of the respective

Oklahoma Statutes - Title 36. Insurance Page 842

premiums specified in the policy for each policy year,

excluding amounts payable as extra premiums to cover

impairments or special hazards and also excluding any

uniform annual contract charge or policy fee specified

in the policy in a statement of the method to be used

in calculating the cash surrender values and paid-up

nonforfeiture benefits, that the present value, at the

date of issue of the policy, of all adjusted premiums

shall be equal to the sum of (i) the then present

value of the future guaranteed benefits provided for

by the policy; (ii) one percent (1%) of either the

amount of insurance, if the insurance be uniform in

amount, or the average amount of insurance at the

beginning of each of the first ten (10) policy years;

and (iii) one hundred twenty-five percent (125%) of

the nonforfeiture net level premium as hereinafter

defined. Provided, however, that in applying the

percentage specified in (iii) above no nonforfeiture

net level premium shall be deemed to exceed four

percent (4%) of either the amount of insurance, if the

insurance be uniform in amount, or the average amount

of insurance at the beginning of each of the first ten

(10) policy years. The date of issue of a policy for

the purpose of this paragraph shall be the date as of

which the rated age of the insured is determined.

(b) The nonforfeiture net level premium shall be equal to

the present value, at the date of issue of the policy,

of the guaranteed benefits provided for by the policy

divided by the present value, at the date of issue of

the policy, of an annuity of one per annum payable on

the date of issue of the policy and on each

anniversary of such policy on which a premium falls

due.

(c) In the case of policies which cause on a basis

guaranteed in the policy unscheduled changes in

benefits or premiums, or which provide an option for

changes in benefits or premiums other than a change to

a new policy, the adjusted premiums and present values

shall initially be calculated on the assumption that

future benefits and premiums do not change from those

stipulated at the date of issue of the policy. At the

time of any such change in the benefits or premiums

the future adjusted premiums, nonforfeiture net level

premiums and present values shall be recalculated on

the assumption that future benefits and premiums do

not change from those stipulated by the policy

immediately after the change.

Oklahoma Statutes - Title 36. Insurance Page 843

(d) Except as otherwise provided in subparagraph (g) of

this paragraph, the recalculated future adjusted

premiums for any such policy shall be such uniform

percentage of the respective future premiums specified

in the policy for each policy year, excluding amounts

payable as extra premiums to cover impairments and

special hazards, and also excluding any uniform annual

contract charge or policy fee specified in the policy

in a statement of the method to be used in calculating

the cash surrender values and paid-up nonforfeiture

benefits, that the present value, at the time of

change to the newly defined benefits or premiums, of

all such future adjusted premiums shall be equal to

the excess of

(A) the sum of

(i) the then present value of the then future

guaranteed benefits provided for by the

policy and

(ii) the additional expense allowance, if any,

over

(B) the then cash surrender value, if any, or present

value of any paid-up nonforfeiture benefit under

the policy.

(e) The additional expense allowance, at the time of the

change to the newly defined benefits or premiums,

shall be the sum of

(i) one percent (1%) of the excess, if positive, of

the average amount of insurance at the beginning

of each of the first ten (10) policy years

subsequent to the change over the average amount

of insurance prior to the change at the beginning

of each of the first ten (10) policy years

subsequent to the time of the most recent

previous change, or, if there has been no

previous change, the date of issue of the policy;

and

(ii) one hundred twenty-five percent (125%) of the

increase, if positive, in the nonforfeiture net

level premium.

(f) The recalculated nonforfeiture net level premium shall

be equal to the result obtained by dividing (A) by (B)

where

(A) equals the sum of

(i) the nonforfeiture net level premium

applicable prior to the change times the

present value of an annuity of one per annum

payable on each anniversary of the policy on

Oklahoma Statutes - Title 36. Insurance Page 844

or subsequent to the date of the change on

which a premium would have fallen due had

the change not occurred, and

(ii) the present value of the increase in future

guaranteed benefits provided for by the

policy, and

(B) equals the present value of an annuity of one per

annum payable on each anniversary of the policy

on or subsequent to the date of change on which a

premium falls due.

(g) Notwithstanding any other provisions of this paragraph

to the contrary, in the case of a policy issued on a

substandard basis which provides reduced graded

amounts of insurance so that, in each policy year,

such policy has the same tabular mortality cost as an

otherwise similar policy issued on the standard basis

which provides higher uniform amounts of insurance,

adjusted premiums and present values for such

substandard policy may be calculated as if it were

issued to provide such higher uniform amounts of

insurance on the standard basis.

(h) All adjusted premiums and present values referred to

in this section shall for all policies of ordinary

insurance be calculated on the basis of (i) the

Commissioners 1980 Standard Ordinary Mortality Table

or (ii) at the election of the insurer for any one or

more specified plans of life insurance, the

Commissioners 1980 Standard Ordinary Mortality Table

with Ten-Year Select Mortality Factors; shall for all

policies of industrial insurance be calculated on the

basis of the Commissioners 1961 Standard Industrial

Mortality Table; and shall for all policies issued in

a particular calendar year be calculated on the basis

of a rate of interest not exceeding the nonforfeiture

interest rate as defined in this paragraph for

policies issued in that calendar year. Provided,

however, that:

(i) At the option of the insurer, calculations for

all policies issued in a particular calendar year

may be made on the basis of a rate of interest

not exceeding the nonforfeiture interest rate, as

defined in this paragraph, for policies issued in

the immediately preceding calendar year.

(ii) Under any paid-up nonforfeiture benefit,

including any paid-up dividend additions, any

cash surrender value available, whether or not

required by subsection B of this section, shall

Oklahoma Statutes - Title 36. Insurance Page 845

be calculated on the basis of the mortality table

and rate of interest used in determining the

amount of such paid-up nonforfeiture benefit and

paid-up dividend additions, if any.

(iii) An insurer may calculate the amount of any

guaranteed paid-up nonforfeiture benefit

including any paid-up additions under the policy

on the basis of an interest rate no lower than

that specified in the policy for calculating cash

surrender values.

(iv) In calculating the present value of any paid-up

term insurance with accompanying pure endowment,

if any, offered as a nonforfeiture benefit, the

rates of mortality assumed may be not more than

those shown in the Commissioners 1980 Extended

Term Insurance Table for policies of ordinary

insurance and not more than the Commissioners

1961 Industrial Extended Term Insurance Table for

policies of industrial insurance.

(v) For insurance issued on a substandard basis, the

calculation of any such adjusted premiums and

present values may be based on appropriate

modifications of the aforementioned tables.

(vi) For policies issued prior to the operative date

of the valuation manual, any Commissioners

Standard mortality tables, adopted after 1980 by

the National Association of Insurance

Commissioners, that are approved by regulation

promulgated by the Commissioner for use in

determining the minimum nonforfeiture standard

may be substituted for the Commissioners 1980

Standard Ordinary Mortality Table with or without

Ten-Year Select Mortality Factors or for the

Commissioners 1980 Extended Term Insurance Table.

For policies issued on or after the operative

date of the valuation manual, the valuation

manual shall provide the Commissioners Standard

mortality table for use in determining the

minimum nonforfeiture standard that may be

substituted for the Commissioners 1980 Standard

Ordinary Mortality Table with or without Ten-Year

Select Mortality Factors or for the Commissioners

1980 Extended Term Insurance Table. If the

commissioner approves by rule any Commissioners

Standard mortality table adopted by the National

Association of Insurance Commissioners for use in

determining the minimum nonforfeiture standard

Oklahoma Statutes - Title 36. Insurance Page 846

for policies issued on or after the operative

date of the valuation manual then that minimum

nonforfeiture standard supersedes the minimum

nonforfeiture standard provided by the valuation

manual, and

(vii) For policies issued prior to the operative date

of the valuation manual, any Commissioners

Standard industrial mortality tables, adopted

after 1980 by the National Association of

Insurance Commissioners, that are approved by

regulation promulgated by the Commissioner for

use in determining the minimum nonforfeiture

standard may be substituted for the Commissioners

1961 Standard Industrial Mortality Table or the

Commissioners 1961 Industrial Extended Term

Insurance Table.

For policies issued on or after the operative

date of the valuation manual the valuation manual

shall provide the Commissioner's Standard

mortality table for use in determining the

minimum nonforfeiture standard that may be

substituted for the Commissioners 1961 Standard

Industrial Mortality Table or the Commissioners

1961 Industrial Extended Term Insurance Table.

If the commissioner approves by regulation any

Commissioner's Standard industrial mortality

table adopted by the National Association of

Insurance Commissioners for use in determining

the minimum nonforfeiture standard for policies

issued on or after the operative date of the

valuation manual then that minimum nonforfeiture

standard supersedes the minimum nonforfeiture

standard provided by the valuation manual.

(i) The nonforfeiture interest rate is defined below:

(i) For policies issued prior to the operative date

of valuation manual, the nonforfeiture interest

rate per annum for any policy issued in a

particular calendar year shall be equal to one

hundred twenty-five percent (125%) of the

calendar year statutory valuation interest rate

for such policy as defined in the Standard

Valuation Law, rounded to the nearest one-fourth

of one percent (1/4 of 1%); provided, however,

that the nonforfeiture interest rate shall not be

less than four percent (4%), and

(ii) For policies issued on and after the operative

date of the valuation manual the nonforfeiture

Oklahoma Statutes - Title 36. Insurance Page 847

interest rate per annum for any policy issued in

a particular calendar year shall be provided by

the valuation manual.

(j) Notwithstanding any other provision in this code to

the contrary, any refiling of nonforfeiture values or

their methods of computation for any previously

approved policy form which involves only a change in

the interest rate or mortality table used to compute

nonforfeiture values shall not require refiling of any

other provisions of that policy form.

(k) Any insurer may file with the Commissioner a written

notice of its election to comply with the provisions

of this paragraph after a specified date before

January 1, 1989, which specified date shall be the

operative date of this paragraph for such insurer. If

an insurer makes no such election, the operative date

of this paragraph for such insurer shall be January 1,

1989.

J. In the case of any plan of life insurance which provides for

future premium determination, the amounts of which are to be

determined by the insurer based on then estimates of future

experience, or in the case of any plan of life insurance which is of

such a nature that minimum values cannot be determined by the

methods described in subsections B through I of this section:

1. The Commissioner must be satisfied that the benefits

provided under the plan are substantially as favorable to

policyholders and insureds as the minimum benefits otherwise

required by subsections B through I of this section;

2. The Commissioner must be satisfied that the benefits and the

pattern of premiums of that plan are not such as to mislead

prospective policyholders or insureds;

3. The cash surrender values and paid-up nonforfeiture benefits

provided by such plan must not be less than the minimum values and

benefits required for the plan computed by a method consistent with

the principles of this Standard Nonforfeiture Law for Life

Insurance, as determined by regulations promulgated by the

Commissioner.

K. Calculation of Values: Any cash surrender value and any

paid-up nonforfeiture benefit available under the policy in the

event of default in a premium payment due at any time other than on

the policy anniversary shall be calculated with allowance for the

lapse of time and the payment of fractional premiums beyond the last

preceding policy anniversary, except in the case of industrial

insurance proportionate increases in value may be calculated on the

basis of quarter-year payments. All values referred to in

subsections D, F, G, H and I of this section may be calculated upon

the assumption that any death benefit is payable at the end of the

Oklahoma Statutes - Title 36. Insurance Page 848

policy year of death. The net value of any paid-up additions, other

than paid-up term additions, shall be not less than the amounts used

to provide such additions. Notwithstanding the provisions of

subsection D of this section, additional benefits payable (1) in the

event of death or dismemberment by accident or accidental means, (2)

in the event of total and permanent disability, (3) as reversionary

annuity or deferred reversionary annuity benefits, (4) as term

insurance benefits provided by a rider or supplemental policy

provision to which, if issued as a separate policy, this section

would not apply, (5) as term insurance on the life of a child or on

the lives of children provided in a policy on the life of a parent

of the child, if such term insurance expires before the child's age

is twenty-six (26) years, is uniform in amount after the child's age

is one (1) year, and has not become paid up by reason of the death

of a parent of the child, and (6) as other policy benefits

additional to life insurance and endorsement benefits, and premiums

for all such additional benefits, shall be disregarded in

ascertaining cash surrender values and nonforfeiture benefits

required by this section, and no such additional benefits shall be

required to be included in any paid-up nonforfeiture benefits.

L. This subsection, in addition to all other applicable

subsections of this section, shall apply to all policies issued on

or after January 1, 1986. Any cash surrender value available under

the policy in the event of default in a premium payment due on any

policy anniversary, shall be in an amount which does not differ by

more than two-tenths of one percent (2/10 of 1%) of either the

amount of insurance, if the insurance be uniform in amount, or the

average amount of insurance at the beginning of each of the first

ten (10) policy years, from the sum of (a) the greater of zero and

the basic cash value hereinafter specified and (b) the present value

of any existing paid-up additions less the amount of any

indebtedness to the insurer under the policy.

The basic cash value shall be equal to the present value, on

such anniversary, of the future guaranteed benefits which would have

been provided for by the policy, excluding any existing paid-up

additions and before deduction of any indebtedness to the insurer,

if there had been no default, less the then present value of the

nonforfeiture factors, as hereinafter defined, corresponding to

premiums which would have fallen due on and after such anniversary.

Provided, however, that the effects on the basic cash value of

supplemental life insurance or annuity benefits or of family

coverage, as described in subsection D or H of this section,

whichever is applicable, shall be the same as are the effects

specified in subsection D or H of this section, whichever is

applicable on the cash surrender values defined in that subsection.

The nonforfeiture factor for each policy year shall be an amount

equal to a percentage of the adjusted premium for the policy year,

Oklahoma Statutes - Title 36. Insurance Page 849

as defined in subsection G or I of this section, whichever is

applicable. Except as is required by the next succeeding sentence

of this paragraph, such percentage:

1. Must be the same percentage for each policy year between the

second policy anniversary and the later of (i) the fifth policy

anniversary and (ii) the first policy anniversary at which there is

available under the policy a cash surrender value in an amount,

before including any paid-up additions and before deducting any

indebtedness, of at least two-tenths of one percent (2/10 of 1%) of

either the amount of insurance, if the insurance be uniform in

amount, or the average amount of insurance at the beginning of each

of the first ten (10) policy years; and

2. Must be such that no percentage after the later of the two

policy anniversaries specified in the preceding paragraph 1 may

apply to fewer than five (5) consecutive policy years.

Provided, that no basic cash value may be less than the value

which would be obtained if the adjusted premiums for the policy, as

defined in subsection G or I of this section, whichever is

applicable, were substituted for the nonforfeiture factors in the

calculation of the basic cash value.

All adjusted premiums and present values referred to in this

section shall for a particular policy be calculated on the same

mortality and interest bases as are used in demonstrating the

policy's compliance with the other subsections of this section. The

cash surrender values referred to in this subsection shall include

any endowment benefits provided for by the policy.

Any cash surrender value available other than in the event of

default in a premium payment due on a policy anniversary, and the

amount of any paid-up nonforfeiture benefit available under the

policy in the event of default in a premium payment shall be

determined in manners consistent with the manners specified for

determining the analogous minimum amounts in subsections B, C, D and

K and paragraph 4 of subsection I of this section. The amounts of

any cash surrender values and of any paid-up nonforfeiture benefits

granted in connection with additional benefits such as those listed

as items (1) through (6) in subsection K of this section shall

conform with the principles of this subsection.

M. 1. This section shall not apply to any of the following:

a. reinsurance,

b. group insurance,

c. pure endowment,

d. annuity or reversionary annuity contract,

e. except as provided in paragraph 1 of subsection D of

this section, term policy of uniform amount, which

provides no guaranteed nonforfeiture or endowment

benefits, or renewal thereof, of twenty (20) years or

less expiring before age seventy-one (71) years, for

Oklahoma Statutes - Title 36. Insurance Page 850

which uniform premiums are payable during the entire

term of the policy,

f. except as provided in paragraph 1 of subsection D of

this section, term policy of decreasing amount which

provides no guaranteed nonforfeiture or endowment

benefits, on which each adjusted premium, calculated

as specified in subsections G, H and I of this

section, is less than the adjusted premium so

calculated on a term policy of uniform amount, or

renewal thereof, which provides no guaranteed

nonforfeiture or endowment benefits, issued at the

same age and for the same initial amount of insurance

for a term defined as follows: For ages at issue

fifty (50) years and under the term shall be twenty

(20) years. Thereafter the term shall decrease one

(1) year for each year of increase in the age at issue

beyond age fifty (50) years; and

g. policy, which provides no guaranteed nonforfeiture or

endowment benefits, for which no cash surrender value,

if any, or present value of any paid-up nonforfeiture

benefit at the beginning of any policy year,

calculated as specified in subsections D, F, G, H and

I of this section, exceeds two and one-half percent (2

1/2%) of the amount of insurance at the beginning of

the same policy year.

2. For purposes of determining the applicability of this act,

the age at expiry for a joint term life insurance policy shall be

the age at expiry of the oldest life.
Okla. Stat. tit. 36, § 36-7125 — OK Code / Title 36 / Section 36-7125
Application for permit - Cancellation of or refusal to
Status: in_force

issue or renew permit - Appeal.

A. Each organization desiring to accept money or anything of

value for prepaid cemetery merchandise shall file an application for

a permit with the Insurance Commissioner, and shall at the time of

filing the application pay one initial filing fee of Two Hundred

Dollars ($200.00). All applications shall be filed electronically

in the manner and form prescribed by the Commissioner, along with

any applicable transaction or other fees. The Commissioner may

issue a permit upon the receipt of the application, the annual

report in accordance with Section 7128 of this title and payment of

the filing fees, and upon making a finding that the applicant has

complied with the Cemetery Merchandise Trust Act and the rules as

may be established pursuant to the Cemetery Merchandise Trust Act by

the Commissioner. All applications shall be signed by the

organization requesting the permit, and shall contain a statement

that the applicant will comply with all the requirements as

established pursuant to the Cemetery Merchandise Trust Act. All

permits shall expire on March 15 of the year following the year the

permit is first issued, unless renewed. Permits may be renewed for

a period not to exceed the succeeding March 15 upon the payment of a

renewal fee of Two Hundred Dollars ($200.00). Any permit expired

for failure to submit a renewal application may be reinstated within

ninety (90) days after the expiration date by electronically

submitting a fee in an amount that is double the renewal fee and a

renewal application in the form and manner prescribed by the

Insurance Commissioner, along with any transaction or other

applicable fees. The Insurance Commissioner shall require a permit

holder whose permit has been expired for more than ninety (90) days

to reapply as if they were a new applicant and pay an application

Oklahoma Statutes - Title 36. Insurance Page 1491

fee equal to an amount that is double the renewal fee in addition to

any fines imposed. All applications received after the permit has

been expired for more than ninety (90) days shall include a detailed

report of services provided in this state during the period of

expired permit.

B. The Commissioner may suspend, revoke, refuse to issue, or

refuse to renew a permit for failure to comply with any provisions

of the Cemetery Merchandise Trust Act or any rules promulgated

thereto by the Commissioner, after reasonable notice to the

permittee and opportunity for hearing before the Commissioner in

accordance with Article II of the Administrative Procedures Act.

C. No organization shall be entitled to a permit after

revocation, or refusal by the Commissioner to renew a permit, but

may thereafter be issued a permit upon satisfactory proof of

compliance with the Cemetery Merchandise Trust Act and the rules

promulgated thereto.

D. An organization aggrieved by the actions of the Commissioner

may appeal therefrom to the Oklahoma Insurance Department as

provided by the Administrative Procedures Act.

E. Each permit holder shall electronically submit, in a form

and manner prescribed by the Insurance Commissioner, along with any

applicable fees, any change of legal business name, dba or assumed

name, address, or email address within thirty (30) days after the

change occurred. Any submission of a change of legal business name,

dba or assumed name, address, or contact eemail address received

more than thirty (30) days after the change occurred shall be

accompanied by a fee of Fifty Dollars ($50.00).

F. Every permit holder, upon receipt of any inquiry from the

Insurance Commissioner, shall, within twenty (20) days from the date

of receipt of the inquiry, furnish the Insurance Commissioner with

an adequate response to the inquiry.
Okla. Stat. tit. 36, § 36-4055.14 — OK Code / Title 36 / Section 36-4055.14
Injunction - Civil action - Cease and desist orders -
Status: in_force

Civil and criminal penalties.

A. In addition to the penalties and other enforcement

provisions of the Viatical Settlements Act of 2008, if any person

violates the Viatical Settlements Act of 2008 or any regulation

implementing the Viatical Settlements Act of 2008, the Insurance

Commissioner may seek an injunction in a court of competent

jurisdiction and may apply for temporary and permanent orders that

the Commissioner determines are necessary to restrain the person

from committing the violation.

Oklahoma Statutes - Title 36. Insurance Page 901

B. Any person damaged by the acts of a person in violation of

the Viatical Settlements Act of 2008 may bring a civil action

against the person committing the violation in a court of competent

jurisdiction.

C. The Commissioner may issue, in accordance with the

Administrative Procedures Act, a cease and desist order upon a

person that violates any provision of the Viatical Settlements Act

of 2008, any regulation or order adopted by the Commissioner, or any

written agreement entered into with the Commissioner.

D. When the Commissioner finds that an activity in violation of

the Viatical Settlements Act of 2008 presents an immediate danger to

the public that requires an immediate final order, the Commissioner

may issue an emergency cease and desist order reciting with

particularity the facts underlying the findings. The emergency

cease and desist order is effective immediately upon service of a

copy of the order on the respondent and remains effective for ninety

(90) days. If the Commissioner begins nonemergency cease and desist

proceedings, the emergency cease and desist order remains effective,

absent an order by a court of competent jurisdiction pursuant to the

Administrative Procedures Act.

E. In addition to the penalties and other enforcement

provisions of the Viatical Settlements Act of 2008, any person who

violates the Viatical Settlements Act of 2008 is subject to civil

penalties of up to Ten Thousand Dollars ($10,000.00) per violation.

Imposition of civil penalties shall be pursuant to an order of the

Commissioner issued under Section 313 of this title. The

Commissioner’s order may require a person found to be in violation

of the Viatical Settlements Act of 2008 to make restitution to

persons aggrieved by violations of the Viatical Settlements Act of

2008.

F. A person convicted of a violation of the Viatical

Settlements Act by a court of competent jurisdiction shall be:

1. Guilty of a Class B3 felony offense punishable by

imprisonment for not more than twenty (20) years or to payment of a

fine of not more than One Hundred Thousand Dollars ($100,000.00), or

both, if the value of the viatical settlement contract is more than

Thirty-five Thousand Dollars ($35,000.00);

2. Guilty of a Class C2 felony offense punishable by

imprisonment as provided for in subsections B through F of Section

20M of Title 21 of the Oklahoma Statutes, or to payment of a fine of

not more than Twenty Thousand Dollars ($20,000.00), or both, if the

value of the viatical settlement contract is more than Two Thousand

Five Hundred Dollars ($2,500.00) but not more than Thirty-five

Thousand Dollars ($35,000.00);

3. Guilty of a Class D1 felony offense punishable by

imprisonment as provided for in subsections B through F of Section

20N of Title 21 of the Oklahoma Statutes, or to payment of a fine of

Oklahoma Statutes - Title 36. Insurance Page 902

not more than Ten Thousand Dollars ($10,000.00), or both, if the

value of the viatical settlement contract is more than Five Hundred

Dollars ($500.00) but not more than Two Thousand Five Hundred

Dollars ($2,500.00); or

4. Guilty of a Class D3 felony offense punishable by

imprisonment as provided for in subsections B through F of Section

20P of Title 21 of the Oklahoma Statutes, or to payment of a fine of

not more than Three Thousand Dollars ($3,000.00), or both, if the

value of the viatical settlement contract is Five Hundred Dollars

($500.00) or less.

A person convicted of a violation of the Viatical Settlements

Act of 2008 shall be ordered to pay restitution to persons aggrieved

by the violation of the Viatical Settlements Act of 2008.

Restitution shall be ordered in addition to a fine or imprisonment,

but not in lieu of a fine or imprisonment.

G. Except for a fraudulent viatical settlement act committed by

a viator, the enforcement provisions and penalties of this section

shall not apply to a viator. A person convicted of a violation of

the Viatical Settlements Act of 2008 by a court of competent

jurisdiction may be sentenced in accordance with paragraph 1, 2, 3

or 4 of subsection F of this section based on the greater of (i) the

value of property, services, or other benefit wrongfully obtained or

attempted to obtain, or (ii) the aggregate economic loss suffered by

any person as a result of the violation. A person convicted of a

fraudulent viatical settlement act must be ordered to pay

restitution to persons aggrieved by the fraudulent viatical

settlement act. Restitution must be ordered in addition to a fine

or imprisonment but not in lieu of a fine or imprisonment.

In any prosecution under paragraphs 1, 2, 3 and 4 of subsection

F of this section the value of the viatical settlement contracts

within any six-month period may be aggregated and the defendant

charged accordingly in applying the provisions of this section.

When two or more offenses are committed by the same person in two or

more counties, the accused may be prosecuted in any county in which

one of the offenses was committed for all of the offenses aggregated

under this section. The applicable statute of limitations provision

under Section 93 of Title 12 of the Oklahoma Statutes shall not

begin to run until the insurance company or law enforcement agency

is aware of the fraud, but in no event may the prosecution be

commenced later than seven (7) years after the act has occurred.
Okla. Stat. tit. 36, § 36-1435.9 — OK Code / Title 36 / Section 36-1435.9
Nonresident producer license
Status: in_force

A. Unless denied licensure pursuant to Section 1435.13 of this

title, a nonresident person shall receive a nonresident producer

license if:

1. The person is currently licensed as a resident and in good

standing in that person's home state;

Oklahoma Statutes - Title 36. Insurance Page 341

2. The person has submitted the proper request for licensure

and has paid the fees required by Section 1435.23 of this title;

3. The person has submitted or transmitted to the Insurance

Commissioner the application for licensure that the person submitted

to the person's home state, or in lieu of the same, a completed

Uniform Application; and

4. The person's home state awards nonresident producer licenses

to residents of this state on the same basis.

B. Any nonresident application submitted pursuant to this

section shall constitute the applicant’s designation of the

Insurance Commissioner as the person upon whom may be served all

lawful process in any action, suit, or proceeding instituted by or

on behalf of any interested person arising out of the insurance

business of the applicant in this state. This designation

constitutes an agreement that said service of process is of the same

legal force and validity as personal service of process in this

state upon the nonresident licensee.

C. The Insurance Commissioner may verify the producer's

licensing status through the Producer Database maintained by the

National Association of Insurance Commissioners, its affiliates or

subsidiaries.

D. A nonresident producer who moves from one state to another

state or a resident producer who moves from this state to another

state shall file a change of address and provide certification from

the new resident state within thirty (30) days of the change of

legal residence.

E. Notwithstanding any other provision of the Oklahoma Producer

Licensing Act or of the Oklahoma Insurance Code, a person licensed

as a surplus lines producer in that person's home state shall

receive a nonresident surplus lines producer license pursuant to

subsections A and B of this section.

F. Notwithstanding any other provision of the Oklahoma Producer

Licensing Act, a person licensed as a limited line credit insurance

or other type of limited lines producer in that person's home state

shall receive a nonresident limited lines producer license, pursuant

to subsections A and B of this section, granting the same scope of

authority as granted under the license issued by the producer's home

state. For the purpose of this subsection, limited line insurance

is any authority granted by the home state which restricts the

authority of the license to less than the total authority prescribed

in the associated major lines pursuant to subsection A of Section

1435.8 of this title.
Okla. Stat. tit. 36, § 36-615.1 — OK Code / Title 36 / Section 36-615.1
Application to transact insurance - Application review
Status: in_force

Oklahoma Statutes - Title 36. Insurance Page 133

A. Unless otherwise instructed by the Insurance Commissioner,

an applicant requesting to be admitted to transact insurance in this

state shall follow the instructions outlined in the National

Association of Insurance Commissioners (NAIC) Uniform Certificate of

Authority Application (UCAA) instructions.

B. The Commissioner shall review and analyze each application

with focus on the following:

1. Identification and evaluation of the business and strategic

plans of the applicant, including but not limited to pro forma

financial projections;

2. Assessment of the quality and expertise of the ultimate

controlling person, proposed officers and directors, appointed

actuary and appointed accountant, including the use of the NAIC Form

A and SAD databases;

3. Adequacy of any proposed reinsurance program;

4. Adequacy of investment policy;

5. Adequacy of short-term and long-term financing arrangements,

including, but not limited to:

a. initial financing of proposed operations or

transaction, and

b. maintenance of adequate capital and surplus levels;

6. Biographical affidavits;

7. Related party agreements’ compliance with SSAP No. 25; and

8. Any other information the Commissioner deems necessary to

review.
Okla. Stat. tit. 36, § 36-1119 — OK Code / Title 36 / Section 36-1119
Exemptions from surplus lines provisions
Status: in_force

The sections of this article relative to surplus line coverages

shall not apply to reinsurance.
Okla. Stat. tit. 36, § 36-306 — OK Code / Title 36 / Section 36-306
Records - Disclosure
Status: in_force

A. The records, books, and papers pertaining to the official

transactions, filings, examinations, investigations, and proceedings

of the Insurance Department shall be maintained by the Department

until disposition thereof has been approved by the Archives and

Records Commission. These records, books, and papers shall be

public records of the state. However, reports of examinations of

insurers shall be filed and made public only as provided in Section

Oklahoma Statutes - Title 36. Insurance Page 55

309.4 of this title. Open and ongoing investigative and

disciplinary files shall not be made public until their completion

or unless they are ordered to be made public by the proper judicial

official. Files of the claims division of the office of the

Commissioner, including but not limited to complaints and requests

for assistance from insureds, and insurance agency and company

records, shall not be public records and shall not be disclosed

except in connection with disciplinary proceedings by the

Commissioner. Final market conduct orders shall be open public

records.

B. Any document or other information generated by the Insurance

Department or received by the Insurance Department from a

governmental agency or any other public body of any kind, including

an insurance guaranty fund or risk pool board, that has a protection

from disclosure under any statute or evidentiary privilege from

disclosure, while in the possession of the body that generated or

received the information, shall retain its confidential character

while in the possession of the Insurance Department. The Insurance

Department may require that any agency or public body providing a

document or other information, if it expects the information to be

treated confidentially by the Insurance Department, to also provide

simultaneously an express reference to the claimed protection from

disclosure.

C. A court shall quash any subpoena commanding the disclosure

of confidential information or closed records of the Insurance

Department absent a showing of justification for the disclosure.
Okla. Stat. tit. 36, § 36-6463 — OK Code / Title 36 / Section 36-6463
Assets to protect purchasers
Status: in_force

The State Insurance Commissioner shall require all risk

insurance groups to have appropriate reserves in Oklahoma, other

assets, or a corporate surety bond to protect purchasers in case of

bankruptcy, withholding of unearned premiums, or failure to pay

benefits.
Okla. Stat. tit. 36, § 36-2713.1 — OK Code / Title 36 / Section 36-2713.1
Reinsurance
Status: in_force

A. A domestic society may, by a reinsurance agreement, cede any

individual risk or risks in whole or in part to an insurer, other

than another fraternal benefit society, having the power to make

such reinsurance and authorized to do business in this state, or if

not so authorized, one which is approved by the Insurance

Commissioner; provided, no such society may reinsure substantially

all of its insurance in force without the written permission of the

Commissioner. It may take credit for the reserves on such ceded

risks to the extent reinsured, but no credit shall be allowed as an

admitted asset or as a deduction from liability, to a ceding society

for reinsurance made, ceded, renewed, or otherwise becoming

effective after the effective date of this act, unless the

Oklahoma Statutes - Title 36. Insurance Page 720

reinsurance is payable by the assuming insured on the basis of the

liability of the ceding society under the contract or contracts

reinsured without diminution because of the insolvency of the ceding

society.

B. Notwithstanding the limitation in subsection A of this

section, a society may reinsure the risks of another society in a

consolidation or merger approved by the Commissioner under Section

14 of this act.
Okla. Stat. tit. 36, § 36-6475.3 — OK Code / Title 36 / Section 36-6475.3
Definitions
Status: in_force

For purposes of the Uniform Health Carrier External Review Act:

1. “Adverse determination” means a determination by a health

carrier or its designee utilization review organization that an

admission, availability of care, continued stay or other health care

service that is a covered benefit has been reviewed and, based upon

the information provided, does not meet the health carrier’s

requirements for medical necessity, appropriateness, health care

setting, level of care or effectiveness, and the requested service

or payment for the service is therefore denied, reduced or

terminated;

2. “Ambulatory review” means utilization review of health care

services performed or provided in an outpatient setting;

3. “Authorized representative” means:

a. a person to whom a covered person has given express

written consent to represent the covered person in an

external review,

b. a person authorized by law to provide substituted

consent for a covered person, or

c. a family member of the covered person or the covered

person’s treating health care professional only when

the covered person is unable to provide consent;

4. “Best evidence” means evidence based on:

Oklahoma Statutes - Title 36. Insurance Page 1236

a. randomized clinical trials,

b. if randomized clinical trials are not available,

cohort studies or case-control studies,

c. if subparagraphs a and b of this paragraph are not

available, case-series, or

d. if subparagraphs a, b and c of this paragraph are not

available, expert opinion;

5. “Case-control study” means a retrospective evaluation of two

groups of patients with different outcomes to determine which

specific interventions the patients received;

6. “Case management” means a coordinated set of activities

conducted for individual patient management of serious, complicated,

protracted or other health conditions;

7. “Case-series” means an evaluation of a series of patients

with a particular outcome, without the use of a control group;

8. “Certification” means a determination by a health carrier or

its designee utilization review organization that an admission,

availability of care, continued stay or other health care service

has been reviewed and, based on the information provided, satisfies

the health carrier’s requirements for medical necessity,

appropriateness, health care setting, level of care and

effectiveness;

9. “Clinical review criteria” means the written screening

procedures, decision abstracts, clinical protocols and practice

guidelines used by a health carrier to determine the necessity and

appropriateness of health care services;

10. “Cohort study” means a prospective evaluation of two groups

of patients with only one group of patients receiving a specific

intervention or specific interventions;

11. “Commissioner” means the Insurance Commissioner;

12. “Concurrent review” means utilization review conducted

during a hospital stay or course of treatment of a patient;

13. “Covered benefits” or “benefits” means those health care

services to which a covered person is entitled under the terms of a

health benefit plan;

14. “Covered person” means a policyholder, subscriber, enrollee

or other individual participating in a health benefit plan;

15. “Discharge planning” means the formal process for

determining, prior to discharge from a facility, the coordination

and management of the care that a patient receives following

discharge from a facility;

16. “Disclose” means to release, transfer or otherwise divulge

protected health information to any person other than the individual

who is the subject of the protected health information;

17. “Emergency medical condition” means the sudden and, at the

time, unexpected onset of a health condition or illness that

requires immediate medical attention, where failure to provide

Oklahoma Statutes - Title 36. Insurance Page 1237

medical attention would result in a serious impairment to bodily

functions, serious dysfunction of a bodily organ or part, or would

place the person’s health in serious jeopardy;

18. “Emergency services” means health care items and services

furnished or required to evaluate and treat an emergency medical

condition;

19. “Evidence-based standard” means the conscientious, explicit

and judicious use of the current best evidence based on the overall

systematic review of the research in making decisions about the care

of individual patients;

20. “Expert opinion” means a belief or an interpretation by

specialists with experience in a specific area about the scientific

evidence pertaining to a particular service, intervention or

therapy;

21. “Facility” means an institution providing health care

services or a health care setting, including but not limited to

hospitals and other licensed inpatient centers, ambulatory surgical

or treatment centers, skilled nursing centers, residential treatment

centers, diagnostic, laboratory and imaging centers, and

rehabilitation and other therapeutic health settings;

22. “Final adverse determination” means an adverse

determination involving a covered benefit that has been upheld by a

health carrier, or its designee utilization review organization, at

the completion of the health carrier’s internal grievance process

procedures;

23. “Health benefit plan” means a policy, contract, certificate

or agreement offered or issued by a health carrier to provide,

deliver, arrange for, pay for or reimburse any of the costs of

health care services;

24. “Health care professional” means a physician or other

health care practitioner licensed, accredited or certified to

perform specified health care services consistent with state law;

25. “Health care provider” or “provider” means a health care

professional or a facility;

26. “Health care services” means services for the diagnosis,

prevention, treatment, cure or relief of a health condition,

illness, injury or disease;

27. “Health carrier” means an entity subject to the insurance

laws and regulations of this state, or subject to the jurisdiction

of the Commissioner, that contracts or offers to contract to

provide, deliver, arrange for, pay for or reimburse any of the costs

of health care services, including but not limited to a sickness and

accident insurance company, a health maintenance organization, a

nonprofit hospital and health service corporation, or any other

entity providing a plan of health insurance, health benefits or

health care services;

Oklahoma Statutes - Title 36. Insurance Page 1238

28. “Health information” means information or data, whether

oral or recorded in any form or medium, and personal facts or

information about events or relationships that relate to:

a. the past, present or future physical, mental, or

behavioral health or condition of an individual or a

member of the individual’s family,

b. the provision of health care services to an

individual, or

c. payment for the provision of health care services to

an individual;

29. “Independent review organization” means an entity that

conducts independent external reviews of adverse determinations and

final adverse determinations;

30. “Medical or scientific evidence” means evidence found in

the following sources:

a. peer-reviewed scientific studies published in or

accepted for publication by medical journals that meet

nationally recognized requirements for scientific

manuscripts and that submit most of the published

articles for review by experts who are not part of the

editorial staff,

b. peer-reviewed medical literature, including literature

relating to therapies reviewed and approved by a

qualified institutional review board, biomedical

compendia and other medical literature that meet the

criteria of the National Institutes of Health’s

Library of Medicine for indexing in Index Medicus

(Medline) and Elsevier Science Ltd. for indexing in

Excerpta Medicus (EMBASE),

c. medical journals recognized by the Secretary of Health

and Human Services under Section 1861(t)(2) of the

federal Social Security Act,

d. the following standard reference compendia:

(1) the American Hospital Formulary Service–Drug

Information,

(2) Drug Facts and Comparisons,

(3) the American Dental Association Accepted Dental

Therapeutics, and

(4) the United States Pharmacopoeia–Drug Information,

e. findings, studies or research conducted by or under

the auspices of federal government agencies and

nationally recognized federal research institutes,

including but not limited to:

(1) the federal Agency for Healthcare Research and

Quality,

(2) the National Institutes of Health,

(3) the National Cancer Institute,

Oklahoma Statutes - Title 36. Insurance Page 1239

(4) the National Academy of Sciences,

(5) the Centers for Medicare and Medicaid Services,

(6) the federal Food and Drug Administration, and

(7) any national board recognized by the National

Institutes of Health for the purpose of

evaluating the medical value of health care

services, or

f. any other medical or scientific evidence that is

comparable to the sources listed in subparagraphs a

through e of this paragraph;

31. “NAIC” means the National Association of Insurance

Commissioners;

32. “Person” means an individual, a corporation, a partnership,

an association, a joint venture, a joint stock company, a trust, an

unincorporated organization, any similar entity or any combination

of the foregoing;

33. “Prospective review” means utilization review conducted

prior to an admission or a course of treatment;

34. “Protected health information” means health information:

a. that identifies an individual who is the subject of

the information, or

b. with respect to which there is a reasonable basis to

believe that the information could be used to identify

an individual;

35. “Randomized clinical trial” means a controlled, prospective

study of patients that have been randomized into an experimental

group and a control group at the beginning of the study with only

the experimental group of patients receiving a specific

intervention, which includes study of the groups for variables and

anticipated outcomes over time;

36. “Retrospective review” means a review of medical necessity

conducted after services have been provided to a patient, but does

not include the review of a claim that is limited to an evaluation

of reimbursement levels, veracity of documentation, accuracy of

coding or adjudication for payment;

37. “Second opinion” means an opportunity or requirement to

obtain a clinical evaluation by a provider other than the one

originally making a recommendation for a proposed health care

service to assess the clinical necessity and appropriateness of the

initial proposed health care service;

38. “Utilization review” means a set of formal techniques

designed to monitor the use of, or evaluate the clinical necessity,

appropriateness, efficacy, or efficiency of, health care services,

procedures, or settings. Techniques may include but are not limited

to ambulatory review, prospective review, second opinion,

certification, concurrent review, case management, discharge

planning, or retrospective review; and

Oklahoma Statutes - Title 36. Insurance Page 1240

39. “Utilization review organization” means an entity that

conducts utilization review, other than a health carrier performing

a review for its own health benefit plans.
Okla. Stat. tit. 36, § 36-1272 — OK Code / Title 36 / Section 36-1272
Definitions
Status: in_force

As used in this act:

1. “Administrative charges” shall include, but not be limited

to, the cost of:

a. file creation,

b. repair orders,

c. vehicle travel on a customary standard drivable

rolling vehicle,

d. vehicle identification,

e. software charges,

f. communication with vehicle owners and insurance

representatives and any other party involved in the

repair or total loss determination,

g. prewashes,

h. COVID-19 cleaning or bio-cleaning,

i. charges related to photographs and electronic

communications,

j. charges for work that is not for obtaining labor,

parts, and materials,

k. securing removed parts, and

l. relocating parts back into a vehicle determined to be

a total loss;

2. “Auto body repair” means all auto body repair shop repairs,

maintenance, painting, exterior body work, part replacements,

assessment, and diagnostic testing provided to an insurance company

to determine a motor vehicle total loss;

3. “Auto body repair shop” means any commercial entity engaged

in the business or occupation of performing auto body repairs on the

body of a motor vehicle;

4. “Insurance company” means the person or entity responsible

for charges incurred by the insured at an auto body repair shop as a

result of repairs or charges incurred in determining a total loss of

a motor vehicle as provided for in Section 1250.8 of Title 36 of the

Oklahoma Statutes;

5. “Motor vehicle” means the same as defined in Section 1-134

of Title 47 of the Oklahoma Statutes;

6. “Owner” means the owner of the vehicle; and

7. “Storage rates” means all charges and fees related to the

auto body repair shop retaining actual physical possession of a

motor vehicle during the time when the auto body repair shop

exercises control, supervision, care, security, protection, and

responsibility over the motor vehicle.
Okla. Stat. tit. 36, § 36-6652 — OK Code / Title 36 / Section 36-6652
Compliance with act
Status: in_force

A. No vehicle protection product may be sold or offered for

sale in this state unless the seller, warrantor and administrator,

if any, comply with the provisions of the Vehicle Protection Product

Act.

B. Vehicle protection product warrantors and related vehicle

protection product sellers and warranty administrators complying

with the Vehicle Protection Product Act are not required to comply

with and are not subject to any other provisions of the Oklahoma

Insurance Code.

C. Licensed service contract providers may sell motor vehicle

ancillary protection products under the Service Warranty Act in

Title 15 of the Oklahoma Statutes and such sales shall not be

subject to the requirements of the Vehicle Protection Product Act.

Licensed service contract providers may also be registered under the

Vehicle Protection Product Act. Sales of the vehicle protection

products under the Vehicle Protection Product Act are exempt from

the requirements of the Service Warranty Act.

D. Warranties, indemnity agreements and guarantees that are not

provided as a part of a vehicle protection product are not subject

to the provisions of the Vehicle Protection Product Act.
Okla. Stat. tit. 36, § 36-302 — OK Code / Title 36 / Section 36-302
Insurance Commissioner
Status: in_force

The Insurance Commissioner of this state shall be at least

twenty-five (25) years of age and a resident of this state for at

least five (5) years, and have had at least five (5) years'

experience in the insurance industry in administration, sales,

servicing or regulation. The Insurance Commissioner shall not be

financially interested, directly or indirectly, in any insurer,

agency, insurance transaction, or other entity that is regulated by

the Insurance Department, except as a policyholder or claimant under

a policy.
Okla. Stat. tit. 36, § 36-6938 — OK Code / Title 36 / Section 36-6938
Definitions
Status: in_force

As used in the Risk-based Capital (RBC) for Health Maintenance

Organizations Act of 2003:

1. “Adjusted Risk-based Capital (RBC) report” means an RBC

report which has been adjusted by the Insurance Commissioner in

accordance with the provisions of subsection C of Section 39 of this

act;

2. “Corrective order” means an order issued by the Commissioner

specifying corrective actions which the Insurance Commissioner has

determined are required;

3. “Domestic health maintenance organization” means a health

maintenance organization domiciled in this state;

4. “Foreign health maintenance organization” means a health

maintenance organization that is licensed to do business in this

Oklahoma Statutes - Title 36. Insurance Page 1415

state under the Health Maintenance Organization Act of 2003, but is

not domiciled in this state;

5. “NAIC” means the National Association of Insurance

Commissioners;

6. “Health maintenance organization” means a health maintenance

organization licensed under the Health Maintenance Organization Act

of 2003. This definition does not include an organization that is

licensed as either a life and health insurer or a property and

casualty insurer under Title 36 of the Oklahoma Statutes and that is

otherwise subject to either life or property and casualty RBC

requirements;

7. “RBC instructions” means the RBC report including risk-based

capital instructions adopted by the NAIC, as these RBC instructions

may be amended by the NAIC from time to time in accordance with the

procedures adopted by the NAIC;

8. “RBC level” means a health maintenance organization’s

Company Action Level RBC, Regulatory Action Level RBC, Authorized

Control Level RBC, or Mandatory Control Level RBC where:

a. “Company Action Level RBC” means, with respect to any

health maintenance organization, the product of 2.0

and its Authorized Control Level RBC,

b. “Regulatory Action Level RBC” means the product of 1.5

and its Authorized Control Level RBC,

c. “Authorized Control Level RBC” means the number

determined under the risk-based capital formula in

accordance with the RBC instructions, or

d. “Mandatory Control Level RBC” means the product of .70

and the Authorized Control Level RBC;

9. “RBC plan” means a comprehensive financial plan containing

the elements specified in subsection B of Section 40 of this act.

If the Insurance Commissioner rejects the RBC plan, and it is

revised by the health maintenance organization, with or without the

Insurance Commissioner’s recommendation, the plan shall be called

the “revised RBC plan”;

10. “RBC report” means the report required in Section 39 of

this act; and

11. “Total adjusted capital” means the sum of:

a. a health maintenance organization’s statutory capital

and surplus, or its net worth, as determined in

accordance with the statutory accounting applicable to

the annual financial statements required to be filed

under Section 9 of this act, and

b. such other items, if any, as the RBC instructions may

provide.
Okla. Stat. tit. 36, § 36-2715.1 — OK Code / Title 36 / Section 36-2715.1
Conversion of fraternal benefit society into mutual
Status: in_force

life insurance company or stock legal reserve life insurance

company.

A. Any domestic fraternal benefit society may be converted and

licensed as a mutual life insurance company by compliance with all

the requirements of the general insurance laws for mutual life

insurance companies. A plan of conversion shall be prepared in

writing by the board of directors setting forth in full the terms

and conditions of conversion. The affirmative vote of two-thirds

(2/3) of all members of the supreme governing body at a regular or

special meeting shall be necessary for approval of the plan. No

conversion shall take effect unless and until approved by the

Insurance Commissioner who may give approval if the Commissioner

finds that the proposed change is in conformity with the

requirements of law and not prejudicial to the certificate holders

of the society.

B. Any domestic fraternal benefit society may be converted and

licensed as a stock legal reserve life insurance company by

compliance with all the requirements of the applicable provisions of

the Insurance Code if such plan of conversion has been approved by

the Commissioner. Such plan shall be prepared in writing setting

forth in full the terms and conditions thereof. The board of

Oklahoma Statutes - Title 36. Insurance Page 722

directors shall submit the plan to the supreme legislative or

governing body of the society at any regular or special meeting

thereof, by giving a full, true, and complete copy of the plan

together with notice of the meeting. The notice shall be given as

provided in the laws of the society for the convocation of a regular

or special meeting of the governing body, as the case may be. The

affirmative vote of two-thirds (2/3) of all members of the governing

body shall be necessary for the approval of the agreement. No

conversion shall take effect unless and until approved by the

Commissioner who may give approval if the Commissioner finds that

the proposed change is in conformity with the requirements of law

and not prejudicial to the certificate holders of the society. If

such fraternal benefit society is converted into a stock legal

reserve life insurance company, each and every certificate holder

shall be entitled to purchase that proportion of the total capital

stock of the company as the amount of his insurance in force bears

to the society's total insurance in force and outstanding at the

time the Commissioner approved the proposed plan of conversion.

Each certificate holder shall have the exclusive right to purchase

said stock within thirty (30) days after receiving notice from the

society of such right and the fact that the conversion has been

approved by the membership. Any stock not purchased by the

certificate holders may then be sold by the board of directors.Oklahoma Statutes - Title 36. Insurance Page 20

Oklahoma Statutes - Title 36. Insurance Page 21
Okla. Stat. tit. 36, § 36-6913 — OK Code / Title 36 / Section 36-6913
Minimum net worth required - Deposit with Insurance Commissioner - Determination of
Status: in_force

liabilities - Liability of subscriber for health maintenance organization's debts - Insolvency plan -Commissioner - Determination of liabilities - Liability of

subscriber for health maintenance organization's debts - Insolvency

plan - Notice of termination of agreement.

A. 1. Before issuing any certificate of authority, the

Insurance Commissioner shall require that the health maintenance

organization have an initial net worth of One Million Five Hundred

Thousand Dollars ($1,500,000.00) and that the HMO shall thereafter

maintain the minimum net worth required under paragraph 2 of this

subsection.

2. Except as provided in paragraphs 3 and 4 of this subsection,

every health maintenance organization shall maintain a minimum net

worth equal to the greater of:

a. One Million Five Hundred Thousand Dollars

($1,500,000.00),

b. two percent (2%) of annual premium revenues as

reported on the most recent annual financial statement

filed with the Commissioner on the first One Hundred

Fifty Million Dollars ($150,000,000.00) of premium and

one percent (1%) of annual premium on the premium in

excess of One Hundred Fifty Million Dollars

($150,000,000.00),

c. an amount equal to the sum of three (3) months of

uncovered health care expenditures as reported on the

most recent financial statement filed with the

Commissioner, or

d. an amount equal to the sum of:

(1) eight percent (8%) of annual health care

expenditures, except those paid on a capitated

basis or managed hospital payment basis, as

reported on the most recent financial statement

filed with the Commissioner, and

(2) four percent (4%) of annual hospital expenditures

paid on a managed hospital payment basis, as

reported on the most recent financial statement

filed with the Commissioner.

3. Every health maintenance organization licensed before

November 1, 2003, shall maintain a minimum net worth of the greater

of Seven Hundred Fifty Thousand Dollars ($750,000.00) or:

a. twenty-five percent (25%) of the amount required by

paragraph 2 of this subsection by December 31, 2003,

b. fifty percent (50%) of the amount required by

paragraph 2 of this subsection by December 31, 2004,

c. seventy-five percent (75%) of the amount required by

paragraph 2 of this subsection by December 31, 2005,

and

Oklahoma Statutes - Title 36. Insurance Page 1397

d. one hundred percent (100%) of the amount required by

paragraph 2 of this subsection by December 31, 2006.

4. a. In determining net worth, no debt shall be considered

fully subordinated unless the subordination clause is

in a form acceptable to the Commissioner. An interest

obligation relating to the repayment of any

subordinated debt shall be similarly subordinated.

b. The interest expenses relating to the repayment of a

fully subordinated debt shall be considered covered

expenses.

c. A debt incurred by a note meeting the requirements of

this section, and otherwise acceptable to the

Insurance Commissioner, shall not be considered a

liability and shall be recorded as equity.

B. 1. Unless otherwise provided below, each health maintenance

organization shall deposit with the Commissioner or, at the

discretion of the Commissioner, with any organization or trustee

acceptable to the Commissioner through which a custodial or

controlled account is utilized, cash, securities, or any combination

of these or other measures that are acceptable to the Commissioner,

which at all times shall have a value of not less than Five Hundred

Thousand Dollars ($500,000.00).

2. The deposit shall be an admitted asset of the health

maintenance organization in the determination of net worth.

3. All income from deposits shall be an asset of the

organization. A health maintenance organization that has made a

securities deposit may withdraw that deposit or any part thereof

after making a substitute deposit of cash, securities, or any

combination of these or other measures of equal amount and value.

Any securities shall be approved by the Commissioner before being

deposited or substituted.

4. The deposit shall be used to protect the interests of the

health maintenance organization's enrollees and to ensure

continuation of health care services to enrollees. If a health

maintenance organization is placed in receivership or liquidation,

the deposit shall be an asset subject to the provisions of the

Uniform Insurers Liquidation Act.

5. The Insurance Commissioner may reduce or eliminate the

deposit requirement if a health maintenance organization deposits

with the Commissioner or other official body of the state or

jurisdiction of domicile for the protection of all subscribers and

enrollees of the health maintenance organization, wherever located,

cash, acceptable securities or surety, and delivers to the

Commissioner a certificate to that effect, duly authenticated by the

appropriate state official holding the deposit.

Oklahoma Statutes - Title 36. Insurance Page 1398

C. 1. Every health maintenance organization shall, when

determining liabilities, include an amount estimated in the

aggregate to provide for:

a. any unearned premium,

b. the payment of all claims for incurred health care

expenditures, whether reported or unreported, that are

unpaid and for which the organization is or may be

liable, and

c. the expense of adjustment or settlement of those

claims.

2. The liabilities shall be computed in accordance with rules

promulgated by the Commissioner upon reasonable consideration of the

ascertained experience and character of the health maintenance

organization.

D. 1. Every contract between a health maintenance organization

and a participating provider of health care services shall be in

writing and shall provide that, in the event the health maintenance

organization fails to pay for health care services as set forth in

the contract, a subscriber or an enrollee shall not be liable to the

provider for any sums owed by the health maintenance organization.

2. In the event that the participating provider contract has

not been reduced to writing as required by this subsection or that

the contract fails to contain the required prohibition, the

participating provider shall not collect or attempt to collect from

a subscriber or an enrollee sums owed by the health maintenance

organization.

3. No participating provider or the provider's agent, trustee

or assignee may maintain an action at law against a subscriber or

enrollee to collect sums owed by the health maintenance

organization.

E. The Commissioner shall require that each health maintenance

organization have a plan for handling insolvency that allows for

continuation of benefits for the duration of the contract period for

which premiums have been paid and continuation of benefits to

subscribers or enrollees who are confined on the date of insolvency

in an inpatient facility until their discharge or expiration of

benefits. In considering such a plan, the Commissioner may require:

1. Insurance to cover the expenses to be paid for continued

benefits after an insolvency;

2. Provisions in provider contracts that obligate the provider

to provide services for the duration of the period after the health

maintenance organization's insolvency for which premium payment has

been made and until the enrollees' discharge from inpatient

facilities;

3. Insolvency reserves;

4. Acceptable letters of credit; or

Oklahoma Statutes - Title 36. Insurance Page 1399

5. Any other arrangements to ensure continuation of benefits as

specified above.

F. An agreement to provide health care services between a

provider and a health maintenance organization shall require that if

the provider terminates the agreement, the provider shall give the

organization at least ninety (90) days' advance notice of such

termination.
Okla. Stat. tit. 36, § 36-1250.17 — OK Code / Title 36 / Section 36-1250.17
Nonemergency patient form - Perjury
Status: in_force

The Insurance Commissioner shall develop, by rule, a form to be

presented to patients by health care providers prior to rendering

nonemergency services. The form shall be designed to seek

information from the patient to further determine the eligibility of

the patient for benefits under the patient’s insurance policy.

Making false statements on the form shall be regarded as willful

misrepresentation.
Okla. Stat. tit. 36, § 36-6944 — OK Code / Title 36 / Section 36-6944
Challenge of determination or action by Insurance
Status: in_force

Commissioner - Required events - Hearing.

Upon the occurrence of any of the events specified in this

section, the health maintenance organization shall have the right to

a confidential departmental hearing, on the record, at which time

the health maintenance organization may challenge any determination

or action by the Insurance Commissioner. The health maintenance

organization shall notify the Commissioner of its request for a

hearing within five (5) days after the notification by the

Commissioner pursuant to the provisions of paragraph 1, 2, 3 or 4 of

this section. Upon receipt of the health maintenance organization’s

request for a hearing, the Commissioner shall set a date for the

hearing, which shall be not less than ten (10), nor more than thirty

(30) days after the date of the health maintenance organization’s

request. The events include:

1. Notification to a health maintenance organization by the

Commissioner of an adjusted Risk-Based Capital (RBC) report;

2. Notification to a health maintenance organization by the

Commissioner that:

a. the health maintenance organization’s RBC plan or

revised RBC plan is unsatisfactory, and

b. notification constitutes a Regulatory Action Level

Event with respect to the health maintenance

organization;

3. Notification to a health maintenance organization by the

Commissioner that the health maintenance organization has failed to

adhere to its RBC plan or revised RBC plan and that the failure has

a substantial adverse effect on the ability of the health

maintenance organization to eliminate the Company Action Level Event

with respect to the health maintenance organization in accordance

with its RBC plan or revised RBC plan; or

4. Notification to a health maintenance organization by the

Commissioner of a corrective order with respect to the health

maintenance organization.
Okla. Stat. tit. 36, § 36-622 — OK Code / Title 36 / Section 36-622
Manner of service of process
Status: in_force

A. Triplicate copies of legal process against an insurer for

whom the Insurance Commissioner is agent shall be served upon the

Commissioner at the principal offices of the Insurance Department.

When legal process against an insurer for whom the Insurance

Commissioner is agent is issued, it shall be served in triplicate by

any manner now provided by law or in lieu thereof by mailing

triplicate copies of such legal process in the United States mails

with postage prepaid to the Insurance Commissioner with return

receipt requested, in which event service shall be sufficient upon

showing of proof of mailing to the Commissioner with the return

receipt attached. At the time of service the plaintiff shall pay to

the Insurance Commissioner Twenty Dollars ($20.00), taxable as costs

in the action. Upon receiving service, the Insurance Commissioner

shall promptly forward a copy thereof by mail with return receipt

requested to the person last so designated by the insurer to receive

the same.

B. Process served upon the Insurance Commissioner and copy

thereof forwarded as provided in this section shall constitute

service upon the insurer.
Okla. Stat. tit. 36, § 36-7128 — OK Code / Title 36 / Section 36-7128
Annual report - Filing fee - Failure to file
Status: in_force

Each organization shall electronically file an annual report

with the Insurance Commissioner on or before March 15 of each year

in the manner and form as the Commissioner may require, showing the

name of the financial institution holding the cemetery merchandise

trust fund and the amount of the trust fund under each contract on

the preceding December 31, and also showing the method of

determination of the wholesale costs made pursuant to Section 7126

of this title. The total required deposits to the cemetery

merchandise trust fund during the year shall also be reported. Each

cemetery is responsible for maintaining satisfactory books and

records, which will adequately justify all information contained in

the annual report required by this section. Any organization which

has discontinued the sale of prepaid cemetery merchandise, but which

still has funds deposited in a cemetery merchandise trust fund or

surety, shall not be required to obtain a renewal of its permit, but

it shall continue to make annual reports to the Commissioner until

all the funds have been disbursed pursuant to the Cemetery

Oklahoma Statutes - Title 36. Insurance Page 1495

Merchandise Trust Act. A filing fee of Two Hundred Dollars

($200.00), along with any applicable transaction or other fees,

shall accompany each report. If any officer of any organization

fails or refuses to file an annual report, or fails or refuses to

cause it to be filed within thirty (30) days after the organization

has been notified by the Commissioner that the report is due and has

not been received, the officer shall be guilty of a misdemeanor and

shall be punished as prescribed in Section 7134 of this title.
Okla. Stat. tit. 36, § 36-2723.1 — OK Code / Title 36 / Section 36-2723.1
Exemptions
Status: in_force

The provisions of this act apply only to fraternal benefit

societies, and societies shall be governed by this act to the extent

provided herein. Societies shall be exempt from all other

provisions of the insurance laws of this state except that the

provisions of Article 1 (Scope of Title), Article 3 (Insurance

Department and Insurance Commissioner), Sections 606, 610, 612.1,

616, 617, 620 and 628 of Article 6 (Authorization of Insurers and

General Requirements), Article 16 (Investments), Article 17

(Administration of Deposits), and Article 19 (Rehabilitation and

Liquidation), of the Insurance Code, shall apply to societies to the

extent that such provisions are not in conflict with the provisions

of this article. No law relating to insurance hereafter enacted

shall apply to societies unless they are expressly designated

therein.
Okla. Stat. tit. 36, § 36-6050 — OK Code / Title 36 / Section 36-6050
Prepaid or discounted ambulance service membership
Status: in_force

subscriptions.

All persons, companies, governmental entities or trust

authorities operating an ambulance service within this state may

sell prepaid or discounted ambulance service membership

subscriptions to individuals who reside within its authorized

service area in exchange for payment of an annual membership fee.

The agreement between the ambulance service and an individual shall

not be deemed to be insurance and shall expressly provide for the

assignment of insurance benefits directly to the ambulance service.

Under such assignment, the insurer shall be obligated directly to

the ambulance service for the lesser of the full and customary

charge by the ambulance service or the designated or allowable

amount set forth by the insurance policy for any services actually

rendered to the individual by the ambulance service during the

membership year less any applicable deductible or copayment.
Okla. Stat. tit. 36, § 36-1639 — OK Code / Title 36 / Section 36-1639
Group-wide supervisor for any internationally active
Status: in_force

insurance group.

A. The Commissioner is authorized to act as the group-wide

supervisor for any internationally active insurance group in

accordance with the provisions of this section. However, the

Commissioner may otherwise acknowledge another regulatory official

as the group-wide supervisor where the internationally active

insurance group:

1. Does not have substantial insurance operations in the United

States;

2. Has substantial insurance operations in the United States,

but not in this state; or

3. Has substantial insurance operations in the United States

and this state, but the Commissioner has determined pursuant to the

factors set forth in subsections B and F of this section that the

other regulatory official is the appropriate group-wide supervisor.

An insurance holding company system that does not otherwise qualify

as an internationally active insurance group may request that the

Commissioner make a determination or acknowledgment as to a group-

wide supervisor pursuant to this section.

B. In cooperation with other state, federal and international

regulatory agencies, the Commissioner will identify a single group-

wide supervisor for an internationally active insurance group. The

Commissioner may determine that the Commissioner is the appropriate

group-wide supervisor for an internationally active insurance group

that conducts substantial insurance operations concentrated in this

state. However, the Commissioner may acknowledge that a regulatory

official from another jurisdiction is the appropriate group-wide

supervisor for the internationally active insurance group. The

Commissioner shall consider the following factors when making a

determination or acknowledgment under this subsection:

1. The place of domicile of the insurers within the

internationally active insurance group that hold the largest share

of the group's written premiums, assets or liabilities;

Oklahoma Statutes - Title 36. Insurance Page 481

2. The place of domicile of the top-tiered insurer or insurers

in the insurance holding company system of the internationally

active insurance group;

3. The location of the executive offices or largest operational

offices of the internationally active insurance group;

4. Whether another regulatory official is acting or is seeking

to act as the group-wide supervisor under a regulatory system that

the Commissioner determines to be:

a. substantially similar to the system of regulation

provided under the laws of this state, or

b. otherwise sufficient in terms of providing for group-

wide supervision, enterprise risk analysis, and

cooperation with other regulatory officials; and

5. Whether another regulatory official acting or seeking to act

as the group-wide supervisor provides the Commissioner with

reasonably reciprocal recognition and cooperation. However, a

Commissioner identified under this section as the group-wide

supervisor may determine that it is appropriate to acknowledge

another supervisor to serve as the group-wide supervisor. The

acknowledgment of the group-wide supervisor shall be made after

consideration of the factors listed in this paragraph and paragraphs

1 through 4 of this subsection, and shall be made in cooperation

with and subject to the acknowledgment of other regulatory officials

involved with supervision of members of the internationally active

insurance group, and in consultation with the internationally active

insurance group.

C. Notwithstanding any other provision of law, when another

regulatory official is acting as the group-wide supervisor of an

internationally active insurance group, the Commissioner shall

acknowledge that regulatory official as the group-wide supervisor.

However, in the event of a material change in the internationally

active insurance group that results in:

1. The internationally active insurance group's insurers

domiciled in this state holding the largest share of the group's

premiums, assets or liabilities; or

2. This state being the place of domicile of the top-tiered

insurer or insurers in the insurance holding company system of the

internationally active insurance group,

the Commissioner shall make a determination or acknowledgment as to

the appropriate group-wide supervisor for such an internationally

active insurance group pursuant to subsection B of this section.

D. Pursuant to Section 7 of this act, the Commissioner is

authorized to collect from any insurer registered pursuant to

Section 5 of this act all information necessary to determine whether

the Commissioner may act as the group-wide supervisor of an

internationally active insurance group or if the Commissioner may

acknowledge another regulatory official to act as the group-wide

Oklahoma Statutes - Title 36. Insurance Page 482

supervisor. Prior to issuing a determination that an

internationally active insurance group is subject to group-wide

supervision by the Commissioner, the Commissioner shall notify the

insurer registered pursuant to Section 5 and the ultimate

controlling person within the internationally active insurance

group. The internationally active insurance group shall have not

less than thirty (30) days to provide the Commissioner with

additional information pertinent to the pending determination. The

Commissioner shall publish on its Internet website the identity of

internationally active insurance groups that the Commissioner has

determined are subject to group-wide supervision by the

Commissioner.

E. If the Commissioner is the group-wide supervisor for an

internationally active insurance group, the Commissioner is

authorized to engage in any of the following group-wide supervision

activities:

1. Assess the enterprise risks within the internationally

active insurance group to ensure that:

a. the material financial condition and liquidity risks

to the members of the internationally active insurance

group that are engaged in the business of insurance

are identified by management, and

b. reasonable and effective mitigation measures are in

place;

2. Request, from any member of an internationally active

insurance group subject to the Commissioner's supervision,

information necessary and appropriate to assess enterprise risk,

including, but not limited to, information about the members of the

internationally active insurance group regarding:

a. governance, risk assessment and management,

b. capital adequacy, and

c. material intercompany transactions;

3. Coordinate and, through the authority of the regulatory

officials of the jurisdictions where members of the internationally

active insurance group are domiciled, compel development and

implementation of reasonable measures designed to ensure that the

internationally active insurance group is able to timely recognize

and mitigate enterprise risks to members of such internationally

active insurance group that are engaged in the business of

insurance;

4. Communicate with other state, federal and international

regulatory agencies for members within the internationally active

insurance group and share relevant information subject to the

confidentiality provisions of Section 10 of this act, through

supervisory colleges as set forth in Section 8 of this act or

otherwise;

Oklahoma Statutes - Title 36. Insurance Page 483

5. Enter into agreements with or obtain documentation from any

insurer registered under Section 5 of this act, any member of the

internationally active insurance group, and any other state, federal

and international regulatory agencies for members of the

internationally active insurance group, providing the basis for or

otherwise clarifying the Commissioner's role as group-wide

supervisor, including provisions for resolving disputes with other

regulatory officials. Such agreements or documentation shall not

serve as evidence in any proceeding that any insurer or person

within an insurance holding company system not domiciled or

incorporated in this state is doing business in this state or is

otherwise subject to jurisdiction in this state; and

6. Other group-wide supervision activities, consistent with the

authorities and purposes enumerated above, as considered necessary

by the Commissioner.

F. If the Commissioner acknowledges that another regulatory

official from a jurisdiction that is not accredited by the National

Association of Insurance Commissioners is the group-wide supervisor,

the Commissioner is authorized to reasonably cooperate, through

supervisory colleges or otherwise, with group-wide supervision

undertaken by the group-wide supervisor, provided that:

1. The Commissioner's cooperation is in compliance with the

laws of this state; and

2. The regulatory official acknowledged as the group-wide

supervisor also recognizes and cooperates with the Commissioner's

activities as a group-wide supervisor for other internationally

active insurance groups where applicable. Where such recognition

and cooperation is not reasonably reciprocal, the Commissioner is

authorized to refuse recognition and cooperation.

G. The Commissioner is authorized to enter into agreements with

or obtain documentation from any insurer registered under Section 5

of this act, any affiliate of the insurer, and other state, federal

and international regulatory agencies for members of the

internationally active insurance group, that provide the basis for

or otherwise clarify a regulatory official's role as group-wide

supervisor.

H. The Commissioner may promulgate regulations necessary for

the administration of this section.

I. A registered insurer subject to this section shall be liable

for and shall pay the reasonable expenses of the Commissioner's

participation in the administration of this section, including the

engagement of attorneys, actuaries and any other professionals and

all reasonable travel expenses.
Okla. Stat. tit. 36, § 36-4055.5 — OK Code / Title 36 / Section 36-4055.5
Filing of forms - Disapproval by Commissioner
Status: in_force

A person shall not use a viatical settlement contract form or

provide to a viator a disclosure statement form in this state unless

first filed with and approved by the Insurance Commissioner. The

Commissioner shall disapprove a viatical settlement contract form or

Oklahoma Statutes - Title 36. Insurance Page 877

disclosure statement form if, in the Commissioner’s opinion, the

contract or provisions contained therein fail to meet the

requirements of Sections 8, 9 and 12 and subsection B of Section 13

of this act or are unreasonable, contrary to the interests of the

public, or otherwise misleading or unfair to the viator. At the

Commissioner’s discretion, the Commissioner may require the

submission of advertising material.
Okla. Stat. tit. 36, § 36-3624.3 — OK Code / Title 36 / Section 36-3624.3
Direct payments to Department for reimbursement of
Status: in_force

medical assistance - Notice of claim - Discharge of obligation.

A. Notwithstanding the provisions of Section 3624 of this

title, whenever an insurer who has not discharged its obligation to

make payments to an individual for medical services, and if that

individual has received medical assistance from the Department of

Human Services, then the insurer, upon notice that medical

assistance has been furnished, shall make its payments directly to

the Department of Human Services, but not to exceed the amount of

medical assistance paid by the Department of Human Services or

medical service rendered by the Department.

B. Provided further, and notwithstanding the provisions of

Section 3626 of this title, any insurer who, after having been put

on notice of payment of a medical claim or claims or the rendering

of medical services by the Department of Human Services, and in

disregard of said notice, subsequently makes payments on the same

claim or claims to persons or entities other than the Department of

Human Services shall not be discharged from payment to the

Department of Human Services in the sum and amount claimed by the

Department. Payment to the Department by the insurer under the

provisions of this section shall discharge the insurer's obligation

with respect to all further payment on the claim or claims for the

amount paid.

Oklahoma Statutes - Title 36. Insurance Page 796

C. Provided, further, that the notice requirements of this act

are satisfied (1) when the insurer receives a copy of the claims

paid or medical services rendered by the Department of Human

Services together with a request for reimbursement by certified or

registered mail, or (2) when the insurer receives a claim from a

beneficiary containing information to the effect that the

beneficiary has applied for or has received medical assistance from

the Department of Human Services in connection with the same claim

as set forth in Section 3 of this act.

The insurer who receives such claim shall notify the Department

of Human Services of its obligation on such claim and shall pay the

obligation to the provider of service or if the Department of Human

Services has provided medical assistance thereon, pay the Department

of Human Services.Oklahoma Statutes - Title 36. Insurance Page 23
Okla. Stat. tit. 36, § 36-6475.8 — OK Code / Title 36 / Section 36-6475.8
Receipt of request for external review
Status: in_force

A. 1. Within four (4) months after the date of receipt of a

notice of an adverse determination or final adverse determination

pursuant to Section 6475.5 of this title, a covered person or the

covered person's authorized representative may file a request for an

external review with the Insurance Commissioner.

2. Within one (1) business day after the date of receipt of a

request for external review pursuant to paragraph 1 of this

subsection, the Commissioner shall send a copy of the request to the

health carrier.

B. Within five (5) business days following the date of receipt

of the copy of the external review request from the Commissioner

under paragraph 2 of subsection A of this section, the health

carrier shall complete a preliminary review of the request to

determine whether:

1. The individual is or was a covered person in the health

benefit plan at the time the health care service was requested or,

in the case of a retrospective review, was a covered person in the

Oklahoma Statutes - Title 36. Insurance Page 1246

health benefit plan at the time the health care service was

provided;

2. The health care service that is the subject of the adverse

determination or the final adverse determination is a covered

service under the covered person's health benefit plan, but for a

determination by the health carrier that the health care service is

not covered because it does not meet the health carrier's

requirements for medical necessity, appropriateness, health care

setting, level of care or effectiveness;

3. The covered person has exhausted the health carrier's

internal grievance process unless the covered person is not required

to exhaust the health carrier's internal grievance process pursuant

to Section 6475.7 of this title; and

4. The covered person has provided all the information and

forms required to process an external review including the release

form provided under subsection B of Section 6475.5 of this title.

C. 1. Within one (1) business day after completion of the

preliminary review, the health carrier shall notify the Commissioner

and covered person and, if applicable, the covered person's

authorized representative in writing whether:

a. the request is complete, and

b. the request is eligible for external review.

2. If the request:

a. is not complete, the health carrier shall inform the

covered person and, if applicable, the covered

person's authorized representative and the

Commissioner in writing and include in the notice what

information or materials are needed to make the

request complete, or

b. is not eligible for external review, the health

carrier shall inform the covered person, if

applicable, the covered person's authorized

representative and the Commissioner in writing and

include in the notice the reasons for its

ineligibility.

3. a. The Commissioner may specify the form for the health

carrier's notice of initial determination under this

subsection and any supporting information to be

included in the notice.

b. The notice of initial determination shall include a

statement informing the covered person and, if

applicable, the covered person's authorized

representative that a health carrier's initial

determination that the external review request is

ineligible for review may be appealed to the

Commissioner.

Oklahoma Statutes - Title 36. Insurance Page 1247

4. a. The Commissioner may determine that a request is

eligible for external review under subsection B of

this section notwithstanding a health carrier's

initial determination that the request is ineligible

and require that it be referred for external review.

b. In making a determination under subparagraph a of this

paragraph, the Commissioner's decision shall be made

in accordance with the terms of the covered person's

health benefit plan and shall be subject to all

applicable provisions of the Uniform Health Carrier

External Review Act.

D. 1. Whenever the Commissioner receives a notice that a

request is eligible for external review following the preliminary

review conducted pursuant to subsection C of this section, within

one (1) business day after the date of receipt of the notice, the

Commissioner shall:

a. assign an independent review organization from the

list of approved independent review organizations

compiled and maintained by the Commissioner pursuant

to Section 6475.12 of this title to conduct the

external review and notify the health carrier of the

name of the assigned independent review organization,

and

b. notify in writing the covered person and, if

applicable, the covered person's authorized

representative of the request's eligibility and

acceptance for external review.

2. In reaching a decision, the assigned independent review

organization shall not be bound by any decisions or conclusions

reached during the health carrier's utilization review process as

set forth in Sections 6551 through 6555 of this title or the health

carrier's internal grievance process.

3. The Commissioner shall include in the notice provided to the

covered person and, if applicable, the covered person's authorized

representative a statement that the covered person or the covered

person's authorized representative may submit in writing to the

assigned independent review organization within five (5) business

days following the date of receipt of the notice provided pursuant

to paragraph 1 of this subsection additional information that the

independent review organization shall consider when conducting the

external review. The independent review organization is not

required to, but may, accept and consider additional information

submitted after five (5) business days.

E. 1. Within five (5) business days after the date of receipt

of the notice provided pursuant to paragraph 1 of subsection D of

this section, the health carrier or its designee utilization review

organization shall provide to the assigned independent review

Oklahoma Statutes - Title 36. Insurance Page 1248

organization the documents and any information considered in making

the adverse determination or final adverse determination.

2. Except as provided in paragraph 3 of this subsection,

failure by the health carrier or its utilization review organization

to provide the documents and information within the time specified

in paragraph 1 of this subsection shall not delay the conduct of the

external review.

3. a. If the health carrier or its utilization review

organization fails to provide the documents and

information within the time specified in paragraph 1

of this subsection, the assigned independent review

organization may terminate the external review and

make a decision to reverse the adverse determination

or final adverse determination.

b. Within one (1) business day after making the decision

under subparagraph a of this paragraph, the

independent review organization shall notify the

covered person, if applicable, the covered person's

authorized representative, the health carrier, and the

Commissioner.

F. 1. The assigned independent review organization shall

review all of the information and documents received pursuant to

subsection E of this section and any other information submitted in

writing to the independent review organization by the covered person

or the covered person's authorized representative pursuant to

paragraph 3 of subsection D of this section.

2. Upon receipt of any information submitted by the covered

person or the covered person's authorized representative pursuant to

paragraph 3 of subsection D of this section, the assigned

independent review organization shall within one (1) business day

forward the information to the health carrier.

G. 1. Upon receipt of the information, if any, required to be

forwarded pursuant to paragraph 2 of subsection F of this section,

the health carrier may reconsider its adverse determination or final

adverse determination that is the subject of the external review.

2. Reconsideration by the health carrier of its adverse

determination or final adverse determination pursuant to paragraph 1

of this subsection shall not delay or terminate the external review.

3. The external review may only be terminated if the health

carrier decides, upon completion of its reconsideration, to reverse

its adverse determination or final adverse determination and provide

coverage or payment for the health care service that is the subject

of the adverse determination or final adverse determination.

4. a. Within one (1) business day after making the decision

to reverse its adverse determination or final adverse

determination, as provided in paragraph 3 of this

subsection, the health carrier shall notify the

Oklahoma Statutes - Title 36. Insurance Page 1249

covered person, if applicable, the covered person's

authorized representative, the assigned independent

review organization, and the Commissioner in writing

of its decision.

b. The assigned independent review organization shall

terminate the external review upon receipt of the

notice from the health carrier sent pursuant to

subparagraph a of this paragraph.

H. In addition to the documents and information provided

pursuant to subsection E of this section, the assigned independent

review organization, to the extent the information or documents are

available and the independent review organization considers them

appropriate, shall consider the following in reaching a decision:

1. The covered person's medical records;

2. The attending health care professional's recommendation;

3. Consulting reports from appropriate health care

professionals and other documents submitted by the health carrier,

covered person, the covered person's authorized representative, or

the covered person's treating provider;

4. The terms of coverage under the covered person's health

benefit plan with the health carrier to ensure that the independent

review organization's decision is not contrary to the terms of

coverage under the covered person's health benefit plan with the

health carrier;

5. The most appropriate practice guidelines, which shall

include applicable evidence-based standards and may include any

other practice guidelines developed by the federal government,

national or professional medical societies, boards and associations;

6. Any applicable clinical review criteria developed and used

by the health carrier or its designee utilization review

organization; and

7. The opinion of the independent review organization's

clinical reviewer or reviewers after considering paragraphs 1

through 6 of this subsection to the extent the information or

documents are available and the clinical reviewer or reviewers

consider appropriate.

I. 1. Within forty-five (45) days after the date of receipt of

the request for an external review, the assigned independent review

organization shall provide written notice of its decision to uphold

or reverse the adverse determination or the final adverse

determination to:

a. the covered person,

b. if applicable, the covered person's authorized

representative,

c. the health carrier, and

d. the Commissioner.

Oklahoma Statutes - Title 36. Insurance Page 1250

2. The independent review organization shall include in the

notice sent pursuant to paragraph 1 of this subsection:

a. a general description of the reason for the request

for external review,

b. the date the independent review organization received

the assignment from the Commissioner to conduct the

external review,

c. the date the external review was conducted,

d. the date of its decision,

e. the principal reason or reasons for its decision

including what applicable, if any, evidence-based

standards were a basis for its decision,

f. the rationale for its decision, and

g. references to the evidence or documentation including

the evidence-based standards, considered in reaching

its decision.

3. Upon receipt of a notice of a decision pursuant to paragraph

1 of this subsection reversing the adverse determination or final

adverse determination, the health carrier immediately shall approve

the coverage that was the subject of the adverse determination or

final adverse determination.

J. The assignment by the Commissioner of an approved

independent review organization to conduct an external review in

accordance with this section shall be done on a random basis among

those approved independent review organizations qualified to conduct

the particular external review based on the nature of the health

care service that is the subject of the adverse determination or

final adverse determination and other circumstances including

conflict of interest concerns pursuant to subsection D of Section

6475.13 of this title.
Okla. Stat. tit. 36, § 36-4504 — OK Code / Title 36 / Section 36-4504
Blanket accident and health insurance
Status: in_force

A. Blanket accident and health insurance is hereby declared to

be that form of accident and health insurance covering special

groups of persons as enumerated in one of the following paragraphs

(1) to (7) inclusive:

Oklahoma Statutes - Title 36. Insurance Page 984

1. Under a policy or contract issued to any common carrier,

which shall be deemed the policyholder, covering a group defined as

all persons who may become passengers on such common carrier.

2. Under a policy or contract issued to an employer, who shall

be deemed the policyholder, covering all employees or any group of

employees defined by reference to exceptional hazards incident to

such employment. Dependents of the employees and guests of the

employer may also be included where exposed to the same hazards.

3. Under a policy or contract issued to a college, school, or

other institution of learning or to the head or principal thereof,

who or which shall be deemed the policyholder, covering students or

teachers.

4. Under a policy or contract issued in the name of any

volunteer fire department, first aid, or other such volunteer group,

or agency having jurisdiction thereof, which shall be deemed the

policyholder, covering all of the members of such fire department or

group.

5. Under a policy or contract issued to a creditor, who shall

be deemed the policyholder, to insure debtors of the creditor.

6. Under a policy or contract issued to a sports team or to a

camp or sponsor thereof, which shall be deemed the policyholder,

covering members or campers.

7. Under a policy or contract issued to any other substantially

similar group which, in the discretion of the Insurance

Commissioner, may be subject to the issuance of a blanket accident

and health policy or contract.

B. An individual application need not be required from a person

covered under a blanket accident and health policy or contract, nor

shall it be necessary for the insurer to furnish each person a

certificate.

C. All benefits under any blanket accident and health policy

shall be payable to the person insured, or to his designated

beneficiary or beneficiaries, or to his estate, except that if the

person insured be a minor, such benefits may be made payable to his

parent, guardian, or other person actually supporting him; except,

that the policy may provide that subject to any written direction of

the insured in the application or otherwise, all or any portion of

any indemnities provided by any such policy on account of hospital,

nursing, medical or surgical services may, at the insurer's option

and unless the insured requests otherwise not later than the time of

filing proofs of such loss, be paid directly to the hospital or

person rendering such services, but the policy may not require that

the service be rendered by a particular hospital or person. Payments

so made shall discharge the insurer's obligation with respect to the

amount of insurance so paid.

Oklahoma Statutes - Title 36. Insurance Page 985

D. Nothing contained in this section shall be deemed to affect

the legal liability of policyholders for the death of or injury to

any such member of such group.
Okla. Stat. tit. 36, § 36-404 — OK Code / Title 36 / Section 36-404
Business of insurance
Status: in_force

Any one of the following acts in this state affected by mail or

otherwise is defined to be doing the business of insurance in this

state:

1. The making of or proposing to make, as an insurer, an

insurance contract;

2. The making of or proposing to make, as guarantor or surety,

any contract of guaranty or suretyship as a vocation and not merely

incidental to any other legitimate business or activity of the

guarantor or surety;

3. The taking or receiving of any application for insurance;

4. Maintaining any agency or office where any acts in

furtherance of an insurance business are transacted, including but

not limited to:

a. the execution of contracts of insurance with citizens

of this or any other state,

b. maintaining files or records of contracts of

insurance,

c. the processing of claims, and

d. the receiving or collection of any premiums,

commissions, membership fees, assessments, dues or

other consideration for any insurance or any part

thereof;

Oklahoma Statutes - Title 36. Insurance Page 119

5. The issuance or delivery of contracts of insurance to

residents of this state or to persons authorized to do business in

this state;

6. Directly or indirectly acting as an agent for, or otherwise

representing or aiding on behalf of another, any person or insurer

in:

a. the solicitation, negotiation, procurement or

effectuation of insurance or renewals thereof,

b. the dissemination of information as to coverage or

rates, or forwarding of applications, or delivery of

policies or contracts,

c. inspection of risks,

d. fixing of rates or investigation or adjustment of

claims or losses,

e. the transaction of matters subsequent to effectuation

of the contract and arising out of it, or

f. in any other manner representing or assisting a person

or insurer in the transaction of insurance with

respect to subjects of insurance resident, located or

to be performed in this state.

Provided, the provisions of this paragraph shall not operate to

prohibit full-time salaried employees of a corporate insured from

acting in the capacity of an insurance manager or buyer in placing

insurance on behalf of such employer;

7. Contracting to provide indemnification or expense

reimbursement in this state to persons domiciled in this state or

for risks located in this state, whether as an insurer, agent,

administrator, trust, funding mechanism, or by any other method, for

any type of medical expenses including, but not limited to,

surgical, chiropractic, physical therapy, speech pathology,

audiology, professional mental health, dental, hospital, or

optometric expenses, whether this coverage is by direct payment,

reimbursement, or otherwise;

8. The doing of any kind of insurance business specifically

recognized as constituting the doing of an insurance business within

the meaning of the statutes relating to insurance;

9. Ownership in whole or in part, directly or indirectly, of

any entity involved in the business of insurance;

10. Acquiring or assisting others in the acquisition or

attempted acquisition of any entity involved in the business of

insurance;

11. Possessing a license, registration or permit issued or

approved by the Insurance Commissioner;

12. Any other transactions of business in this state by an

insurance company, producer, title insurance producer, adjuster,

third-party administrator, service warranty association, title

Oklahoma Statutes - Title 36. Insurance Page 120

insurer or any other person that is licensed by or registered with

the Insurance Commissioner; or

13. The doing of or proposing to do any insurance business in

substance equivalent to any of the foregoing in a manner designed to

evade the provisions of the statutes.
Okla. Stat. tit. 36, § 36-632 — OK Code / Title 36 / Section 36-632
Certain entities subject to jurisdiction of Insurance
Status: in_force

Commissioner and Oklahoma Insurance Code - Exemptions.

A. Unless otherwise provided for by law or exempted by the

provisions of this section, any person or other entity which

provides coverage in this state for medical, surgical, chiropractic,

physical therapy, speech pathology, audiology, professional mental

health, dental, hospital, or ophthalmologic expenses, whether

coverage is by direct payment, reimbursement, or other means, shall

be presumed to be subject to the jurisdiction of the Insurance

Commissioner unless the person or other entity shows that while

providing coverage the person or entity is subject to the

jurisdiction of another agency of this or another state, any

subdivision of this state, or the federal government, or provides a

plan of self-insurance or other employee welfare benefit program for

an individual employer or labor union maintained pursuant to a

collective bargaining agreement or other arrangement which provides

for health care services solely for its employees or members and

their dependents.

B. A person or entity may show that it is subject to the

jurisdiction of another agency of this or another state, any

subdivision of this state, or the federal government by providing to

the Insurance Commissioner the certificate, license, or other

document issued by the other governmental agency which permits or

qualifies the person or entity to provide those services.

Oklahoma Statutes - Title 36. Insurance Page 154

C. Any person or entity which is unable to show that it is

subject to the jurisdiction of another agency of this or another

state, any subdivision of this state, or the federal government, or

provides an employee welfare benefit program for an individual

employer or labor union as provided for in subsection A of this

section, shall submit to an examination by the Insurance

Commissioner to determine the organization and solvency of the

person or entity, and to determine whether or not the person or

entity is in compliance with applicable provisions of the Oklahoma

Insurance Code, Section 101 et seq. of this title.

D. Any person or entity unable to show that it is subject to

the jurisdiction of another agency of this or another state, any

subdivision of this state, or the federal government, or provides an

employee welfare benefit program for an individual employer or labor

union as provided for in subsection A of this section, shall be

subject to all appropriate provisions of the Oklahoma Insurance Code

regarding the conduct of its business.

1. Any agent, broker, administrator, or other person or company

which advertises, solicits, negotiates, procures, sells, renews,

continues, or administers coverage in this state which is provided

by any person or entity specified in subsection C of this section

for expenses specified in subsection A of this section shall advise

any purchaser, prospective purchaser, and covered person of the lack

of insurance or other coverage, if the coverage for expenses

specified in subsection A of this section is not fully insured or

otherwise fully covered by a company authorized to do such business

in this state; and

2. Any administrator who advertises or administers coverage in

this state which is provided by any person or entity specified in

subsection C of this section for expenses specified in subsection A

of this section shall advise any agent, broker, or other person or

company which advertises, solicits, negotiates, sells, procures,

renews, or continues said coverage of the elements of the coverage

including the amount of stop-loss insurance in effect.

E. 1. Those entities which are not licensed insurers in this

state, other than a hospital service and medical indemnity

corporation as authorized in Section 2601 et seq. of this title,

shall place the following statement in conspicuous bold-face type on

the front page of their policy or certificate: "State insurance

insolvency guaranty funds are not available for your use in the

event of insolvency or liquidation of this company"; and

2. Those entities which are not licensed insurers, or not

subject to the jurisdiction of the Insurance Commissioner or any

other state agency, shall place the following statement in

conspicuous bold-face type on the front page of their policy, plan

or certificate: "This policy, plan or certificate and this entity

Oklahoma Statutes - Title 36. Insurance Page 155

are not subject to the jurisdiction of the Oklahoma State Insurance

Commissioner".
Okla. Stat. tit. 36, § 36-6571 — OK Code / Title 36 / Section 36-6571
Determination of average area or customary and reasonable
Status: in_force

charges - Disclosure to health care provider of information used.

A. As used in this section:

1. "Health care provider" means any person, firm, corporation

or other legal entity that is licensed, certified or otherwise

authorized by the laws of this state to provide health care

services, procedures or supplies in the ordinary course of business

or practice of a profession; and

2. "Insurer" means any insurance company, not-for-profit

hospital service and medical indemnity plan, health insurance

service organization, preferred provider organization or other

entity offering health insurance policies, contracts or benefits in

this state.

B. Any insurer which:

1. Makes a determination or contracts with a third party who

makes the determination of average area charges or customary and

reasonable charges for health care services, procedures or supplies;

and

2. Based on such determination, authorizes payment in an amount

which is less than the amount charged by the health care provider

for such services, procedures or supplies;

shall, upon the request of a health care provider, furnish the name,

mailing address and telephone number of the party making the

determination to the health care provider.

C. Upon the request of the health care provider, the party

shall furnish, for a reasonable charge, information used to

determine the average area charges or customary and reasonable

charges for the services, procedures or supplies provided by the

health care provider and authorized for payment pursuant to

paragraph 2 of subsection B of this section. The information shall

include the rationale and documentation of sources used in the

determination of the average area charges or customary and

reasonable charges for the services, procedures or supplies in

question, including names, mailing addresses and telephone numbers

of sources if available. Such information shall be furnished to the

health care provider no later than ten (10) working days after the

request for information by the health care provider.

D. 1. No insurer shall use the services of a party for the

determination of average area charges or customary and reasonable

charges which is not in compliance with the provisions of this

section.

2. Noncompliance shall be reported to the Insurance

Commissioner who, upon investigation of the complaint and

Oklahoma Statutes - Title 36. Insurance Page 1323

determination that the party is in noncompliance and that no

resolution of the complaint will be made within a reasonable time,

shall compile and maintain a list of parties which are not in

compliance with the provisions of this section.
Okla. Stat. tit. 36, § 36-1674 — OK Code / Title 36 / Section 36-1674
Required contract provisions - Producers and insurers
Status: in_force

affected - Audit Committees - Reporting requirements.

A. Applicability of section.

1. The provisions of this section shall apply if, in any

calendar year, the aggregate amount of gross written premium on

business placed with a controlled insurer by a controlling producer

is equal to or greater than five percent (5%) of the admitted assets

of the controlled insurer, as reported in the controlled insurers'

quarterly statement filed as of September 30 of the prior year.

2. Notwithstanding paragraph 1 of this subsection, the

provisions of this section shall not apply if:

a. the controlling producer:

(1) places insurance only with the controlled

insurer, or only with the controlled insurer and

a member or members of the controlled insurer's

holding company system, or the controlled

insurer's parent, affiliate or subsidiary and

receives no compensation based upon the amount of

premiums written in connection with such

insurance, and

(2) accepts insurance placements only from

nonaffiliated subproducers, and not directly from

insureds, and

b. the controlled insurer, except for insurance business

written through a residual market facility, accepts

insurance business only from a controlling producer, a

producer controlled by the controlled insurer, or a

producer that is a subsidiary of the controlled

insurer.

B. Required contract provisions. A controlled insurer shall

not accept business from a controlling producer and a controlling

producer shall not place business with a controlled insurer unless

there is a written contract between the controlling producer and the

Oklahoma Statutes - Title 36. Insurance Page 496

insurer specifying the responsibilities of each party, which

contract has been approved by the board of directors of the insurer

and contains the following minimum provisions:

1. The controlled insurer may terminate the contract for cause,

upon written notice to the controlling producer. The controlled

insurer shall suspend the authority of the controlling producer to

write business during the pendency of any dispute regarding the

cause for the termination;

2. The controlling producer shall render accounts to the

controlled insurer detailing all material transactions, including

information necessary to support all commissions, charges and other

fees received by, or owing to, the controlling producer;

3. The controlling producer shall remit all funds due under the

terms of the contract to the controlled insurer on at least a

monthly basis. The due date shall be fixed so that premiums or

installments thereof collected shall be remitted no later than

ninety (90) days after the effective date of any policy placed with

the controlled insurer under this contract;

4. All funds collected for the controlled insurer's account

shall be held by the controlling producer in a fiduciary capacity,

in one or more appropriately identified bank accounts in banks that

are members of the Federal Reserve System, in accordance with the

provisions of the insurance law as applicable. However, funds of a

controlling producer not required to be licensed in this state shall

be maintained in compliance with the requirements of the controlling

producer's domiciliary jurisdiction;

5. The controlling producer shall maintain separately

identifiable records of business written for the controlled insurer;

6. The contract shall not be assigned in whole or in part by

the controlling producer;

7. The controlled insurer shall provide the controlling

producer with its underwriting standards, rules and procedures,

manuals setting forth the rates to be charged, and the conditions

for the acceptance or rejection of risks. The controlling producer

shall adhere to the standards, rules, procedures, rates and

conditions. The standards, rules, procedures, rates and conditions

shall be the same as those applicable to comparable business placed

with the controlled insurer by a producer other than the controlling

producer;

8. The rate and terms of the controlling producer's

commissions, charges or other fees and the purposes for those

charges or fees. The rates of the commissions, charges and other

fees shall be no greater than those applicable to comparable

business placed with the controlled insurer by producers other than

controlling producers. For purposes of this paragraph and paragraph

7 of this subsection, examples of "comparable business" include the

Oklahoma Statutes - Title 36. Insurance Page 497

same lines of insurance, same kinds of insurance, same kinds of

risks, similar policy limits, and similar quality of business;

9. If the contract provides that the controlling producer, on

insurance business placed with the insurer, is to be compensated

contingent upon the insurer's profits on that business, then such

compensation shall not be determined and paid until at least five

(5) years after the premiums on liability insurance are earned and

at least one (1) year after the premiums are earned on any other

insurance. In no event shall the commissions be paid until the

adequacy of the controlled insurer's reserves on remaining claims

has been independently verified pursuant to subsection D of this

section;

10. A limit on the controlling producer's writings in relation

to the controlled insurer's surplus and total writings. The insurer

may establish a different limit for each line or subline of

business. The controlled insurer shall notify the controlling

producer when the applicable limit is approached and shall not

accept business from the controlling producer if the limit is

reached. The controlling producer shall not place business with the

controlled insurer if it has been notified by the controlled insurer

that the limit has been reached; and

11. The controlling producer may negotiate but shall not bind

reinsurance on behalf of the controlled insurer on business the

controlling producer places with the controlled insurer, except that

the controlling producer may bind facultative reinsurance contracts

pursuant to obligatory facultative agreements if the contract with

the controlled insurer contains underwriting guidelines including,

for both reinsurance assumed and ceded, a list of reinsurers with

which such automatic agreements are in effect, the coverages and

amounts of percentages that may be reinsured and commission

schedules.

C. Audit Committee. Every controlled insurer shall have an

Audit Committee of the Board of Directors composed of independent

directors. The Audit Committee shall annually meet with management,

the insurer's licensed public accountant or a certified public

accountant holding a permit to practice in this state and an

independent casualty actuary or other independent loss reserve

specialist acceptable to the Commissioner to review the adequacy of

the insurer's loss reserves.

D. Reporting requirements.

1. In addition to any other required loss reserve

certification, the controlled insurer shall annually, on April 1 of

each year, file with the Commissioner an opinion of an independent

casualty actuary, or such other independent loss reserve specialist

acceptable to the Commissioner, reporting loss ratios for each line

of business written and attesting to the adequacy of loss reserves

established for losses incurred and outstanding as of year-end,

Oklahoma Statutes - Title 36. Insurance Page 498

including incurred but not reported losses, on business placed by

the producer; and

2. The controlled insurer shall annually report to the

Commissioner the amount of commissions paid to the producer, the

percentage such amount represents of the net premiums written and

comparable amounts and percentage paid to noncontrolling producers

for placements of the same kinds of insurance.
Okla. Stat. tit. 36, § 36-2903 — OK Code / Title 36 / Section 36-2903
Scope of article; existing insurers
Status: in_force

A. All authorized reciprocal insurers shall be governed by

those sections of this article not expressly made applicable to

domestic reciprocals only.

B. To the extent not modified by the provisions of this

article, reciprocal insurers shall be subject to and governed by the

other applicable provisions of this Code.

C. Existing authorized reciprocal insurers shall after the

effective date of this Code comply with the provisions of this

article, and shall make such amendments to their subscribers'

agreement, power of attorney, policies and other documents and

accounts and perform such other acts as may be required for such

compliance.
Okla. Stat. tit. 36, § 36-1646 — OK Code / Title 36 / Section 36-1646
Authority to suspend, revoke or refuse to renew license
Status: in_force

or authority to do business.

Oklahoma Statutes - Title 36. Insurance Page 492

Whenever it appears to the Commissioner that any person has

committed a violation of this act which makes the continued

operation of an insurer contrary to the interests of policyholders

or the public, the Commissioner may, after giving notice and an

opportunity to be heard, suspend, revoke or refuse to renew the

insurer's license or authority to do business in this state for such

period as the Commissioner finds is required for the protection of

policyholders or the public. Any such determination shall be

accompanied by specific findings of fact and conclusions of law.
Okla. Stat. tit. 36, § 36-6915 — OK Code / Title 36 / Section 36-6915
Insolvency - Replacement coverage - Reduction or
Status: in_force

exclusion of benefits.

A. 1. In the event of an insolvency of a commercial health

maintenance organization, upon order of the Insurance Commissioner,

all other carriers that participated in the enrollment process with

the insolvent health maintenance organization at a group’s last

regular enrollment period shall offer the group’s enrollees of the

insolvent health maintenance organization a thirty-day enrollment

period commencing upon the date of insolvency. Each carrier shall

offer the enrollees of the insolvent health maintenance organization

the same coverages and rates offered to the enrollees of the group

at its last regular enrollment period.

2. If no other carrier had been offered to some groups enrolled

in the insolvent health maintenance organization, or if the

Insurance Commissioner determines that the other health benefit

plans lack sufficient health care delivery resources to ensure that

health care services will be available and accessible to all of the

group enrollees of the insolvent health maintenance organization,

the Insurance Commissioner shall equitably allocate the insolvent

health maintenance organization’s group contracts for these groups

among all health maintenance organizations that operate within a

portion of the insolvent health maintenance organization’s service

area, taking into consideration the health care delivery resources

of each health maintenance organization. Each health maintenance

organization to which a group or groups are so allocated shall offer

the group or groups the health maintenance organization’s existing

coverage that is most similar to each group’s coverage with the

insolvent health maintenance organization, at rates determined in

accordance with the successor health maintenance organization’s

existing rating methodology.

B. 1. “Discontinuance” means the termination of the contract

between the group contract holder and a health maintenance

organization due to the insolvency of the health maintenance

organization, and does not refer to the termination of any agreement

Oklahoma Statutes - Title 36. Insurance Page 1400

between any individual enrollee and the health maintenance

organization.

2. Any carrier providing replacement coverage with respect to

group hospital, medical or surgical expense or service benefits

within a period of sixty-three (63) days from the date of

discontinuance of a prior health maintenance organization contract

or policy providing hospital, medical or surgical expense or service

benefits shall, as of the effective date of the replacement

coverage, cover all enrollees who were validly covered under the

previous health maintenance organization contract or policy at the

date of discontinuance and who would otherwise be eligible for

coverage under the succeeding carrier’s contract, regardless of any

provisions of the contract relating to active employment, hospital

confinement or pregnancy.

3. Except to the extent benefits for the condition would have

been reduced or excluded under the prior carrier’s contract or

policy, no provision in a succeeding carrier’s contract of

replacement coverage that would operate to reduce or exclude

benefits on the basis that the condition giving rise to benefits

preexisted the effective date of the succeeding carrier’s contract

shall be applied with respect to those enrollees validly covered

under the prior carrier’s contract or policy on the date of

discontinuance.

4. a. Upon being declared insolvent, a health maintenance

organization shall provide to the Insurance

Commissioner:

(1) the names of all known enrollees who were validly

enrolled under the insolvent HMO’s contract, or

(2) policy information on validly enrolled enrollees

who are hospitalized or whose health conditions

require continuity of care.

b. The insolvent HMO shall continue to provide such

information to the Insurance Commissioner throughout

the period of time required to provide replacement

coverage to the validly covered enrollees of the

insolvent HMO.
Okla. Stat. tit. 36, § 36-2105 — OK Code / Title 36 / Section 36-2105
Articles of incorporation; contents
Status: in_force

A. This section applies to stock and mutual insurers hereafter

incorporated in Oklahoma.

B. Five or more individuals of age of twenty-one (21) years or

more may incorporate a stock insurer; ten or more such individuals

may incorporate a mutual insurer. Not less than two-thirds (2/3) of

the incorporators shall be citizens of the United States residing in

Oklahoma. The articles of incorporation shall be signed and

acknowledged by the incorporators as deeds are required to be

acknowledged.

C. The articles of incorporation shall state:

1. The name of the corporation; if a mutual, the word "mutual"

shall be a part of the name;

2. The duration of its existence, which may be perpetual;

3. The kinds of insurance the corporation is formed to

transact, according to the definitions thereof in this Code;

4. If a stock corporation, its authorized capital, the classes

and number of shares into which divided, the par value of each such

share, and the respective rights of each such class. Shares without

par value shall not be authorized;

5. If a mutual corporation, the maximum contingent liability of

its members, other than as to nonassessable policies, for payment of

losses and expenses incurred, which liability shall be as stated in

the articles of incorporation but not less than one nor more than

six times the premium for the member's policy at the annual premium

rate for a term of one (1) year;

6. The number of directors, of which there shall be not less

than three nor more than fifty, who shall conduct the affairs of the

corporation, and the names and addresses of the corporation's first

directors and officers for stated terms of office of not less than

two (2) months nor more than one (1) year; provided, however, that

the Insurance Commissioner may approve amended articles of

Oklahoma Statutes - Title 36. Insurance Page 625

incorporation for a domestic insurer to permit the board of

directors to consist of three or more directors;

7. The city or town in Oklahoma in which is to be located the

principal place of business, and the counties, states, and countries

in which business may be transacted;

8. The limitations, if any, on the corporation's indebtedness;

9. If a stock corporation, the extent, if any, to which stock

of the corporation shall be liable to assessment;

10. Such other provisions, not inconsistent with law, as deemed

appropriate by the incorporators;

11. The names and addresses of the incorporators; and

12. The name and address of the person in Oklahoma upon whom

all process in any action or proceeding may be served. Such

designation may be changed or amended on authority of the Board of

Directors evidenced by the filing of a certificate stating such

change, executed by the President, attested by the Secretary, and

filed with the Insurance Commissioner.
Okla. Stat. tit. 36, § 36-625.2 — OK Code / Title 36 / Section 36-625.2
Premium tax credit - Applicable insurers
Status: in_force

A. Except as provided by subsection B of this section, the tax

credits set forth in Section 625.1 of this title shall apply to

insurers who take action after November 1, 1987, to:

1. Establish new regional home offices; or

2. Expand existing regional home offices, and hire new

employees.

B. The tax credits set forth in Section 625.1 of this title

shall not be available to a contracted entity as defined in Section

4002.2 of Title 56 of the Oklahoma Statutes.

C. An insurer in either category of the requirements of

subsection A of this section must also meet the hiring minimum

requirements for the applicable tax credit bracket in Section 625.1

of this title.
Okla. Stat. tit. 36, § 36-999.1 — OK Code / Title 36 / Section 36-999.1
Short title
Status: in_force

Sections 1 through 7 of this act shall constitute Article 9C of

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

“Oklahoma Subsidence Insurance Act”.
Okla. Stat. tit. 36, § 36-2018 — OK Code / Title 36 / Section 36-2018
Payment of assessment - Effect on rate increase or
Status: in_force

decrease.

Any member insurer who has paid an assessment pursuant to the

Oklahoma Property and Casualty Insurance Guaranty Association Act

shall include amounts sufficient to recoup a sum equal to the

amounts paid to the Oklahoma Property and Casualty Insurance

Guaranty Association by the member insurer, less any amounts

returned to the member insurer by the Association. Rates shall not

be deemed excessive because they contain an additional amount

reasonably calculated to recoup all assessments paid by the member

Oklahoma Statutes - Title 36. Insurance Page 587

insurer in its next filing for a rate increase or decrease before

the Insurance Commissioner.
Okla. Stat. tit. 36, § 36-6459.1 — OK Code / Title 36 / Section 36-6459.1
Premium taxes
Status: in_force

Premium taxes and taxes on premiums paid for coverage of risks

resident or located in this state by a purchasing group or any

members of the purchasing group shall be:

1. Imposed at the same rate and subject to the same interest,

fines and penalties as applicable to premium taxes and taxes on

premiums paid for similar coverage from a similar insurance source;

and

2. Paid by the insurance source, the agent or broker for the

purchasing group, the purchasing group or any members of the

purchasing group.
Okla. Stat. tit. 36, § 36-6470.2 — OK Code / Title 36 / Section 36-6470.2
Definitions
Status: in_force

As used in the Oklahoma Captive Insurance Company Act:

1. "Alien company" means an insurance company formed and

licensed pursuant to the laws of a country or jurisdiction other

than the United States of America, or any of its states, districts,

commonwealths and possessions;

2. "Affiliated company" means a company in the same corporate

system as a parent, an industrial insured, or a member organization

by virtue of common ownership, control, operation, or management;

3. "Association" means a legal association of individuals,

corporations, partnerships, or associations that has been in

continuous existence for at least one (1) year or such lesser period

of time approved by the Commissioner:

a. the member organizations of which, or which does

itself or either of them acting in concert directly or

indirectly own, control, or hold with power to vote

all of the outstanding voting securities or interests

of, or have complete voting control over an

association captive insurance company, or

b. the member organizations of which collectively

constitute all of the subscribers of an association

captive insurance company formed as a reciprocal

insurer;

4. "Association captive insurance company" means a captive

insurance company that insures risks of the member organizations of

the association and their affiliated companies;

5. "Branch business" means any insurance business transacted by

a branch captive insurance company in this state;

6. "Branch captive insurance company" means an alien captive

insurance company licensed by the Insurance Commissioner to transact

the business of insurance in this state through a business unit with

Oklahoma Statutes - Title 36. Insurance Page 1210

a principal place of business in this state. A branch captive

insurance company must be a pure captive insurance company with

respect to operations in this state, unless otherwise permitted by

the Insurance Commissioner;

7. "Branch operations" means any business operations of a

branch captive insurance company in this state;

8. "Capital and surplus" means the amount by which the value of

all of the assets of the captive insurance company exceeds all of

the liabilities of the captive insurance company, as determined

under the method of accounting utilized by the captive insurance

company in accordance with the applicable provisions of this act;

9. "Captive insurance company" means a pure captive insurance

company, association captive insurance company, sponsored captive

insurance company, special purpose captive insurance company,

industrial insured captive insurance company, branch captive

insurance company, or series captive insurance company formed or

licensed under the Oklahoma Captive Insurance Company Act;

10. "Controlled unaffiliated business" means a company:

a. that is not in the corporate system of a parent and

affiliated companies,

b. that has an existing contractual relationship with a

parent or affiliated company, and

c. whose risks are managed by a pure captive insurance

company in accordance with Section 6470.27 of this

title;

11. "Insurance Commissioner" means the Insurance Commissioner

of this state or designee of the Insurance Commissioner;

12. "Department" means the Insurance Department;

13. "GAAP" means generally accepted accounting principles;

14. "Industrial insured" means an insured:

a. who procures the insurance of any risk or risks by use

of the services of a full-time employee acting as an

insurance manager or buyer,

b. whose aggregate annual premiums for insurance on all

risks total at least Twenty-five Thousand Dollars

($25,000.00), and

c. who has at least twenty-five full-time employees;

15. "Industrial insured captive insurance company" means a

company that insures risks of the industrial insureds that comprise

the industrial insured group and their affiliated companies;

16. "Industrial insured group" means a group of industrial

insureds that collectively directly or indirectly owns, controls, or

holds with power to vote all of the outstanding voting securities or

other voting interests or has complete control over an industrial

insured captive insurance company;

17. "Member organization" means any individual, corporation,

partnership, or association that belongs to an association;

Oklahoma Statutes - Title 36. Insurance Page 1211

18. "Parent" means any corporation, partnership, or individual

that directly or indirectly owns, controls, or holds with power to

vote more than fifty percent (50%) of the outstanding voting

securities of a pure captive insurance company;

19. "Participant" means an entity as defined in Section 6470.31

of this title, and any affiliates of that entity, that are insured

by a sponsored captive insurance company, where the losses of the

participant are limited through a participant contract to the

participant's pro rata share of the assets of one or more protected

cells identified in the participant contract;

20. "Participant contract" means a contract by which a

sponsored captive insurance company insures the risks of one or more

participants and limits the losses of each participant to its pro

rata share of the assets of one or more protected cells identified

in the participant contract;

21. "Protected cell" means a separate and distinct account

established and maintained by or on behalf of a sponsored captive

insurance company in which assets are accounted for and recorded for

one or more participants in accordance with the terms of one or more

participant contracts to fund the liability of the sponsored captive

insurance company assumed on behalf of the participants as set forth

in the participant contracts;

22. "Pure captive insurance company" means a company that

insures risks of its parent, affiliated companies of its parent, and

any controlled unaffiliated business, or a combination thereof. For

purposes of this paragraph, "controlled unaffiliated business" means

an entity insured by a pure captive insurance company:

a. that is not in the corporate system of a parent and

affiliated companies,

b. that has an existing contractual relationship with a

parent or affiliated company, and

c. whose risks are managed by a pure captive insurance

company;

23. "Reciprocal insurer" has the meaning given that term in

Article 29 of the Oklahoma Insurance Code;

24. "Risk retention group" means a risk retention group formed

pursuant to the Liability Risk Retention Act of 1986 under Section

3901 of Title 15 of the United States Code;

25. "Series" means a series of members, managers, membership

interests or assets under the Oklahoma Limited Liability Company Act

pursuant to Section 2054.4 of Title 18 of the Oklahoma Statutes, or

the corresponding law of another state;

26. "Series captive insurance company" means a series which has

received a certificate of authority pursuant to this act;

27. "Special purpose captive insurance company" means a captive

insurance company that is formed or licensed under the Oklahoma

Captive Insurance Company Act that does not meet the definition of

Oklahoma Statutes - Title 36. Insurance Page 1212

any other type of captive insurance company defined in this section

and is designated as a special purpose captive insurance company by

the Commissioner;

28. "Sponsor" means an entity that meets the requirements of

Section 6470.30 of this title and is approved by the Insurance

Commissioner to provide all or part of the capital and surplus

required by applicable law and to organize and operate a sponsored

captive insurance company;

29. "Sponsored captive insurance company" means a captive

insurance company:

a. in which the minimum capital and surplus required by

applicable law is provided by one or more sponsors,

b. that is formed or licensed under the Oklahoma Captive

Insurance Company Act,

c. that insures the risks of its participants only

through separate participant contracts, and

d. that funds its liability to each participant through

one or more protected cells and segregates the assets

of each protected cell from the assets of other

protected cells and from the assets of the sponsored

captive insurance company's general account; and

30. "Workers' compensation insurance" means insurance provided

in satisfaction of an employer's responsibility as set forth in the

Administrative Workers' Compensation Act and the Oklahoma Employee

Injury Benefit Act.
Okla. Stat. tit. 36, § 36-3003 — OK Code / Title 36 / Section 36-3003
Application for license; contents; kinds of insurance
Status: in_force

authorized; financial statement; process.

The attorney shall file with the Insurance Commissioner a

verified application for license setting forth and accompanied by:

1. The name of the attorney or attorneys and the title under

which the business is to be conducted, which title shall contain the

name Lloyds, and shall not be so similar to any name or title in use

in this state as to be likely to confuse or deceive.

2. The location of the principal office.

3. The kind or combination of kinds of insurance to be written,

as defined in Article 7, (Kinds of Insurance; Reinsurance; Limits of

Risk) of this Code.

4. A copy of the form of power of attorney by virtue of which

the attorney is to act for and bind the several underwriters, and a

copy of the articles of agreement entered into between the

underwriters themselves and the attorney.

5. The names and addresses of all underwriters, whose number

shall not be less than three.

6. A financial statement showing in detail the assets

contributed or accumulated in the hands of the attorneys-in-fact,

committee of underwriters, trustees, or other officers of such

underwriters at Lloyd's, together with the liabilities incurred and

outstanding and the income received and disbursements made by the

attorney for the underwriters.

7. An instrument executed by each and all of the underwriters

specially empowering the attorney to accept service of process for

each underwriter in any action on any policy or contract of

insurance, and an instrument from the attorney to the Insurance

Commissioner delegating the attorney's powers in this respect to

such Insurance Commissioner.
Okla. Stat. tit. 36, § 36-1106.2 — OK Code / Title 36 / Section 36-1106.2
Due diligence - Flood insurance with a nonadmitted
Status: in_force

insurer.

A surplus lines licensee or broker is not required to make a due

diligence search to determine whether the full amount or type of

insurance can be obtained from admitted insurers when the surplus

lines licensee or broker is seeking to procure or place flood

insurance with a nonadmitted insurer.
Okla. Stat. tit. 36, § 36-7108 — OK Code / Title 36 / Section 36-7108
Exceptions to application of act
Status: in_force

Oklahoma Statutes - Title 36. Insurance Page 1486

A. The provisions of the Perpetual Care Fund Act shall not

apply to municipal, 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.

B. The provisions of the Perpetual Care Fund Act may apply to

unincorporated cemetery associations operating cemeteries in this

state. Unincorporated cemetery associations that make application

with the Insurance Commissioner to maintain a perpetual care fund

and are approved by the Commissioner shall comply with all

provisions of the Perpetual Care Fund Act.
Okla. Stat. tit. 36, § 36-4003.1 — OK Code / Title 36 / Section 36-4003.1
Cancellation of policy - Time period
Status: in_force

A. No policy of individual life insurance or any annuity shall

be delivered or issued for delivery in this state unless it shall

have printed thereon or attached thereto a notice stating in

substance that, during a period of ten (10) days from the date the

policy or annuity is delivered to the insured, it may be surrendered

to the insurer together with a written request for cancellation of

the policy or annuity and, in such event, the policy or annuity

shall be void from the beginning and the insurer will refund any

premium or moneys paid therefor within thirty (30) days from the

date of cancellation. If the insurer does not return any premiums

or moneys paid therefor within thirty (30) days from the date of

cancellation, the insurer shall pay interest on the proceeds which

shall be the same rate of interest as the average United States

Treasury Bill rate of the preceding calendar year, as certified to

the Insurance Commissioner by the State Treasurer on the first

regular business day in January of each year, plus two (2)

percentage points, which shall accrue from the date of cancellation

Oklahoma Statutes - Title 36. Insurance Page 825

until the premiums or moneys are returned. In such event, the

policy or annuity shall be deemed to have been canceled on the date

the policy was placed in the U.S. mails in a properly addressed,

postpaid envelope; or, if not so posted, on the date of delivery of

such policy or annuity to the insurer.

B. This section shall not apply to life insurance policies

issued in connection with a credit transaction or issued under a

contractual policy change or conversion privilege provision

contained in the policy.
Okla. Stat. tit. 36, § 36-1219.2 — OK Code / Title 36 / Section 36-1219.2
Definitions
Status: in_force

As used in the Health Care Fraud Prevention Act:

1. “Accident and health insurance policy” means any policy,

certificate, contract, agreement or other instrument that provides

accident and health insurance, as defined in Section 703 of this

title, to any person in this state;

2. “Health care provider” means a physician, hospital,

ambulatory surgical center, pharmacy, pharmacist, laboratory, or any

other state-licensed or state-recognized provider of health care

services;

3. “Insured” means any person entitled to reimbursement for

expenses of health care services and procedures under an accident

and health insurance policy issued by an insurer;

Oklahoma Statutes - Title 36. Insurance Page 290

4. “Insurer” means any entity that provides an accident and

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

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

medical indemnity corporation, a fraternal benefit society, a

multiple employer welfare arrangement, or any other entity subject

to regulation by the Insurance Commissioner;

5. ”Perferred provider organization” means any entity defined

as a “preferred provider organization (PPO)” in Section 6054 of this

title; and

6. “Third-party administrator” means any person defined as an

“administrator” in Section 1442 of this title.
Okla. Stat. tit. 36, § 36-955 — OK Code / Title 36 / Section 36-955
Disclosure statement
Status: in_force

A. If an insurer writing personal insurance uses credit

information in underwriting or rating a consumer, the insurer or its

agent shall disclose, either on the insurance application or at the

time the insurance application is taken, that it may obtain credit

information in connection with such application. Such disclosure

shall be either written or provided to an applicant in the same

medium as the application for insurance. The insurer need not

provide the disclosure statement required under this section to any

insured on a renewal policy, if such consumer has previously been

provided a disclosure statement.

B. Use of the following example disclosure statement

constitutes compliance with this section: “In connection with this

application for insurance, we may review your credit report or

obtain or use a credit-based insurance score based on the

information contained in that credit report. We may use a third

party in connection with the development of your insurance score”.
Okla. Stat. tit. 36, § 36-6560 — OK Code / Title 36 / Section 36-6560
Expiration of certificate - Renewal
Status: in_force

A. A certificate expires on the first anniversary of its

effective date unless the certificate is renewed for a one-year term

as provided in this section.

B. Before the certificate expires, a certificate may be renewed

for an additional one-year term, if the applicant:

1. Otherwise is entitled to the certificate;

2. Pays the Insurance Commissioner an annual renewal fee in the

amount of Five Hundred Dollars ($500.00);

3. Submits to the Commissioner:

a. a renewal application on the form that the

Commissioner requires, and

b. satisfactory evidence of compliance with any

requirement for certificate renewal;

4. Establishes and maintains a complaint system which has been

approved by the Commissioner and which provides reasonable

procedures for the resolution of written complaints concerning

utilization review; and

5. Maintains records of written complaints for five (5) years

from the time the complaints are filed and submits to the

Commissioner a summary report at such times and in such format as

the Commissioner may require.
Okla. Stat. tit. 36, § 36-1450 — OK Code / Title 36 / Section 36-1450
Licensing procedure - Violations
Status: in_force

Oklahoma Statutes - Title 36. Insurance Page 373

A. No person shall act as or present himself or herself to be

an administrator, as defined by the provisions of the Third-party

Administrator Act, in this state, unless the person holds a valid

license as an administrator which is issued by the Insurance

Commissioner.

B. An administrator shall not be eligible for a nonresident

administrator license under this section if the administrator does

not hold a home state certificate of authority or license in a state

that has adopted the Third-party Administrator Act or that applies

substantially similar provisions as are contained in the Third-party

Administrator Act to that administrator. If the Third-party

Administrator Act in the administrator's home state does not extend

to stop-loss insurance, but if the home state otherwise applies

substantially similar provisions as are contained in the Third-party

Administrator Act to that administrator, then that omission shall

not operate to disqualify the administrator from receiving a

nonresident administrator license in this state.

1. "Home state" means the United States jurisdiction that has

adopted the Third-party Administrator Act or a substantially similar

law governing third-party administrators and which has been

designated by the administrator as its principal regulator. The

administrator may designate either its state of incorporation or its

principal place of business within the United States if that

jurisdiction has adopted the Third-party Administrator Act or a

substantially similar law governing third-party administrators. If

neither the administrator's state of incorporation nor its principal

place of business within the United States has adopted the Third-

party Administrator Act or a substantially similar law governing

third-party administrators, then the third-party administrator shall

designate a United States jurisdiction in which it does business and

which has adopted the Third-party Administrator Act or a

substantially similar law governing third-party administrators. For

purposes of this paragraph, "United States jurisdiction" means the

District of Columbia or a state or territory of the United States.

2. "Nonresident administrator" means a person who is applying

for licensure or is licensed in any state other than the

administrator's home state.

C. In the case of a partnership which has been licensed, each

general partner shall be licensed and shall qualify therefore as

though an individual licensee. The Commissioner shall charge a full

additional license fee and a separate license shall be issued for

each individual so named in the license. The partnership shall

notify the Commissioner within thirty (30) days if any individual

licensed on its behalf has been terminated, or is no longer

associated with or employed by the partnership. Any person making

application as an administrator or currently licensed as an

administrator under the Third-party Administrator Act shall provide

Oklahoma Statutes - Title 36. Insurance Page 374

a National Association of Insurance Commissioners (NAIC)

Biographical Affidavit.

D. An application for an administrator's license shall be in a

form prescribed by the Commissioner and shall be accompanied by a

fee of One Hundred Dollars ($100.00). The application shall be

filed and the fee shall be paid electronically in a form and manner

prescribed by the Commissioner. This fee shall not be refundable if

the application is denied or refused for any reason by either the

applicant or the Commissioner.

E. The administrator's license shall continue in force no

longer than twelve (12) months from the original month of issuance.

Upon filing a renewal form prescribed by the Commissioner,

accompanied by a fee of One Hundred Dollars ($100.00), the license

may be renewed annually for a one-year term. The renewal shall be

filed, and the fee shall be paid electronically in a form and manner

prescribed by the Commissioner. A license that expires for failure

to submit a renewal application may be reinstated within ninety (90)

days after the expiration date by electronically submitting a fee in

an amount of Two Hundred Dollars ($200.00) in a form and manner

prescribed by the Commissioner and any other transaction or other

fee deemed necessary by the Commissioner. All applications received

after the license has expired for more than ninety (90) days shall

include a detailed report of administrator services provided in this

state during the period of expired licensure. The administrator

shall submit, together with the application for renewal, a list of

the names and addresses of the persons with whom the administrator

has contracted in accordance with Section 1443 of this title. The

Commissioner shall hold this information confidential except as

provided in Section 1443 of this title.

F. 1. The administrator's license may be issued or renewed by

the Commissioner unless, after notice and opportunity for hearing,

the Commissioner determines that the administrator is not competent,

trustworthy, or financially responsible, or has had any insurance

license denied for cause by any state, has been convicted or has

pleaded guilty or nolo contendere to any felony or to a misdemeanor

involving moral turpitude or dishonesty.

2. The administrator shall report to the Insurance Commissioner

any administrative or criminal action taken against the

administrator in another jurisdiction or by another governmental

agency in this state within thirty (30) calendar days of the final

disposition of the matter. This report shall include a copy of the

order, consent to order, copy of any payment required as a result of

the administrative or criminal action, or other relevant legal

documents.

3. Any entity making application to the Insurance Department as

a third-party administrator (TPA) or within thirty (30) days of a

change for a licensed TPA shall provide current National Association

Oklahoma Statutes - Title 36. Insurance Page 375

of Insurance Commissioners (NAIC) Biographical Affidavits on behalf

of all officers, directors and key managerial personnel of the TPA,

and individuals with a ten percent (10%) or more beneficial

ownership in the TPA and the TPA's ultimate controlling person

(affiant) as required for insurers pursuant to the laws of this

state.

G. After notice and opportunity for hearing, and upon

determining that the administrator has violated any of the

provisions of the Oklahoma Insurance Code or upon finding reasons

for which the issuance or renewal of such license could have been

denied, the Commissioner may deny, refuse to renew, suspend or

revoke an administrator's license or assess a civil penalty not more

than Five Thousand Dollars ($5,000.00) for each occurrence, or any

combination thereof. The payment of the penalty may be enforced in

the same manner as civil judgments may be enforced.

H. Any person who is acting as or presenting himself or herself

to be an administrator without a valid license shall be subject,

upon conviction, to a fine not less than One Thousand Dollars

($1,000.00) nor more than Ten Thousand Dollars ($10,000.00) for each

occurrence. This fine shall be in addition to any other penalties

which may be imposed for violations of the Oklahoma Insurance Code

or other laws of this state.

I. Except as provided for in subsections F and G of this

section, any person convicted of violating any provisions of the

Third-party Administrator Act shall be guilty of a misdemeanor and

shall be subject to a fine not more than One Thousand Dollars

($1,000.00).

J. Each administrator shall electronically submit, in a form

and manner prescribed by the Commissioner, any change of legal

business name, "doing business as" or assumed name, address, service

agent contact information, or contact email address, and any

necessary fees within thirty (30) days after the change occurred.

Any submission of a change under this subsection that is received

more than thirty (30) days after the change occurred shall be

accompanied by a fee of Fifty Dollars ($50.00).

K. Upon receipt of any inquiry from the Insurance Commissioner,

a licensed administrator shall furnish the Commissioner with an

adequate response to the inquiry within twenty (20) days from

receipt of the inquiry.
Okla. Stat. tit. 36, § 36-6060.18 — OK Code / Title 36 / Section 36-6060.18
Withdrawals – Taxation – Transfer of interest
Status: in_force

A. Notwithstanding paragraphs C, D, E, and F of this section,

an eligible individual may withdraw money from their health savings

account for any purpose other than a purpose described in Section

6060.17 of this title.

B. If the eligible individual withdraws money for any purpose

other than a purpose described in Section 6060.17 of this title, at

any other time, all of the following shall apply:

1. The amount of the withdrawal is income for the purposes of

the Oklahoma Income Tax Act in the tax year of the withdrawal; and

2. The tax imposed on the withdrawal which is includable in

income shall be increased by ten percent (10%) of the amount which

is so includable.

C. The amount of disbursement of any assets of a health savings

account pursuant to a filing for protection under Section 101 of

Title 11 of the United States Code by an eligible individual or

person for whose benefit the account was established is not

considered a withdrawal for purposes of this section. The amount of

a disbursement is not subject to taxation under the Oklahoma Income

Tax Act and subsection B of this section does not apply.

D. The transfer of an eligible individual's interest in a

health savings account to an eligible individual's spouse or former

spouse under a divorce or separation instrument shall not be

considered a taxable transfer made by such eligible individual,

notwithstanding any other provision of this title, and the interest

Oklahoma Statutes - Title 36. Insurance Page 1115

shall, after the transfer, be treated as a health savings account

with respect to which the spouse is the eligible individual.

E. Upon the death of the eligible individual, the trustee or

custodian shall distribute the principal and accumulated interest of

the health savings account to the estate of the deceased.

F. If an employee becomes employed with a different employer

that participates in a health savings account program, the employee

may transfer their health savings account to that new employer's

trustee or custodian, or to an individually purchased account

program.
Okla. Stat. tit. 36, § 36-1477 — OK Code / Title 36 / Section 36-1477
Violations - Penalties - Judicial review - Rights
Status: in_force

affected.

A. If the Insurance Commissioner finds, after a hearing

conducted in accordance with Article II of the Administrative

Procedures Act, that any person had violated any provision of the

Managing General Agents Act or rules promulgated pursuant thereto,

the Commissioner may order:

1. For each separate violation, a penalty in an amount of not

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

Dollars ($5,000.00) for each occurrence;

2. Revocation or suspension of the producer's license; and

3. The managing general agent to reimburse the insurer, the

rehabilitator or the liquidator of the insurer for any losses

incurred by the insurer which were caused by a violation of the

Managing General Agents Act committed by the managing general agent.

B. The decision, determination or order of the Commissioner

pursuant to subsection A of this section shall be subject to

judicial review pursuant to the Administrative Procedures Act and

any applicable insurance laws and regulations.

Oklahoma Statutes - Title 36. Insurance Page 383

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

the Commissioner to impose any other penalties provided for in the

Oklahoma Insurance Code.

D. Nothing contained in the Managing General Agents Act is

intended to or shall, in any manner, limit or restrict the rights of

policyholders, claimants and auditors.

E. No insurer may continue to utilize the services of a

managing general agent on or after July 1, 1991, unless such

utilization is in compliance with the Managing General Agents Act.
Okla. Stat. tit. 36, § 36-6060.10A — OK Code / Title 36 / Section 36-6060.10A
Health benefit plan
Status: in_force

A. 1. No health benefit plan shall deny coverage, refuse to

issue or renew, cancel or otherwise terminate, restrict or exclude

any person from any health benefit plan issued or renewed on or

after November 1, 2010, on the basis of the applicant’s or insured’s

status as a victim of domestic abuse as defined in Section 60.1 of

Title 22 of the Oklahoma Statutes.

2. No health benefit plan shall deny a claim on the basis of

the insured’s status as a victim of domestic violence.

3. Domestic abuse shall not be considered to be a preexisting

condition.

B. As used in this section, “health benefit plan” means

individual or group coverage, a not-for-profit hospital or medical

Oklahoma Statutes - Title 36. Insurance Page 1104

service or indemnity plan, a prepaid health plan, a health

maintenance organization plan, a preferred provider organization

plan, the State and Education Employees Group Health Insurance Plan,

any program funded under Title XIX of the Social Security Act or

such other publicly funded program, and coverage provided by a

Multiple Employer Welfare Arrangement (MEWA) or employee self-

insured plan except as exempt under federal ERISA provisions.

C. In order to comply with the provisions of this section, the

acts constituting the domestic abuse shall be reported to a law

enforcement agency setting forth the relevant facts.
Okla. Stat. tit. 36, § 36-2106 — OK Code / Title 36 / Section 36-2106
Corporate powers granted; general powers and duties
Status: in_force

Every corporation organized under the provisions of this act

may, in its corporate name, sue and be sued; and shall have power to

make contracts of insurance, indemnity or suretyship with any

person, government or governmental agency, state or political

subdivision thereof, public or private corporation, board,

association, firm, estate, trustee or fiduciary in this state or

elsewhere; to prescribe the qualifications and the manner and form

of the admission or withdrawal of members; to have and use a common

seal which may be changed or altered at pleasure; to be capable in

its corporate name, or in the name of trustee chosen by the board of

directors, to take, purchase, lease, hold and dispose of real or

personal property for carrying into effect the purpose of the

corporation; to make all necessary rules and regulations concerning

the hazards incurred, the premium rates to be used, and adjustment

and payment of losses; to fix the compensation of its directors and

officers and require bond for the faithful performance of their

duties; to exercise all such other powers as may be necessary to

effect the object of such corporation, subject to the restrictions

herein provided; to make or amend bylaws not inconsistent with law

or the provisions of the articles of association, which bylaws shall

fix the date and place of the annual meeting of members, shall

designate the number of directors, which shall be not less than

five, define the duties of the officers and fix the term of office

of the directors and officers of such company, and make all further

necessary provisions concerning the conduct of its business or

affairs.

Oklahoma Statutes - Title 36. Insurance Page 626
Okla. Stat. tit. 36, § 36-2653 — OK Code / Title 36 / Section 36-2653
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 nonprofit

optometric service or indemnity corporation;

2. The contracts between the applicant and the participating

optometrists, if any, obligate each optometrist 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;

Oklahoma Statutes - Title 36. Insurance Page 695

4. The amount of money actually available for working capital

is sufficient to carry on the plan for a period of three (3) months

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

5. The applicant has secured contracts of participation from

sufficient optometrists to provide ample protection for its

subscribers within the area proposed to be served by the applicant.

6. At least a majority of the directors of every such

optometric service plan corporation must at all times be Oklahoma

licensed optometrists.
Okla. Stat. tit. 36, § 36-6912 — OK Code / Title 36 / Section 36-6912
Investment of funds
Status: in_force

With the exception of investments made in accordance with the

provisions of paragraph 1 of subsection A of Section 5 of this act,

the funds of a health maintenance organization shall be invested

only in accordance with the provisions of Article 16 of the

Insurance Code.