Okla. Stat. tit. 36, § 36-3614.1 — OK Code / Title 36 / Section 36-3614.1
Genetic nondiscrimination in insurance
Status: in_force

A. This section shall be known and may be cited as the "Genetic

Nondiscrimination in Insurance Act".

B. For purposes of the Genetic Nondiscrimination in Insurance

Act:

1. "Accident and health insurance" means accident and health

insurance as defined in Section 703 of this title, but shall not

include disability income or long-term care insurance;

2. “Family member” means, with respect to an individual, any

other individual who is a first-degree, second-degree, third-degree,

or fourth-degree relative of the individual;

Oklahoma Statutes - Title 36. Insurance Page 784

3. "Genetic information" means, with respect to any

individual, information about the genetic tests of an individual,

the genetic tests of family members of an individual, and the

manifestation of a disease or disorder in family members of the

individual. Genetic information includes, but is not limited to,

with respect to any individual, any request for, or receipt of,

genetic services, or participation in clinical research which

includes genetic services, by an individual or any family member of

the individual. Any reference to genetic information concerning an

individual or family member of an individual who is a pregnant

woman, includes genetic information of any fetus carried by a

pregnant woman, or with respect to an individual or family member

utilizing reproductive technology, includes genetic information of

any embryo legally held by an individual or family member. Genetic

information shall not include information about the sex or age of

any individual;

4. “Genetic services” mean a genetic test, genetic education,

or genetic counseling, including, but not limited to, obtaining,

interpreting, or assessing genetic information;

5. "Genetic test" means an analysis of the human DNA, RNA,

chromosomes, proteins, or metabolites that detect genotypes,

mutations or chromosomal changes. "Genetic test" shall not mean an

analysis of proteins or metabolites that does not detect genotypes,

mutations, or chromosomal changes or an analysis of proteins or

metabolites that is directly related to a manifested disease,

disorder, or pathological condition that could reasonably be

detected by a health care professional with appropriate training and

expertise in the field of medicine involved;

6. "Insurer" means any individual, corporation, association,

partnership, insurance support organization, fraternal benefit

society, insurance producer, third-party administrator, self-

insurer, or any other legal entity engaged in the business of

insurance which is licensed to do business in or incorporated or

domesticated or domiciled in or under the statutes of this state, or

actually engaged in business in this state, regardless of where the

contract of insurance is written or plan is administered or where

the corporation is incorporated, that issues accident and health

policies or plans or that administers any other type of health

insurance policy containing medical provisions including, but not

limited to, any nonprofit hospital service and indemnity and medical

service and indemnity corporation, health maintenance organizations,

preferred provider organizations, prepaid health plans and the State

and Education Employees Group Health Insurance Plan. Insurer shall

not include insurers issuing life, disability income, or long-term

care insurance;

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

or agreement of accident and health insurance, or subscriber

Oklahoma Statutes - Title 36. Insurance Page 785

certificates of medical care corporations, health care corporations,

hospital service associations, or health care maintenance

organizations, delivered or issued for delivery in this state by any

insurer; any certificate, contract or policy issued by a fraternal

benefit society; any certificate issued pursuant to a group

insurance policy delivered or issued for delivery in this state; and

any evidence of coverage issued by a health maintenance

organization. Policy or policy form shall not include life,

disability income, and long-term care insurance policies; and

8. “Underwriting purposes” means:

a. rules for, or determination of, eligibility, including

but not limited to enrollment and continued

eligibility, for benefits under the policy,

b. the computation of premium or contribution amounts

under the policy,

c. the application of any preexisting condition exclusion

under the policy, and

d. other activities related to the creation, renewal, or

replacement of a contract of health insurance or

health benefits.

C. No insurer offering an individual or group accident and

health insurance policy shall:

1. Deny or condition the issuance or effectiveness of the

policy or certificate, including but not limited to the imposition

of any exclusion of benefits under the policy based on a preexisting

condition, on the basis of the genetic information with respect to

any individual; and

2. Discriminate in the pricing of the policy or certificate,

including but not limited to the adjustment of premium rates, of an

individual on the basis of the genetic information with respect to

any individual.

D. Nothing in subsection C of this section shall be construed

to limit the ability of an insurer, to the extent otherwise

permitted under this title, from:

1. Denying or conditioning the issuance or effectiveness of the

policy or certificate or increasing the premium for a group on the

basis of manifestations of any condition, disease or disorder of an

insured or applicant; or

2. Increasing the premium for any policy or certificate issued

to an individual based on the manifestation of a condition, disease

or disorder of an individual who is covered under the policy. The

manifestation of a disease or disorder in one individual shall not

also be used as genetic information about other group members and to

further increase the premium for the group.

E. An insurer shall not request or require an individual or a

family member of an individual to undergo a genetic test.

Oklahoma Statutes - Title 36. Insurance Page 786

F. Subsection E of this section shall not be construed to

preclude an insurer from obtaining and using the results of a

genetic test in making a determination regarding payment, as defined

for the purposes of applying the regulations promulgated under part

C of Title XI and Section 264 of the Health Insurance Portability

and Accountability Act of 1996, as may be revised from time to time,

and consistent with subsection C of this section.

G. In accordance with subsection F of this section, an insurer

may request only the minimum amount of information necessary to

accomplish the intended purpose.

H. Notwithstanding subsection E of this section, an insurer may

request, but shall not require, that an individual or a family

member of an individual undergo a genetic test if each of the

following conditions is met:

1. The request is made pursuant to research that complies with

part 46 of Title 45, Code of Federal Regulations, or equivalent

Federal regulations, and any applicable state or local law or

regulations for the protection of human subjects in research;

2. The insurer clearly indicates to each individual, or in the

case of a minor child, to the legal guardian of the minor child, to

whom the request is made that:

a. compliance with the request is voluntary, and

b. noncompliance shall have no effect on enrollment

status or premium or contribution amounts;

3. No genetic information collected or acquired pursuant to the

Genetic Nondiscrimination in Insurance Act shall be used for

underwriting, determination of eligibility to enroll or maintain

enrollment status, premium rates, or the issuance, renewal, or

replacement of a policy or certificate;

4. The insurer notifies the Secretary of Health and Human

Services in writing that the insurer is conducting activities

pursuant to the exception provided for under this subsection,

including but not limited to a description of the activities

conducted; and

5. The insurer complies with other conditions as the Secretary

of Health and Human Services may by regulation require for

activities conducted pursuant to this subsection.

I. An insurer shall not request, require, or purchase genetic

information for underwriting purposes.

J. An insurer shall not request, require, or purchase genetic

information with respect to any individual prior to the enrollment

of the individual under the policy in connection with the

enrollment.

K. If an insurer obtains genetic information incidental to the

requesting, requiring, or purchasing of other information concerning

any individual, the request, requirement, or purchase shall not be

considered a violation of subsection J of this section if the

Oklahoma Statutes - Title 36. Insurance Page 787

request, requirement, or purchase is not in violation of subsection

I of this section.
Okla. Stat. tit. 36, § 36-5404 — OK Code / Title 36 / Section 36-5404
Promulgation of rules — Enforcement
Status: in_force

A. The Insurance Department is authorized to establish rules

and regulations interpreting the provisions of this act concerning

health insurers. The Department is responsible for enforcing this

act specifically with respect to health insurers. It may levy civil

fines ranging from One Hundred Dollars ($100.00) to Ten Thousand

Dollars ($10,000.00) per violation of this act. This section does

not prevent the Insurance Department from seeking assistance from

the Attorney General in enforcing this act or limit the Insurance

Departments ability to regulate the licensing of pharmacy benefit

managers. Each instance of a prohibited act constitutes a separate

violation.

B. The Attorney General is authorized to establish rules and

regulations interpreting the provisions of this act and concerning

any person or entity who is not a health insurer subject to

enforcement by the Insurance Department. The Attorney General may

impose civil fines of not less than One Hundred Dollars ($100.00)

and not greater than Ten Thousand Dollars ($10,000.00) for each

violation of the provisions of this act.

C. Nothing shall prohibit the Attorney General’s Office or the

Insurance Department from sharing any information with each other as

a part of an investigation regarding conduct that is prohibited by

Oklahoma Statutes - Title 36. Insurance Page 1057

this act. Any information shared between the Attorney General’s

Office and the Insurance Department shall be kept confidential

unless it is used during an enforcement action authorized by this

act, the disclosing agency has authorized such disclosure, or the

information is publicly available.

A violation occurs each time a prohibited act is committed.
Okla. Stat. tit. 36, § 36-6054 — OK Code / Title 36 / Section 36-6054
Definitions
Status: in_force

As used in the Health Care Freedom of Choice Act:

1. “Accident and health insurance policy” or “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. “Ambulatory surgical center” means any ambulatory surgery

facility licensed by the State Department of Health as defined in

Section 2657 of Title 63 of the Oklahoma Statutes;

3. “Home care agency” means any sole proprietorship,

partnership, association, corporation, or other organization which

administers, offers, or provides home care services, for a fee or

pursuant to a contract for such services, to clients in their place

of residence. The term “home care agency” shall not include an

individual who contracts with the Department of Human Services to

provide personal care services; provided, such individual shall not

be exempt from certification as a home health aide;

4. “Hospital” means any facility as defined in Section 1-701 of

Title 63 of the Oklahoma Statutes;

5. “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;

6. “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;

7. “Practitioner” means any person holding a valid license to

practice medicine and surgery, osteopathic medicine, chiropractic,

Oklahoma Statutes - Title 36. Insurance Page 1069

podiatric medicine, optometry or dentistry, pursuant to the state

licensing provisions of Title 59 of the Oklahoma Statutes; and

8. “Preferred provider organization (PPO)” means a network of

practitioners, hospitals, home care agencies or ambulatory surgical

centers, which have entered into a contract with an insurer to

provide health care services under the terms and conditions

established in the contract.
Okla. Stat. tit. 36, § 36-6530 — OK Code / Title 36 / Section 36-6530
Bona fide association health plans
Status: in_force

A. "Bona fide association" means any association that has a

current form M-1 filed with and accepted by the United States

Department of Labor showing Oklahoma as the state of operation and:

1. Is formed under a pathway established in accordance with the

applicable provisions of 29 CFR 2510; or

2. Was previously established or is newly formed under federal

regulatory guidance effective prior to August 20, 2018.

B. "Bona fide association health plan" means a health benefit

plan that is sponsored by a bona fide association as defined in

subsection A of this section.

C. The provisions of the Small Employer Health Insurance Reform

Act shall not apply to a health benefit plan issued to a bona fide

association health plan.

D. Each bona fide association health plan that meets the

requirements of this section shall be considered a large group for

purposes of application of the Oklahoma Insurance Code.

E. A bona fide association health plan shall be subject to the

following requirements:

1. The bona fide association health plan shall be delivered or

issued for delivery to a bona fide association in a form that meets

the requirements of Section 4502 of Title 36 of the Oklahoma

Statutes;

2. The bona fide association health plan shall comply with any

federal nondiscrimination requirement applicable to the association

health plan;

3. Small employer groups that have two (2) or more eligible

employees and that are members of the association may not be

excluded from the association health plan;

4. a. Except as provided in subparagraph b of this

paragraph, the association health plan shall maintain

an eighty percent (80%) retention rate.

b. The eighty percent (80%) retention rate specified in

subparagraph a of this paragraph shall not include

employer groups or working owners that:

Oklahoma Statutes - Title 36. Insurance Page 1291

(1) go out of business, whether through merger,

acquisition or any other reason,

(2) no longer meet eligibility requirements for

membership in the association,

(3) no longer meet participation requirements for

employers that are set forth in the plan

documents, or

(4) fail to pay premiums.

c. A bona fide association health plan that fails to

maintain the eighty percent (80%) retention rate

during any year may have twelve (12) months to correct

the retention level before being required to become

subject to the requirements of the Small Employer

Health Insurance Reform Act.

d. A bona fide association health plan may not require a

contract under this subsection between the bona fide

association health plan and the member to be effective

for a period of longer than two (2) years. This

provision shall not be construed to prevent a contract

from being extended for additional two-year periods or

preventing the member from voluntarily electing a

contract period of longer than two (2) years; and

5. Each bona fide association health plan shall be available to

be marketed and sold by all licensed agents and brokers of the

health carrier, at the health carrier's standard commission and/or

fee schedule for the calendar year.
Okla. Stat. tit. 36, § 36-1648 — OK Code / Title 36 / Section 36-1648
Powers, remedies, procedures and penalties as additional
Status: in_force

The powers, remedies, procedures and penalties provided in this

act shall be in addition to, and not in limitation of, any other

powers, remedies, procedures and penalties provided by law.
Okla. Stat. tit. 36, § 36-1510 — OK Code / Title 36 / Section 36-1510
Definitions - Valuation law - Life - Exemption -
Status: in_force

Conflict.

A. Definitions. For the purposes of this section the following

definitions shall apply on or after the operative date of the

valuation manual:

1. "Accident and health insurance" means contracts that

incorporate morbidity risk and provide protection against economic

loss resulting from accident, sickness, or medical conditions and as

may be specified in the valuation manual;

2. "Company" means an entity which:

(a) has written, issued, or reinsured life insurance

contracts, accident and health insurance contracts, or

deposit-type contracts in this state and has at least

one such policy in force or on claim, or

(b) has written, issued, or reinsured life insurance

contracts, accident and health insurance contracts, or

deposit-type contracts in any state and is required to

hold a certificate of authority to write life

insurance, accident and health insurance, or deposit-

type contracts in this state;

Oklahoma Statutes - Title 36. Insurance Page 391

3. "Deposit-type contract" means contracts that do not

incorporate mortality or morbidity risks and as may be specified in

the valuation manual;

4. "Life insurance" means contracts that incorporate mortality

risk, including annuity and pure endowment contracts, and as may be

specified in the valuation manual;

5. "NAIC" means the National Association of Insurance

Commissioners;

6. "Policyholder behavior" means any action a policyholder,

contract holder or any other person with the right to elect options,

such as a certificate holder, may take under a policy or contract

subject to this section, including, but not limited to, lapse,

withdrawal, transfer, deposit, premium payment, loan, annuitization,

or benefit elections prescribed by the policy or contract but

excluding events of mortality or morbidity that result in benefits

prescribed in their essential aspects by the terms of the policy or

contract;

7. "Principle-based valuation" means a reserve valuation that

uses one or more methods or one or more assumptions determined by

the insurer and is required to comply with subsection Q of this

section as specified in the valuation manual;

8. "Tail risk" means a risk that occurs either where the

frequency of low probability events is higher than expected under a

normal probability distribution or where there are observed events

of very significant size or magnitude; and

9. "Valuation manual" means the manual of valuation

instructions adopted by the NAIC as specified in this section or as

subsequently amended.

B. Reserve Valuation.

1. Policies and Contracts Issued Prior to the Operative Date of

the Valuation Manual.

(a) The Insurance Commissioner shall annually make

calculations of all outstanding policies, additions

thereto, unpaid dividends, annuity and pure endowment

contracts and all other obligations of every life

insurance corporation doing business in this state

issued prior to the operative date of the valuation

manual. In lieu of the valuation of the reserves

required of a foreign or alien company, the Insurance

Commissioner may accept a valuation made, or caused to

be made, by the insurance supervisory official of any

state or other jurisdiction when the valuation

complies with the minimum standard provided in this

section.

(b) The provisions set forth in subsections C, D, E, F, G,

H, J, K, L, M, N and O of this section shall apply to

all policies and contracts, as appropriate, subject to

Oklahoma Statutes - Title 36. Insurance Page 392

this section issued prior to the operative date of the

valuation manual and the provisions set forth in

subsections P and Q of this section shall not apply to

any such policies and contracts.

2. Policies and Contracts Issued On and After the Operative

Date of the Valuation Manual.

(a) The Insurance Commissioner shall annually make

calculations of all outstanding policies, additions

thereto, unpaid dividends, annuity and pure endowment

contracts, accident and health contracts, deposit-type

contracts, and all other obligations of every company

doing business in this state issued on or after the

operative date of the valuation manual. In lieu of

the valuation of the reserves required of a foreign or

alien company, the Insurance Commissioner may accept a

valuation made, or caused to be made, by the insurance

supervisory official of any state or other

jurisdiction when the valuation complies with the

minimum standard provided in this section.

(b) The provisions set forth in subsections P and Q of

this section shall apply to all policies and contracts

issued on or after the operative date of the valuation

manual.

C. 1. Valuations made by the Insurance Commissioner shall be

made upon the net premium basis. In the case of alien insurers,

such valuation shall be limited to its United States business. The

legal minimum standard for valuation of contracts issued before the

first day of January, 1910, shall be the Actuaries or Combined

Experience Table of Mortality, with interest at four percent (4%)

per annum, and for valuation of contracts issued on or after said

date and before June 6, 1949, shall be the American Experience Table

of Mortality, or the American Men Table of Mortality, with interest

at three and one-half percent (3 1/2%) per annum. Except as

otherwise provided policies issued on or after the operative date of

paragraph 4 of subsection I of Section 4029 of this title, policies

issued on or after June 6, 1949, shall be valued, collectively as to

all such policies or severally as to policies of any plan or form at

the option of the company according to the American Experience Table

of Mortality, the American Men Table of Mortality, the Commissioners

1941 Standard Ordinary Mortality Table or on and after July 1, 1962,

the Commissioners 1958 Standard Ordinary Mortality Table for

policies of ordinary insurance, and the Standard Industrial

Mortality Table (1907), or the 1941 Standard Industrial Mortality

Table or the Commissioners 1961 Standard Industrial Mortality Table

for policies of industrial insurance, with interest at not more than

three and one-half percent (3 1/2%) per annum, or four percent (4%)

per annum in the case of policies issued on or after April 11, 1974,

Oklahoma Statutes - Title 36. Insurance Page 393

and prior to March 17, 1978, and four and one-half percent (4 1/2%)

per annum for policies issued on or after March 17, 1978; provided,

however, that policies issued to substandard risks or other special

classes may be valued according to such other mortality tables, with

interest at not more than three and one-half percent (3 1/2%) per

annum, or four percent (4%) per annum in the case of policies issued

on or after April 11, 1974, and prior to March 17, 1978, and four

and one-half percent (4 1/2%) per annum for policies issued on or

after March 17, 1978, as may be approved by the Insurance

Commissioner.

2. For individual annuity and pure endowment contracts,

excluding any disability and accidental death benefits in such

policies, the 1937 Standard Annuity Mortality Table, or, at the

option of the company, the Annuity Mortality Table for 1949,

Ultimate, or any modification of either of these tables approved by

the Commissioner.

3. For group annuity and pure endowment contracts, excluding

any disability and accidental death benefits in such policies, the

Group Annuity Mortality Table for 1951, any modification of such

table approved by the Commissioner, or, at the option of the

company, any of the tables or modifications of tables specified for

individual annuity and pure endowment contracts.

4. The mortality table used in determining the minimum standard

for the valuation of ordinary life insurance policies issued on or

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

4029 of this title shall be (i) the Commissioners 1980 Standard

Ordinary Mortality Table, or (ii) at the election of the company for

any one or more specified plans of life insurance, the Commissioners

1980 Standard Ordinary Mortality Table with Ten-Year Select

Mortality Factors, or (iii) any ordinary mortality table, adopted

after 1980 by the NAIC, that is approved by regulation promulgated

by the Commissioner for use in determining the minimum standard of

valuation for such policies.

5. Except as provided in subsection D of this section, the

minimum standard of valuation for individual annuity and pure

endowment contracts issued on or after the operative date of this

section and for annuities and pure endowments purchased on or after

such operative date under group annuity and pure endowment contracts

shall be the Commissioner's reserve valuation methods defined in

subsections G and H of this section and the following tables and

interest rates:

(a) For individual annuity and pure endowment contracts

issued prior to August 29, 1977, excluding any

disability and accidental death benefit in such

contracts, the 1971 Individual Annuity Mortality

Table, or any modification of this table approved by

the Commissioner, and six percent (6%) interest for

Oklahoma Statutes - Title 36. Insurance Page 394

single premium immediate annuity contracts, and four

percent (4%) interest for all other individual annuity

and pure endowment contracts,

(b) For individual single premium immediate annuity

contracts issued on or after August 29, 1977,

excluding any disability and accidental death benefits

in such contracts, the 1971 Individual Annuity

Mortality Table or any individual annuity mortality

table adopted after 1980 by the NAIC that is approved

by regulation promulgated by the Commissioner for use

in determining the minimum standard of valuation for

such contracts, or any modification of these tables

approved by the Commissioner, and seven and one-half

percent (7 1/2%) interest,

(c) For individual annuity and pure endowment contracts

issued on or after August 29, 1977, other than single

premium immediate annuity contracts, excluding any

disability and accidental death benefits in such

contracts, the 1971 Individual Annuity Mortality Table

or any individual annuity mortality table adopted

after 1980 by the NAIC that is approved by regulation

promulgated by the Commissioner for use in determining

the minimum standard of valuation for such contracts,

or any modification of these tables approved by the

Commissioner, and five and one-half percent (5 1/2%)

interest for single premium deferred annuity and pure

endowment contracts and four and one-half percent (4

1/2%) interest for all other such individual annuity

and pure endowment contracts,

(d) For all annuities and pure endowments purchased prior

to August 29, 1977, under group annuity and pure

endowment contracts, excluding any disability and

accidental death benefits purchased under such

contracts, the 1971 Group Annuity Mortality Table, or

any modification of this table approved by the

Commissioner, and six percent (6%) interest, and

(e) For all annuities and pure endowments purchased on or

after August 29, 1977, under group annuity and pure

endowment contracts, excluding any disability and

accidental death benefits purchased under such

contracts, the 1971 Group Annuity Mortality Table or

any group annuity mortality table adopted after 1980

by the NAIC that is approved by regulation promulgated

by the Commissioner for use in determining the minimum

standard of valuation for such annuities and pure

endowments, or any modification of these tables

Oklahoma Statutes - Title 36. Insurance Page 395

approved by the Commissioner, and seven and one-half

percent (7 1/2%) interest.

After June 14, 1973, any company may file with the Commissioner

a written notice of its election to comply with the provisions of

this section after a specified date before January 1, 1985, which

shall be the operative date of this section for such company,

provided, a company may elect a different operative date for

individual annuity and pure endowment contracts from that elected

for group annuity and pure endowment contracts. If a company makes

no such election, the operative date of this section for such

company shall be January 1, 1985.

D. 1. The interest rates used in determining the minimum

standard for the valuation of all life insurance policies issued in

a particular calendar year on or after the operative date of

paragraph 4 of subsection I of Section 4029 of this title shall be

the calendar year statutory valuation interest rates as defined in

this section.

2. The interest rates used in determining the minimum standard

valuation of individual annuity and pure endowment contracts issued

in a particular calendar year on or after January 1, 1985, and

annuities and pure endowments purchased in a particular calendar

year on or after January 1, 1985, under group annuity and pure

endowment contracts shall be the calendar year statutory valuation

interest rates as defined in this section.

E. 1. The calendar year statutory valuation interest rates, I,

shall be determined as follows and the results rounded to the

nearest one-fourth of one percent (1/4 of 1%):

(a) For life insurance,

I = .03 + W (Ra - .03) + (W/2) (Rb - .09)

where Ra is the lesser of R and .09, Rb is the greater

of R and .09, R is the reference interest rate defined

in this section, and W is the weighting factor defined

in this section,

(b) For single premium immediate annuities and for annuity

benefits involving life contingencies arising from

other annuities with cash settlement options and from

guaranteed interest contracts with cash settlement

options,

I = .03 + W(r - .03)

where R 1 is the lesser of R and .09, R 2 is the

greater of R and .09, R is the reference interest rate

defined in this section, and W is the weighting factor

defined in this section,

(c) For other annuities with cash settlement options and

guaranteed interest contracts with cash settlement

options, valued on an issue year basis, except as

stated in subparagraph (b) of this paragraph, the

Oklahoma Statutes - Title 36. Insurance Page 396

formula for life insurance stated in subparagraph (a)

of this paragraph shall apply to annuities and

guaranteed interest contracts with guarantee durations

in excess of ten (10) years and the formula for single

premium immediate annuities stated in subparagraph (b)

of this paragraph shall apply to annuities and

guaranteed interest contracts with guarantee duration

of ten (10) years or less,

(d) For other annuities with no cash settlement options

and for guaranteed interest contracts with no cash

settlement options, the formula for single premium

immediate annuities stated in subparagraph (b) of this

paragraph shall apply, and

(e) For other annuities with cash settlement options and

guaranteed interest contracts with cash settlement

options, valued on a change in fund basis, the formula

for single premium immediate annuities stated in

subparagraph (b) of this paragraph shall apply.

2. However, if the calendar year statutory valuation interest

rate for any life insurance policies issued in any calendar year

determined without reference to this sentence differs from the

corresponding actual rate for similar policies issued in the

immediately preceding calendar year by less than one-half of one

percent (1/2 of 1%), the calendar year statutory valuation interest

rate for such life insurance policies shall be equal to the

corresponding actual rate for the immediately preceding calendar

year. For purposes of applying the immediately preceding sentence,

the calendar year statutory valuation interest rate for life

insurance policies issued in a calendar year shall be determined for

1980, using the reference interest rate defined for 1979, and shall

be determined for each subsequent calendar year.

F. 1. The weighting factors referred to in the formulas stated

above are given in the following table:

(a) Weighting Factors for Life Insurance:

Guarantee

Duration Weighting

(Years) Factors

10 or less .50

More than 10, but not

more than 20 .45

More than 20 .35

For life insurance, the guarantee duration is the

maximum number of years the life insurance can remain

in force on a basis guaranteed in the policy or under

options to convert to plans of life insurance with

premium rates or nonforfeiture values or both which

are guaranteed in the original policy.

Oklahoma Statutes - Title 36. Insurance Page 397

(b) Weighting factor for single premium immediate

annuities and for annuity benefits involving life

contingencies arising from other annuities with cash

settlement options and guaranteed interest contracts

with cash settlement options: .80

(c) Weighting factors for other annuities and for

guaranteed interest contracts, except as stated in

subparagraph (b) of this paragraph, shall be as

specified in tables (1), (2) and (3) below, according

to the rules and definitions in (4) and (5) below:

(1) For annuities and guaranteed interest contracts

valued on an issue year basis:

Guarantee Weighting Factor

Duration for Plan Type

(Years) A B C

5 or less .80 .60 .50

More than 5, but not

more than 10 .75 .60 .50

More than 10, but not

more than 20 .65 .50 .45

More than 20 .45 .35 .35

(2) For annuities and guaranteed interest contracts

valued on a change in fund basis, the factors

shown in (1) above increased by:

Plan Type

A B C

.15 .25 .05

(3) For annuities and guaranteed interest contracts

valued on an issue year basis (other than those

with no cash settlement options) which do not

guarantee interest on considerations received

more than one (1) year after issue or purchase

and for annuities and guaranteed interest

contracts valued on a change in fund basis which

do not guarantee interest rates on considerations

received more than twelve (12) months beyond the

valuation date, the factors shown in (1) or

derived in (2) increased by:

Plan Type

A B C

.05 .05 .05

(4) For other annuities with cash settlement options

and guaranteed interest contracts with cash

settlement options, the guarantee duration is the

number of years for which the contract guarantees

interest rates in excess of the calendar year

statutory valuation interest rate for life

Oklahoma Statutes - Title 36. Insurance Page 398

insurance policies with guarantee duration in

excess of twenty (20) years. For other annuities

with no cash settlement options and for

guaranteed interest contracts with no cash

settlement options, the guarantee duration is the

number of years from the date of issue or date of

purchase to the date annuity benefits are

scheduled to commence.

(5) Plan type as used in the above tables is defined

as follows:

Plan Type A: At any time policyholder may

withdraw funds only (1) with an adjustment to

reflect changes in interest rates or asset values

since receipt of the funds by the insurance

company, or (2) without such adjustment but in

installments over five (5) years or more, or (3)

as an immediate life annuity, or (4) no

withdrawal permitted.

Plan Type B: Before expiration of the interest

rate guarantee, policyholder may withdraw funds

only (1) with adjustment to reflect changes in

interest rates or asset values since receipt of

the funds by the insurance company, or (2)

without such adjustment but in installments over

five (5) years or more, or (3) no withdrawal

permitted. At the end of interest rate

guarantee, funds may be withdrawn without such

adjustment in a single sum or installments over

less than five (5) years.

Plan Type C: Policyholder may withdraw funds

before expiration of interest rate guarantee in a

single sum or installments over less than five

(5) years either (1) without adjustment to

reflect changes in interest rates or asset values

since receipt of the funds by the insurance

company, or (2) subject only to a fixed surrender

charge stipulated in the contract as a percentage

of the fund.

2. A company may elect to value guaranteed interest contracts

with cash settlement options and annuities with cash settlement

options on either an issue year basis or on a change in fund basis.

Guaranteed interest contracts with no cash settlement options and

other annuities with no cash settlement options shall be valued on

an issue year basis. As used in this section, an issue year basis

of valuation refers to a valuation basis under which the interest

rate used to determine the minimum valuation standard for the entire

duration of the annuity or guaranteed interest contract is the

Oklahoma Statutes - Title 36. Insurance Page 399

calendar year valuation interest rate for the year of issue or year

of purchase of the annuity or guaranteed interest contract, and the

change in fund basis of valuation refers to a valuation basis under

which the interest rate used to determine the minimum valuation

standard applicable to each change in the fund held under the

annuity or guaranteed interest contract is the calendar year

valuation interest rate for the year of the change in the fund.

G. 1. The reference interest rate referred to above shall be

defined as follows:

(a) For life insurance, the lesser of the average over a

period of thirty-six (36) months and the average over

a period of twelve (12) months, ending on June 30 of

the calendar year next preceding the year of issue, of

Moody's Corporate Bond Yield Average - Monthly Average

Corporates, as published by Moody's Investors Service,

Inc.,

(b) For single premium immediate annuities and for annuity

benefits involving life contingencies arising from

other annuities with cash settlement options and

guaranteed interest contracts with cash settlement

options, the average over a period of twelve (12)

months, ending on June 30 of the calendar year of

issue or year of purchase of the Monthly Average of

the Composite Yield on Seasoned Corporate Bonds, as

published by Moody's Investors Service, Inc.,

(c) For other annuities with cash settlement options and

guaranteed interest contracts with cash settlement

options, valued on an issue year basis, except as

stated in subparagraph (b) of this paragraph, with

guarantee duration in excess of ten (10) years, the

lesser of the average over a period of thirty-six (36)

months and the average over a period of twelve (12)

months, ending on June 30 of the calendar year of

issue or purchase, of the Monthly Average of the

Composite Yield on Seasoned Corporate Bonds, as

published by Moody's Investors Service, Inc.,

(d) For other annuities with cash settlement options and

guaranteed interest contracts with cash settlement

options, valued on an issue year basis, except as

stated in subparagraph (b) of this paragraph, with

guarantee duration of ten (10) years or less, the

average over a period of twelve (12) months, ending on

June 30 of the calendar year of issue or purchase, of

the Monthly Average of the Composite Yield on Seasoned

Corporate Bonds, as published by Moody's Investors

Service, Inc.,

Oklahoma Statutes - Title 36. Insurance Page 400

(e) For other annuities with no cash settlement options

and for guaranteed interest contracts with no cash

settlement options, the average over a period of

twelve (12) months, ending on June 30 of the calendar

year of issue or purchase, of the Monthly Average of

the Composite Yield on Seasoned Corporate Bonds, as

published by Moody's Investors Service, Inc., and

(f) For other annuities with cash settlement options and

guaranteed interest contracts with cash settlement

options, valued on a change in fund basis, except as

stated in subparagraph (b) of this paragraph, the

average over a period of twelve (12) months, ending on

June 30 of the calendar year of the change in the

fund, of the Monthly Average of the Composite Yield on

Seasoned Corporate Bonds, as published by Moody's

Investors Service, Inc.

H. In the event that the Moody's Corporate Bond Yield Average -

Monthly Average Corporates is no longer published by Moody's

Investors Service, Inc., or in the event that the NAIC determines

that the Moody's Corporate Bond Yield Average - Monthly Average

Corporates as published by Moody's Investors Service, Inc., is no

longer appropriate for the determination of the reference interest

rate, then an alternative method for determination of the reference

interest rate, which is adopted by the NAIC and approved by

regulation promulgated by the Commissioner, may be substituted.

I. The Commissioner may vary the standards of interest and

mortality in particular cases of invalid life and other extra

hazards and value policies in groups, use approximate averages for

fractions of a year and otherwise, and accept the valuation of the

Department of Insurance of any other state or country, if made upon

a basis and according to standards not lower than herein required or

authorized, in place of the valuation herein required.

J. If in any contract year the gross premium charged by any

company on any policy or contract is less than the valuation net

premium for the policy or contract calculated by the method used in

computing the reserve liability thereon but using the minimum

valuation standards of mortality and rate of interest, the minimum

reserve required for such policy or contract shall be the greater of

either the reserve calculated according to the mortality table, rate

of interest and method actually used for such policy or contract, or

the reserve calculated by the method actually used for such policy

or contract, but using the minimum valuation standards of mortality

and rate of interest and replacing the valuation net premium by the

actual gross premium in each contract year for which the valuation

net premium exceeds the actual gross premium. The minimum valuation

standards of mortality and rate of interest referred to in this

subsection are those standards stated in this section.

Oklahoma Statutes - Title 36. Insurance Page 401

Provided that for any life insurance policy issued on or after

January 1, 1986, for which the gross premium in the first policy

year exceeds that of the second year and for which no comparable

additional benefit is provided in the first year for such excess,

and which provides an endowment benefit or a cash surrender value or

a combination thereof in an amount greater than such excess premium,

the foregoing provisions of this subsection shall be applied as if

the method actually used in calculating the reserve for such policy

were the method described in paragraph 2 of subsection L of this

section, ignoring subparagraph (c) of that paragraph. The minimum

reserve at each policy anniversary of such a policy shall be the

greater of the minimum reserve calculated in accordance with

paragraph 2 of subsection L of this section, including subparagraph

(c) of that paragraph, and the minimum reserve calculated in

accordance with this subsection.

K. Term Insurance.

Policies issued by life insurance companies doing business in

this state may provide for not more than one (1) year preliminary

term insurance, purchased by the whole or part of the premium to be

received during the first policy year, under the conditions

prescribed in this section.

L. Reserves.

1. Reserves on policies of ordinary insurance which are valued

in accordance with the American Experience Table of Mortality, or

the American Men Table of Mortality, and policies of industrial

insurance which are valued in accordance with the Standard

Industrial Mortality Table (1907), which are issued on or after June

6, 1949, may be computed as follows: If the premium charged for

term insurance under a limited payment life preliminary term policy

providing for the payment of all premiums thereon in less than

twenty (20) years from the date of the policy or under an endowment

preliminary term policy, exceeds that charged for life insurance,

under twenty-year payment life preliminary term policies of the same

company, the reserve thereon at the end of any year, including the

first, shall not be less than the reserve on a twenty-payment life

preliminary term policy issued in the same year and at the same age,

together with an amount which shall be equivalent to the

accumulation of a net level premium sufficient to provide for a pure

endowment at the end of the premium payment period equal to the

difference between the value at the end of such period of such a

twenty-payment life preliminary term policy and the full reserve at

such time of such a limited payment life or endowment policy. The

premium payment period is the period during which premiums are

concurrently payable under such twenty-payment life preliminary term

policy and such limited payment life or endowment policy. Any

policy valued in accordance with this paragraph shall specify the

Oklahoma Statutes - Title 36. Insurance Page 402

mortality table, rate of interest, and method used in calculating

the reserves on the policy.

2. Reserves on policies of ordinary insurance which are valued

in accordance with the Commissioners 1941 Standard Ordinary

Mortality Table, the Commissioners 1958 Standard Ordinary Mortality

Table, or the Commissioners 1980 Standard Ordinary Mortality Table,

policies of industrial insurance which are valued in accordance with

the 1941 Standard Industrial Mortality Table or the Commissioners

1961 Standard Industrial Mortality Table and policies valued in

accordance with any substandard mortality table approved by the

Commissioner pursuant to this section, issued on or after June 6,

1949, may be computed in accordance with the Commissioners Reserve

Valuation method, defined as follows: Reserves for the life

insurance and endowment benefits of policies providing for a uniform

amount of insurance and requiring the payment of uniform premiums

shall be the excess, if any, of the present value, at the date of

valuation, of such future guaranteed benefits provided for by such

policies, over the then present value of any future modified net

premiums therefor. The modified net premiums for any such policy

shall be such uniform percentage of the respective contract premiums

for such benefits that the present value, at the date of issue of

the policy, of all such modified net premiums shall be equal to the

sum of the then present value of such benefits provided for by the

policy and the excess of subparagraph (a) over subparagraph (b) as

follows:

(a) a net level annual premium equal to the present value,

at the date of issue, of such benefits provided for

after the first policy year, divided by the present

value, at the date of issue, of an annuity of one per

annum payable on the first and each subsequent

anniversary of such policy on which a premium falls

due; provided, however, that such level annual premium

shall not exceed the net level annual premium on the

nineteen-year premium whole life plan for insurance of

the same amount at the age one (1) year higher than

the age at issue of such policy,

(b) a net one-year term premium for such benefits provided

for in the first policy year, and

(c) provided that for any life insurance policy issued on

or after January 1, 1986, for which the contract

premium in the first policy year exceeds that of the

second year and for which no comparable additional

benefit is provided in the first year for such excess

and which provides an endowment benefit or a cash

surrender value or a combination thereof in an amount

greater than such excess premium, the reserve

according to the commissioners reserve valuation

Oklahoma Statutes - Title 36. Insurance Page 403

method as of any policy anniversary occurring on or

before the assumed ending date defined herein as the

first policy anniversary on which the sum of any

endowment benefit and any cash surrender value then

available is greater than such excess premium shall,

except as otherwise provided in subsection J of this

section, be the greater of the reserve as of such

policy anniversary calculated as described in this

paragraph and the reserve as of such policy

anniversary calculated as described in subparagraph

(a) of this paragraph, but with (i) the value defined

in subparagraph (a) of that paragraph being reduced by

fifteen percent (15%) of the amount of such excess

first-year premium, (ii) all present values of

benefits and premiums being determined without

reference to premiums or benefits provided for by the

policy after the assumed ending date, (iii) the policy

being assumed to mature on such date as an endowment,

and (iv) the cash surrender value provided on such

date being considered as an endowment benefit. In

making the above comparison, the mortality and

interest bases stated in this section shall be used.

Reserves for life insurance policies providing for a varying

amount of insurance or requiring the payment of varying premiums

shall be calculated by a method consistent with the principles of

paragraph 2 of this subsection, provided that any extra premiums

charged because of impairments or special hazards shall be

disregarded in the determination of modified net premiums. All

modified net premiums and present values referred to in this

section, except those based on sex-distinct mortality tables, may be

calculated according to an age not more than six (6) years younger

than the actual age of the insured in the case of any category of

ordinary policies issued on female risks.

M. 1. Reserves on policies of any category may be computed, at

the option of the company, according to any valuation standard which

produces greater aggregate reserves than those computed according to

the minimum standard provided in this section.

2. 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 insurance company based on then estimates of

future experience, or in the case of any plan of life insurance or

annuity which is of such a nature that the minimum reserves cannot

be determined by the methods described in subsections C, I, J, K,

and N of this section, the reserves which are held under any such

plan must:

(a) be appropriate in relation to the benefits and the

pattern of premiums for that plan, and

Oklahoma Statutes - Title 36. Insurance Page 404

(b) be computed by a method which is consistent with the

principles of this Standard Valuation Law,

as determined by regulations promulgated by the Commissioner.

N. This section shall apply to all annuity and pure endowment

contracts other than group annuity and pure endowment contracts

purchased under a retirement plan or plan of deferred compensation,

established or maintained by an employer (including a partnership or

sole proprietorship) or by an employee organization, or by both,

other than a plan providing individual retirement accounts or

individual retirement annuities under Section 408 of the Internal

Revenue Code, as now or hereafter amended.

Reserves according to the Commissioners Annuity Reserve method

for benefits under annuity or pure endowment contracts, excluding

any disability and accidental death benefits in such contracts,

shall be the greatest of the respective excesses of the present

values, at the date of valuation, of the future guaranteed benefits,

including guaranteed nonforfeiture benefits, provided for by such

contracts at the end of each respective contract year, over the

present value, at the date of valuation, of any future valuation

considerations derived from future gross considerations, required by

the terms of such contract, that become payable prior to the end of

such respective contract year. The future guaranteed benefits shall

be determined by using the mortality table, if any, and the interest

rate, or rates, specified in such contracts for determining

guaranteed benefits. The valuation considerations are the portions

of the respective gross considerations applied under the terms of

such contracts to determine nonforfeiture values.

O. For accident and health insurance contracts issued on or

after the operative date of the valuation manual, the standard

prescribed in the valuation manual is the minimum standard of

valuation required under paragraph 2 of subsection B of this

section. For accident and health insurance contracts issued prior

to the operative date of the valuation manual, the minimum standard

of valuation is the standard adopted by the commissioner by rule.

P. Valuation Manual for Policies Issued On or After the

Operative Date of the Valuation Manual.

1. For policies issued on or after the operative date of the

valuation manual, the standard prescribed in the valuation manual is

the minimum standard of valuation required under paragraph 2 of

subsection B of this section, except as provided under paragraph 5

or 7 of this subsection.

2. The operative date of the valuation manual is January 1 of

the first calendar year following the first July 1 as of which all

of the following have occurred:

(a) the valuation manual has been adopted by the NAIC by

an affirmative vote of at least forty-two members, or

Oklahoma Statutes - Title 36. Insurance Page 405

three-fourths (3/4) of the members voting, whichever

is greater,

(b) the Standard Valuation Law, as amended by the NAIC in

2009, or legislation including substantially similar

terms and provisions, has been enacted by states

representing greater than seventy-five percent (75%)

of the direct premiums written as reported in the

following annual statements submitted for 2008: life,

accident and health annual statements; health annual

statements; or fraternal annual statements, and

(c) the Standard Valuation Law, as amended by the NAIC in

2009, or legislation including substantially similar

terms and provisions, has been enacted by at least

forty-two of the following fifty-five jurisdictions:

the fifty states of the United States, American Samoa,

the American Virgin Islands, the District of Columbia,

Guam, and Puerto Rico.

3. Unless a change in the valuation manual specifies a later

effective date, changes to the valuation manual shall be effective

on January 1 following the date when all of the following have

occurred:

(a) the change to the valuation manual has been adopted by

the NAIC by an affirmative vote representing:

(1) at least three-fourths (3/4) of the members of

the NAIC voting, but not less than a majority of

the total membership, and

(2) members of the NAIC representing jurisdictions

totaling greater than seventy-five percent (75%)

of the direct premiums written as reported in the

following annual statements most recently

available prior to the vote in division (1) of

this subparagraph: life, accident and health

annual statements; health annual statements; or

fraternal annual statements, and

(b) the valuation manual becomes effective pursuant to

order adopted by the commissioner.

4. The valuation manual must specify all of the following:

(a) minimum valuation standards for and definitions of the

policies or contracts subject to paragraph 2 of

subsection B of this section. Such minimum valuation

standards shall be:

(1) the commissioner's reserve valuation method for

life insurance contracts, other than annuity

contracts, subject to paragraph 2 of subsection B

of this section,

Oklahoma Statutes - Title 36. Insurance Page 406

(2) the commissioner's annuity reserve valuation

method for annuity contracts subject to paragraph

2 of subsection B of this section, and

(3) minimum reserves for all other policies or

contracts subject to paragraph 2 of subsection B

of this section,

(b) which policies or contracts or types of policies or

contracts that are subject to the requirements of a

principle-based valuation in paragraph 1 of subsection

Q of this section and the minimum valuation standards

consistent with those requirements,

(c) for policies and contracts subject to a principle-

based valuation under subsection Q of this section:

(1) requirements for the format of reports to the

commissioner under subparagraph (c) of paragraph

2 of subsection Q of this section and which shall

include information necessary to determine if the

valuation is appropriate and in compliance with

this section,

(2) assumptions shall be prescribed for risks over

which the company does not have significant

control or influence, and

(3) procedures for corporate governance and oversight

of the actuarial function, and a process for

appropriate waiver or modification of such

procedures,

(d) for policies not subject to a principle-based

valuation under subsection Q of this section, the

minimum valuation standard shall either:

(1) be consistent with the minimum standard of

valuation prior to the operative date of the

valuation manual, or

(2) develop reserves that quantify the benefits and

guarantees, and the funding, associated with the

contracts and their risks at a level of

conservatism that reflects conditions that

include unfavorable events that have a reasonable

probability of occurring,

(e) other requirements, including, but not limited to,

those relating to reserve methods, models for

measuring risk, generation of economic scenarios,

assumptions, margins, use of company experience, risk

measurement, disclosure, certifications, reports,

actuarial opinions and memorandums, transition rules

and internal controls, and

(f) the data and form of the data required under

subsection R of this section, with whom the data must

Oklahoma Statutes - Title 36. Insurance Page 407

be submitted, and may specify other requirements,

including data analyses and reporting of analyses.

5. In the absence of a specific valuation requirement or if a

specific valuation requirement in the valuation manual is not, in

the opinion of the commissioner, in compliance with this subsection,

then the company shall, with respect to such requirements, comply

with minimum valuation standards prescribed by the commissioner by

regulation.

6. The commissioner may engage a qualified actuary, at the

expense of the company, to perform an actuarial examination of the

company and opine on the appropriateness of any reserve assumption

or method used by the company, or to review and opine on a company's

compliance with any requirement set forth in this section. The

commissioner may rely upon the opinion, regarding provisions

contained within this section, of a qualified actuary engaged by the

commissioner of another state, district or territory of the United

States. As used in this paragraph, the term "engage" includes

employment and contracting.

7. The commissioner may require a company to change any

assumption or method that in the opinion of the commissioner is

necessary in order to comply with the requirements of the valuation

manual or this section; and the company shall adjust the reserves as

required by the commissioner. The commissioner may take other

disciplinary action as permitted pursuant to rule.

Q. Requirements of a Principle-Based Valuation.

1. A company must establish reserves using a principle-based

valuation that meets the following conditions for policies or

contracts as specified in the valuation manual:

(a) quantify the benefits and guarantees, and the funding,

associated with the contracts and their risks at a

level of conservatism that reflects conditions that

include unfavorable events that have a reasonable

probability of occurring during the lifetime of the

contracts. For policies or contracts with significant

tail risk, reflects conditions appropriately adverse

to quantify the tail risk,

(b) incorporate assumptions, risk analysis methods and

financial models and management techniques that are

consistent with, but not necessarily identical to,

those utilized within the company's overall risk

assessment process, while recognizing potential

differences in financial reporting structures and any

prescribed assumptions or methods,

(c) incorporate assumptions that are derived in one of the

following manners:

(1) the assumption is prescribed in the valuation

manual,

Oklahoma Statutes - Title 36. Insurance Page 408

(2) for assumptions that are not prescribed, the

assumptions shall:

(i) be established utilizing the company's

available experience, to the extent it is

relevant and statistically credible, or

(ii) to the extent that company data is not

available, relevant, or statistically

credible, be established utilizing other

relevant, statistically credible experience,

and

(d) provide margins for uncertainty including adverse

deviation and estimation error, such that the greater

the uncertainty the larger the margin and resulting

reserve.

2. A company using a principle-based valuation for one or more

policies or contracts subject to this subsection as specified in the

valuation manual shall:

(a) establish procedures for corporate governance and

oversight of the actuarial valuation function

consistent with those described in the valuation

manual,

(b) provide to the commissioner and the board of directors

an annual certification of the effectiveness of the

internal controls with respect to the principle-based

valuation. Such controls shall be designed to assure

that all material risks inherent in the liabilities

and associated assets subject to such valuation are

included in the valuation, and that valuations are

made in accordance with the valuation manual. The

certification shall be based on the controls in place

as of the end of the preceding calendar year, and

(c) develop, and file with the commissioner upon request,

a principle-based valuation report that complies with

standards prescribed in the valuation manual.

3. A principle-based valuation may include a prescribed

formulaic reserve component.

R. Experience Reporting for Policies In Force On or After the

Operative Date of the Valuation Manual.

A company shall submit mortality, morbidity, policyholder

behavior, or expense experience and other data as prescribed in the

valuation manual.

S. When the actual funds of any life insurance company doing

business in this state, exclusive of its capital, are not of a net

cash value equal to its liabilities including the net value of its

policies according to the basis and minimum standards prescribed or

authorized by the laws of this state, it shall be the duty of the

Insurance Commissioner to give notice to such company and its agents

Oklahoma Statutes - Title 36. Insurance Page 409

to discontinue issuing new policies within this state, until such

time as its funds have become equal to its liabilities as aforesaid.

Any officer or agent who, after such notice has been given, issues

or delivers a new policy from and on behalf of such company before

its funds have become equal to its liabilities, as aforesaid, shall

forfeit to the state for each offense a sum not less than One

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

($5,000.00) for each occurrence.

T. Single State Exemption.

1. The Commissioner may exempt specific product forms or

product lines of a domestic company that is licensed and doing

business only in Oklahoma from the requirements of subsection P of

this section provided:

(a) the Commissioner has issued an exemption in writing to

the company and has not subsequently revoked the

exemption in writing, and

(b) the company computes reserves using assumptions and

methods used prior to the operative date of the

valuation manual in addition to any requirements

established by the commissioner and promulgated by

regulation.

2. For any company granted an exemption under this section,

subsections B and C of Section 4061 of this title and subsections C,

D, E, F, G, H, J, K, L, M, N and O of this section shall be

applicable. With respect to any company applying this exemption,

any reference to subsection P found in subsections B and C of

Section 4061 and subsections C, D, E, F, G, H, J, K, L, M, N and O

of this section shall not be applicable.

U. Conflict of law.

If any provision of law is inconsistent with the provisions of

this section, this section shall prevail.
Okla. Stat. tit. 36, § 36-5124 — OK Code / Title 36 / Section 36-5124
Rules and regulations
Status: in_force

A. The Insurance Commissioner may promulgate and adopt rules

and regulations implementing the provisions of the Credit for

Reinsurance Act.

B. The Insurance Commissioner is further authorized to adopt

rules and regulations applicable to reinsurance arrangements

described in paragraph 1 of this subsection.

1. A regulation adopted pursuant to this subsection may apply

only to reinsurance relating to:

a. life insurance policies with guaranteed nonlevel gross

premiums or guaranteed nonlevel benefits,

b. universal life insurance policies with provisions

resulting in the ability of a policyholder to keep a

policy in force over a secondary guarantee period,

c. variable annuities with guaranteed death or living

benefits,

d. long-term care insurance policies, or

e. such other life and health insurance and annuity

products as to which the National Association of

Insurance Commissioners (NAIC) adopts model regulatory

requirements with respect to credit for reinsurance.

2. A regulation adopted pursuant to this subsection which is

applicable to policies listed in subparagraph a or b of paragraph 1

of this subsection may apply to any treaty containing:

a. policies issued on or after January 1, 2015, and

b. policies issued prior to January 1, 2015, if risk

pertaining to such pre-2015 policies is ceded in

connection with the treaty, in whole or in part, on or

after January 1, 2015, unless the NAIC Accounting

Practices and Procedures Manual in effect as of

December 31, 2015, excluded such pre-2015 policies

from the requirements concerning the amounts and forms

Oklahoma Statutes - Title 36. Insurance Page 1053

of security supporting reinsurance arrangements that

would otherwise be applicable to such policies.

3. A regulation adopted pursuant to this subsection may require

the ceding insurer, in calculating the amounts or forms of security

required to be held under regulations promulgated under this

authority, to use the Valuation Manual adopted by the NAIC under

Section 11B (1) of the NAIC Standard Valuation Law including all

amendments adopted by the NAIC and in effect on the date as of which

the calculation is made, to the extent applicable.

4. A regulation adopted pursuant to this subsection shall not

apply to cessions to an assuming insurer that:

a. meets the conditions set forth in subsection G of

Section 5122 of this title,

b. is certified in this state, or

c. maintains at least Two Hundred Fifty Million Dollars

($250,000,000.00) in capital and surplus when

determined in accordance with the NAIC Accounting

Practices and Procedures Manual including all

amendments thereto adopted by the NAIC, excluding the

impact of any permitted or prescribed practices, and

is:

(1) licensed in at least twenty-six states, or

(2) licensed in at least ten states, and licensed or

accredited in a total of at least thirty-five

states.

5. The authority to adopt regulations pursuant to this

subsection does not limit the Commissioner's general authority to

adopt regulations pursuant to subsection A of this section.
Okla. Stat. tit. 36, § 36-2707.1 — OK Code / Title 36 / Section 36-2707.1
Principal office - Annual statement - Grievance and
Status: in_force

complaint procedures.

A. The principal office of any domestic society shall be

located in this state. The meetings of its supreme governing body

may be held in any state, district, province or territory wherein

such society has at least one subordinate lodge. All business

transacted at such meetings shall be as valid in all respects as if

such meetings were held in this state. The minutes of the

proceedings of the supreme governing body and of the board of

directors shall be in the English language.

B. 1. A society may provide in its laws for an official

publication in which any notice, report, or statement required by

law to be given to members, including notice of election, may be

published. Such required reports, notices and statements shall be

printed conspicuously in the publication. If the records of a

society show that two or more members have the same mailing address,

an official publication mailed to one member is deemed to be mailed

to all members at the same address unless a member requests a

separate copy.

2. Not later than June 1 of each year, a synopsis of the

society's annual statement providing an explanation of the facts

concerning the condition of the society thereby disclosed shall be

printed and mailed to each benefit member of the society or, in lieu

thereof, such synopsis may be published in the society's official

publication.

C. A society may provide in its laws or rules for grievance or

complaint procedures for members.
Okla. Stat. tit. 36, § 36-1608 — OK Code / Title 36 / Section 36-1608
State, district or Canadian obligations
Status: in_force

An insurer may invest in bonds, notes, warrants and other

securities not in default which are the direct obligations of any

state of the United States or of the District of Columbia, or of the

government of Canada or any province thereof, or for which the full

faith and credit of such state, district, government or province has

been pledged for the payment of principal and interest. Bonds,

notes, warrants and other securities classified as revenue,

prerefunded or declining balances are not considered acceptable

investments for this purpose.
Okla. Stat. tit. 36, § 36-3642 — OK Code / Title 36 / Section 36-3642
Purpose of act - Intent
Status: in_force

A. The purpose of the Life, Accident and Health Insurance

Policy Language Simplification Act is to establish minimum standards

for language used in policies and certificates of life, accident and

health insurance, and subscriber certificates of medical care

corporations, health care corporations, hospital service

associations, and health maintenance organizations, delivered or

issued for delivery in this state, to facilitate ease of reading by

insureds and subscribers.

B. The Life, Accident and Health Insurance Policy Language

Simplification Act is not intended to increase the risk assumed by

insurance companies or other entities or to supercede their

obligation to comply with the substance of other applicable

insurance laws. The Life, Accident and Health Insurance Policy

Language Simplification Act is not intended to impede flexibility

and innovation in the development of policy forms or content, or to

lead to the standardization of policy forms or content.
Okla. Stat. tit. 36, § 36-660.7 — OK Code / Title 36 / Section 36-660.7
Multiple mutual insurers — Joint application and plan
Status: in_force

The concurrent reorganization of a domestic mutual insurer with

one or more mutual insurers, domestic or foreign, into a single

mutual insurance holding company, whether domestic or foreign, may

be accomplished by a joint application and a joint plan of

reorganization and may be approved by the Oklahoma Insurance

Commissioner by complying with the requirements of this act. The

Commissioner may determine that such other procedures are

unnecessary to avoid duplicative costs and efforts in satisfying the

requirements of this act and effectuating the reorganization.
Okla. Stat. tit. 36, § 36-6812.1 — OK Code / Title 36 / Section 36-6812.1
Required information, format, and coding protocol in
Status: in_force

reports.

Reports required under Section 6811 of this title must contain

the following information in a format and coding protocol prescribed

by the Insurance Commissioner. To the greatest extent possible

while still fulfilling the purposes of the Medical Professional

Liability Insurance Closed Claim Reports Act, the format and coding

protocol shall be consistent with the format and coding protocol for

data reported to the National Practitioner Data Bank.

1. Claim and incident identifiers, including:

a. a claim identifier assigned to the claim by the

insuring entity, self-insurer, facility, or provider,

and

Oklahoma Statutes - Title 36. Insurance Page 1371

b. an incident identifier if companion claims have been

made by a claimant;

2. The policy limits of the medical professional liability

insurance policy covering the claim;

3. The medical specialty of the provider who was primarily

responsible for the medical malpractice incident that led to the

claim;

4. The type of health care facility where the medical

malpractice incident occurred;

5. The primary location within a facility where the medical

malpractice incident occurred;

6. The geographic location, by city and county, where the

medical malpractice incident occurred;

7. The sex and age of the injured person on the incident date;

8. The severity of malpractice injury using the National

Practitioner Data Bank severity scale;

9. The dates of:

a. the earliest act or omission by the defendant that was

the proximate cause of the claim,

b. notice to the insuring entity, self-insurer, facility,

or provider,

c. suit, if a suit was filed,

d. final indemnity payment, if any, and

e. final action by the insuring entity, self-insurer,

facility, or provider to close the claim;

10. Settlement information that identifies the timing and final

method of claim disposition, including:

a. claims settled by the parties,

b. claims disposed of by a court, including the date

disposed,

c. claims disposed of by alternative dispute resolution,

such as arbitration, mediation, private trial, and

other common dispute resolution methods, and

d. whether the settlement occurred before or after trial,

if a trial occurred;

11. Specific information about the indemnity payments and

defense and cost-containment expenses, including:

a. for claims disposed of by a court that result in a

verdict or judgment that itemizes damages:

(1) the indemnity payment made on behalf of the

defendant,

(2) economic damages,

(3) noneconomic damages,

(4) punitive damages, if applicable, and

(5) defense and cost-containment expenses, including

court costs, attorney fees, and costs of expert

witnesses, and

Oklahoma Statutes - Title 36. Insurance Page 1372

b. for claims that do not result in a verdict or judgment

that itemizes damages:

(1) the total amount of the settlement on behalf of

the defendant,

(2) the insuring entity’s or self-insurer’s best

estimate of economic damages included in the

settlement,

(3) the insuring entity’s or self-insurer’s best

estimate of noneconomic damages included in the

settlement, and

(4) defense and cost-containment expenses, including

court costs, attorney fees, and costs of expert

witnesses;

12. The reason for the medical professional liability claim.

The reporting entity must use the same allegation group and specific

allegation codes that are used for mandatory reporting to the

National Practitioner Data Bank; and

13. Any other closed claim data the Commissioner determines to

be necessary to accomplish the purpose of the Medical Professional

Liability Insurance Closed Claim Reports Act and requires by rule.
Okla. Stat. tit. 36, § 36-2813 — OK Code / Title 36 / Section 36-2813
Applicability
Status: in_force

The provisions of this article apply only to farmers' mutual

fire insurance associations and such associations shall be governed

by this article to the extent provided herein. Such associations

shall comply with all provisions of the Insurance Code to the extent

that such provisions are not in conflict with the provisions of this

article.
Okla. Stat. tit. 36, § 36-1250.11 — OK Code / Title 36 / Section 36-1250.11
Statement of charges - Notice of hearing
Status: in_force

Upon the receipt of the results of an investigation instituted

pursuant to the provisions of Section 1250.10 of this title, the

Insurance Commissioner shall review the results and shall determine

whether, by the standards set out in Sections 1250.3 and 1250.5 of

this title, further action is required. If the Insurance

Commissioner deems further action necessary, the Commissioner shall

issue and serve upon the insurer a statement of the charges and a

notice in accordance with the Administrative Procedures Act. No

insurer shall be deemed in violation of the Unfair Claims Settlement

Practices Act solely by reason of the numbers and types of such

complaints or claims.
Okla. Stat. tit. 36, § 36-5007 — OK Code / Title 36 / Section 36-5007
Statutory premium reserve
Status: in_force

A. Statutory Premium Reserve Required.

1. Each domestic title insurer doing title insurance business

under this chapter shall establish and maintain a statutory premium

reserve during the period and for the uses and purposes provided by

this article, which shall at all times and for all purposes be

deemed and shall constitute unearned portions of the original

premium, and shall be charged as a reserve liability of that insurer

in determining its financial condition.

2. The reserve required under this section shall be cumulative.

The reserve shall be established and shall consist of the amounts

required under this article.

B. Annual Additions to Reserves for Calendar Year 2014 and

Thereafter.

1. For companies with annual gross premiums of Twenty Million

Dollars ($20,000,000.00) or more, beginning with premiums received

on January 1, 2015, the statutory premium reserve shall consist of

an amount not less than five percent (5%) of the sum of the

following, as set forth in the title insurer's annual statement:

a. the direct premium written by the title insurer, and

b. premium for reinsurance assumed less premium for

reinsurance ceded during the year.

Oklahoma Statutes - Title 36. Insurance Page 1020

2. Companies with annual gross premiums of less than Twenty

Million Dollars ($20,000,000.00) may, at their election, establish

premium reserves as set forth in paragraph 1 of subsection B of this

section, or alternatively, in an amount not less than the title

insurer's reserve for incurred but not reported claims (IBNR) plus

the reserve for unallocated loss adjustment expense (ULAE). For

companies electing the latter option, the remainder of subsections B

and C of this section do not apply.

3. The statutory premium reserve calculations in subsection B

of this section are minimum amounts. A title insurance underwriter

may set aside amounts in excess of the minimum reserve requirement.

4. Additions to the statutory premium reserve set aside for

title insurance policies written or assumed under paragraph 1 of

subsection B of this section shall be reduced over a 20-year period

beginning in the year after the year in which the policies are

written or assumed, as provided by paragraph 5 of this subsection,

no faster than:

a. thirty-five percent (35%) of the additions in the

first year succeeding the year of addition,

b. fifteen percent (15%) of the additions in each of the

succeeding two years,

c. ten percent (10%) of the additions in the next

succeeding year,

d. three percent (3%) of the additions in the next three

succeeding years,

e. two percent (2%) of the additions in the next three

succeeding years, and

f. one percent (1%) of the additions in the next ten

succeeding years.

5. The annual reductions under paragraph 4 of subsection B of

this section shall be made in increments of one-fourth (1/4) of the

appropriate percentage of the additions on March 31, June 30,

September 30, and December 31 of each year.

C. Establishment of Reserves for the Periods After 2014.

1. In addition to the requirements imposed under this section,

each domestic title insurer shall compute a total statutory premium

reserve balance for all policy years combined as of December 31,

2013.

2. The balance shall be computed as if this section were in

effect during the twenty-year period ending December 31, 2013. For

purposes of this calculation, the balance of the reserve as of

December 31, 1993, is considered to be zero.

a. If the total minimum statutory premium reserve so

calculated exceeds the aggregate amount set aside for

statutory premiums in the insurer's most recent annual

statement filed with the Insurance Commissioner, the

insurer shall, out of total charges for policies of

Oklahoma Statutes - Title 36. Insurance Page 1021

title insurance, increase its statutory premium

reserve by an amount equal to one-sixth (1/6) of that

deficit in each of the succeeding six (6) years,

beginning with calendar year 2014, until the entire

deficit has been added. These added amounts (the

excess reserve) shall be released in accordance with

paragraph 3 of this subsection.

b. If the total minimum statutory premium reserve so

calculated is less than the aggregate amount set aside

for statutory premiums in the insurer's most recent

annual statement filed with the commissioner, the

insurer shall release the excess amount previously set

aside by an amount equal to one-sixth (1/6) of that

excess in each of the succeeding six (6) years,

beginning with calendar year 2014, until the entire

excess has been released. The balance of the reserve

(equal to the calculated minimum statutory premium

reserve) shall be released in accordance with each

title insurer's previous method of amortizing its

statutory premium reserve.

3. The aggregate of the amounts set aside, if any, in excess of

the statutory premium reserve pursuant to subparagraph a of

paragraph 2 of this subsection in any calendar year as adjustments

to the insurer's statutory premium reserve shall be released from

the reserve and restored to net profits, or equity directly, over a

period not exceeding ten (10) years pursuant to the following table:

Year of addition Release

Year 1 Equally over ten (10) years

Year 2 Equally over nine (9) years

Year 3 Equally over eight (8) years

Year 4 Equally over seven (7) years

Year 5 Equally over six (6) years

Year 6 Equally over five (5) years

D. Companies Transitioning to five percent (5%) Statutory

Premium Reserve After Calendar Year 2015.

1. Companies with annual gross premiums of less than Twenty

Million Dollars ($20,000,000.00) as of January 1, 2014, which elect

to set aside reserves in an amount not less than the title insurer's

IBNR reserve plus the ULAE reserve as set forth in paragraph 2 of

subsection B of this section, may voluntarily transition to the five

percent (5%) statutory premium reserve described elsewhere in

subsection B of this section beginning in any calendar year

subsequent to 2014.

2. Companies with annual gross premiums of less than Twenty

Million Dollars ($20,000,000.00) as of January 1, 2015, which have

not voluntarily transitioned as set forth in subsection C of this

section, but which later earn annual gross premiums of Twenty

Oklahoma Statutes - Title 36. Insurance Page 1022

Million Dollars ($20,000,000.00) or more, shall transition to the

five percent (5%) statutory premium reserve standard beginning

January 1 of the year after they earn annual gross premiums of

Twenty Million Dollars ($20,000,000.00) or more.

3. Companies transitioning to the five percent (5%) statutory

premium reserve, as set forth in subsections B and C of this

section, may, but need not, establish reserves for years prior to

the transitional year in accordance with subsection C of this

section. Alternatively, such companies may continue to use the

previously established reserves for prior years until such reserves

are fully amortized. Reserves established on a go-forward basis

beginning with the year of transition, shall be amortized in

accordance with paragraphs 4 and 5 of subsection B of this section.

E. Maintenance of Fund.

The statutory premium reserve and supplemental reserve fund

shall be held in cash or invested in first mortgage notes or other

securities admissible for investment by Section 5002 this title.

F. Effect of Insolvency or Dissolution.

In the event of the insolvency or dissolution of a title

insurer, the statutory premium reserve and supplemental reserve fund

shall be used to protect title insurance contract holders, even if

there are no accrued title insurance claims and even if there are

unpaid obligations of other types.
Okla. Stat. tit. 36, § 36-2691.3 — OK Code / Title 36 / Section 36-2691.3
Certificate of authority; requirement
Status: in_force

The Insurance Commissioner shall certify such corporation 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

chiropractic service corporation;

2. The contracts between the applicant and the participating

chiropractors or other providers of health services, if any,

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, but without interest, and only out of operating income;

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 signed contracts of participation

from not less than one-third of the chiropractors within the State

of Oklahoma, who are licensed by the State of Oklahoma. The form of

such contracts of participation shall be approved by the Board of

Chiropractic Examiners of Oklahoma prior to securing the required

signatures.
Okla. Stat. tit. 36, § 36-1224 — OK Code / Title 36 / Section 36-1224
Renumbered as § 1250.10 of this title by Laws 1994, c
Status: in_force

342, § 20, eff. Sept. 1, 1994.
Okla. Stat. tit. 36, § 36-1633 — OK Code / Title 36 / Section 36-1633
Acquisition of control of or merger with domestic
Status: in_force

insurer.

A. The requirements for filing shall be as follows:

1. No person other than the issuer shall make a tender offer

for or a request or invitation for tenders of, or enter into any

agreement to exchange securities for, seek to acquire, or acquire,

in the open market or otherwise, any voting security of a domestic

insurer if, after the consummation thereof, such person would,

directly or indirectly, or by conversion or by exercise of any right

to acquire, be in control of the insurer, and no person shall enter

into an agreement to merge with or otherwise to acquire control of a

domestic insurer or any person controlling a domestic insurer

unless, at the time the offer, request or invitation is made or the

agreement is entered into, or prior to the acquisition of the

securities if no offer or agreement is involved, such person has

filed with the Commissioner and has sent to the insurer, and such

insurer has sent to its shareholders, a statement containing the

information required by this section and the offer, request,

invitation, agreement or acquisition has been approved by the

Commissioner in the manner prescribed in this act;

2. For purposes of this section, any controlling person of a

domestic insurer seeking to divest its controlling interest in the

domestic insurer, in any manner, shall file with the Commissioner,

with a copy to the insurer, confidential notice of its proposed

divestiture at least thirty (30) days prior to the cessation of

control. The Commissioner shall determine those instances in which

the party or parties seeking to divest or to acquire a controlling

interest in an insurer shall be required to file for and obtain

approval of the transaction. The information shall remain

confidential until the conclusion of the transaction unless the

Commissioner, in his or her discretion, determines that confidential

Oklahoma Statutes - Title 36. Insurance Page 454

treatment will interfere with enforcement of this section. If the

statement referred to in paragraph 1 of this subsection is otherwise

filed, this paragraph shall not apply;

3. With respect to a transaction subject to this section, the

acquiring person must also file a preacquisition notification with

the Commissioner, which shall contain the information set forth in

paragraph 1 of subsection C of Section 4 of this act. A failure to

file the notification may be subject to the penalty specified in

paragraph 3 of subsection E of Section 4 of this act; and

4. For purposes of this section, a "domestic insurer" shall

include any person controlling a domestic insurer unless the person,

as determined by the Commissioner, is either directly or through its

affiliates primarily engaged in business other than the business of

insurance. For the purposes of this section, "person" shall not

include any securities broker holding, in the usual and customary

broker's function, less than twenty percent (20%) of the voting

securities of an insurance company or of any person which controls

an insurance company.

B. The statement to be filed with the Commissioner shall be

made under oath or affirmation and shall contain the following:

1. The name and address of each person by whom or on whose

behalf the merger or other acquisition of control referred to in

subsection A of this section, hereinafter called the "acquiring

party", is to be affected:

a. if the person is an individual, his or her principal

occupation and all offices and positions held during

the past five (5) years, and any conviction of crimes

other than minor traffic violations during the past

ten (10) years, and

b. if the person is not an individual, a report of the

nature of its business operations during the past five

(5) years or for the lesser period as the person and

any predecessors shall have been in existence; an

informative description of the business intended to be

done by the person and the person's subsidiaries; and

a list of all individuals who are or who have been

selected to become directors or executive officers of

the person, or who perform or will perform functions

appropriate to such positions. The list shall include

for each individual the information required by

subparagraph a of this paragraph;

2. The source, nature and amount of the consideration used or

to be used in effecting the merger or other acquisition of control,

a description of any transaction where funds were or are to be

obtained for any such purpose, including any pledge of the insurer's

stock or the stock of any of its subsidiaries or controlling

affiliates, and the identity of persons furnishing consideration;

Oklahoma Statutes - Title 36. Insurance Page 455

provided, however, that where a source of consideration is a loan

made in the lender's ordinary course of business, the identity of

the lender shall remain confidential, if the person filing the

statement so requests;

3. Fully audited financial information as to the earnings and

financial condition of each acquiring party for the preceding five

(5) fiscal years of each acquiring party, or for such lesser period

as the acquiring party and any predecessors shall have been in

existence, and similar unaudited information as of a date not

earlier than ninety (90) days prior to the filing of the statement;

4. Any plans or proposals which each acquiring party may have

to liquidate the insurer, to sell its assets or merge or consolidate

it with any person, or to make any other material change in its

business or corporate structure or management;

5. The number of shares of any security referred to in

subsection A of this section which each acquiring party proposes to

acquire, and the terms of the offer, request, invitation, agreement

or acquisition referred to in subsection A of this section, and a

statement as to the method by which the fairness of the proposal was

arrived at;

6. The amount of each class of any security referred to in

subsection A of this section which is beneficially owned or

concerning which there is a right to acquire beneficial ownership by

each acquiring party;

7. A full description of any contracts, arrangements or

understandings with respect to any security referred to in

subsection A of this section in which any acquiring party is

involved, including but not limited to transfer of any of the

securities, joint ventures, loan or option arrangements, puts or

calls, guarantees of loans, guarantees against loss or guarantees of

profits, division of losses or profits, or the giving or withholding

of proxies. The description shall identify the persons with whom

the contracts, arrangements or understandings have been entered

into;

8. A description of the purchase of any security referred to in

subsection A of this section during the twelve (12) calendar months

preceding the filing of the statement by any acquiring party,

including the dates of purchase, names of the purchasers and

consideration paid or agreed to be paid;

9. A description of any recommendations to purchase any

security referred to in subsection A of this section made during the

twelve (12) calendar months preceding the filing of the statement by

any acquiring party, or by anyone based upon interviews or at the

suggestion of the acquiring party;

10. Copies of all tender offers for, requests, or invitations

for tenders of, exchange offers for, and agreements to acquire or

Oklahoma Statutes - Title 36. Insurance Page 456

exchange any securities referred to in subsection A of this section,

and, if distributed, additional related soliciting material;

11. The term of any agreement, contract or understanding made

with or proposed to be made with any broker-dealer as to

solicitation of securities referred to in subsection A of this

section for tender, and the amount of any fees, commissions or other

compensation to be paid to broker-dealers with regard thereto;

12. An agreement by the person required to file the statement

referred to in subsection A of this section that it will provide the

annual report, specified in subsection L of Section 5 of this act,

for so long as control exists;

13. An acknowledgement by the person required to file the

statement referred to in subsection A of this section that the

person and all subsidiaries within its control in the insurance

holding company system will provide information to the Commissioner

upon request as necessary to evaluate enterprise risk to the

insurer; and

14. Such additional information as the Commissioner may by rule

or regulation prescribe as necessary or appropriate for the

protection of policyholders of the insurer or in the public

interest. If the person required to file the statement referred to

in subsection A of this section is a partnership, limited

partnership, syndicate or other group, the Commissioner may require

that the information required pursuant to paragraphs 1 through 14 of

this subsection shall be given with respect to each partner of the

partnership or limited partnership, each member of the syndicate or

group, and each person who controls the partner or member. If any

partner, member or person is a corporation or the person required to

file the statement referred to in subsection A of this section is a

corporation, the Commissioner may require that the information

required pursuant to paragraphs 1 through 14 of this subsection

shall be given with respect to the corporation, each officer and

director of the corporation, and each person who is directly or

indirectly the beneficial owner of more than ten percent (10%) of

the outstanding voting securities of the corporation. If any

material change occurs in the facts set forth in the statement filed

with the Commissioner and sent to the insurer pursuant to this

section, an amendment setting forth the change, together with copies

of all documents and other material relevant to the change, shall be

filed with the Commissioner and sent to the insurer within two (2)

business days after the person learns of the change.

C. If any offer, request, invitation, agreement or acquisition

referred to in subsection A of this section is proposed to be made

by means of a registration statement under the Securities Act of

1933, or in circumstances requiring the disclosure of similar

information under the Securities Exchange Act of 1934 or under a

state law requiring similar registration or disclosure, the person

Oklahoma Statutes - Title 36. Insurance Page 457

required to file the statement referred to in subsection A of this

section may utilize the documents in furnishing the information

called for by that statement.

D. 1. The Commissioner shall approve any merger or other

acquisition of control referred to in subsection A of this section

unless, after a public hearing, the Commissioner finds that:

a. after the change of control, the domestic insurer

referred to in subsection A of this section would not

be able to satisfy the requirements for the issuance

of a license to write the line or lines of insurance

for which it is presently licensed,

b. the effect of the merger or other acquisition of

control would be substantially to lessen competition

in insurance in this state or tend to create a

monopoly. In applying the competitive standard in

this subparagraph:

(1) the informational requirements of paragraph 1 of

subsection C of Section 4 of this act and the

standards of paragraph 2 of subsection D of

Section 4 of this act shall apply,

(2) the merger or other acquisition shall not be

disapproved if the Commissioner finds that any of

the situations meeting the criteria provided by

paragraph 3 of subsection D of Section 4 of this

act exist, and

(3) the Commissioner may condition the approval of

the merger or other acquisition on the removal of

the basis of disapproval within a specified

period of time,

c. the financial condition of any acquiring party is such

as might jeopardize the financial stability of the

insurer, or prejudice the interest of its

policyholders,

d. the plans or proposals which the acquiring party has

to liquidate the insurer, sell its assets or

consolidate or merge it with any person, or to make

any other material change in its business or corporate

structure or management, are unfair and unreasonable

to policyholders of the insurer and not in the public

interest,

e. the competence, experience and integrity of those

persons who would control the operation of the insurer

are such that it would not be in the interest of

policyholders of the insurer and of the public to

permit the merger or other acquisition of control, or

f. the acquisition is likely to be hazardous or

prejudicial to the insurance-buying public.

Oklahoma Statutes - Title 36. Insurance Page 458

2. The public hearing referred to in paragraph 1 of this

subsection shall be held within thirty (30) days after the statement

required by subsection A of this section is filed, and at least

twenty (20) days' notice shall be given by the Commissioner to the

person filing the statement. Not less than fourteen (14) days'

notice of the public hearing shall be given by the person filing the

statement to the insurer and to such other persons as may be

designated by the Commissioner. The insurer shall give notice to

its securityholders. The Commissioner shall make a determination

within the sixty-day period preceding the effective date of the

proposed transaction. At the hearing, the person filing the

statement, the insurer, any person to whom notice of hearing was

sent, and any other person whose interest may be affected shall have

the right to present evidence, examine and cross-examine witnesses,

and offer oral and written arguments and in connection therewith

shall be entitled to conduct discovery proceedings in the same

manner as is presently allowed by subsection A of Section 317 of

Title 36 of the Oklahoma Statutes. All discovery proceedings shall

be concluded not later than three (3) days prior to the commencement

of the public hearing.

3. If the proposed acquisition of control will require the

approval of more than one state's Commissioner, the public hearing

referred to in paragraph 2 of this subsection may be held on a

consolidated basis upon request of the person filing the statement

referred to in subsection A of this section. Such person shall file

the statement referred to in subsection A of this section with the

National Association of Insurance Commissioners (NAIC) within five

(5) days of making the request for a public hearing. The

Commissioner may opt out of a consolidated hearing, and shall

provide notice to the applicant of the opt-out within ten (10) days

of the receipt of the statement referred to in subsection A of this

section. A hearing conducted on a consolidated basis shall be

public and shall be held within the United States before the

Commissioners of the states in which the insurers are domiciled.

Such Commissioners shall hear and receive evidence. A Commissioner

may attend such hearing, in person or by telecommunication.

4. In connection with a change of control of a domestic

insurer, any determination by the Commissioner that the person

acquiring control of the insurer shall be required to maintain or

restore the capital of the insurer to the level required by the laws

and regulations of this state shall be made not later than sixty

(60) days after the date of notification of the change in control

submitted pursuant to paragraph 1 of subsection A of Section 3 of

this act.

5. The Commissioner may retain at the acquiring person's

expense any attorneys, actuaries, accountants and other experts not

otherwise a part of the Commissioner's staff as may be reasonably

Oklahoma Statutes - Title 36. Insurance Page 459

necessary to assist the Commissioner in reviewing the proposed

acquisition of control.

E. The provisions of this section shall not apply to any offer,

request, invitation, agreement or acquisition which the Commissioner

by order shall exempt as not having been made or entered into for

the purpose and not having the effect of changing or influencing the

control of a domestic insurer, or as otherwise not comprehended

within the purposes of this section.

F. The following shall be violations of this section:

1. The failure to file any statement, amendment or other

material required to be filed pursuant to subsection A or B of this

section; or

2. The effectuation or any attempt to effectuate an acquisition

of control of, divestiture of, or merger with, a domestic insurer

unless the Commissioner has given approval.

G. The courts of this state are hereby vested with jurisdiction

over every person not resident, domiciled or authorized to do

business in this state who files a statement with the Commissioner

under this section, and overall actions involving such person

arising out of violations of this section, and each such person

shall be deemed to have performed acts equivalent to and

constituting an appointment by the person of the Commissioner to be

his true and lawful attorney upon whom may be served all lawful

process in any action, suit or proceeding arising out of violations

of this section. Copies of all lawful process shall be served on

the Commissioner and transmitted by registered or certified mail by

the Commissioner to the person at his or her last-known address.
Okla. Stat. tit. 36, § 36-982 — OK Code / Title 36 / Section 36-982
Definitions
Status: in_force

Definitions.

As used in the Property and Casualty Competitive Loss Cost

Rating Act:

1. "Accepted actuarial standards" means the standards adopted

by the Casualty Actuarial Society Statement of Principles regarding

property and casualty ratemaking or the Standards of Practice

adopted by the Actuarial Standards Board;

2. "Advisory organization" means any corporation,

unincorporated association, partnership or person, whether located

inside or outside this state, that is licensed in accordance with

Section 1140 of this title and which assists insurers in ratemaking-

related activities such as enumerated in Section 1142 of this title;

3. "Classification system" or "classification" means the

process of grouping risks with similar risk characteristics so that

differences in costs may be recognized;

4. "Commercial risk" means any kind of risk that is not a

personal risk;

Oklahoma Statutes - Title 36. Insurance Page 229

5. "Commissioner" means the Commissioner of Insurance of this

state;

6. "Competitive market" means a market which has not been found

to be noncompetitive pursuant to Section 984 of this title;

7. "Developed losses" means losses, including loss adjustment

expenses, adjusted using accepted actuarial standards, to eliminate

the effect of differences between current payment or reserve

estimates and those which are anticipated to provide actual ultimate

loss, including loss adjustment expense payments;

8. "Expenses" means that portion of a rate attributable to

acquisition, field supervision, collection expenses, general

expenses, taxes, licenses and fees;

9. "Experience rating" means a rating procedure utilizing past

insurance experience of the individual policyholder to forecast

future losses by measuring the policyholder’s loss experience

against the loss experience of policyholders in the same

classification to produce a prospective premium credit, debit or

unity modification;

10. "Joint underwriting" means a voluntary arrangement

established to provide insurance coverage for a risk pursuant to

which two or more insurers jointly contract with the insured at a

price and under policy terms agreed upon between the insurers;

11. "Loss adjustment expense" means the expenses incurred by

the insurer in the course of settling claims;

12. "Market" means the statewide interaction between buyers and

sellers of identical or readily substitutable products that provide

insurance protection of identifiable perils to buyers;

13. "Mass marketed plan" means a method of selling property-

liability insurance wherein the insurance is offered to employees of

particular employers or to members of particular associations or

organizations or to persons grouped in other ways, and the employer

or association or other organization has agreed to, or otherwise

affiliated itself with, the sale of such insurance to its employees

or members;

14. "Noncompetitive market" means a market for which there is a

ruling in effect pursuant to Section 984 of this title that a

reasonable degree of competition does not exist;

15. "Personal risk" means homeowners, tenants, private

passenger nonfleet automobiles, manufactured homes and other

property and casualty insurance for personal, family or household

needs, including any property and casualty insurance that is

otherwise intended for noncommercial coverage;

16. "Pool" means a voluntary arrangement, established on an

ongoing basis, pursuant to which two or more insurers participate in

the sharing of risks on a predetermined basis. The pool may operate

through an association, syndicate or other pooling agreement;

Oklahoma Statutes - Title 36. Insurance Page 230

17. "Prospective loss costs" means historical aggregate losses

and may include loss adjustment expenses, including all assessments

that are loss based, projected through development to their ultimate

value and through trending to a future point in time;

18. "Pure premium rate" means that portion of the rate which

represents the loss costs per unit of exposure including loss

adjustment expense;

19. "Rate" or "rates" means that cost of insurance per exposure

unit whether expressed as a single number or as a prospective loss

cost with an adjustment to account for the treatment of expenses,

profit, and individual insurer variation in loss experience, prior

to any application of individual risk variations based on loss or

expense considerations, and does not include minimum premium;

20. "Residual market mechanism" means an arrangement, either

voluntary or mandated by law, involving participation by insurers in

the equitable apportionment among them of insurance which may be

afforded applicants who are unable to obtain insurance through

ordinary methods;

21. "Special assessments" means guaranty fund assessments,

Special Indemnity Fund assessments, Vocational Rehabilitation Fund

assessments, and other similar assessments. Special assessments

shall not be considered as either expenses or losses;

22. "Statistical plan" means the plan, system or arrangement

used in collecting data;

23. "Supplementary rating information" means any manual or plan

of rates, classification, rating schedule, minimum premium, policy

fee rating rule and any other information needed to determine the

applicable premium in effect or to be in effect. This includes,

rating plans, territory codes and descriptions and rules which

include factors or relativities such as increased limits factors,

deductible discounts or relativities, classification relativities or

similar factors used to determine the rate in effect or to be in

effect;

24. "Supporting information" means the experience and judgment

of the filer and the experience or data of other insurers or

advisory organizations relied upon by the filer, the interpretation

of any other data relied upon by the filer, descriptions of methods

used in making the rates and any other information required by the

Commissioner to be filed; and

25. "Trending" means any procedure for projecting losses to the

average date of loss, or premiums or exposures to the average date

of writing, for the period during which the policies are to be

effective.
Okla. Stat. tit. 36, § 36-4414 — OK Code / Title 36 / Section 36-4414
Issuance of accident or health policies by insurers not
Status: in_force

authorized to engage in the insurance business in Oklahoma -

Approval process.

A. The Oklahoma Legislature recognizes the need for purchasers

of health insurance coverage in this state to have the opportunity

to choose health insurance plans that are more affordable and

flexible than existing market policies offering accident and health

coverage. Therefore, the Oklahoma Legislature seeks to increase the

availability of health insurance coverage by allowing insurers

authorized to engage in the business of insurance in other states,

and not so authorized in Oklahoma, to issue accident and health

policies in Oklahoma by granting a limited exemption from Section

606 of Title 36 of the Oklahoma Statutes. Insurers authorized to

engage in the business of insurance in other states, and not so

authorized in Oklahoma, shall be subject to the following

Oklahoma Statutes - Title 36. Insurance Page 957

requirements in order to be able to obtain an exemption to Section

606 of Title 36 of the Oklahoma Statutes and to issue accident and

health policies in Oklahoma through agents licensed in the state:

1. No insurer authorized to engage in the business of insurance

in other states that is not so licensed in Oklahoma may issue an

accident or a health policy pursuant to this section unless it is

approved to do so, in writing, by the Insurance Commissioner;

2. An insurer seeking to obtain the written approval described

in paragraph 1 of this subsection shall request such approval in the

manner required by the Insurance Commissioner, and shall pay any and

all fees associated with such application as may be required by the

Insurance Commissioner; and

3. In order to first be considered for the written approval

from the Insurance Commissioner, an insurer shall be domiciled in a

state which has a legislatively approved compact with the State of

Oklahoma.

B. Pursuant to the provisions of the Health Care Choice Act,

all approved insurers domiciled in a compacting state selling health

and accident insurance policies in Oklahoma shall:

1. Offer accident and health insurance policies that contain

all mandated health benefits that are required by Oklahoma law to be

included in accident or health insurance policies and Health

Maintenance Organization (HMO) policies issued in the state and will

comply with all other applicable laws pertaining to coverage and

coverage decisions;

2. Keep a full and true record of each insurance policy issued

to an insured in this state by or on behalf of the insurer,

containing such information as may be required by the Insurance

Commissioner, which record may be examined at any time within three

(3) years after issuance by the Insurance Commissioner;

3. File with the Insurance Commissioner, on or before April 1

of each year, a verified statement of all insurance transacted by

the insurer during the preceding calendar year in Oklahoma. The

statement shall be on a form prescribed and furnished by the

Insurance Commissioner and contain such information as required by

the Insurance Commissioner;

4. Issue an insurance policy in this state pursuant to this

section through an insurance agent or other person or entity that is

licensed in this state, as well as in a state in which the insurer

is licensed, to engage in the sale, solicitation or negotiation of

accident and/or health insurance in this state, and that is

appointed by the insurer for such purpose;

5. Appoint one or more third-party administrators that are

licensed in this state, and that have licensed adjusters in this

state, that shall be responsible for administering claims under the

insurance policies issued by the insurer in this state and be

Oklahoma Statutes - Title 36. Insurance Page 958

available to answer any questions from insureds under the insurance

policies issued by the insurer in this state; and

6. Submit to the jurisdiction of this state and be subject to

service of legal process within this state in any action or

proceeding against the insurer arising out of any insurance policy

issued to an insured policyholder in this state and the Insurance

Commissioner is appointed as its exclusive agent to receive service

of legal process.

C. The Insurance Commissioner may only grant the written

approval described in paragraph 1 of subsection A of this section to

an insurer that:

1. Is properly licensed and has met the requirements for

solvency in its domiciliary state to issue accident and health

insurance policies;

2. Has met the requirements for market conduct applicable to

insurers domiciled in Oklahoma authorized to issue accident and

health insurance policies in the state set forth in Title 36 of the

Oklahoma Statutes; and

3. Has submitted the policy form that it will issue to insureds

in this state for a determination by the Insurance Commissioner that

the policy form is in compliance with all laws and regulations in

this state applicable to health insurance policies.

D. The Insurance Commissioner for the State of Oklahoma shall

be required to obtain verification in writing by the regulating

authority of the domiciliary state, certifying that the insurer has

met the financial solvency requirements of the insurer's domiciliary

state. No insurer domiciled in a compacting state may be approved

to sell health and accident insurance policies in Oklahoma without

such verification.

E. The Insurance Commissioner may require an insurer to reapply

for the written approval described in paragraph 1 of subsection A of

this section on an annual basis, or as often as the Insurance

Commissioner deems prudent. Reapplication shall be in the form and

manner required by the Insurance Commissioner.

F. The Insurance Commissioner may, as a condition to providing

an insurer with the written approval described in paragraph 1 of

subsection A of this section, impose on the insurer any additional

requirement that the Insurance Commissioner deems necessary.

G. The Insurance Commissioner may negotiate one or more

compacts with other states to allow insurers domiciled in such

compacting state that obtain the written approval from the Insurance

Commissioner described in paragraph 1 of subsection A of this

section to sell policies of accident and health insurance in

Oklahoma. Such compacts shall provide for appropriate protection of

Oklahoma consumers by requiring the Commissioner to regulate the

compliance to Oklahoma laws and regulations, and market conduct of

the insurers pursuant to compact provisions. The terms of any such

Oklahoma Statutes - Title 36. Insurance Page 959

compact shall be presumed a valid exercise of the discretionary

authority of the Commissioner. The compact shall be required to be

approved by the Legislature by adoption of a joint resolution,

provided that the joint resolution becomes law in accordance with

Section 11 of Article VI of the Oklahoma Constitution. Joint

resolutions introduced for such purpose shall not be subject to

regular legislative deadlines and shall be limited to such

provisions as may be necessary for approval of a compact. The

Legislature retains the authority to approve or not approve a

compact with a state.

H. The Insurance Commissioner may require every approved

insurer to submit to a market conduct examination. Any examination

by the Commissioner of the regulatory compliance or market conduct

of any insurer domiciled in a compacting state seeking to offer

health benefit plans in this state, or who has been given approval

to offer health benefit plans in this state, shall be conducted in

the same manner and under the same terms and conditions as

examinations of companies located in this state.

I. An insurer domiciled in a compacting state is required to

provide Oklahoma state-mandated health benefits and to comply with

all other applicable laws that apply to Oklahoma accident and health

insurers including coverage of services and coverage decisions.

J. All approved insurers domiciled in a compacting state

selling health and accident insurance policies in Oklahoma must

comply with the Unfair Claims Settlement Practices Act, Health Care

Freedom of Choice Act, Genetic Nondiscrimination in Insurance Act,

Hospital and Medical Services Utilization Review Act and all

requirements found in Sections 4401 through 4411 of Title 36 of the

Oklahoma Statutes. All Health Maintenance Organizations shall be

subject to and comply with the Health Maintenance Organization Act

of 2003.

K. Each written application for purchase of a policy offered by

an insurer domiciled in a compacting state pursuant to the Health

Care Choice Act shall contain the following language in boldface

type at the beginning of the document:

"This policy may be subject, in part, to the laws of (insert

state where the master policy is filed); in particular, all of the

premium rating laws applicable to policies filed in Oklahoma do not

apply to this policy. This may result in increases in your premium

at renewal that would not be permissible in a policy that was issued

by an Oklahoma domestic insurer. For information concerning health

insurance coverage under a policy issued by an Oklahoma insurer,

please consult your insurance agent or the Oklahoma Department of

Insurance."

L. Each policy issued pursuant to the Health Care Choice Act by

an insurer domiciled in a compacting state shall contain the

Oklahoma Statutes - Title 36. Insurance Page 960

following language in boldface type at the beginning of the

document:

"The benefits provided under this policy may be affected, in

part, by the laws of a state other than Oklahoma; however, they must

include the Oklahoma state-mandated benefits, including coverage of

services, and coverage decisions, and must comply with all other

applicable Oklahoma and federal laws. Please consult with your

insurance agent to determine which health benefits are included or

excluded under this policy."

M. Approved insurers domiciled in a compacting state selling

health and accident insurance policies in Oklahoma shall be subject

to payment of any applicable premium taxes pursuant to Section 624

of Title 36 of the Oklahoma Statutes.

N. Approved insurers domiciled in a compacting state selling

health and accident insurance policies in Oklahoma shall participate

on a nondiscriminatory basis and in the same manner as admitted

participating insurers in the Oklahoma Life and Health Insurance

Guaranty Association Act.

O. Approved insurers domiciled in a compacting state selling

health and accident insurance policies in Oklahoma shall participate

on a nondiscriminatory basis and in the same manner as admitted

participating insurers in any existing or future Health Insurance

High Risk Pool created by or for the State of Oklahoma.

P. The Commissioner shall promulgate rules necessary for the

administration and implementation of the Health Care Choice Act,

which rules shall specify how the requirements set forth in

subsection A of this section shall be implemented.
Okla. Stat. tit. 36, § 36-2004 — OK Code / Title 36 / Section 36-2004
Definitions
Status: in_force

As used in the Oklahoma Property and Casualty Insurance Guaranty

Association Act:

1. "Affiliate" means a person who directly or indirectly,

through one or more intermediaries, controls, is controlled by, or

Oklahoma Statutes - Title 36. Insurance Page 570

is under common control with another person on December 31 of the

year next preceding the date the insurer becomes an insolvent

insurer;

2. "Association" means the Oklahoma Property and Casualty

Insurance Guaranty Association as created in Section 2005 of this

title;

3. "Assumed claims transaction" means:

a. policy obligations that have been assumed by the

insolvent insurer, prior to the entry of a final order

of liquidation, pursuant to a plan, approved by a

domestic commissioner of the assuming insurer, which

transfers the direct policy obligations and future

policy renewals from one insurer to another insurer,

or

b. an assumption reinsurance transaction in which all of

the following have occurred:

(1) the insolvent insurer assumed, prior to the entry

of a final order of liquidation, the claim or

policy obligations of another insurer under the

claims or policies,

(2) the assumption of the claim or policy obligations

has been approved, if an approval is required, by

the appropriate regulatory authorities, and

(3) as a result of the assumption, the claim or

policy obligations became the direct obligations

of the insolvent insurer through novation of the

claims or policies;

4. "Claimant" means any person instituting a covered claim;

provided that no person who is an affiliate of the insolvent insurer

may be a claimant;

5. "Commissioner" means the Insurance Commissioner of Oklahoma;

6. "Control" means the possession, direct or indirect, of the

power to direct or cause the direction of the management and

policies of a person, whether through the ownership of voting

securities, by contract other than a commercial contract for goods

or nonmanagement services, or otherwise, unless the power is the

result of an official position with or corporate office held by the

person. Control shall be presumed to exist if a person, directly or

indirectly, owns, controls, holds with the power to vote, or holds

proxies representing ten percent (10%) or more of the voting

securities of any other person. This presumption may be rebutted by

a showing that control does not exist in fact;

7. "Covered claim" means:

a. an unpaid claim, including one of unearned premiums,

submitted by a claimant, which arises out of and is

within the coverage and is subject to the applicable

limits of an insurance policy to which this act

Oklahoma Statutes - Title 36. Insurance Page 571

applies, if the insurer becomes an insolvent insurer

after the effective date of this act and the policy

was issued by the insurer, and:

(1) the claimant or insured is a resident of this

state at the time of the insured event, provided

that for entities other than an individual, the

residence of a claimant or insured is the state

in which its principal place of business is

located at the time of the insured event, or

(2) the claim is a first-party claim for damage to

property with a permanent location in this state,

b. "Covered claim" includes claim obligations that arose

through the issuance of an insurance policy by a

member insurer, which are later allocated,

transferred, merged into, novated, assumed by, or

otherwise made the sole responsibility of a member or

nonmember insurer if:

(1) the original member insurer has no remaining

obligations on the policy after the transfer,

(2) a final order of liquidation with a finding of

insolvency has been entered against the insurer

that assumed the member's coverage obligations by

a court of competent jurisdiction in the

insurer's state of domicile,

(3) the claim would have been a covered claim, as

defined in subparagraph a of paragraph 7 of this

section, if the claim had remained the

responsibility of the original member insurer and

the order of liquidation had been entered against

the original member insurer, with the same claim

submission date and liquidation date, and

(4) in cases where the member's coverage obligations

were assumed by a nonmember insurer, the

transaction received prior regulatory or judicial

approval,

c. "Covered claim" shall not include:

(1) any amount awarded as punitive or exemplary

damages,

(2) any amount sought as a return of premium under

any retrospective rating plan,

(3) any amount due any reinsurer, insurer, insurance

pool, or underwriting association, health

maintenance organization, hospital plan

corporation, professional health service

corporation or self-insurer as subrogation

recoveries, reinsurance recoveries, contribution,

indemnification or otherwise. No claim for any

Oklahoma Statutes - Title 36. Insurance Page 572

amount due any reinsurer, insurer, insurance

pool, or underwriting association, health

maintenance organization, hospital plan

corporation, professional health service

corporation or self-insurer may be asserted

against a person insured under a policy issued by

an insolvent insurer other than to the extent the

claim exceeds the association obligation

limitations set forth in Section 2007 of this

title,

(4) any claims excluded pursuant to Section 2020.2 of

this title due to the high net worth of an

insured,

(5) any first-party claims by an insured that is an

affiliate of the insolvent company,

(6) any fee or other amount relating to goods or

services sought by or on behalf of any attorney

or other provider of goods and services retained

by the insolvent insurer or an insured prior to

the date it was determined to be insolvent,

(7) any fee or other amount sought by or on behalf of

any attorney or other provider of goods and

services retained by any insured or claimant in

connection with the assertion or prosecution of

any claim, covered or otherwise, against the

Association,

(8) any claims for interest,

(9) any claim filed with the association or a

liquidator for protection afforded under the

policy of the insured for incurred-but-not-

reported losses, or

(10) notwithstanding any other provision of this act

or any other law to the contrary, a claim that is

filed with the Association on the earlier of:

(a) the final date set by the court for filing

of claims against the liquidator or receiver

of an insolvent insurer, or

(b) a date that is later than eighteen (18)

months after the date of the order of

liquidation or that is unknown and

unreported as of said date; provided,

however, that this shall not include any

claim for workers' compensation benefits

pursuant to Title 85A of the Oklahoma

Statutes and the applicable rules of OAC

Title 810;

Oklahoma Statutes - Title 36. Insurance Page 573

8. "Cybersecurity insurance", for purposes of this act,

includes first-party and third-party coverage, in a policy or

endorsement, written on a direct, admitted basis for losses and loss

mitigation arising out of or relating to data privacy breaches,

unauthorized information network, security intrusions, computer

viruses, ransomware, cyber extortion, identity theft, and similar

exposures;

9. "Insolvent insurer" means an insurer that is licensed to

transact insurance in this state either at the time the policy was

issued, when the obligation with respect to the covered claim was

assumed under an assumed claims transaction, or when the insured

event occurred and against whom a final order of liquidation has

been entered after the effective date of this act with a finding of

insolvency by a court of competent jurisdiction in the state of

domicile of the insurer;

10. "Insured" means any named insured, any additional insured,

any vendor, lessor or any other party identified as an insured under

the policy;

11. a. "Member insurer" means any person who:

(1) writes any kind of direct insurance to which the

Oklahoma Property and Casualty Insurance Guaranty

Association Act applies pursuant to Section 2003

of this title, including the exchange of

reciprocal or inter-insurance contracts, and

(2) is licensed to transact insurance in this state,

except those insurers enumerated in Section 110

of this title or those insurers that are

otherwise exempted by law or order of the

Commissioner;

b. An insurer shall cease to be a member insurer

effective on the day following the termination or

expiration of its license to transact the kinds of

insurance to which the Oklahoma Property and Casualty

Insurance Guaranty Association Act applies; however,

the insurer shall be liable as a member insurer for

any and all obligations, including but not limited to

obligations for assessments levied after the

termination or expiration, which relate to any insurer

that becomes an insolvent insurer prior to the

termination or expiration of the license of the

insurer; and

c. "Member insurer" does not mean:

(1) a "surplus lines insurer" or a person writing

surplus lines insurance as defined in Section

1101.1 of this title, or

(2) a "risk retention group" as defined in Section

6453 of this title, or

Oklahoma Statutes - Title 36. Insurance Page 574

(3) a "captive insurance company" as defined in

Section 6470.2 of this title;

12. "Net direct written premiums" means direct gross premiums

written in this state on insurance policies to which this act

applies, including but not limited to policy and membership fees,

less the following amounts:

a. return premiums,

b. premiums on policies not taken, and

c. dividends paid or credited to policyholders on direct

business. "Net direct written premiums" does not

include premiums on contracts between insurers or

reinsurers;

13. "Novation" means that the assumed claim or policy

obligations became the direct obligations of the insolvent insurer

through consent of the policyholder and that thereafter the ceding

insurer or entity initially obligated under the claims or policies

is released by the policyholder from performing its claim or policy

obligations. Consent shall be express and an implied novation shall

not be allowed for the purposes, implementation and application of

the Oklahoma Property and Casualty Insurance Guaranty Association

Act;

14. "Person" means the individual or other entities as defined

in Section 104 of this title;

15. "Receiver" means liquidator, rehabilitator, conservator or

ancillary receiver, as the context requires; and

16. "Self-insurer" means a person who covers its liability

through a qualified individual or group self-insurance program or

any other formal program created for the specific purpose of

covering liabilities typically covered by insurance.
Okla. Stat. tit. 36, § 36-6530.4 — OK Code / Title 36 / Section 36-6530.4
Oklahoma Individual Health Insurance Market
Status: in_force

Stabilization Program.

A. There is hereby created a nonprofit legal entity to be known

as the "Oklahoma Individual Health Insurance Market Stabilization

Program".

B. 1. The Program shall operate under the management of a

nine-member Board of Directors appointed by the Insurance

Commissioner. The Board shall consist of:

Oklahoma Statutes - Title 36. Insurance Page 1294

a. two representatives of domestic insurance companies

licensed to do business in this state,

b. one member from the general public who is a member of

the class of individuals to which the program would

apply,

c. one representative of a health maintenance

organization,

d. one member from a health-related profession,

e. one member from the general public who is not

associated with the medical profession, a hospital or

an insurer,

f. one representative of reinsurers, and

g. two representatives from the providers of individual

plans licensed to do business in this state.

2. The original Board shall be appointed for the following

terms:

a. three members for a term of one (1) year,

b. three members for a term of two (2) years, and

c. three members for a term of three (3) years.

3. All terms after the initial term shall be for three (3)

years.

4. The Board shall elect one of its members as chairperson.

5. Members of the Board may be reimbursed from monies of the

Program for actual and necessary expenses incurred by them in the

performance of their official duties as members of the Board but

shall not otherwise be compensated for their services.

6. The Board shall adopt a plan of operation and submit its

articles, bylaws and operating rules to the Insurance Commissioner

for approval. If the Board fails to submit a suitable plan of

operation, articles, bylaws and operating rules within one hundred

eighty (180) days, then the Insurance Commissioner shall promulgate

rules governing the operation of the Program. If the Board

subsequently adopts and submits any plan of operation, articles,

bylaws or operating rules that are approved by the Commissioner,

then the Commissioner shall revoke prior adopted administrative

rules that the Commissioner determines to be inconsistent with the

approved plan of operation, articles, bylaws or operating rules.

7. The Board shall have the authority to hire an Executive

Director of the Program.

8. The Oklahoma Insurance Department shall provide

administrative and operational support to the Program and to the

Board. The Board shall reimburse the Insurance Commissioner for any

direct and actual administrative costs associated with administering

the provisions of this act from monies collected by the Board.

C. The Board shall cause an audit to be made of, including, but

not limited to, the funds, accounts and fiscal affairs of the

Program which shall be prepared by an independent certified public

Oklahoma Statutes - Title 36. Insurance Page 1295

accountant or a licensed public accountant. One copy of the annual

audit shall be filed with the State Auditor and Inspector, and one

copy shall be presented to the Board not more than one hundred

twenty (120) days following the close of each fiscal year. In the

event that a copy of the audit as required by this section is not

filed with the State Auditor and Inspector within the time herein

provided, the State Auditor and Inspector is authorized to either

commence an audit or employ a certified public accountant or

licensed public accountant to make the audit herein required at the

cost and expense of the Program.
Okla. Stat. tit. 36, § 36-6570.54 — OK Code / Title 36 / Section 36-6570.54
Timeframes for prior authorizations
Status: in_force

A. If a utilization review entity requires prior authorization

of a prescription drug, the utilization review entity shall make a

prior authorization or adverse determination and notify the enrollee

and the enrollee's health care provider of the prior authorization

or adverse determination in accordance with the time frames set

forth below:

1. For purposes of approving prior authorization for urgent

prescription drugs, within twenty-four (24) hours of obtaining all

necessary information to make the prior authorization or adverse

determination; or

2. For purposes of approving prior authorization for nonurgent

prescription drugs, within four (4) business days of obtaining all

Oklahoma Statutes - Title 36. Insurance Page 1320

necessary information to make the prior authorization or adverse

determination.

For purposes of this section, "necessary information" includes,

but is not limited to, the results of any face-to-face clinical

evaluation or second opinion that may be required.

B. For those health care providers that submit all necessary

information through the utilization review entity's authorized prior

authorization system, prescription drugs are deemed authorized if a

utilization review entity fails to comply with the deadlines set

forth in this section.

C. In the notification to the health care provider that a prior

authorization has been approved, the utilization review entity shall

include in such notification the duration of the prior authorization

or the date by which the prior authorization will expire.
Okla. Stat. tit. 36, § 36-904 — OK Code / Title 36 / Section 36-904
Inspection of filed rates - Information to insured -
Status: in_force

Proceedings by aggrieved persons - False or misleading information -

Withholding policy or evidence.

A. All schedules and insurance rates and supporting information

filed in accordance with the provisions of this article shall be

open to inspection to the public after such filings are made.

B. Every advisory organization and every insurer which makes

its own rates shall, within a reasonable time after receiving

written request therefor and upon payment of such reasonable charge

as it may make, furnish to any insured affected by a rate made by

it, or to the authorized representative of such insured, all

pertinent information as to such rate.

C. Every advisory organization and every insurer which makes

its own rates shall provide within the state reasonable means

whereby any person, aggrieved by the application of its rating

system, may be heard, in person or by his authorized representative,

on his written request to revise the manner in which such rating

system has been applied in connection with the insurance afforded

him. If the advisory organization or insurer fails to grant or

reject such request, within thirty (30) days after it is made, this

applicant may proceed in the same manner as if his application had

been rejected. Any party affected by the action of such advisory

organization or such insurer on such request may, within thirty (30)

days after written notice of such action, appeal to the Insurance

Oklahoma Statutes - Title 36. Insurance Page 204

Commissioner, which, after a hearing held upon not less than ten

(10) days written notice to the appellant and to such advisory

organization or insurer, may modify, affirm or reverse such action.

D. No insurer, agent, broker, or advisory organization may

willfully withhold required information from or give false or

misleading information to the Commissioner.

E. No insurer, agent, or broker shall fail to furnish to an

insured any policy or comparable evidence of insurance to which the

insured is entitled.
Okla. Stat. tit. 36, § 36-1634 — OK Code / Title 36 / Section 36-1634
Acquisitions leading to change in control of an insurer -
Status: in_force

Exceptions - Examination by Commissioner.

A. The following definitions shall apply for the purposes of

this section only:

1. "Acquisition" means any agreement, arrangement or activity

the consummation of which results in a person acquiring directly or

indirectly the control of another person, and includes but is not

limited to the acquisition of voting securities, the acquisition of

assets, bulk reinsurance and mergers; and

2. "Involved insurer" includes an insurer which acquires or is

acquired, is affiliated with an acquirer or acquired, or is the

result of a merger.

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

this section applies to any acquisition in which there is a change

in control of an insurer authorized to do business in this state.

2. This section shall not apply to the following:

a. a purchase of securities solely for investment

purposes so long as the securities are not used by

Oklahoma Statutes - Title 36. Insurance Page 460

voting or otherwise to cause or attempt to cause the

substantial lessening of competition in any insurance

market in this state. If a purchase of securities

results in a presumption of control under paragraph 3

of Section 1 of this act, it is not solely for

investment purposes unless the Commissioner of the

insurer's state of domicile accepts a disclaimer of

control or affirmatively finds that control does not

exist and the disclaimer action or affirmative finding

is communicated by the domiciliary Commissioner to the

Commissioner of this state,

b. the acquisition of a person by another person when

both persons are neither directly nor through

affiliates primarily engaged in the business of

insurance, if preacquisition notification is filed

with the Commissioner in accordance with paragraph 1

of subsection C of this section thirty (30) days prior

to the proposed effective date of the acquisition.

However, such preacquisition notification is not

required for exclusion from this section if the

acquisition would otherwise be excluded from the

requirements of this section by any other subparagraph

of this paragraph,

c. the acquisition of already affiliated persons,

d. an acquisition if, as an immediate result of the

acquisition,

(1) in no market would the combined market share of

the involved insurers exceed five percent (5%) of

the total market,

(2) there would be no increase in any market share,

or

(3) in no market would:

(a) the combined market share of the involved

insurers exceed twelve percent (12%) of the

total market, and

(b) the market share increase by more than two

percent (2%) of the total market.

For the purpose of this subparagraph, a "market" means

direct written insurance premium in this state for a

line of business as contained in the annual statement

required to be filed by insurers licensed to do

business in this state,

e. an acquisition for which a preacquisition notification

would be required pursuant to this section due solely

to the resulting effect on the ocean marine insurance

line of business, and

Oklahoma Statutes - Title 36. Insurance Page 461

f. an acquisition of an insurer whose domiciliary

Commissioner affirmatively finds that the insurer is

in failing condition; there is a lack of feasible

alternative to improving such condition; the public

benefits of improving the insurer's condition through

the acquisition exceed the public benefits that would

arise from not lessening competition; and the findings

are communicated by the domiciliary Commissioner to

the Commissioner of this state.

C. Any acquisition described in subsection B of this section

may be subject to an order pursuant to subsection E of this section

unless the acquiring person files a preacquisition notification and

the waiting period has expired. The acquired person may file a

preacquisition notification. The Commissioner shall give

confidential treatment to information submitted under this

subsection in the same manner as provided in Section 10 of this act.

1. The preacquisition notification shall be in such form and

contain such information as prescribed by the National Association

of Insurance Commissioners (NAIC) relating to those markets which,

under subparagraph d of paragraph 2 of subsection B of this section,

cause the acquisition not to be exempted from the provisions of this

section. The Commissioner may require such additional material and

information as deemed necessary to determine whether the proposed

acquisition, if consummated, would violate the competitive standard

of subsection D of this section. The required information may

include an opinion of an economist as to the competitive impact of

the acquisition in this state accompanied by a summary of the

education and experience of such person indicating his or her

ability to render an informed opinion.

2. The waiting period required shall begin on the date of

receipt of the Commissioner of a preacquisition notification and

shall end on the earlier of the thirtieth day after the date of

receipt, or termination of the waiting period by the Commissioner.

Prior to the end of the waiting period, the Commissioner on a one-

time basis may require the submission of additional needed

information relevant to the proposed acquisition, in which event the

waiting period shall end on the earlier of the thirtieth day after

receipt of the additional information by the Commissioner or

termination of the waiting period by the Commissioner.

D. 1. The Commissioner may enter an order under paragraph 1 of

subsection E of this section with respect to an acquisition if there

is substantial evidence that the effect of the acquisition may be

substantially to lessen competition in any line of insurance in this

state or tend to create a monopoly or if the insurer fails to file

adequate information in compliance with subsection C of this

section.

Oklahoma Statutes - Title 36. Insurance Page 462

2. In determining whether a proposed acquisition would violate

the competitive standard of paragraph 1 of this subsection, the

Commissioner shall consider the following:

a. any acquisition covered under subsection B of this

section involving two or more insurers competing in

the same market is evidence of violation of the

competitive standards.

(1) if the market is highly concentrated and the

involved insurers possess the following shares of

the market:

Insurer A Insurer B

4% 4% or more

10% 2% or more

15% 1% or more, or

(2) if the market is not highly concentrated and the

involved insurers possess the following shares of

the market:

Insurer A Insurer B

5% 5% or more

10% 4% or more

15% 3% or more

19% 1% or more

A highly concentrated market, for purposes of this

subparagraph, is one in which the share of the four

largest insurers is seventy-five percent (75%) or more

of the market. Percentages not shown in the tables

are interpolated proportionately to the percentages

that are shown. If more than two insurers are

involved, exceeding the total of the two columns in

the table is prima facie evidence of violation of the

competitive standard in paragraph 1 of this

subsection. For the purpose of this subparagraph, the

insurer with the largest share of the market shall be

deemed to be Insurer A,

b. there is a significant trend toward increased

concentration when the aggregate market share of any

grouping of the largest insurers in the market, from

the two largest to the eight largest, has increased by

seven percent (7%) or more of the market over a period

of time extending from any base year five (5) to ten

(10) years prior to the acquisition up to the time of

the acquisition. Any acquisition or merger covered

under subsection B of Section 5 of this act involving

two or more insurers competing in the same market is

evidence of violation of the competitive standard in

paragraph 1 of this subsection if:

Oklahoma Statutes - Title 36. Insurance Page 463

(1) there is a significant trend toward increased

concentration in the market,

(2) one of the insurers involved is one of the

insurers in a grouping of large insurers showing

the requisite increase in the market share, and

(3) another involved insurer's market is two percent

(2%) or more,

c. for the purposes of this paragraph:

(1) the term "insurer" includes any company or group

of companies under common management, ownership

or control,

(2) the term "market" means the relevant product and

geographical markets. In determining the

relevant product and geographical markets, the

Commissioner shall give due consideration to,

among other things, the definitions or

guidelines, if any, promulgated by the NAIC and

to information, if any, submitted by parties to

the acquisition. In the absence of sufficient

information to the contrary, the relevant product

market is assumed to be the direct written

insurance premium for a line of business, such

line being that used in the annual statement

required to be filed by insurers doing business

in this state, and the relevant geographical

market is assumed to be this state,

(3) the burden of showing prima facie evidence of

violation of the competitive standard rests upon

the Commissioner, and

d. even though an acquisition is not a prima facie

violation of the competitive standard under

subparagraphs a and b of this paragraph, the

Commissioner may establish the requisite

anticompetitive effect based upon other substantial

evidence. Even though an acquisition is a prima facie

violation of the competitive standard under

subparagraphs a and b of this paragraph, a party may

establish the absence of the requisite anticompetitive

effect based upon other substantial evidence.

Relevant factors in making a determination under this

subparagraph include, but are not limited to, market

shares, volatility of ranking of market leaders,

number of competitors, concentration, trend of

concentration in the industry, and ease of entry and

exit into the market.

3. An order may not be entered under subsection E of this

section if:

Oklahoma Statutes - Title 36. Insurance Page 464

a. the acquisition will yield substantial economies of

scale or economies in resource utilization that cannot

be feasibly achieved in any other way, and the public

benefits which would arise from such economies exceed

the public benefits which would arise from not

lessening competition, or

b. the acquisition will substantially increase the

availability of insurance, and the public benefits of

the increase exceed the public benefits which would

arise from not lessening competition.

E. 1. a. If an acquisition violates the standards of this

section, the Commissioner may enter an order:

(1) requiring an involved insurer to cease and desist

from doing business in this state with respect to

the line or lines of insurance involved in the

violation, or

(2) denying the application of an acquired or

acquiring insurer for a license to do business in

this state.

b. The order shall not be entered unless:

(1) there is a hearing,

(2) notice of the hearing is issued prior to the end

of the waiting period and not less than fifteen

(15) days prior to the hearing, and

(3) the hearing is concluded and the order is issued

no later than sixty (60) days after the date of

the filing of the preacquisition notification

with the Commissioner.

c. Every order shall be accompanied by a written decision

of the Commissioner setting forth findings of fact and

conclusions of law.

d. An order pursuant to this paragraph shall not apply if

the acquisition is not consummated.

2. Any person who violates a cease and desist order of the

Commissioner under paragraph 1 of this subsection and while the

order is in effect may, after notice and hearing and upon order of

the Commissioner, be subject at the discretion of the Commissioner

to one or more of the following:

a. a monetary penalty of not more than Ten Thousand

Dollars ($10,000.00) for every day of violation, or

b. suspension or revocation of the person's license.

3. Any insurer or other person who fails to make any filing

required by this section, and who also fails to demonstrate a good-

faith effort to comply with any filing requirement, shall be subject

to a fine of not more than Fifty Thousand Dollars ($50,000.00).

Oklahoma Statutes - Title 36. Insurance Page 465

F. Subsections B and C of Section 12 of this act and Section 14

of this act shall not apply to acquisitions covered under subsection

B of this section.
Okla. Stat. tit. 36, § 36-3305 — OK Code / Title 36 / Section 36-3305
ORSA Summary Report
Status: in_force

A. Upon the Insurance Commissioner's request, and no more than

once each year, an insurer shall submit to the Insurance

Commissioner an ORSA Summary Report or any combination of reports

that together contain the information described in the ORSA Guidance

Manual, applicable to the insurer and/or the insurance group of

which it is a member. Notwithstanding any request from the

Insurance Commissioner, if the insurer is a member of an insurance

group, the insurer shall submit the report(s) required by this

subsection if the Insurance Commissioner is the lead state Insurance

Commissioner of the insurance group as determined by the procedures

within the Financial Analysis Handbook adopted by the National

Association of Insurance Commissioners.

Oklahoma Statutes - Title 36. Insurance Page 764

B. The report(s) shall include a signature of the insurer or

insurance group's chief risk officer or other executive having

responsibility for the oversight of the insurer's enterprise risk

management process attesting to the best of his or her belief and

knowledge that the insurer applies the enterprise risk management

process described in the ORSA Summary Report and that a copy of the

report has been provided to the insurer's board of directors or the

appropriate committee thereof.

C. An insurer may comply with subsection A of this section by

providing the most recent and substantially similar reports provided

by the insurer or another member of an insurance group of which the

insurer is a member to the Insurance Commissioner of another state

or to a supervisor or regulator of a foreign jurisdiction, if that

report provides information that is comparable to the information

described in the ORSA Guidance Manual. Any such report in a

language other than English must be accompanied by a translation of

that report into the English language.

D. The first filing of the ORSA Summary Report shall be in 2016

pursuant to this section.
Okla. Stat. tit. 36, § 36-1219.4 — OK Code / Title 36 / Section 36-1219.4
Definitions - Requirements for discount medical plan
Status: in_force

organizations - Penalties.

A. As used in this section:

1. "Direct contract" means a contractual arrangement tying the

ultimate seller purporting to offer discounts through the discount

card to the health care provider, which expressly states the intent

of this agreement to be used for the purpose of offering discounts

on health-related purchases to uninsured or noncovered persons;

2. "Discount card" means a card or any other purchasing

mechanism or device, which is not insurance, that purports to offer

discounts or access to discounts in health-related purchases from

health care providers;

Oklahoma Statutes - Title 36. Insurance Page 291

3. "Discount medical plan" means a business arrangement or

contract in which a person, in exchange for fees, dues, charges, or

other consideration, provides access for plan members to providers

of medical services and the right to receive medical services from

those providers at a discount. The term discount medical plan does

not include any product regulated as an insurance product, group

health service product or health maintenance organization (HMO)

product in the State of Oklahoma or discounts provided by an

insurer, group health service, or health maintenance organizations

(HMOs) where those discounts are provided at no cost to the insured

or member and are offered due to coverage with a licensed insurer,

group health service, or HMO;

4. "Discount medical plan organization" means a person or an

entity which operates a discount medical plan;

5. "Health care provider" means any person or entity licensed

by this state to provide health care services including, but not

limited to, physicians, hospitals, home health agencies, pharmacies,

and dentists;

6. “Health care provider network” means an entity which

directly contracts with physicians and hospitals and has contractual

rights to negotiate on behalf of those health care providers with a

discount medical plan organization to provide medical services to

members of the discount medical plan organization;

7. "Marketer" means a person or entity who markets, promotes,

sells or distributes a discount medical plan, including a private

label entity that places its name on and markets or distributes a

discount medical plan but does not operate a discount medical plan;

8. "Medical services" means any care, service or treatment of

illness or dysfunction of, or injury to, the human body including,

but not limited to, physician care, inpatient care, hospital

surgical services, emergency services, ambulance services, dental

care services, vision care services, mental health services,

substance abuse services, chiropractic services, podiatric care

services, laboratory services, and medical equipment and supplies.

The term does not include pharmaceutical supplies or prescriptions;

9. "Member" means any person who pays fees, dues, charges, or

other consideration for the right to receive the purported benefits

of a discount medical plan; and

10. "Person" means an individual, corporation, business trust,

estate, trust, partnership, association, joint venture, limited

liability company, or any other government or commercial entity.

B. 1. Before doing business in this state as a discount

medical plan organization, an entity shall be a corporation, limited

liability corporation, partnership, limited liability partnership or

other legal entity, organized under the laws of this state or, if a

foreign entity, authorized to transact business in this state, and

shall be registered as a discount medical plan organization with the

Oklahoma Statutes - Title 36. Insurance Page 292

Insurance Department or be licensed by the Insurance Department as a

licensed insurance company, licensed HMO, licensed group health

service organization or motor service club.

2. To register as a discount medical plan organization, an

applicant shall:

a. file with the Insurance Department an application on

the form that the Insurance Commissioner requires, and

b. pay to the Insurance Department an application fee of

Two Hundred Fifty Dollars ($250.00).

3. A registration is valid for a one-year term.

4. A registration expires one year following the registration

unless it is renewed as provided in this subsection.

5. Before it expires, a registrant may renew the registration

for an additional one-year term if the registrant:

a. otherwise is entitled to be registered,

b. files with the Insurance Department a renewal

application on the form that the Insurance

Commissioner requires, and

c. pays to the Insurance Department a renewal fee of Two

Hundred Fifty Dollars ($250.00).

6. The Insurance Commissioner may deny a registration to an

applicant or refuse to renew, suspend, or revoke the registration of

a registrant if the applicant or registrant, or an officer,

director, or employee of the applicant or registrant:

a. makes a material misstatement or misrepresentation in

an application for registration,

b. fraudulently or deceptively obtains or attempts to

obtain a registration for the applicant or registrant

or for another,

c. in connection with the administration of a health care

discount program, commits fraud or engages in illegal

or dishonest activities, or

d. has violated any provisions of this section.

7. Prior to registration by the Insurance Department, each

discount medical plan organization shall establish an Internet web

site.

8. All amounts collected as registration or renewal fees shall

be deposited into the General Revenue Fund.

9. Nothing in this subsection shall require a provider who

provides discounts to his or her own patients to obtain and maintain

a registration as a discount medical plan organization.

10. a. Nothing in this subsection shall apply to an affiliate

of a licensed insurance company, HMO, group health

service organization or motor service club, provided

that the affiliate registers with and maintains

registration in good standing with the Insurance

Oklahoma Statutes - Title 36. Insurance Page 293

Department in accordance with subparagraphs b and c of

this paragraph.

b. An affiliate shall register as a discount medical plan

organization on a form prescribed by the Insurance

Commissioner prior to the sale, marketing or

solicitation of a discount medical plan and pay an

application fee of One Hundred Dollars ($100.00).

c. A registration shall expire one (1) year after the

date of registration, and each year on that date

thereafter. A registrant may renew the registration

if the registrant pays an annual registration fee of

One Hundred Dollars ($100.00) and remains in good

standing with the Insurance Department.

d. For purposes of this section, “affiliate” means a

person that, directly or indirectly through one or

more intermediaries, controls or is controlled by or

is under common control with an insurance company,

HMO, group health service organization or motor

service club licensed in this state.

C. 1. The Insurance Department may examine or investigate the

business and affairs of any discount medical plan organization. The

Insurance Department may require any discount medical plan

organization or applicant to produce any records, books, files,

advertising and solicitation materials, or other information and may

take statements under oath to determine whether the discount medical

plan organization or applicant is in violation of the law or is

acting contrary to the public interest. The expenses incurred in

conducting any examination or investigation shall be paid by the

discount medical plan organization or applicant. Examinations and

investigations shall be conducted as provided in Sections 309.1 and

309.3 through 309.7 of this title. Discount medical plan

organizations shall be governed by the provisions of this section

and shall not be subject to the provisions of the Insurance Code

unless specifically referenced.

2. All work papers, recorded information, documents, books,

files, advertising and solicitation materials, copies or other

information produced by, obtained by or disclosed to the

Commissioner or any other person in the course of an examination or

investigation made pursuant to this section or in the course of

analysis by the Commissioner or other person, shall be given

confidential treatment by the Commissioner and may not be made

public by the Commissioner or any other person who obtained the

information in the course of the examination or investigation,

except to the extent provided in this section. Access may be

granted to the National Association of Insurance Commissioners. The

parties shall agree in writing prior to receiving the information to

provide to it the same confidential treatment as required by this

Oklahoma Statutes - Title 36. Insurance Page 294

section, unless the prior written consent of the company to which it

pertains has been obtained. The confidentiality and protection from

discovery by subpoena provided for in this paragraph shall not be

construed to be extended to identical, similar or other related

documents or information or to the work papers that are not deemed

to be in the possession, custody or control of the Commissioner.

3. Failure by the discount medical plan organization to pay the

expenses incurred under paragraph 1 of this subsection shall be

grounds for denial or revocation of the discount medical plan

organization’s registration.

D. 1. A discount medical plan organization may charge a

reasonable one-time processing fee and a periodic charge.

2. If the member cancels the membership within the first thirty

(30) days after receipt of the discount card and other membership

materials, the member shall receive a reimbursement of all periodic

charges paid. The return of all periodic charges shall be made

within thirty (30) days of the date of the cancellation. If all of

the periodic charges have not been paid within thirty (30) days,

interest shall be assessed and paid on the proceeds at a rate of the

Treasury Bill rate of the preceding calendar year, plus two (2)

percentage points.

3. The right of cancellation shall be set out in the contract

on the first page, in ten-point type or larger.

4. If a discount medical plan charges for a time period in

excess of one (1) month, the plan shall, in the event of

cancellation of the membership by either party, make a pro rata

reimbursement of all periodic charges to the member.

E. 1. A discount medical plan organization may not:

a. use in its advertisements, marketing material,

brochures, and discount cards the terms “insurance”,

"health plan", "coverage", "copay", "copayments",

"preexisting conditions", "guaranteed issue",

"premium", "PPO", "preferred provider organization”,

or other terms in a manner that could reasonably

mislead a person to believe that the discount medical

plan is health insurance,

b. except for hospital services, have restrictions on

free access to plan providers including waiting

periods and notification periods, or

c. pay providers any fees for medical services.

2. A discount medical plan organization may not collect or

accept money from a member for payment to a provider for specific

medical services furnished or to be furnished to the member unless

the organization has an active license from the Insurance Department

to act as an administrator.

F. 1. The following disclosures, to be printed in not less

than twelve-point type, shall be made in writing to any prospective

Oklahoma Statutes - Title 36. Insurance Page 295

member and shall appear on the first page of any advertisements,

marketing materials or brochures relating to a discount medical

plan:

a. that the plan is not insurance,

b. that the plan provides discounts with certain health

care providers for medical services,

c. that the plan does not make payments directly to the

providers of medical services,

d. that the plan member is obligated to pay for all

health care services but will receive a discount from

those health care providers who have contracted with

the discount plan organization, and

e. the name and the location of the registered discount

medical plan organization, including the current

telephone number of the registered discount medical

plan organization or other entity responsible for

customer service for the plan, if different from the

registered discount medical plan organization.

2. If the discount medical plan is sold, marketed, or solicited

by telephone, the disclosures required by this section shall be made

orally and provided in the initial written materials that describe

the benefits under the discount medical plan provided to the

prospective or new member.

3. The discount card provided to members shall prominently

display the words “This is not insurance”.

G. 1. All providers offering medical services to members under

a discount medical plan shall provide such services pursuant to a

written agreement. The agreement may be entered into directly by

the health care provider or by a health care provider network to

which the provider belongs if the provider network has contracts

with the health care provider that allow the provider network to

contract on behalf of the health care provider.

2. A health care provider agreement shall provide the

following:

a. a description of the services and products to be

provided at a discount,

b. the amount or amounts of the discounts or,

alternatively, a fee schedule which reflects the

health care provider's discounted rates, and

c. a provision that the health care provider will not

charge members more than the discounted rates.

3. A health care provider agreement with a health care provider

network shall require that the health care provider network have

written agreements with its health care providers that:

a. contain the terms described in paragraph 2 of this

subsection,

Oklahoma Statutes - Title 36. Insurance Page 296

b. authorize the health care provider network to contract

with the discount medical plan organization on behalf

of the provider, and

c. require the network to maintain an up-to-date list of

its contracted health care providers and to provide

that list on a quarterly basis to the discount medical

plan organization.

4. The discount medical plan organization shall maintain a copy

of each active health care provider agreement into which it has

entered.

H. 1. There shall be a written agreement between the discount

medical plan organization and the member specifying the benefits

under the discount medical plan and complying with the disclosure

requirements of this section.

2. All forms used, including the written agreement pursuant to

the provisions of subsection G of this section, shall first be filed

with the Insurance Department. Every form filed shall be identified

by a unique form number placed in the lower left corner of each

form. A filing fee of Twenty-five Dollars ($25.00) per form shall

be payable to the Insurance Department for deposit into the General

Revenue Fund.

I. 1. Each discount medical plan organization required to be

registered pursuant to this section except an affiliate shall, at

all times, maintain a net worth of at least One Hundred Fifty

Thousand Dollars ($150,000.00).

2. The Insurance Department may not allow a registration unless

the discount medical plan organization has a net worth of at least

One Hundred Fifty Thousand Dollars ($150,000.00).

J. 1. The Insurance Department may suspend the authority of a

discount medical plan organization to enroll new members, revoke any

registration issued to a discount medical plan organization, or

order compliance if the Department finds that any of the following

conditions exist:

a. the organization is not operating in compliance with

the provisions of this section,

b. the organization does not have the minimum net worth

as required by this section,

c. the organization has advertised, merchandised or

attempted to merchandise its services in such a manner

as to misrepresent its services or capacity for

service or has engaged in deceptive, misleading or

unfair practices with respect to advertising or

merchandising,

d. the organization is not fulfilling its obligations as

a discount medical plan organization, or

e. the continued operation of the organization would be

hazardous to its members.

Oklahoma Statutes - Title 36. Insurance Page 297

2. If the Insurance Department has cause to believe that

grounds for the suspension or revocation of a registration exist,

the Insurance Department shall notify the discount medical plan

organization in writing, specifically stating the grounds for

suspension or revocation, and shall provide opportunity for a

hearing on the matter in accordance with the Administrative

Procedures Act and the Oklahoma Insurance Code.

3. When the certificate of registration of a discount medical

plan organization is nonrenewed, surrendered or revoked, such

organization shall proceed, immediately following the effective date

of the order of revocation, or in the case of nonrenewal, the date

of expiration of the certificate of registration, to wind up its

affairs transacted under the certificate of registration. The

organization may not engage in any further advertising,

solicitation, collecting of fees, or renewal of contracts.

4. The Insurance Department shall, in its order suspending the

authority of a discount medical plan organization to enroll new

members, specify the period during which the suspension is to be in

effect and the conditions, if any, which shall be met by the

discount medical plan organization prior to reinstatement of its

registration to enroll new members. The order of suspension is

subject to rescission or modification by further order of the

Insurance Department prior to the expiration of the suspension

period. Reinstatement may not be made unless requested by the

discount medical plan organization; however, the Insurance

Department may not grant reinstatement if it finds that the

circumstances for which the suspension occurred still exist or are

likely to reoccur.

K. Each discount medical plan organization required to be

registered pursuant to this section shall provide the Insurance

Department at least thirty (30) days' advance notice of any change

in the discount medical plan organization's name, address, principal

business address, or mailing address.

L. Each discount medical plan organization shall maintain an

up-to-date list of the names and addresses of the providers with

which it has contracted on an Internet web site page, the address of

which shall be prominently displayed on all its advertisements,

marketing materials, brochures, and discount cards. This section

applies to those providers with whom the discount medical plan

organization has contracted directly, as well as those who are

members of a provider network with which the discount medical plan

organization has contracted.

M. 1. All advertisements, marketing materials, brochures and

discount cards used by marketers shall be approved in writing for

such use by the discount medical plan organization.

2. The discount medical plan organization shall have an

executed written agreement with a marketer prior to the marketer's

Oklahoma Statutes - Title 36. Insurance Page 298

marketing, promoting, selling, or distributing the discount medical

plan.

N. The Insurance Commissioner may promulgate rules to

administer the provisions of this section.

O. Regulation of discount medical plan organizations shall be

done pursuant to the Administrative Procedures Act.

P. 1. A discount medical plan organization required to be

registered pursuant to this section except an affiliate shall

maintain a surety bond with the Insurance Department, having at all

times a value of not less than Thirty-five Thousand Dollars

($35,000.00), for use by the Insurance Department in protecting plan

members.

2. No judgment creditor or other claimant of a discount medical

plan organization, other than the Insurance Department, shall have

the right to levy upon the surety bond held pursuant to the

provisions of paragraph 1 of this subsection.

Q. 1. A person who knowingly and willfully operates as or aids

and abets another operating as a discount medical plan organization

in violation of subsection B of this section commits a felony,

punishable as provided for in Oklahoma law, as if the discount

medical plan organization were an unauthorized insurer, and the

fees, dues, charges, or other consideration collected from the

members by the discount medical plan organization or marketer were

insurance premium.

2. A person who collects fees for purported membership in a

discount medical plan but fails to provide the promised benefits

commits a theft, punishable as provided in Oklahoma law.

R. 1. In addition to the penalties and other enforcement

provisions of this section, the Insurance Department may seek both

temporary and permanent injunctive relief if:

a. a discount medical plan organization is being operated

by any person or entity that is not registered

pursuant to this section, or

b. any person, entity, or discount medical plan

organization has engaged in any activity prohibited by

this section or any rule adopted pursuant to this

section.

2. The venue for any proceeding brought pursuant to the

provisions of this section shall be in the district court of

Oklahoma County.

S. 1. The provisions of this section apply to the activities

of a discount medical plan organization that is not registered

pursuant to this section as if the discount medical plan

organization were an unauthorized insurer.

2. A discount medical plan organization being operated by any

person or entity that is not registered pursuant to this section, or

any person, entity or discount medical plan organization that has

Oklahoma Statutes - Title 36. Insurance Page 299

engaged or is engaging in any activity prohibited by this section or

any rules adopted pursuant to this section shall be subject to the

Unauthorized Insurer Act as if the discount medical plan

organization were an unauthorized insurer, and shall be subject to

all the remedies available to the Insurance Commissioner under the

Unauthorized Insurer Act.

T. If the Insurance Commissioner finds that a discount medical

plan organization has violated any provision of this section or that

grounds exist for the discretionary revocation or suspension of a

registration, the Commissioner, in lieu of such revocation or

suspension, may impose a fine upon the discount medical plan

organization in an amount not to exceed One Thousand Dollars

($1,000.00) per violation.
Okla. Stat. tit. 36, § 36-6419 — OK Code / Title 36 / Section 36-6419
Rules and regulations
Status: in_force

The Commissioner may adopt any rules and regulations necessary

for the implementation, administration or furtherance of the

provisions of the Market Assistance Association Act.
Okla. Stat. tit. 36, § 36-6974 — OK Code / Title 36 / Section 36-6974
Credentials — Reimbursement and requirements for
Status: in_force

physicians and optometrists — Subcontracts.

A. 1. No agreement between an insurer or a prepaid vision plan

and a vision care provider shall require that a provider participate

with or be credentialed by any specific prepaid vision plan as a

condition for participation in the health care network of the

insurer to provide covered services to its enrollees.

2. In the event that a vision care provider is credentialed by

an insurer or vision care plan organization, no insurer or vision

care plan organization shall construe re-credentialing as re-

contracting with a vision care provider. All contracts shall be

distinct and separate documents from any credentialing materials.

B. Any insurer issuing or renewing a health benefit plan or

prepaid vision plan which provides coverage for services rendered by

a duly licensed physician or osteopath that are within the scope of

practice of a duly licensed optometrist shall provide the same

reimbursement for services to optometrists as allowed for those

services rendered by physicians or osteopaths.

C. No insurer or prepaid vision plan organization shall require

an optometrist to meet terms and conditions that are not required of

a physician or osteopath as a condition for participation in its

provider network for the provision of services that are within the

scope of practice of an optometrist.

D. If a vision care provider enters into any subcontract

agreement with another provider to provide his or her licensed

health care services to the enrollee, dependent of the enrollee, or

an enrollee of a managed care plan where the subcontracted provider

will bill the managed care plan or enrollee directly for the

subcontracted services, the subcontract agreement shall meet all

requirements of this act.Oklahoma Statutes - Title 36. Insurance Page 41
Okla. Stat. tit. 36, § 36-6530.9 — OK Code / Title 36 / Section 36-6530.9
Unfair practice – Separating individual employees from
Status: in_force

group health insurance coverage.

It shall constitute an unfair practice for the purposes of

Sections 1201 through 1220 of Title 36 of the Oklahoma Statutes for

an insurer, insurance agent, insurance broker or third-party

administrator to refer an individual employee to the Program or

arrange for an individual employee to apply for the Program, for the

purpose of separating that employee from group health insurance

coverage provided in connection with the employee's employment.
Okla. Stat. tit. 36, § 36-1807 — OK Code / Title 36 / Section 36-1807
Foreign or alien insurers
Status: in_force

A. In the event that the Commissioner makes any of the findings

provided for in Section 3 of this act concerning any foreign or

alien insurer or finds that any such insurer is not possessed of the

minimum surplus or capital required by the Insurance Code of this

state for similar type domestic companies, or if a conservator,

rehabilitator, receiver or liquidator has been appointed in the

state of domicile, or if the insurer gives its consent, the

Commissioner shall have the same power and jurisdiction to appoint a

supervisor or conservator as to the assets of such insurer located

in this state as provided herein for domestic insurance companies.

B. In the event that any such insurer shall fail to comply with

the provisions of Section 4 of this act with respect to any of its

assets or policies located within this state during any 90-day

period of supervision, such act or violation shall constitute

sufficient grounds for the immediate revocation of its certificate

of authority to do business in this state and for the immediate

appointment of a conservator to take charge of its assets located

within this state.

C. Any supervisor or conservator appointed with respect to

assets located in this state belonging to a foreign or alien insurer

shall have all of the power and authority provided for in Section 5

of this act with respect to such assets located in this state and,

in addition, may reinsure all or any part of such insurer's

policyholders or certificate holders located within this state with

insurers authorized to transact business in this state and may

transfer to the reinsuring company, as reserve funds, assets or any

portion thereof in his possession as may be required to consummate

the reinsurance of such policies and any of such assets transferred

as reserve funds shall not be deemed a preference of creditors.
Okla. Stat. tit. 36, § 36-1206 — OK Code / Title 36 / Section 36-1206
Statement of charges and notice of hearing - Opportunity
Status: in_force

to be heard.

A. Whenever the Insurance Commissioner shall have reason to

believe that any person has been engaged or is engaging in this

state in any unfair method of competition or any unfair or deceptive

act or practice defined in Section 1204 of this title, and that a

proceeding by the Commissioner in respect thereto would be to the

interest of the public, the Commissioner shall issue and serve upon

Oklahoma Statutes - Title 36. Insurance Page 277

the person a statement of the charges in that respect and a notice

in accordance with the Administrative Procedures Act.

B. At the time and place fixed for a hearing, the person shall

have an opportunity to be heard and to show cause why an order

should not be made by the Commissioner requiring the person to cease

and desist from the acts, methods or practices so complained of.

Upon good cause shown, the Commissioner shall permit any person to

intervene, appear and be heard at the hearing by counsel or in

person.