2023 Oklahoma Statutes › Title 36. Insurance › §36-6060.15. Definitions.

As used in this act:
1. "Deductible" means the total deductible for an eligible individual and all the dependents of that eligible individual for a calendar year;
2. "Dependent" means the spouse or child of the eligible individual as defined in Section 152 of the Internal Revenue Code;
3. "Eligible individual" means the individual taxpayer, including employees of an employer who contributes to health savings accounts on the employees' behalf, who:
a.
must be covered by a "high deductible health plan" individually or with dependent,
b.
may not be covered under any health plan that is not a high deductible health plan, except for:
(1)
coverage for accidents,
(2)
workers’ compensation insurance,
(3)
insurance for a specified disease or illness,
(4)
insurance paying a fixed amount per day per hospitalization, and
(5)
tort liabilities, and
c.
establishes the health savings account, or on whose behalf the health savings account is established;
4. "Health savings account" or "account" means a trust or custodian established in this state pursuant to a health savings account program exclusively to pay the qualified medical expenses of an eligible individual or their dependents, but only if the written governing instrument creating the account meets the following requirements:
a.
except in the case of a rollover contribution, no contribution will be accepted:
(1)
unless it is in cash, or
(2)
to the extent the contribution, when added to the previous contributions to the account for the calendar year, exceeds the maximum contribution amount pursuant to Section 223 of the Internal Revenue Code,
b.
the trustee or custodian is a bank, a credit union, an insurance company, or another person approved by the United States Secretary of Health and Human Services,
c.
no part of the trust assets will be invested in life insurance contracts,
d.
the assets of the account will not be commingled with other property except as allowed for under Individual Retirement Accounts, and
e.
eligible individual's interest in the account is nonforfeitable;
5. "Health savings account program" or "program" means a program that includes all of the following:
a.
the purchase by an eligible individual or by an employer of a high deductible health plan, and
b.
the contribution into a health savings account by an eligible individual or on behalf of an employee or by their employer. The total annual contribution may not exceed the maximum contribution amount pursuant to Section 223 of the Internal Revenue Code;
6. "High deductible health plan" means a health coverage policy, certificate, or contract that provides for payments for covered benefits that exceed the higher deductible;
7. "Qualified medical expense" means an expense paid by the taxpayer for medical care described in paragraph d of Section 213 of the Internal Revenue Code, but only to the extent such amounts are not compensated for by insurance or otherwise; and
8. "High deductible" means:
a.
in the case of self-only coverage, an annual deductible which is not less than One Thousand Dollars ($1,000.00) and the sum of the annual deductible and other annual out-of-pocket expenses required to be paid under the plan for covered benefits does not exceed Five Thousand Dollars ($5,000.00), or
b.
in the case of family coverage, an annual deductible of not less than Two Thousand Dollars ($2,000.00) and the sum of the annual deductible and other annual out-of-pocket expenses required to be paid under the plan for covered benefits does not exceed Ten Thousand Dollars ($10,000.00).
A plan shall not fail to be treated as a high deductible plan by reason of failing to have a deductible for preventive care or, in the case of network plans, for having out-of-pocket expenses which exceed these limits on an annual deductible for services provided outside the network.
Added by Laws 2005, c. 306, § 2, eff. Nov. 1, 2005. Amended by Laws 2007, c. 269, § 1, emerg. eff. June 4, 2007.