Oklahoma Administrative Code › Title 365 - Insurance Department › Chapter 40 - Health Maintenance Organization (HMO) › Subchapter 3 - Financial › Part 1 - HMO FORMS AND INSTRUCTIONS › Section 365:40-3-1 - Licensure forms

Current through Vol. 41, No. 20, July 1,
				  2024
(a)
Certificate of authority form.
The certificate of authority form,
				  executed under the hand and seal of the Insurance Commissioner and delivered,
				  is evidence of an HMO's authority to transact business within
				  Oklahoma.
(b)
Annual
				  statement form.
Annual statement forms must be filed by all admitted
				  companies and postmarked on or before the first day of March of each year,
				  reporting their business and financial condition as of December 31st of the
				  preceding year. The completed forms must be subscribed and sworn to by the
				  President, Secretary and other proper officers of the company. The Annual
				  Statement is referred to as the "Convention Blank" and is in the general form
				  and content approved by the National Association of Insurance Commissioners.
				  The statements shall be prepared in accordance with the NAIC annual statement
				  instruction handbooks and follow the NAIC accounting practices and procedures
				  manuals as supplemented by the Insurance Commissioner by rule.
(c)
Quarterly statement form.
Quarterly statement forms must be filed by all domestic HMOs and postmarked on
				  or before the forty-fifth day after the end of the reporting period of each
				  year, reporting their business and financial condition as of March 31st, June
				  30th, and September 30th respectively. The completed forms must be subscribed
				  and sworn to by the President, Secretary, and other proper executive officers
				  of the company.
(d)
Uniform
				  Consent To Service of Process form.
All companies must file the Uniform
				  Consent to Service of Process form of the NAIC listing the person to whom
				  service of process is to be forwarded. The appointment of Insurance
				  Commissioner as attorney for service of process form for the State of Oklahoma
				  must be filed by all licensed alien and foreign HMOs using the Uniform Consent
				  to Service of Process form of the NAIC and shall continue in force so long as
				  any liability remains outstanding in Oklahoma against the filing company as
				  required by 36 O.S. §
										6903.
(e)
Uniform Certificate of Authority
				  Application form (UCAA).
All companies desiring admission or renewal
				  licensure within Oklahoma shall submit the Uniform Certificate of Authority
				  Application form of the NAIC (UCAA). A company agrees by its execution of such
				  form to transact business, upon issuance of license, in accordance with the
				  laws of Oklahoma, and to pay all fees and taxes as may at any time be imposed
				  by law.
(1) Applicants shall submit three (3)
				  copies of the form and its exhibits and/or attachments as well as any
				  accompanying forms.
(2) State
				  specific information required by the UCAA form shall include applicable items
				  listed in 36 O.S. §
											6903(C)
				  and documentation to demonstrate compliance with 36 O.S. §
											6907.