SECTION 365:10-5-151. Definitions

  The following words or terms, when used in this Part, shall have the following meaning, unless the context clearly indicates otherwise:

"Act" means the Small Employer Health Insurance Reform Act, 36 O.S.Supp.1994, §6511 et seq.

"Associate member of an employee organization" means any individual who participates in an employee benefit plan [as defined in 29 U.S.C. §1002(1)] that is a multi-employer plan [as defined in 29 U.S.C. §1002(37A)], other than the following:

(A)   An individual or the beneficiary of such individual who is employed by a participating employer within a bargaining unit covered by at least one of the collective bargaining agreements under or pursuant to which the employee benefit plan is established or maintained; or

(B)   An individual who is a present or former employee (or a beneficiary of such employee) of the sponsoring employee organization, of an employer who is or was a party to at least one of the collective bargaining agreements under or pursuant to which the employee benefit plan is established or maintained, or of the employee benefit plan (or of a related plan).

"New entrant" means an eligible employee, or the dependent of an eligible employee, who becomes part of an employer group after the initial period for enrollment in a health benefit plan.

"Risk characteristic" means the health status, claims experience, duration of coverage, or any similar characteristic related to the health status or experience of a small employer group or of any member of a small employer group.

"Risk load" means the percentage above the applicable base premium rate that is charged by a small employer carrier to a small employer to reflect the risk characteristics of the small employer group.

[Source: Added at 12 Ok Reg 3137, eff 7-31-95]