SECTION 365:40-3-1. Licensure forms

(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.

(f)   Certificate of similarity form. All alien and foreign HMOs must execute the certificate of similarity form and such form must be attached to the Annual Statement filed with the Insurance Commissioner. This form certifies that the Annual Statement filed with Oklahoma is an exact copy of the annual statement filed with the domiciliary regulatory agency.

(g)   Certificate of deposit form. The certificate of deposit form, when executed by the Insurance Commissioner, certifies to the securities on deposit with the State of Oklahoma. Upon making application for license in Oklahoma, all alien and foreign HMOs must file a substantially similar form executed by their domiciliary regulatory agency.

(h)   Certificate of compliance form. The certificate of compliance form, when executed by the Insurance Commissioner, certifies that the company named therein has complied with all the requirements of the Oklahoma law and is authorized to transact business within Oklahoma. Upon making application for license in Oklahoma, all alien and foreign HMOs must file a substantially similar form executed by their domiciliary regulatory agency.

(i)   Annual Oklahoma premium tax report. The Oklahoma annual premium tax report, submitted with the Annual Statement filed with the Insurance Commissioner, reports Oklahoma tax on premium income of the filing HMO, and includes fire marshal tax calculations if applicable.

(j)   Appointment of examiner form. The appointment of examiner form is used by the Insurance Commissioner to appoint examiners to represent Oklahoma and/or Zone 3 of the National Association of Insurance Commissioners in the examination of an HMO, which empowers the person so appointed to enter into the examination of the HMO named therein.

[Source: Added at 21 Ok Reg 77, eff 11-1-03 (emergency); Added at 21 Ok Reg 1672, eff 7-14-04]