Oklahoma Administrative Code (Last Updated: March 11, 2021) |
TITLE 365. Insurance Department |
Chapter 10. Life, Accident and Health |
Subchapter 1. General Provisions |
Part 1. GENERAL PROVISIONS |
Part 3. STANDARDIZED HEALTH CLAIM FORMS |
Subchapter 3. Advertising |
Part 1. ACCIDENT AND HEALTH INSURANCE |
Part 3. LIFE INSURANCE ADVERTISING |
Part 5. LIFE INSURANCE ILLUSTRATIONS REGULATION |
Subchapter 5. Minimum Standards; Contract Guidelines |
Part 1. MINIMUM STANDARDS AND BENEFITS FOR ACCIDENT AND HEALTH INSURANCE |
Part 3. MINIMUM STANDARDS AND BENEFITS FOR MEDICARE SUPPLEMENT POLICIES [revoked] |
Part 5. LONG-TERM CARE INSURANCE |
Part 7. CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE |
Part 9. UNIVERSAL LIFE RULE |
Part 11. ACCELERATED BENEFITS |
Part 13. MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS |
Part 15. SMALL EMPLOYER HEALTH INSURANCE REFORM REGULATION |
Part 17. ACTUARIAL OPINION AND MEMORANDUM REGULATION |
Part 19. OKLAHOMA HEALTH CARE FREEDOM OF CHOICE REGULATION |
Part 21. EXTENSION AND TERMINATION OF COVERAGE UNDER GROUP ACCIDENT AND HEALTH POLICY AND CONTRACTS OF HOSPITAL AND MEDICAL SERVICES OR INDEMNITY [revoked] |
Subchapter 7. Mortality Tables |
Part 1. PERMITTING SMOKER/NONSMOKER MORTALITY TABLES FOR USE IN DETERMINING MINIMUM RESERVE LIABILITIES AND NONFORFEITURE BENEFITS |
Part 3. MIXED-GENDER MORTALITY TABLES |
Subchapter 9. Annuities |
Part 1. NEW ANNUITY MORTALITY TABLE FOR USE IN DETERMINING RESERVE LIABILITIES FOR ANNUITIES |
Part 3. PERTAINING TO SEPARATE ACCOUNTS IN CONNECTION WITH VARIABLE ANNUITY CONTRACTS |
Subchapter 11. Coordination of Benefit Guidelines |
SECTION 365:10-11-1. Purpose |
SECTION 365:10-11-2. Definitions |
SECTION 365:10-11-3. Effect on benefits |
SECTION 365:10-11-4. Right to receive and release necessary information |
SECTION 365:10-11-5. Benefit payments |
SECTION 365:10-11-6. Subrogation |
SECTION 365:10-11-7. Small claim waivers |
SECTION 365:10-11-8. Public education |
SECTION 365:10-11-9. Applicability |
SECTION 365:10-11-10. Facility of payment |
SECTION 365:10-11-11. Right of recovery |
Subchapter 13. Industrial Insurance: Settlement of Claims - Payment by Cash Prohibited |
SECTION 365:10-13-1. Purpose |
SECTION 365:10-13-2. Settlement of industrial insurance claims |
Subchapter 15. Utilization Review Regulations |
SECTION 365:10-15-1. Purpose |
SECTION 365:10-15-2. Private review agents |
SECTION 365:10-15-3. Private review agent certification and renewal |
SECTION 365:10-15-4. Transferability of Certificates |
SECTION 365:10-15-5. Use of Oklahoma physician in utilization review |
SECTION 365:10-15-6. Third party payors |
SECTION 365:10-15-7. In-house utilization review by insurance companies |
Subchapter 17. Valuation of Life Insurance Policies Regulation (Including the Introduction and Use of New Select Mortality Factors) |
SECTION 365:10-17-1. Purpose |
SECTION 365:10-17-2. Applicability |
SECTION 365:10-17-3. Definitions |
SECTION 365:10-17-4. General calculation requirements for basic reserves and premium deficiency reserves |
SECTION 365:10-17-5. Calculation of minimum valuation standard for policies with guaranteed nonlevel gross premiums or guaranteed nonlevel benefits (other than universal life policies) |
SECTION 365:10-17-7. Effective date [Expired] |
Subchapter 19. Health Insurance Purchasing Groups |
SECTION 365:10-19-1. Definitions |
SECTION 365:10-19-2. Applicability and scope |
SECTION 365:10-19-3. Establishment of business |
SECTION 365:10-19-4. Board of directors and plan of operations |
SECTION 365:10-19-5. Requirement to insure all employees of the purchaser and new entrants |
SECTION 365:10-19-6. Prohibited provisions and other requirements |
SECTION 365:10-19-7. Filing requirements |
SECTION 365:10-19-8. Annual reporting requirements |
Subchapter 21. Recognition of the 2001 CSO Mortality Table for Use in Determining Minimum Reserve Liabilities and Nonforfeiture Benefits Regulation |
SECTION 365:10-21-1. Authority |
SECTION 365:10-21-2. Purpose |
SECTION 365:10-21-3. Definitions |
SECTION 365:10-21-4. 2001 CSO Mortality Table |
SECTION 365:10-21-5. Conditions |
SECTION 365:10-21-6. Applicability of the 2001 CSO Mortality Table to Oklahoma Valuation of Life Insurance Policies Regulation, O.A.C. 365:10-17-1, et seq. |
SECTION 365:10-21-7. Gender-Blended Tables |
SECTION 365:10-21-8. Separability |
SECTION 365:10-21-9. Effective date |
Subchapter 23. Discount Medical Plan Organizations |
SECTION 365:10-23-1. Forms |
SECTION 365:10-23-2. Inducements. |
SECTION 365:10-23-3. Audited Financial Statements |
SECTION 365:10-23-4. Marketers of Discount Medical Plan Organizations |
Subchapter 25. Regulation Permitting the Recognition of Preferred Mortality Tables for Use in Determining Minimum Reserve Liabilities |
SECTION 365:10-25-1. Authority |
SECTION 365:10-25-2. Purpose |
SECTION 365:10-25-3. Definitions |
SECTION 365:10-25-4. 2001 CSO Preferred Class Structure Table |
SECTION 365:10-25-5. Conditions |
SECTION 365:10-25-6. Separability |
SECTION 365:10-25-7. Effective Date |
Subchapter 27. Preneed Life Insurance Minimum Standards for Determining Reserve Liabilities and Nonforfeiture Values Regulation |
SECTION 365:10-27-1. Authority |
SECTION 365:10-27-2. Scope |
SECTION 365:10-27-3. Purpose |
SECTION 365:10-27-4. Definitions |
SECTION 365:10-27-5. Minimum valuation mortality standards |
SECTION 365:10-27-6. Transition rules |
SECTION 365:10-27-7. Effective date [Expired] |
Subchapter 29. External Review Regulation |
SECTION 365:10-29-1. Purpose |
SECTION 365:10-29-2. Applicability and scope |
SECTION 365:10-29-3. Definitions |
SECTION 365:10-29-4. Notice of right to an external review and external review procedures |
SECTION 365:10-29-5. Authorization to disclose protected health information |
SECTION 365:10-29-6. External review requests |
SECTION 365:10-29-7. Notice of initial determination |
SECTION 365:10-29-8. Independent review organization application |
SECTION 365:10-29-9. Independent review organization recordkeeping and reporting requirements |
SECTION 365:10-29-10. Health carrier recordkeeping and reporting requirements |
Subchapter 31. Navigators and Navigator Entities |
SECTION 365:10-31-1. Purpose |
SECTION 365:10-31-2. Scope |
SECTION 365:10-31-3. Authority |
SECTION 365:10-31-4. Individual navigator registration application, registration renewals, fees, and civil penalties |
SECTION 365:10-31-5. Navigator entity registration application, registration renewals, fees, and civil penalties |
SECTION 365:10-31-6. Individual navigator requirements |
SECTION 365:10-31-7. Navigator entity requirements |
Appendix A. Uniform Health Claim Form |
Appendix B. Medicare Supplement Policy Standards [revoked] |
Appendix C. Rescission Reporting Form for Long-Term Care Policies |
Appendix D. Mixed-Gender Mortality Tables |
Appendix E. Presumptively Reasonable Accident and Health Rates |
Appendix F. Credit Insurance Deviation Request Form |
Appendix G. Credibility Table |
Appendix H. Inventory Credit Life and Disability Presumptive Rates |
Appendix I. Inventory Credit Life and Disability Deviated Rates |
Appendix J. Credit Life Insurance Experience Report |
Appendix K. Credit Disability Insurance Experience Report |
Appendix L. Credit Life Insurance Experience Report |
Appendix M. Credit Disability Insurance Experience Report |
Appendix N. Credit Life Insurance Experience Reconciliation to State Page |
Appendix O. Credit Disability Insurance Experience Reconciliation to State Page |
Appendix P. Selection Factors Memorandum |
Appendix Q. Medicare Supplement |
Appendix R. Form for Reporting Medicare Supplement Policies |
Appendix S. Outline of Coverage [revoked] |
Appendix T. Notice to Applicant Regarding Replacement of Medicare Supplement Insurance or Medicare Advantage |
Appendix U. Portability Form |
Appendix V. Disclosure Statements |
Appendix W. Long Term Care Insurance Personal Worksheet |
Appendix X. Disclosure Form |
Appendix Y. Suitability Letter |
Appendix Z. Asset Adequacy Test Amounts - Reserves and Liabilities |
Appendix AA. Long Term Care Insurance Format for Outline of Coverage |
Appendix BB. Select Mortality Factors |
Appendix CC. Long-Term Care Insurance Claims Denial Reporting Form |
Appendix DD. Long Term Care Insurance Potential Rate Increase Disclosure Form |
Appendix EE. Triggers for a Substantial Premium Increase |
Appendix FF. Medicare Supplement Insurance Questions |
Appendix GG. Information Provided Pursuant to Section 365:10-5-176(F)(1)(C)(Ii) of the Actuarial Opinion and Memorandum Regulation |
Appendix HH. Partnership Program Notice |
Appendix II. Partnership Status Disclosure Notice |
Appendix JJ. Issuer Certification Form |
Appendix KK. Approved Long Term Care Partnership Program Policy Summary |
Appendix LL. Notice to Applicant Regarding Replacement of Individual Accident and Sickness or Long-Term Care Insurance for Solicitations Other than Direct Response |
Appendix MM. Notice to Applicant Regarding Replacement of Accident and Sickness or Long-Term Care Insurance for Direct Response Solicitations |
Appendix NN. Patient's Affidavit [Expired] |
Appendix OO. Provider Assistance Form [Expired] |
Appendix PP. Notice of Appeal Rights |
Appendix QQ. External Review Request Form |
Appendix RR. Application for Registration as an Independent review organization |
Appendix SS. Independent review organization external review annual report form |
Appendix TT. Health Carrier External Review Annual Report Form |
Appendix UU. Policy Holder's Authorization to Release Insurance Policy Information to Agent of Record [revoked] |
Appendix VV. Uniform Health Questionnaire |
Appendix WW. 2012 Iam Period Table, Female, Age Nearest Birthday |
Appendix XX. 2012 Iam Period Table, Male, Age Nearest Birthday |
Appendix YY. Projection Scale G2, Female, Age Nearest Birthday |
Appendix ZZ. Projection Scale G2, Male, Age Nearest Birthday |
Note
[Authority: 36 O.S., §§ 122, 307.1, 311, 1204, 1219.4(N), 1415.5, 1466, 1510, 2043, 3611, 3611.1, 4029, 4061, 4403, 4403.1, 4427, 4502(B), 4529, 6101, 6475.5(A)(3), 6475.6(A)(2), 6475.12(G), 6516(A), 6526, 6555, and 6571; 75 O.S., §§ 302 through 308.2]
[Source: Codified 12-31-91]