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 365:10-17-6. Calculation of minimum valuation standard for flexible premium and fixed premium universal life insurance policies that contain provisions resulting in the ability of a policyowner to keep a policy in force over a secondary guarantee period
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
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]