{"data":{"id":"us-ok/okla.-stat.-tit.-36-36-4250","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 36, § 36-4250","heading":"Rate filing – Definitions","body":"A. On or after the effective date of this act, pursuant to the\n\nprovisions of this section and any other applicable section of Title\n\n36 of the Oklahoma Statutes, every health benefit plan shall file\n\nall group and individual initial rates and group and individual rate\n\nadjustments with the Insurance Commissioner. If the Commissioner\n\ndetermines that the initial rate or rate adjustment is unreasonable,\n\nexcessive, unjustified or unfairly discriminatory, the Commissioner\n\nshall make a written decision stating the reason or reasons for the\n\ndetermination, and shall deliver a copy of the determination to the\n\ncompany within thirty (30) calendar days unless the Commissioner\n\nextends the determination period for an additional thirty (30)\n\ncalendar days.\n\nB. 1. For purposes of this section, \"health benefit plan\"\n\nmeans a plan that:\n\na. provides benefits for medical or surgical expenses\n\nincurred as a result of a health condition, accident,\n\nor sickness, and\n\nb. is offered by any insurance company, group hospital\n\nservice corporation, or health maintenance\n\norganization that delivers or issues for delivery an\n\nindividual, group, blanket, or franchise insurance\n\npolicy or insurance agreement, a group hospital\n\nservice contract, or an evidence of coverage, or, to\n\nthe extent permitted by the Employee Retirement Income\n\nSecurity Act of 1974, 29 U.S.C., Section 1001 et seq.,\n\nby a multiple employer welfare arrangement as defined\n\nin Section 3 of the Employee Retirement Income\n\nSecurity Act of 1974, or any other analogous benefit\n\narrangement, whether the payment is fixed or by\n\nindemnity.\n\n2. The term \"health benefit plan\" shall not include:\n\na. a plan that provides coverage:\n\n(1) only for a specified disease or diseases or under\n\nan individual limited benefit policy,\n\n(2) only for accidental death or dismemberment,\n\n(3) for dental or vision care,\n\n(4) a hospital confinement indemnity policy or other\n\nfixed indemnity insurance,\n\n(5) disability income insurance or a combination of\n\naccident-only and disability income insurance, or\n\n(6) as a supplement to liability insurance,\n\nb. a Medicare supplemental policy as defined by Section\n\n1882(g)(1) of the Social Security Act (42 U.S.C.,\n\nSection 1395ss),\n\nc. workers’ compensation insurance coverage,\n\nd. medical payment insurance issued as part of a motor\n\nvehicle insurance policy,\n\ne. a long-term care policy, including a nursing home\n\nfixed indemnity policy, unless a determination is made\n\nthat the policy provides benefit coverage so\n\ncomprehensive that the policy meets the definition of\n\na health benefit plan,\n\nf. short-term health insurance issued on a nonrenewable\n\nbasis with duration of six (6) months or less,\n\ng. policy issued under Title XVIII, or\n\nh. a plan issued to any person, firm, corporation,\n\npartnership, limited liability company or association\n\nthat is actively engaged in business and that, on at\n\nleast fifty percent (50%) of its working days during\n\nthe preceding calendar quarter, employed more than\n\nfifty (50) eligible employees.","path":["OK Code","Title 36"],"source_url":"https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os36.pdf","current_through":"2026-08-14","vintage":"open-us-law v2026.08, retrieved 2026-09-14","retrieved_at":"2026-09-14T18:32:36Z","sha256":"a6ed26b8bb673c258dd94bdbd853f51a9df457c88c36ebc125f94a3b26c507f1","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-36-36-4218","next":"us-ok/okla.-stat.-tit.-36-36-4400"},"notice":"GroundRules: Original legal text. Not legal advice."}