{"data":{"id":"us-ok/okla.-stat.-tit.-36-36-4414","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 36, § 36-4414","heading":"Issuance of accident or health policies by insurers not","body":"authorized to engage in the insurance business in Oklahoma -\n\nApproval process.\n\nA. The Oklahoma Legislature recognizes the need for purchasers\n\nof health insurance coverage in this state to have the opportunity\n\nto choose health insurance plans that are more affordable and\n\nflexible than existing market policies offering accident and health\n\ncoverage. Therefore, the Oklahoma Legislature seeks to increase the\n\navailability of health insurance coverage by allowing insurers\n\nauthorized to engage in the business of insurance in other states,\n\nand not so authorized in Oklahoma, to issue accident and health\n\npolicies in Oklahoma by granting a limited exemption from Section\n\n606 of Title 36 of the Oklahoma Statutes. Insurers authorized to\n\nengage in the business of insurance in other states, and not so\n\nauthorized in Oklahoma, shall be subject to the following\n\nrequirements in order to be able to obtain an exemption to Section\n\n606 of Title 36 of the Oklahoma Statutes and to issue accident and\n\nhealth policies in Oklahoma through agents licensed in the state:\n\n1. No insurer authorized to engage in the business of insurance\n\nin other states that is not so licensed in Oklahoma may issue an\n\naccident or a health policy pursuant to this section unless it is\n\napproved to do so, in writing, by the Insurance Commissioner;\n\n2. An insurer seeking to obtain the written approval described\n\nin paragraph 1 of this subsection shall request such approval in the\n\nmanner required by the Insurance Commissioner, and shall pay any and\n\nall fees associated with such application as may be required by the\n\nInsurance Commissioner; and\n\n3. In order to first be considered for the written approval\n\nfrom the Insurance Commissioner, an insurer shall be domiciled in a\n\nstate which has a legislatively approved compact with the State of\n\nOklahoma.\n\nB. Pursuant to the provisions of the Health Care Choice Act,\n\nall approved insurers domiciled in a compacting state selling health\n\nand accident insurance policies in Oklahoma shall:\n\n1. Offer accident and health insurance policies that contain\n\nall mandated health benefits that are required by Oklahoma law to be\n\nincluded in accident or health insurance policies and Health\n\nMaintenance Organization (HMO) policies issued in the state and will\n\ncomply with all other applicable laws pertaining to coverage and\n\ncoverage decisions;\n\n2. Keep a full and true record of each insurance policy issued\n\nto an insured in this state by or on behalf of the insurer,\n\ncontaining such information as may be required by the Insurance\n\nCommissioner, which record may be examined at any time within three\n\n(3) years after issuance by the Insurance Commissioner;\n\n3. File with the Insurance Commissioner, on or before April 1\n\nof each year, a verified statement of all insurance transacted by\n\nthe insurer during the preceding calendar year in Oklahoma. The\n\nstatement shall be on a form prescribed and furnished by the\n\nInsurance Commissioner and contain such information as required by\n\nthe Insurance Commissioner;\n\n4. Issue an insurance policy in this state pursuant to this\n\nsection through an insurance agent or other person or entity that is\n\nlicensed in this state, as well as in a state in which the insurer\n\nis licensed, to engage in the sale, solicitation or negotiation of\n\naccident and/or health insurance in this state, and that is\n\nappointed by the insurer for such purpose;\n\n5. Appoint one or more third-party administrators that are\n\nlicensed in this state, and that have licensed adjusters in this\n\nstate, that shall be responsible for administering claims under the\n\ninsurance policies issued by the insurer in this state and be\n\navailable to answer any questions from insureds under the insurance\n\npolicies issued by the insurer in this state; and\n\n6. Submit to the jurisdiction of this state and be subject to\nhat have licensed adjusters in this\n\nstate, that shall be responsible for administering claims under the\n\ninsurance policies issued by the insurer in this state and be\n\navailable to answer any questions from insureds under the insurance\n\npolicies issued by the insurer in this state; and\n\n6. Submit to the jurisdiction of this state and be subject to\n\nservice of legal process within this state in any action or\n\nproceeding against the insurer arising out of any insurance policy\n\nissued to an insured policyholder in this state and the Insurance\n\nCommissioner is appointed as its exclusive agent to receive service\n\nof legal process.\n\nC. The Insurance Commissioner may only grant the written\n\napproval described in paragraph 1 of subsection A of this section to\n\nan insurer that:\n\n1. Is properly licensed and has met the requirements for\n\nsolvency in its domiciliary state to issue accident and health\n\ninsurance policies;\n\n2. Has met the requirements for market conduct applicable to\n\ninsurers domiciled in Oklahoma authorized to issue accident and\n\nhealth insurance policies in the state set forth in Title 36 of the\n\nOklahoma Statutes; and\n\n3. Has submitted the policy form that it will issue to insureds\n\nin this state for a determination by the Insurance Commissioner that\n\nthe policy form is in compliance with all laws and regulations in\n\nthis state applicable to health insurance policies.\n\nD. The Insurance Commissioner for the State of Oklahoma shall\n\nbe required to obtain verification in writing by the regulating\n\nauthority of the domiciliary state, certifying that the insurer has\n\nmet the financial solvency requirements of the insurer's domiciliary\n\nstate. No insurer domiciled in a compacting state may be approved\n\nto sell health and accident insurance policies in Oklahoma without\n\nsuch verification.\n\nE. The Insurance Commissioner may require an insurer to reapply\n\nfor the written approval described in paragraph 1 of subsection A of\n\nthis section on an annual basis, or as often as the Insurance\n\nCommissioner deems prudent. Reapplication shall be in the form and\n\nmanner required by the Insurance Commissioner.\n\nF. The Insurance Commissioner may, as a condition to providing\n\nan insurer with the written approval described in paragraph 1 of\n\nsubsection A of this section, impose on the insurer any additional\n\nrequirement that the Insurance Commissioner deems necessary.\n\nG. The Insurance Commissioner may negotiate one or more\n\ncompacts with other states to allow insurers domiciled in such\n\ncompacting state that obtain the written approval from the Insurance\n\nCommissioner described in paragraph 1 of subsection A of this\n\nsection to sell policies of accident and health insurance in\n\nOklahoma. Such compacts shall provide for appropriate protection of\n\nOklahoma consumers by requiring the Commissioner to regulate the\n\ncompliance to Oklahoma laws and regulations, and market conduct of\n\nthe insurers pursuant to compact provisions. The terms of any such\n\ncompact shall be presumed a valid exercise of the discretionary\n\nauthority of the Commissioner. The compact shall be required to be\n\napproved by the Legislature by adoption of a joint resolution,\n\nprovided that the joint resolution becomes law in accordance with\n\nSection 11 of Article VI of the Oklahoma Constitution. Joint\n\nresolutions introduced for such purpose shall not be subject to\n\nregular legislative deadlines and shall be limited to such\n\nprovisions as may be necessary for approval of a compact. The\n\nLegislature retains the authority to approve or not approve a\n\ncompact with a state.\n\nH. The Insurance Commissioner may require every approved\n\ninsurer to submit to a market conduct examination. Any examination\n\nby the Commissioner of the regulatory compliance or market conduct\n\nof any insurer domiciled in a compacting state seeking to offer\nions as may be necessary for approval of a compact. The\n\nLegislature retains the authority to approve or not approve a\n\ncompact with a state.\n\nH. The Insurance Commissioner may require every approved\n\ninsurer to submit to a market conduct examination. Any examination\n\nby the Commissioner of the regulatory compliance or market conduct\n\nof any insurer domiciled in a compacting state seeking to offer\n\nhealth benefit plans in this state, or who has been given approval\n\nto offer health benefit plans in this state, shall be conducted in\n\nthe same manner and under the same terms and conditions as\n\nexaminations of companies located in this state.\n\nI. An insurer domiciled in a compacting state is required to\n\nprovide Oklahoma state-mandated health benefits and to comply with\n\nall other applicable laws that apply to Oklahoma accident and health\n\ninsurers including coverage of services and coverage decisions.\n\nJ. All approved insurers domiciled in a compacting state\n\nselling health and accident insurance policies in Oklahoma must\n\ncomply with the Unfair Claims Settlement Practices Act, Health Care\n\nFreedom of Choice Act, Genetic Nondiscrimination in Insurance Act,\n\nHospital and Medical Services Utilization Review Act and all\n\nrequirements found in Sections 4401 through 4411 of Title 36 of the\n\nOklahoma Statutes. All Health Maintenance Organizations shall be\n\nsubject to and comply with the Health Maintenance Organization Act\n\nof 2003.\n\nK. Each written application for purchase of a policy offered by\n\nan insurer domiciled in a compacting state pursuant to the Health\n\nCare Choice Act shall contain the following language in boldface\n\ntype at the beginning of the document:\n\n\"This policy may be subject, in part, to the laws of (insert\n\nstate where the master policy is filed); in particular, all of the\n\npremium rating laws applicable to policies filed in Oklahoma do not\n\napply to this policy. This may result in increases in your premium\n\nat renewal that would not be permissible in a policy that was issued\n\nby an Oklahoma domestic insurer. For information concerning health\n\ninsurance coverage under a policy issued by an Oklahoma insurer,\n\nplease consult your insurance agent or the Oklahoma Department of\n\nInsurance.\"\n\nL. Each policy issued pursuant to the Health Care Choice Act by\n\nan insurer domiciled in a compacting state shall contain the\n\nfollowing language in boldface type at the beginning of the\n\ndocument:\n\n\"The benefits provided under this policy may be affected, in\n\npart, by the laws of a state other than Oklahoma; however, they must\n\ninclude the Oklahoma state-mandated benefits, including coverage of\n\nservices, and coverage decisions, and must comply with all other\n\napplicable Oklahoma and federal laws. Please consult with your\n\ninsurance agent to determine which health benefits are included or\n\nexcluded under this policy.\"\n\nM. Approved insurers domiciled in a compacting state selling\n\nhealth and accident insurance policies in Oklahoma shall be subject\n\nto payment of any applicable premium taxes pursuant to Section 624\n\nof Title 36 of the Oklahoma Statutes.\n\nN. Approved insurers domiciled in a compacting state selling\n\nhealth and accident insurance policies in Oklahoma shall participate\n\non a nondiscriminatory basis and in the same manner as admitted\n\nparticipating insurers in the Oklahoma Life and Health Insurance\n\nGuaranty Association Act.\n\nO. Approved insurers domiciled in a compacting state selling\n\nhealth and accident insurance policies in Oklahoma shall participate\n\non a nondiscriminatory basis and in the same manner as admitted\n\nparticipating insurers in any existing or future Health Insurance\n\nHigh Risk Pool created by or for the State of Oklahoma.\n\nP. The Commissioner shall promulgate rules necessary for the\n\nadministration and implementation of the Health Care Choice Act,\n\nwhich rules shall specify how the requirements set forth in\nhoma shall participate\n\non a nondiscriminatory basis and in the same manner as admitted\n\nparticipating insurers in any existing or future Health Insurance\n\nHigh Risk Pool created by or for the State of Oklahoma.\n\nP. The Commissioner shall promulgate rules necessary for the\n\nadministration and implementation of the Health Care Choice Act,\n\nwhich rules shall specify how the requirements set forth in\n\nsubsection A of this section shall be implemented.","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":"8b9cf680204423e10fe3b98280ec16073e7b4d6b2e0f3bf2fc459c620901d24e","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-36-36-4413","next":"us-ok/okla.-stat.-tit.-36-36-4415"},"notice":"GroundRules: Original legal text. Not legal advice."}