Okla. Stat. tit. 36, § 36-4414

authorized to engage in the insurance business in Oklahoma -

Approval process.

A. The Oklahoma Legislature recognizes the need for purchasers

of health insurance coverage in this state to have the opportunity

to choose health insurance plans that are more affordable and

flexible than existing market policies offering accident and health

coverage. Therefore, the Oklahoma Legislature seeks to increase the

availability of health insurance coverage by allowing insurers

authorized to engage in the business of insurance in other states,

and not so authorized in Oklahoma, to issue accident and health

policies in Oklahoma by granting a limited exemption from Section

606 of Title 36 of the Oklahoma Statutes. Insurers authorized to

engage in the business of insurance in other states, and not so

authorized in Oklahoma, shall be subject to the following

Oklahoma Statutes - Title 36. Insurance Page 957

requirements in order to be able to obtain an exemption to Section

606 of Title 36 of the Oklahoma Statutes and to issue accident and

health policies in Oklahoma through agents licensed in the state:

1. No insurer authorized to engage in the business of insurance

in other states that is not so licensed in Oklahoma may issue an

accident or a health policy pursuant to this section unless it is

approved to do so, in writing, by the Insurance Commissioner;

2. An insurer seeking to obtain the written approval described

in paragraph 1 of this subsection shall request such approval in the

manner required by the Insurance Commissioner, and shall pay any and

all fees associated with such application as may be required by the

Insurance Commissioner; and

3. In order to first be considered for the written approval

from the Insurance Commissioner, an insurer shall be domiciled in a

state which has a legislatively approved compact with the State of

Oklahoma.

B. Pursuant to the provisions of the Health Care Choice Act,

all approved insurers domiciled in a compacting state selling health

and accident insurance policies in Oklahoma shall:

1. Offer accident and health insurance policies that contain

all mandated health benefits that are required by Oklahoma law to be

included in accident or health insurance policies and Health

Maintenance Organization (HMO) policies issued in the state and will

comply with all other applicable laws pertaining to coverage and

coverage decisions;

2. Keep a full and true record of each insurance policy issued

to an insured in this state by or on behalf of the insurer,

containing such information as may be required by the Insurance

Commissioner, which record may be examined at any time within three

(3) years after issuance by the Insurance Commissioner;

3. File with the Insurance Commissioner, on or before April 1

of each year, a verified statement of all insurance transacted by

the insurer during the preceding calendar year in Oklahoma. The

statement shall be on a form prescribed and furnished by the

Insurance Commissioner and contain such information as required by

the Insurance Commissioner;

4. Issue an insurance policy in this state pursuant to this

section through an insurance agent or other person or entity that is

licensed in this state, as well as in a state in which the insurer

is licensed, to engage in the sale, solicitation or negotiation of

accident and/or health insurance in this state, and that is

appointed by the insurer for such purpose;

5. Appoint one or more third-party administrators that are

licensed in this state, and that have licensed adjusters in this

state, that shall be responsible for administering claims under the

insurance policies issued by the insurer in this state and be

Oklahoma Statutes - Title 36. Insurance Page 958

available to answer any questions from insureds under the insurance

policies issued by the insurer in this state; and

6. Submit to the jurisdiction of this state and be subject to
hat have licensed adjusters in this

state, that shall be responsible for administering claims under the

insurance policies issued by the insurer in this state and be

Oklahoma Statutes - Title 36. Insurance Page 958

available to answer any questions from insureds under the insurance

policies issued by the insurer in this state; and

6. Submit to the jurisdiction of this state and be subject to

service of legal process within this state in any action or

proceeding against the insurer arising out of any insurance policy

issued to an insured policyholder in this state and the Insurance

Commissioner is appointed as its exclusive agent to receive service

of legal process.

C. The Insurance Commissioner may only grant the written

approval described in paragraph 1 of subsection A of this section to

an insurer that:

1. Is properly licensed and has met the requirements for

solvency in its domiciliary state to issue accident and health

insurance policies;

2. Has met the requirements for market conduct applicable to

insurers domiciled in Oklahoma authorized to issue accident and

health insurance policies in the state set forth in Title 36 of the

Oklahoma Statutes; and

3. Has submitted the policy form that it will issue to insureds

in this state for a determination by the Insurance Commissioner that

the policy form is in compliance with all laws and regulations in

this state applicable to health insurance policies.

D. The Insurance Commissioner for the State of Oklahoma shall

be required to obtain verification in writing by the regulating

authority of the domiciliary state, certifying that the insurer has

met the financial solvency requirements of the insurer's domiciliary

state. No insurer domiciled in a compacting state may be approved

to sell health and accident insurance policies in Oklahoma without

such verification.

E. The Insurance Commissioner may require an insurer to reapply

for the written approval described in paragraph 1 of subsection A of

this section on an annual basis, or as often as the Insurance

Commissioner deems prudent. Reapplication shall be in the form and

manner required by the Insurance Commissioner.

F. The Insurance Commissioner may, as a condition to providing

an insurer with the written approval described in paragraph 1 of

subsection A of this section, impose on the insurer any additional

requirement that the Insurance Commissioner deems necessary.

G. The Insurance Commissioner may negotiate one or more

compacts with other states to allow insurers domiciled in such

compacting state that obtain the written approval from the Insurance

Commissioner described in paragraph 1 of subsection A of this

section to sell policies of accident and health insurance in

Oklahoma. Such compacts shall provide for appropriate protection of

Oklahoma consumers by requiring the Commissioner to regulate the

compliance to Oklahoma laws and regulations, and market conduct of

the insurers pursuant to compact provisions. The terms of any such

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compact shall be presumed a valid exercise of the discretionary

authority of the Commissioner. The compact shall be required to be

approved by the Legislature by adoption of a joint resolution,

provided that the joint resolution becomes law in accordance with

Section 11 of Article VI of the Oklahoma Constitution. Joint

resolutions introduced for such purpose shall not be subject to

regular legislative deadlines and shall be limited to such

provisions as may be necessary for approval of a compact. The

Legislature retains the authority to approve or not approve a

compact with a state.

H. The Insurance Commissioner may require every approved

insurer to submit to a market conduct examination. Any examination

by the Commissioner of the regulatory compliance or market conduct

of any insurer domiciled in a compacting state seeking to offer
ions as may be necessary for approval of a compact. The

Legislature retains the authority to approve or not approve a

compact with a state.

H. The Insurance Commissioner may require every approved

insurer to submit to a market conduct examination. Any examination

by the Commissioner of the regulatory compliance or market conduct

of any insurer domiciled in a compacting state seeking to offer

health benefit plans in this state, or who has been given approval

to offer health benefit plans in this state, shall be conducted in

the same manner and under the same terms and conditions as

examinations of companies located in this state.

I. An insurer domiciled in a compacting state is required to

provide Oklahoma state-mandated health benefits and to comply with

all other applicable laws that apply to Oklahoma accident and health

insurers including coverage of services and coverage decisions.

J. All approved insurers domiciled in a compacting state

selling health and accident insurance policies in Oklahoma must

comply with the Unfair Claims Settlement Practices Act, Health Care

Freedom of Choice Act, Genetic Nondiscrimination in Insurance Act,

Hospital and Medical Services Utilization Review Act and all

requirements found in Sections 4401 through 4411 of Title 36 of the

Oklahoma Statutes. All Health Maintenance Organizations shall be

subject to and comply with the Health Maintenance Organization Act

of 2003.

K. Each written application for purchase of a policy offered by

an insurer domiciled in a compacting state pursuant to the Health

Care Choice Act shall contain the following language in boldface

type at the beginning of the document:

"This policy may be subject, in part, to the laws of (insert

state where the master policy is filed); in particular, all of the

premium rating laws applicable to policies filed in Oklahoma do not

apply to this policy. This may result in increases in your premium

at renewal that would not be permissible in a policy that was issued

by an Oklahoma domestic insurer. For information concerning health

insurance coverage under a policy issued by an Oklahoma insurer,

please consult your insurance agent or the Oklahoma Department of

Insurance."

L. Each policy issued pursuant to the Health Care Choice Act by

an insurer domiciled in a compacting state shall contain the

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following language in boldface type at the beginning of the

document:

"The benefits provided under this policy may be affected, in

part, by the laws of a state other than Oklahoma; however, they must

include the Oklahoma state-mandated benefits, including coverage of

services, and coverage decisions, and must comply with all other

applicable Oklahoma and federal laws. Please consult with your

insurance agent to determine which health benefits are included or

excluded under this policy."

M. Approved insurers domiciled in a compacting state selling

health and accident insurance policies in Oklahoma shall be subject

to payment of any applicable premium taxes pursuant to Section 624

of Title 36 of the Oklahoma Statutes.

N. Approved insurers domiciled in a compacting state selling

health and accident insurance policies in Oklahoma shall participate

on a nondiscriminatory basis and in the same manner as admitted

participating insurers in the Oklahoma Life and Health Insurance

Guaranty Association Act.

O. Approved insurers domiciled in a compacting state selling

health and accident insurance policies in Oklahoma shall participate

on a nondiscriminatory basis and in the same manner as admitted

participating insurers in any existing or future Health Insurance

High Risk Pool created by or for the State of Oklahoma.

P. The Commissioner shall promulgate rules necessary for the

administration and implementation of the Health Care Choice Act,

which rules shall specify how the requirements set forth in
homa shall participate

on a nondiscriminatory basis and in the same manner as admitted

participating insurers in any existing or future Health Insurance

High Risk Pool created by or for the State of Oklahoma.

P. The Commissioner shall promulgate rules necessary for the

administration and implementation of the Health Care Choice Act,

which rules shall specify how the requirements set forth in

subsection A of this section shall be implemented.