Okla. Stat. tit. 36, § 36-4512

employees.

A. This section applies to an insured employer health benefit

plan providing health insurance to employees of employers employing

twenty (20) or more full-time or full-time-equivalent employees.

B. An employer carrier, on written request from an insured

employer covered by that carrier, shall report to the employer

information from the twelve (12) months preceding the date of the

report regarding:

1. The total amount of charges submitted to the carrier for

persons covered under the employer health benefit plan;

2. The total amount of premium payments made by the

policyholder to the insured carrier;

3. The total amount of payments made by the carrier to health

care providers for persons covered under the plan, including the

total hospital charges, physician charges, and pharmaceutical

charges; and

4. For any claims for an individual paid in excess of Ten

Thousand Dollars ($10,000.00), information on claims paid, including

diagnostic evaluations.

C. An employer shall have to make a written request for

information. The employer may make one request per year prior to

the anniversary or renewal date. In addition, prior to the date of

a rate change, an employer may make additional written requests for

the information, provided the employer shall not make more than one

additional request in any one (1) year.

D. Except as otherwise provided in this subsection, an employer

carrier shall provide the information provided for in this section

not later than sixty (60) days before the anniversary or annual

renewal date, or thirty (30) days before the date of any rate change

action of the employer's benefit plan. Provided, if the carrier

receives the request from the employer less than sixty (60) days

before the anniversary or renewal date or less than thirty (30) days

before the date of a rate change, the carrier shall have sixty (60)

days from the date of receiving the request to provide the

information. Provided further, if the carrier requires the employer

to submit any changes to the benefit plan prior to the anniversary

or annual renewal date, the carrier shall provide the information

not later than sixty (60) days before the date the employer is

required to submit any changes.

E. An employer carrier shall not report any information

required under this section if the release of such information is

prohibited by federal law or regulation.

F. Claim information provided by an employer carrier under this

section shall be provided in the aggregate, without information

through which a specific individual covered by the health insurance

or evidence or coverage may be identified. Claim information shall

Oklahoma Statutes - Title 36. Insurance Page 992

include the total claims made, the total claims paid, the total plan

charges and the head count by coverage.

G. 1. If an employer carrier fails to provide the information

in the time required by subsection D of this section, the Insurance

Commissioner may, after notice and hearing, subject an insurer to a

civil penalty of One Hundred Dollars ($100.00) for each day that the

information is delinquent.

2. If an employer carrier has a risk-bearing contract with a

medical group, independent practice association (IPA), or management

services organization (MSO) that stipulates the delegation of claims

payment, and the carrier satisfies the Insurance Commissioner that

the medical group, IPA, or MSO has failed to provide the information

to the employer carrier in a sufficient time for the carrier to

comply with subsection D of this section, the Commissioner may waive

the penalty provided for in paragraph 1 of this subsection.

3. The civil penalty may be enforced in the same manner in

which civil judgments may be enforced, as provided in Section 312A

of this title. Such penalties shall be placed in the State

Insurance Commissioner Revolving Fund. Any person aggrieved by the
he carrier to

comply with subsection D of this section, the Commissioner may waive

the penalty provided for in paragraph 1 of this subsection.

3. The civil penalty may be enforced in the same manner in

which civil judgments may be enforced, as provided in Section 312A

of this title. Such penalties shall be placed in the State

Insurance Commissioner Revolving Fund. Any person aggrieved by the

determination of the Insurance Commissioner may seek judicial review

pursuant to Section 320 of this title.

H. The Insurance Commissioner shall promulgate rules for the

implementation and administration of this section.

I. As used in this section, "employer carrier" means any entity

which provides health insurance in this state. For the purposes of

this section, employer carrier includes a licensed insurance

company, not-for-profit hospital service or medical indemnity

corporation, a fraternal benefit society, a health maintenance

organization, a multiple employer welfare arrangement or any other

entity providing a plan of health insurance or health benefits

subject to state insurance regulation.