Okla. Stat. tit. 36, § 36-4522
This is the official text of Okla. Stat. tit. 36, § 36-4522, part of Oklahoma’s Stat. tit. 36, — part of the compiled statutory law of Oklahoma, published by the state as "Stat. tit. 36,." Browse the sections below, each linked to its official government source.
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Definitions
Official statutory text
As used in the Employer Health Insurance Purchasing Group Act:
1. "Commissioner" means the Oklahoma Insurance Commissioner;
2. "Eligible employee" means an employee or individual who
works the number of hours per week designated by the employer as
full-time employment and is qualified to enroll in a health benefit
plan offered through a HIPG;
3. "Eligible employer" means an employer employing no more than
one hundred eligible employees;
4. "Employer", "employee", and "dependent", unless otherwise
defined in this section, shall have the meaning applied to the terms
with respect to the coverage under the laws of the state relating to
the coverage and the issuer;
5. "Full time" shall be defined by the employer, but in no
event shall it be less than twenty-four (24) hours per week;
6. "Health benefits plan" means a group plan, group policy, or
group contract for health care services, issued or delivered by a
HIPG health carrier, excluding plans, policies, or contracts
providing health care benefits or health care services pursuant to
the Workers’ Compensation Laws and mandatory liability laws;
7. "Health insurer" means any entity which provides health
insurance in this state. For the purposes of the Employer Health
Insurance Purchasing Group Act, “health insurer” includes a licensed
insurance company, not-for-profit hospital service or medical
indemnity corporation, or a health maintenance organization;
8. "HIPG" means a Health Insurance Purchasing Group meeting the
requirements of this act;
9. "HIPG health carrier" means a health insurer as defined in
this act;
Oklahoma Statutes - Title 36. Insurance Page 994
10. "Large group" means a combination of two or more eligible
employers belonging to a HIPG;
11. "Limited benefit contract" means, for the purposes of this
act, a policy or certificate that does not contain state-mandated
health benefits;
12. "Member" means an individual enrolled for health benefits
coverage in a HIPG;
13. "Purchaser" means an eligible employer that has contracted
with a HIPG for the purchase of health benefits coverage;
14. a. "State-mandated health benefits" means coverages for
health care services or benefits, required by state
law or state regulations, requiring the reimbursement
or utilization related to a specific illness, injury,
or condition of the covered person, or inclusion of a
specific category of licensed health care practitioner
to be provided to the covered person in a health
benefits plan for a health-related condition of a
covered person. Provided, that for the purposes of
the options provided by this act, state-mandated
health benefits which may be excluded in whole or in
part shall not include any health care services or
benefits which were mandated by federal law, and
b. "State-mandated health benefits" does not mean
standard provisions or rights required to be present
in a health benefit plan pursuant to state law or
state regulations unrelated to a specific illness,
injury or condition of the insured, including, but not
limited to, those related to continuation of benefits
found in Article 45 of the Oklahoma Insurance Code;
and
15. "Total eligible employees" means two hundred or more
eligible employees.
1. "Commissioner" means the Oklahoma Insurance Commissioner;
2. "Eligible employee" means an employee or individual who
works the number of hours per week designated by the employer as
full-time employment and is qualified to enroll in a health benefit
plan offered through a HIPG;
3. "Eligible employer" means an employer employing no more than
one hundred eligible employees;
4. "Employer", "employee", and "dependent", unless otherwise
defined in this section, shall have the meaning applied to the terms
with respect to the coverage under the laws of the state relating to
the coverage and the issuer;
5. "Full time" shall be defined by the employer, but in no
event shall it be less than twenty-four (24) hours per week;
6. "Health benefits plan" means a group plan, group policy, or
group contract for health care services, issued or delivered by a
HIPG health carrier, excluding plans, policies, or contracts
providing health care benefits or health care services pursuant to
the Workers’ Compensation Laws and mandatory liability laws;
7. "Health insurer" means any entity which provides health
insurance in this state. For the purposes of the Employer Health
Insurance Purchasing Group Act, “health insurer” includes a licensed
insurance company, not-for-profit hospital service or medical
indemnity corporation, or a health maintenance organization;
8. "HIPG" means a Health Insurance Purchasing Group meeting the
requirements of this act;
9. "HIPG health carrier" means a health insurer as defined in
this act;
Oklahoma Statutes - Title 36. Insurance Page 994
10. "Large group" means a combination of two or more eligible
employers belonging to a HIPG;
11. "Limited benefit contract" means, for the purposes of this
act, a policy or certificate that does not contain state-mandated
health benefits;
12. "Member" means an individual enrolled for health benefits
coverage in a HIPG;
13. "Purchaser" means an eligible employer that has contracted
with a HIPG for the purchase of health benefits coverage;
14. a. "State-mandated health benefits" means coverages for
health care services or benefits, required by state
law or state regulations, requiring the reimbursement
or utilization related to a specific illness, injury,
or condition of the covered person, or inclusion of a
specific category of licensed health care practitioner
to be provided to the covered person in a health
benefits plan for a health-related condition of a
covered person. Provided, that for the purposes of
the options provided by this act, state-mandated
health benefits which may be excluded in whole or in
part shall not include any health care services or
benefits which were mandated by federal law, and
b. "State-mandated health benefits" does not mean
standard provisions or rights required to be present
in a health benefit plan pursuant to state law or
state regulations unrelated to a specific illness,
injury or condition of the insured, including, but not
limited to, those related to continuation of benefits
found in Article 45 of the Oklahoma Insurance Code;
and
15. "Total eligible employees" means two hundred or more
eligible employees.
Status: in_force · Read it on the official government site
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