Okla. Stat. tit. 36, § 36-6530.2
This is the official text of Okla. Stat. tit. 36, § 36-6530.2, 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 Oklahoma Individual Health Insurance Market
Stabilization Act:
1. "Agent" means any person who is licensed to sell health
insurance in this state;
2. "Board" means the Board of Directors of the Oklahoma
Individual Health Insurance Market Stabilization Program;
3. "Health insurance" means any individual or group hospital or
medical-expense-incurred policy or health care benefits plan or
contract providing insurance against loss through illness or injury
of the insured. The term does not include any policy governing
short-term accidents only, a fixed indemnity policy, a limited
benefit policy, a specified accident policy, a specified disease
policy, a Medicare supplement policy, a long-term care policy,
medical payment or personal injury coverage in a motor vehicle
policy, coverage issued as a supplement to liability insurance, a
disability policy or workers' compensation;
4. "High-risk pool" means specially designated health insurance
plans organized by federal or state entities, or a combination of
federal and state entities, to serve high-risk, high-cost or both
high-risk and high-cost individuals who meet enrollment criteria and
do not have access to group insurance. They are organized as
independent entities governed by their own boards and administrators
and supported by the state's department of insurance;
5. "Insurer" means any individual, corporation, association,
partnership, fraternal benefit society or any other entity engaged
in the health insurance business, except insurance agents and
brokers. This term shall also include not-for-profit hospital
service and medical indemnity plans, health maintenance
organizations, preferred provider organizations, prepaid health
plans, the State and Education Employees Group Health Insurance
Plan, stop-loss insurance plans and any reinsurer reinsuring health
insurance in this state, which shall be designated as engaged in the
business of insurance for the purposes of the Oklahoma Individual
Health Insurance Market Stabilization Act;
6. "Market" means the individual health insurance market in
Oklahoma, wherein income-eligible individuals may receive federal
financial assistance for the purchase of qualified health plans as
provided by Section 36B of Title 26 of the United States Code and
Section 1301 of the federal Patient Protection and Affordable Care
Act;
Oklahoma Statutes - Title 36. Insurance Page 1293
7. "Market stabilization activities" means a high-risk pool,
reinsurance, hybrid programs or any combination thereof authorized
by this act;
8. "Plan" means any of the comprehensive health insurance
benefit plans as approved by the Board of Directors of the Oklahoma
Individual Health Insurance Market Stabilization Program or
qualified for participation in the market or by rule;
9. "Program" means the Oklahoma Individual Health Insurance
Market Stabilization Program;
10. "Reinsurer" means any insurer from whom any insurer
providing health insurance to Oklahomans procures insurance for
itself with respect to all or part of the health insurance risk of
the person; and
11. "Reinsurance" means the contract made between an entity
providing insurance coverage and a third party to protect the
insurer from losses. The contract provides for the third party to
pay for the loss sustained by the insurer when the insurer makes a
payment on the original contract. Reinsurance lets insurers cover a
portion of their financial risks by recovering some or all of the
claimed amounts they pay.
Stabilization Act:
1. "Agent" means any person who is licensed to sell health
insurance in this state;
2. "Board" means the Board of Directors of the Oklahoma
Individual Health Insurance Market Stabilization Program;
3. "Health insurance" means any individual or group hospital or
medical-expense-incurred policy or health care benefits plan or
contract providing insurance against loss through illness or injury
of the insured. The term does not include any policy governing
short-term accidents only, a fixed indemnity policy, a limited
benefit policy, a specified accident policy, a specified disease
policy, a Medicare supplement policy, a long-term care policy,
medical payment or personal injury coverage in a motor vehicle
policy, coverage issued as a supplement to liability insurance, a
disability policy or workers' compensation;
4. "High-risk pool" means specially designated health insurance
plans organized by federal or state entities, or a combination of
federal and state entities, to serve high-risk, high-cost or both
high-risk and high-cost individuals who meet enrollment criteria and
do not have access to group insurance. They are organized as
independent entities governed by their own boards and administrators
and supported by the state's department of insurance;
5. "Insurer" means any individual, corporation, association,
partnership, fraternal benefit society or any other entity engaged
in the health insurance business, except insurance agents and
brokers. This term shall also include not-for-profit hospital
service and medical indemnity plans, health maintenance
organizations, preferred provider organizations, prepaid health
plans, the State and Education Employees Group Health Insurance
Plan, stop-loss insurance plans and any reinsurer reinsuring health
insurance in this state, which shall be designated as engaged in the
business of insurance for the purposes of the Oklahoma Individual
Health Insurance Market Stabilization Act;
6. "Market" means the individual health insurance market in
Oklahoma, wherein income-eligible individuals may receive federal
financial assistance for the purchase of qualified health plans as
provided by Section 36B of Title 26 of the United States Code and
Section 1301 of the federal Patient Protection and Affordable Care
Act;
Oklahoma Statutes - Title 36. Insurance Page 1293
7. "Market stabilization activities" means a high-risk pool,
reinsurance, hybrid programs or any combination thereof authorized
by this act;
8. "Plan" means any of the comprehensive health insurance
benefit plans as approved by the Board of Directors of the Oklahoma
Individual Health Insurance Market Stabilization Program or
qualified for participation in the market or by rule;
9. "Program" means the Oklahoma Individual Health Insurance
Market Stabilization Program;
10. "Reinsurer" means any insurer from whom any insurer
providing health insurance to Oklahomans procures insurance for
itself with respect to all or part of the health insurance risk of
the person; and
11. "Reinsurance" means the contract made between an entity
providing insurance coverage and a third party to protect the
insurer from losses. The contract provides for the third party to
pay for the loss sustained by the insurer when the insurer makes a
payment on the original contract. Reinsurance lets insurers cover a
portion of their financial risks by recovering some or all of the
claimed amounts they pay.
Status: in_force · Read it on the official government site
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