Okla. Stat. tit. 36, § 36-6905
This is the official text of Okla. Stat. tit. 36, § 36-6905, 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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Powers of health maintenance organization - Notice of
Official statutory text
effect on financial soundness.
Oklahoma Statutes - Title 36. Insurance Page 1386
A. The powers of a health maintenance organization (HMO)
include, but are not limited to, the following:
1. The purchase, lease, construction, renovation, operation or
maintenance of hospitals, medical facilities, or both, and their
ancillary equipment and property reasonably required for its
principal office or for purposes necessary to the transaction of the
business of the organization;
2. Transactions between affiliated entities, including loans
and the transfer of responsibility under all provider or subscriber
contracts between affiliates or between the health maintenance
organization and its parent;
3. The furnishing of health care services through providers,
provider associations or agents for providers which are under
contract with or employed by the health maintenance organization;
4. The contracting with a person for the performance on its
behalf of certain functions such as marketing, enrollment and
administration;
5. The contracting with an insurance company licensed in this
state, or with a hospital or medical service corporation authorized
to do business in this state, for the provision of insurance,
indemnity or reimbursement against the cost of health care services
provided by the health maintenance organization;
6. The offering of other health care services in addition to
basic health care services. Nonbasic health care services may be
offered by a health maintenance organization on a prepaid basis
without offering basic health care services to any group or
individual; and
7. The joint marketing of products with an insurance company
licensed in this state or with a hospital or medical service
corporation authorized to do business in this state as long as the
company that is offering each product is clearly identified.
B. 1. A health maintenance organization shall file notice,
with adequate supporting information, with the Insurance
Commissioner prior to the exercise of any power granted in
paragraphs 1, 2 or 4 of subsection A of this section that may affect
the financial soundness of the health maintenance organization. The
Insurance Commissioner shall disapprove the exercise of power only
if, in the Insurance Commissioner’s opinion, it would substantially
and adversely affect the financial soundness of the health
maintenance organization and endanger its ability to meet its
obligations. If the Insurance Commissioner does not disapprove such
exercise of power within sixty (60) days of the filing, it shall be
deemed approved.
2. The Insurance Commissioner may promulgate rules exempting
those activities having a de minimis effect from the filing
requirement of paragraph 1 of this subsection.
Oklahoma Statutes - Title 36. Insurance Page 1386
A. The powers of a health maintenance organization (HMO)
include, but are not limited to, the following:
1. The purchase, lease, construction, renovation, operation or
maintenance of hospitals, medical facilities, or both, and their
ancillary equipment and property reasonably required for its
principal office or for purposes necessary to the transaction of the
business of the organization;
2. Transactions between affiliated entities, including loans
and the transfer of responsibility under all provider or subscriber
contracts between affiliates or between the health maintenance
organization and its parent;
3. The furnishing of health care services through providers,
provider associations or agents for providers which are under
contract with or employed by the health maintenance organization;
4. The contracting with a person for the performance on its
behalf of certain functions such as marketing, enrollment and
administration;
5. The contracting with an insurance company licensed in this
state, or with a hospital or medical service corporation authorized
to do business in this state, for the provision of insurance,
indemnity or reimbursement against the cost of health care services
provided by the health maintenance organization;
6. The offering of other health care services in addition to
basic health care services. Nonbasic health care services may be
offered by a health maintenance organization on a prepaid basis
without offering basic health care services to any group or
individual; and
7. The joint marketing of products with an insurance company
licensed in this state or with a hospital or medical service
corporation authorized to do business in this state as long as the
company that is offering each product is clearly identified.
B. 1. A health maintenance organization shall file notice,
with adequate supporting information, with the Insurance
Commissioner prior to the exercise of any power granted in
paragraphs 1, 2 or 4 of subsection A of this section that may affect
the financial soundness of the health maintenance organization. The
Insurance Commissioner shall disapprove the exercise of power only
if, in the Insurance Commissioner’s opinion, it would substantially
and adversely affect the financial soundness of the health
maintenance organization and endanger its ability to meet its
obligations. If the Insurance Commissioner does not disapprove such
exercise of power within sixty (60) days of the filing, it shall be
deemed approved.
2. The Insurance Commissioner may promulgate rules exempting
those activities having a de minimis effect from the filing
requirement of paragraph 1 of this subsection.
Status: in_force · Read it on the official government site
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