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0 chapters · 1,670 sections in this title.
36 O.S. § 6059 Adopted children - Coverage
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A. All individual and group health insurance policies providing coverage on an expense incurred, fixed, or capitated basis, and all individual and group insurance policies, certificates, service or indemnity type contracts issued by insurance companies, health maintenance organiz…
36 O.S. § 606 Authority to transact insurance required
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A. No person shall act as an insurer and no insurer shall transact insurance in Oklahoma except as authorized by a subsisting authority granted to it by the Insurance Commissioner, except as to such transactions as are expressly otherwise provided for in this Code. B. No such aut…
36 O.S. § 606.1 Certain foreign or alien insurers may become domestic
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insurers - Requirements and procedures. A. 1. Any foreign or alien insurer which is organized under the laws of any other jurisdiction for the purpose of transacting insurance may become a domestic insurer by complying with all of the requirements of law relative to the organizat…
36 O.S. § 6060 Mammography screening and diagnostic examination
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A. For the purposes of this section: 1. "Breast magnetic resonance imaging" means a diagnostic tool used to produce detailed pictures of the structure of the breast; 2. "Breast ultrasound" means a noninvasive, diagnostic imaging technique that uses high-frequency sound waves to p…
36 O.S. § 6060.1 Bone density testing
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A. All individual and group health insurance policies providing coverage on an expense incurred basis, and all individual and group service or indemnity type contracts issued by a nonprofit corporation which provide coverage for a female forty-five (45) years of age or older in t…
36 O.S. § 6060.10 Definitions
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As used in this act: 1. "Base period" means the period of coverage pursuant to the issuance or renewal of a health benefit plan that is required to provide benefits pursuant to the provisions of Section 6060.11 of this title; 2. "Health benefit plan" means any plan or arrangement…
36 O.S. § 6060.10A Health benefit plan
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A. 1. No health benefit plan shall deny coverage, refuse to issue or renew, cancel or otherwise terminate, restrict or exclude any person from any health benefit plan issued or renewed on or after November 1, 2010, on the basis of the applicant’s or insured’s status as a victim o…
36 O.S. § 6060.11 Benefits required
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A. Subject to the limitations set forth in this section and Sections 6060.12 and 6060.13 of this title, any health benefit plan that is offered, issued, or renewed in this state on or after January 1, 2000, shall provide benefits for treatment of mental health and substance use d…
36 O.S. § 6060.11a Procedure to assist plan members in accessing out-of-
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network behavioral health care providers. A. For the purposes of this act: 1. “Health benefit plan” means a health benefit plan as defined pursuant to Section 6060.4 of Title 36 of the Oklahoma Statutes; 2. “Health care provider” or “provider” means a health care provider as defi…
36 O.S. § 6060.11b Reimbursement for benefits delivered through
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behavioral health integration and psychiatric collaborative care models. A. For the purposes of this section: 1. “Behavioral health integration” means an approach to delivering mental health care that improves the ability for primary care providers to include mental and behaviora…
36 O.S. § 6060.12 Exempted plans - Calculation of increase in premium
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cost. 1. A health benefit plan that, at the end of its base period, experiences a greater than two percent (2%) increase in premium costs pursuant to providing benefits for treatment of mental health and substance use disorders shall be exempt from the provisions of Section 6060.…
36 O.S. § 6060.13 Incremental impact on premium costs - Analysis and
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report by Commissioner. A. The Insurance Commissioner shall analyze any direct incremental impact on premium costs pursuant to the requirements of Section 6060.11 of this title. The Commissioner shall submit a report of all preliminary data and findings to the Governor, the Presi…
36 O.S. § 6060.14 Short title
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This act shall be known and may be cited as the "Health Savings Account Act". Added by Laws 2005, c. 306, § 1, eff. Nov. 1, 2005.
36 O.S. § 6060.15 Definitions
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As used in this act: 1. "Deductible" means the total deductible for an eligible individual and all the dependents of that eligible individual for a calendar year; 2. "Dependent" means the spouse or child of the eligible individual as defined in Section 152 of the Internal Revenue…
36 O.S. § 6060.16 Eligibility – Contributions - Exemptions
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A. The provisions of this act shall also apply to taxpayers who are not receiving preferred federal tax treatment for a health savings account pursuant to Section 223 of the Internal Revenue Code. B. For taxable years beginning after 2005, a resident of Oklahoma or an employer sh…
36 O.S. § 6060.17 Allowable expenditures
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The trustee or custodian shall utilize the funds held in a health savings account solely for the following purposes: 1. To pay the qualified medical expenses of the eligible individual or their dependents; or 2. To purchase a health coverage policy certificate, or contract, if th…
36 O.S. § 6060.18 Withdrawals – Taxation – Transfer of interest
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A. Notwithstanding paragraphs C, D, E, and F of this section, an eligible individual may withdraw money from their health savings account for any purpose other than a purpose described in Section 6060.17 of this title. B. If the eligible individual withdraws money for any purpose…
36 O.S. § 6060.2 Treatment of diabetes - Equipment, supplies and
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services. A. 1. Every health benefit plan issued or renewed on or after November 1, 1996, shall, subject to the terms of the policy contract or agreement, include coverage for the following equipment, supplies and related services for the treatment of Type I, Type II, and gestati…
36 O.S. § 6060.20 Equal health coverage for autistic minors
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A. All individual and group health insurance policies that provide medical and surgical benefits shall provide the same coverage and benefits to any individual under the age of eighteen (18) years who has been diagnosed with an autistic disorder as it would provide coverage and b…
36 O.S. § 6060.21 Screening, diagnosis and treatment of autism spectrum
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disorder. A. For all plans issued or renewed on or after November 1, 2016, a health benefit plan and the Oklahoma Employees Health Insurance Plan shall provide coverage for the screening, diagnosis and treatment of autism spectrum disorder in individuals. No insurer shall termina…
36 O.S. § 6060.22 Exemption for health benefit plans from autism
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spectrum disorder coverage. A. 1. A health benefit plan that, at the end of its base period, experiences a greater than one percent (1%) increase in premium costs pursuant to providing applied behavior analysis for treatment of autism spectrum disorders shall be exempt from the p…
36 O.S. § 6060.3 Maternity benefits - Postpartum care
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A. Every health benefit plan issued, amended, renewed or delivered in this state on or after July 1, 1996, that provides maternity benefits shall provide for coverage of: 1. A minimum of forty-eight (48) hours of inpatient care at a hospital, or a birthing center licensed as a ho…
36 O.S. § 6060.30 Living organ donor protection
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No insurer in this state shall refuse to insure, or refuse to continue to insure, or limit the amount, extent or kind of coverage available for life insurance, disability insurance or long-term care insurance to an individual, or charge an individual a different rate for the same…
36 O.S. § 6060.3a Annual obstetrical/gynecological examinations
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A. Any health benefit plan, including the State and Education Employees Group Health Insurance plan, that is offered, issued or renewed in this state on or after January 1, 2005, that provides medical and surgical benefits shall provide coverage for routine annual obstetrical/gyn…
36 O.S. § 6060.3b Contraceptive drug coverage
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A. As used in this section: 1. “Contraceptive drugs” means all drugs approved by the United States Food and Drug Administration that are used to prevent pregnancy including but not limited to hormonal drugs administered orally, transdermally, and intravaginally; and 2. “Health be…
36 O.S. § 6060.4 Child immunization coverage
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A. A health benefit plan delivered, issued for delivery or renewed in this state on or after January 1, 1998, that provides benefits for the dependents of an insured individual shall provide coverage for each child of the insured, from birth through the date the child is eighteen…
36 O.S. § 6060.40 Short title - Oklahoma Right to Shop Act
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This act shall be known and may be cited as the "Oklahoma Right to Shop Act". Added by Laws 2022, c. 151, § 1.
36 O.S. § 6060.41 Definitions
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As used in the Oklahoma Right to Shop Act: 1. "Allowed amount" means the contractually agreed-upon amount paid by a carrier to a health care entity participating in the network of the carrier; 2. "Comparable health care service" means any covered nonemergency health care service …
36 O.S. § 6060.42 Shared savings incentive program
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A. An insurance carrier may offer a shared savings incentive program to provide incentives to an enrollee when the enrollee obtains a comparable health care service that is covered by the carrier from providers that charge less than the average allowed amount paid by that carrier…
36 O.S. § 6060.43 Promulgation of rules
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The Insurance Department shall promulgate necessary rules for the implementation of the Oklahoma Right to Shop Act. Added by Laws 2022, c. 151, § 4.
36 O.S. § 6060.44 Cost-effectiveness analysis
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The Office of Management and Enterprise Services shall conduct an analysis no later than November 1, 2022, of the cost- effectiveness of implementing a shared savings incentive program, as defined in paragraph 6 of Section 2 of this act, for current enrollees of the Oklahoma Empl…
36 O.S. § 6060.4a Claims in conjunction with arrest or pretrial
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detention. A. No health benefit plan, including, but not limited to, the State and Education Employees Group Health Insurance Plan, that is offered, issued or renewed in the state on or after January 1, 2009, shall exclude otherwise allowable claims which occur in conjunction wit…
36 O.S. § 6060.4b Standard serological tests for syphilis
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A. As used in this section: 1. “Health benefit plan” has the same meaning as provided by Section 6060.4 of Title 36 of the Oklahoma Statutes; and 2. “Medically necessary” means services or supplies provided by a health care provider that are: a. provided for the diagnosis of syph…
36 O.S. § 6060.5 Oklahoma Breast Cancer Patient Protection Act
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A. This section shall be known and may be cited as the "Oklahoma Breast Cancer Patient Protection Act". B. Any health benefit plan that is offered, issued or renewed in this state on or after January 1, 1998, that provides medical and surgical benefits with respect to the treatme…
36 O.S. § 6060.51 Definitions
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As used in this section: 1. “Health benefit plan” means group hospital coverage, individual and group medical insurance coverage, a not-for-profit hospital or medical service or indemnity plan, a prepaid health plan, a health maintenance organization plan, a preferred provider or…
36 O.S. § 6060.52 Choice to pay out of pocket — Documentation to carrier
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— Deductible and out of pocket apportionment. A. An enrollee may choose to pay out of pocket for a health care service from a health care provider. If an enrollee obtains a medically necessary health care service covered by his or her health benefit plan and negotiates for a pric…
36 O.S. § 6060.5a Biomarker testing
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A. As used in this section: 1. "Biomarker" means a biological molecule found in blood, other body fluids, or tissues that is a sign of a normal or abnormal process, or of a condition or disease. A biomarker may be used to see how well the body responds to a treatment for a diseas…
36 O.S. § 6060.5b Clinical genetic testing coverage
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A. For the purposes of this section: 1. “Clinical utility” means clinical utility as defined pursuant to Section 6060.5a of Title 36 of the Oklahoma Statutes; 2. “Evidence-based cancer imaging” means appropriate preventative screening and imaging supported by evidence; 3. “Geneti…
36 O.S. § 6060.6 Dental procedures for certain minor and severely
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disabled persons. A. Any health benefit plan that is offered, issued or renewed in this state on or after January 1, 1999, that provides hospitalization benefits shall provide coverage for anesthesia expenses including anesthesia practitioner expenses for the administration of th…
36 O.S. § 6060.7 Audiological services and hearing aids for children
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A. 1. Any health benefit plan that is offered, issued, or renewed on or after the effective date of this act shall provide coverage for audiological services and hearing aids for children up to eighteen (18) years of age. 2. Such coverage: a. shall only apply to hearing aids that…
36 O.S. § 6060.8 Prostate cancer screening coverage
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A. Any health benefit plan that is offered, issued or renewed in this state on or after January 1, 2000, that provides coverage to men forty (40) years of age or older in this state shall offer coverage for annual screening for the early detection of prostate cancer in men over t…
36 O.S. § 6060.8a Colorectal cancer coverage
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A. Any health benefit plan, including the State and Education Employees Group Health Insurance Plan, that is offered, issued or renewed in this state on or after January 1, 2002, which provides medical and surgical benefits, shall offer coverage for colorectal cancer examinations…
36 O.S. § 6060.8b Coverage for fertility preservation services —
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Iatrogenic infertility. A. As used in this section: 1. “Health benefit plan” means a health benefit plan as defined pursuant to Section 6060.4 of Title 36 of the Oklahoma Statutes; 2. “Iatrogenic infertility” means an impairment of fertility caused directly or indirectly by surge…
36 O.S. § 6060.9 Coverage for wigs or other scalp prostheses
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A. Any health benefit plan, including the State and Education Employees Group Health Insurance Plan, that is offered, issued, or renewed in this state on or after January 1, 2001, that provides medical and surgical benefits with respect to the treatment of cancer and other condit…
36 O.S. § 6060.9a Anti-cancer medication coverage
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A. 1. Any health benefit plan that provides coverage and benefits for cancer treatment shall provide coverage of prescribed orally administered anticancer medications on a basis no less favorable than intravenously administered or injected cancer medications. 2. Coverage of orall…
36 O.S. § 6060.9b Cancer therapy coverage – Standard for proton
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radiation therapy. A. A health benefit plan, as defined in subsection C of Section 6060.4 of Title 36 of the Oklahoma Statutes, that provides coverage for cancer therapy shall be prohibited from holding proton radiation therapy to a higher standard of clinical evidence for medica…
36 O.S. § 6060.9c Anti-abuse-formulated opioids - Study of effectiveness
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The College of Pharmacy at Southwestern Oklahoma State University shall analyze the effectiveness of the anti-abuse properties of anti-abuse-formulated opioids. In addition, the College of Pharmacy shall analyze the discrepancies between insurance coverage for the anti-abuse-form…
36 O.S. § 6060.9d Prescription eyedrop refills
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A. Any health benefit plan issued or renewed on or after November 1, 2017, that provides coverage for prescription eyedrops shall not deny coverage for a refill of a prescription if: 1. For a thirty-day supply, the amount of time has passed after which a patient should have used …
36 O.S. § 6061 Separate accounts - Variable annuity and life insurance
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contracts - Regulations. A. Any domestic life insurance company may establish one or more separate accounts, and may allocate to such separate account or accounts any amounts including without limitation proceeds applied under optional modes of settlement or under dividend option…
36 O.S. § 6062 Application of insurance laws
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Except for Sections 4003, 4008, 4009, 4010, 4011, 4017, 4021, 4022, 4029, subsection 1 of 4103, 4106 and 4109, and except as otherwise provided in this act, all pertinent provisions of the insurance laws of this state shall apply to separate accounts and contracts relating theret…