§36-2024. Definitions.
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/ok/title-36-insurance/36-2024·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
As used in the Oklahoma Life and Health Insurance Guaranty Association Act:
1. "Account" means one of the three accounts created under Section 2023 of this title;
2. "Association" means the Oklahoma Life and Health Insurance Guaranty Association created in Section 2023 of this title;
3. "Commissioner" means the Oklahoma Insurance Commissioner;
4. "Contractual obligation" means an obligation under a policy or contract or certificate under a group policy or contract, or portion thereof for which coverage is provided under Section 2025 of this title;
5. "Covered contract" or "covered policy" means a policy or contract or portion of a policy or contract for which coverage is provided under Section 2025 of this title;
6. "Extra-contractual claims" includes, but is not limited to, claims relating to bad faith in the payment of claims, punitive or exemplary damages or attorneys fees and costs;
7. "Health benefit plan" means any hospital or medical expense policy or certificate or health maintenance organization subscriber contract or any other similar health contract. Health benefit plan does not include:
a. accident-only insurance,
b. credit insurance,
c. dental-only insurance,
d. vision-only insurance,
e. Medicare supplemental insurance,
f. benefits for long-term care, home health care,
community-based care, or any combination thereof,
g. disability income insurance,
h. coverage for on-site medical clinics, or
i. specified disease, hospital confinement indemnity or
limited health insurance if the types of coverage do
not provide coordination of benefits and are provided
under separate policies or certificates;
8. "Impaired insurer" means a member insurer which, after the effective date of this act, is not an insolvent insurer and is placed under an order of rehabilitation or conservation by a court of competent jurisdiction;
9. "Insolvent insurer" means a member insurer which, after the effective date of this act, is placed under an order of liquidation by a court of competent jurisdiction with a finding of insolvency;
10. "Member insurer" means any nonprofit hospital service and medical indemnity corporation and any insurer or health maintenance organization licensed or that holds a certificate of authority to transact in this state any kind of insurance or health maintenance organization business for which coverage is provided under Section
2025 of this title, and includes any insurer or health maintenance organization whose license or certificate of authority in this state may have been suspended, revoked, not renewed or voluntarily withdrawn, but does not include:
a. a fraternal benefit society,
b. a mandatory state-pooling plan,
c. a mutual assessment company or other person that
operates on an assessment basis,
d. an insurance exchange,
e. an organization that has a certificate or license
limited to the issuance of charitable gift annuities
under Sections 4071 through 4082 of this title, or
f. any entity similar to any of the above;
11. "Moody's Corporate Bond Yield Average" means the Monthly Average Corporates as published by Moody's Investors Service, Inc., or any successor thereto;
12. "Owner", "policyholder", "policy owner" or "contract owner" means the person who is identified as the legal owner of a policy or contract under the terms of the policy or contract or who is otherwise vested with legal title to the policy or contract through a valid assignment completed in accordance with the terms of the policy or contract and properly recorded as the owner on the books of the member insurer. Owner, policyholder, policy owner or contract owner does not include persons with a mere beneficial interest in a policy or contract;
13. "Person" means an individual, corporation, limited liability company, partnership, association, governmental body or entity, or voluntary organization;
14. "Premiums" means amounts or considerations by whatever name called, received on covered policies or contracts less returned premiums, considerations and deposits and less dividends and experience credits. "Premiums" does not include amounts or considerations received for policies or contracts or for the portions of any policies or contracts for which coverage is not provided under subsection B of Section 2025 of this title except that assessable premium shall not be reduced on account of subparagraph c of paragraph 2 of subsection B of Section 2025 of this title relating to interest limitations and paragraph 2 of subsection C of Section 2025 of this title relating to limitations with respect to one individual, one participant and one policy or contract owner.
Premiums does not include:
a. premiums on an unallocated annuity contract, or
b. premiums in excess of Five Million Dollars
($5,000,000.00) on multiple non-group policies of life
insurance owned by one owner, whether the policy or
contract owner is an individual, firm, corporation or
other person, and whether the persons insured are
officers, managers, employees or other persons,
regardless of the number of policies or contracts held
by the owner;
15. "Principal place of business" of a person other than a natural person means the single state in which the natural persons who establish policy for the direction, control and coordination of the operations of the entity as a whole primarily exercise that function, determined by the Association in its reasonable judgment by considering the following factors:
a. the state in which the primary executive and
administrative headquarters of the entity are located,
b. the state in which the principal office of the chief
executive officer of the entity is located,
c. the state in which the board of directors or similar
governing person or persons of the entity conducts the
majority of its meetings,
d. the state in which the executive or management
committee of the board of directors or similar
governing person or persons of the entity conducts the
majority of its meetings,
e. the state from which the management of the overall
operations of the entity is directed, and
f. in the case of a benefit plan sponsored by affiliated
companies comprising a consolidated corporation, the
state in which the holding company or controlling
affiliate has its principal place of business as
determined using the factors listed in subparagraphs a
through e of this paragraph;
16. "Receivership court" means the court in the insolvent or impaired state of the insurer having jurisdiction over the conservation, rehabilitation or liquidation of the member insurer;
17. "Resident" means a person to whom a contractual obligation is owed and who resides in this state on the date of entry of a court order that determines a member insurer to be an impaired insurer or a court order that determines a member insurer to be an insolvent insurer. A person may be a resident of only one state, which in the case of a person other than a natural person shall be its principal place of business. Citizens of the United States that are either residents of foreign countries or residents of the United States possessions, territories or protectorates that do not have an association similar to the Association created by the Oklahoma Life and Health Insurance Guaranty Association Act, shall be deemed residents of the state of domicile of the insurer that issued the policy or contract;
18. "State" means a state of the United States, the District of Columbia, Puerto Rico, or a United States possession, territory or protectorate;
19. "Structured settlement annuity" means an annuity purchased in order to fund periodic payments for a plaintiff or other claimant in payment for or with respect to personal injury suffered by a plaintiff or other claimant;
20. "Supplemental contract" means a written agreement entered into for the distribution of proceeds under a life, health or annuity policy or contract; and
21. "Unallocated annuity contract" means an annuity contract or group annuity certificate which is not issued to and owned by an individual, except to the extent of any annuity benefits guaranteed to an individual by an insurer under the contract or certificate. Added by Laws 1981, c. 133, § 4. Amended by Laws 1987, c. 177, § 2, eff. Nov. 1, 1987; Laws 1988, c. 291, § 4, eff. Nov. 1, 1988; Laws 1994, c. 294, § 3, eff. Sept. 1, 1994; Laws 2010, c. 145, § 1, eff. Nov. 1, 2010; Laws 2019, c. 384, § 3, eff. Nov. 1, 2019.