§36-6060.51. Definitions.

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A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

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 organization plan, the Oklahoma Employees Insurance Plan, and coverage provided by a multiple employer welfare arrangement. The term shall not include:

a. a plan that provides coverage:

(1)only for a specified disease or diseases or under

an individual limited benefit policy,

(2)only for accidental death or dismemberment,

(3)only for dental or vision care,

(4)for a hospital confinement indemnity policy,

(5)for disability income insurance or a combination

of accident-only and disability income insurance,

(6)as a supplement to liability insurance,

b. any health plan offered by a contracted entity, as

defined in Section 4002.2 of Title 56 of the Oklahoma

Statutes, that provides coverage to members of the

state Medicaid program,

c. a Medicare supplemental policy as defined by Section

1882(g)(1) of the Social Security Act (42 U.S.C.,

Section 1395ss),

d. workers’ compensation insurance coverage,

e. medical payment insurance issued as part of a motor

vehicle insurance policy,

f. a long-term care policy, including a nursing home

fixed indemnity policy, unless a determination is made

that the policy provides benefit coverage so

comprehensive that the policy meets the definition of

a health benefit plan, or

g. short-term health insurance issued on a nonrenewable

basis with a duration of six

(6)months or less;

2. “Health care provider” means the same as defined in Section 1219.6 of Title 36 of the Oklahoma Statutes; and

3. “Health care service” means any service provided by a health care provider, or by an individual working for or under the supervision of a health care provider, that relates to the diagnosis, assessment, prevention, treatment, or care of any human illness, disease, injury, or condition.

The term shall also include mental health and substance use disorder services, as defined by Section 6060.10 of Title 36 of the Oklahoma Statutes, and durable medical equipment as defined by Section 375.2 of Title 59 of the Oklahoma Statutes. The term shall not include the administration or prescription of pharmaceutical products or services.

Added by Laws 2025, c. 131, § 1, eff. Nov. 1, 2025.