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OAC 365:10

INSURANCE DEPARTMENT

TITLE 365. INSURANCE DEPARTMENT CHAPTER 10. LIFE, ACCIDENT AND HEALTH SUBCHAPTER 5. MINIMUM STANDARDS; CONTRACT GUIDELINES

PART 13. MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS

365:10-5-120. Purpose

The purpose of this Part is to provide for the reasonable standardization of coverage and simplification of terms and benefits of Medicare supplement policies; to facilitate public understanding and comparison of such policies; to eliminate provisions contained in such policies which may be misleading or confusing in connection with the purchase of such policies or with the settlement of claims; and to provide for full disclosures in the sale of accident and health insurance coverages to persons eligible for Medicare.

[Source: Added at 9 Ok Reg 549, eff 12-13-91 (emergency); Added at 9 Ok Reg 2499, eff 6-26-92; Amended at 9 Ok Reg 3899, eff 8-24-92 (emergency); Amended at 10 Ok Reg 1475, eff 5-1-93]

365:10-5-121. Authority This Part is issued pursuant to the authority vested in the Commissioner under 36 O.S. §3611.1.

[Source: Added at 9 Ok Reg 2499, eff 6-26-92]

365:10-5-122. Applicability and scope (a) Except as otherwise specifically provided in Sections 365:10-5-126, 365:10-5-130, 365:10-5-131 and 365:10-5-139, this Part shall apply to:

    • (1)

      All Medicare supplement policies delivered or issued for delivery in this state on or after the effective date hereof, and

    • (2)

      All certificates issued under group Medicare supplement policies which certificates have been delivered or issued for delivery in this state.

  • (b)

    This Part shall not apply to a policy or contract of one or more employers or labor organizations,

or of the trustees of a fund established by one or more employers or labor organizations, or combination thereof, for employees or former employees, or a combination thereof, or for members or former members, or a combination thereof, of the labor organizations.

[Source: Added at 9 Ok Reg 2499, eff 6-26-92]

365:10-5-123. Definitions The following words or terms, when used in this Part, shall have the following meaning, unless the context clearly indicates otherwise: "Applicant" means: (A) In the case of an individual Medicare supplement policy, the person who seeks to contract for insurance benefits, and (B) In the case of a group Medicare supplement policy, the proposed certificateholder. "Bankruptcy" means when a Medicare Advantage organization that is not an issuer has filed, or

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