Okla. Admin. Code § 365:10-5-123
The following words or terms, when used in this Part, shall have the following meaning, unless the context clearly indicates otherwise:
"Applicant" means:
"Bankruptcy" means when a Medicare Advantage organization that is not an issuer has filed, or has had filed against it, a petition for declaration of bankruptcy and has ceased doing business in the state.
"Certificate" means any certificate delivered or issued for delivery in this state under a group Medicare supplement policy.
"Certificate Form" means the form on which the certificate is delivered or issued for delivery by the issuer.
"Continuous period of creditable coverage" means the period during which an individual was covered by creditable coverage, if during the period of the coverage the individual had no breaks in coverage greater than sixty-three (63) days.
"Creditable coverage" means, with respect to an individual, coverage of the individual provided under any of the following:
"Creditable coverage" shall not include one or more, or any combination of the following:
"Creditable coverage" shall not include the following benefits if they are provided under a separate policy, certificate or contract of insurance or are otherwise not an integral part of the plan:
"Creditable coverage" shall not include the following benefits if offered as independent, noncoordinated benefits:
"Creditable coverage" shall not include the following if it is offered as a separate policy, certificate or contract of insurance:
"Employee welfare benefit plan" means a plan, fund or program of employee benefits as defined in 29 U.S.C. Section 1002 (Employee Retirement Income Security Act).
"Insolvency" means an issuer is placed under an order of liquidation by a court of competent jurisdiction with a finding of insolvency.
"Issuer" includes insurance companies, fraternal benefit societies, health care service plans, health maintenance organizations, and any other entity delivering or issuing for delivery in this state Medicare supplement policies or certificates.
"Medicare" means the "Health Insurance for the Aged Act," Title XVIII of the Social Security Amendments of 1965, as then constituted or later amended.
"Medicare Advantage plan" means a plan of coverage for health benefits under Medicare Part C as defined in 42 U.S.C. 1395w-28(b)(1), and includes:
"Medicare Supplement Policy" means a group or individual policy of accident and health insurance or a subscriber contract of a non-profit hospital service and medical indemnity corporation or health maintenance organization, other than a policy issued pursuant to a contract under Section 1876 of the federal Social Security Act (42 U.S.C. Section 1395 et seq.) or an issued policy under a demonstration project specified in 42 U.S.C. Section 1395ss(g)(1), which is advertised, marketed or designed primarily as a supplement to reimbursements under Medicare for the hospital, medical or surgical expenses of persons eligible for Medicare. "Medicare Supplement Policy" does not include Medicare Advantage plans established under Medicare Part C, Outpatient Prescription Drug plans established under Medicare Part D, or any Health Care Prepayment Plan (HCPP) that provides benefits pursuant to an agreement under §1833(a)(1)(A) of the Social Security Act.
"Pre-Standardized Medicare supplement benefit plan," "Pre-Standardized benefit plan" or "Pre-Standardized plan" means a group or individual policy of Medicare supplement insurance issued prior to July 1, 1992.
"1990 Standardized Medicare supplement benefit plan", "1990 Standardized benefit plan" or "1990 plan" means a group or individual policy of Medicare supplement insurance issued on or after July 1, 1992 and prior to June 1, 2010 and includes Medicare supplement insurance policies and certificates renewed on or after that date which are not replaced by the issuer at the request of the insured."2010 Standardized Medicare supplement benefit plan," "2010 Standardized benefit plan" or "2010 plan" means a group or individual policy of Medicare supplement insurance issued on or after June 1, 2010.
"Policy Form" means the form on which the policy is delivered or issued for delivery by the issuer.
"Secretary" means the Secretary of the United States Department of Health and Human Services.
Added at 9 Ok Reg 2499, eff 6-26-92
Amended at 14 Ok Reg 2292, eff 7-1-97
Amended at 15 Ok Reg 3569, eff 5-29-98 (emergency)
Amended at 16 Ok Reg 1088, eff 4-26-99
Amended at 22 Ok Reg 1954, eff 7-14-05
Amended at 26 Ok Reg 1551, eff 7-1-09
Amended at 36 Ok Reg 1917, eff 9-15-19