TPL FF_08_2012 1
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20 and Under, 42,188 21 to 54, 39,653 55 to 64, 18,914 65 and Over, 55,193 TPL by Age Black or African American, 18,824, 12% American Indian, 12,926, 8% Asian or Pacific Islander, 2,151, 2% Caucasian, 116,894, 75% Multiple Race, 5,153, 3% TPL by Race Third Party Liability Fast Facts 9/11/2012 Race is self-reported by members at the time of enrollment. The multiple race members have selected two or more races. Hispanic is an ethnicity not a race. Hispanics can be of any race and are accounted for in a race category above. Unless otherwise stated, CHILD is defined as an individual age 18 and under. TPL counts include those with the following coverage types: hospitalization, medical, major medical, Medicare supple-mental insurance Part A and/or B and skilled or intermediate care in a nursing facility. This publication is authorized by the Oklahoma Health Care Authority in accordance with state and federal regulations. OHCA is in compliance with the Title VI and Title VII of the 1964 Civil Rights Act and the Rehabilitation Act of 1973. For additional copies, you can go online to OHCA’s web site www.okhca.org under Research/Statistics and Data (www.okhca.org/research/data). The Oklahoma Health Care Authority does not discriminate on the basis of race, color, national origin, gender, religion, age or disability in employment or the provision of services. The data is valid as of the report date and is subject to change. All counts exclude Insure Oklahoma. Members can be in multiple coverage types. *Approximately 98% of the members with Medicare are enrolled in both Part A and Part B. Total Members with Medicare - 108,252 Total Members with Other TPL - 55,062 Total 108,252* 52,696 4,459 233 Medicare Supplemental Insurance Other Insurance TPL Coverage Type Medicare A and/or B Major Medical Insurance Medicare Only Medicare and Other TPL Other TPL Only Total Female 62,115 5,563 26,092 93,770 Male 38,771 1,803 21,604 62,178 Total 100,886 7,366 47,696 155,948 TPL by Gender and Type Medicare Only Medicare and Other TPL Other TPL Only Total Child 33 3 40,461 40,497 Adult 100,853 7,363 7,235 115,451 Total 100,886 7,366 47,696 155,948 TPL by Age Group and Type Hispanic Ethnicity - 8,524 Total TPL Enrollment Total Enrollment Percent of Total Child 40,497 483,256 8.4% Adult 115,451* 286,247 40.3% Total 155,948 769,503 20.3% *87.4% of the Adults with TPL are Medicare Only. Members can have both Medicare and Other TPL. Unless otherwise stated, CHILD is defined as an individual age 18 and under. August 2012 SoonerCare is the payer of last resort in most circumstances. If another insurer or program has the responsibility to pay for medical costs incurred by a SoonerCare member, that entity is generally required to pay all or part of the cost of the claim prior to SoonerCare making any payment. This is known as “Third Party Liability” (TPL). Third parties include but are not limited to, private health insurance, casualty insurance, worker's compensation, estates, trusts, tort proceeds and Medicare. SoonerCare members with Medicare are also known as "Dual Enrollees". For more information go to our website at www.okhca.org.
|Okla State Agency||
Health Care Authority, Oklahoma
|Okla Agency Code||'807'|
|Title||Third party liability fast facts, 08/2012|
Oklahoma Health Care Authority.
|Purpose||Enrollment demographics and breakdowns for SoonerCare members with additional insurance through a third party.|
|For all issues click||H1300.6 T445p|
|Digital Format||PDF Adobe Reader required|
|ODL electronic copy||Downloaded from agency website: http://www.okhca.org/WorkArea/linkit.aspx?LinkIdentifier=id&ItemID=14137&libID=13120|
|Rights and Permissions||This Oklahoma State Government publication is provided for educational purposes under US copyright law. Other usage requires permission of copyright holders.|