Third party liability fast facts, 06/2012

              20 and Under,
44,119
21 to 54,
40,081
55 to 64,
18,804
65 and Over,
55,316
TPL by Age
Black or African
American,
18,971, 12%
American
Indian, 13,299,
8%
Asian or Pacific
Islander, 2,192,
1%
Caucasian,
118,891, 75%
Multiple Race,
4,967, 3%
TPL by Race
Third Party Liability Fast Facts
7/10/2012
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.
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.
Total Members with Medicare - 108,253
Total Members with Other TPL - 57,411
Total
108,253*
55,016
4,489
255
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 62,167 5,552 27,459 95,178
Male 38,742 1,792 22,608 63,142
Total 100,909 7,344 50,067 158,320
TPL by Gender and Type
Medicare Only
Medicare and
Other TPL
Other TPL
Only
Total
Child 33 4 42,337 42,374
Adult 100,876 7,340 7,730 115,946
Total 100,909 7,344 50,067 158,320
TPL by Age Group and Type
Hispanic Ethnicity - 8,702
Total TPL Enrollment Total Enrollment Percent of Total
Child 42,374 480,510 8.8%
Adult 115,946* 284,555 40.7%
Total 158,320 765,065 20.7%
*87.0% 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.
June 2012