Okla. Admin. Code § 260:40-37-14

Current through Vol. 42, No. 6, December 2, 2024

Section 260:40-37-14 - Vision Plan Participation

(a) A Vision Plan must notify the EBD of its intention to participate in the flexible benefits plan no later than 4:45 p.m., Central Standard Time on the first day of July prior to the beginning of each Plan Year. Such notification must conform to the requirements this section. If the first day of July is a weekend day or other day when the offices of the EBD are closed, notification of Vision Plan participation is due by 4:45 p.m., Central Time, on the next day the EBD's offices are open.

(b) Notice of a vision plan's intent to participate in the flexible benefits plan is properly provided upon submission of all of the following:

(1) A statement from the Vision Plan indicating Vision Plan's intent to participate;

(2) A list of the providers in Vision Plan's network;

(3) A document(s) indicating Vision Plan has operated in Oklahoma for at least five (5) years;

(4) Either a license issued by the Oklahoma State Insurance Department, or a certificate issued by the Oklahoma State Department of Health;

(5) A list of the rates the Vision Plan will charge during the subsequent Plan Year. Rates must be listed independently for the following categories:

(A) Employee Only,

(B) Spouse Only,

(C) One Child, and

(D) Two or More Children;

(6) Accurate product information in a format not to exceed two pages.

(c) The EBD may create forms to standardize and simply the information required by 74 O.S. § 1374 and subsection (b) of this section. If a form(s) have been created, a Vision Plan must complete the form(s) to provide proper notification.

(d) The EBD may require a Vision Plan to submit information in addition to that required in subsection (b) of this section from time to time if the EBD deems such information is essential to ensure statutory compliance.

(e) Information a Vision Plan submits to the EBD pursuant to 74 O.S. § 1374 shall be retained as confidential if such information is clearly designated as confidential when submitted.

(f) Vision Plans not eligible to be offered on a pretax basis as a part of an Internal Revenue Code Section 125 Cafeteria Plan must indicate so when the Vision Plan notifies the EBD of its desire to participate in the Flexible Benefits Plan.

(g) Vision Plans which submit notification of intent to participate in the flexible benefits plan that conform to subsection (a) of this Section and the requirements of 74 O.S. § 1374 are obligated to:

(1) Enroll employees and eligible dependents in their benefit plan, and

(2) Offer their benefit plan during the entire subsequent plan year period as that period is defined by the EBD.

(h) The EBD may remove a Vision Plan from the Flexible Benefits Plan at any time if it fails to comply or remain in compliance with 74 O.S. § 1374.

Okla. Admin. Code § 260:40-37-14

Adopted by Oklahoma Register, Volume 31, Issue 24, September 2, 2014, eff. 9/12/2014