Okla. Admin. Code § 260:40-7-32

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

Section 260:40-7-32 - Benefit plans offered as part of the Flexible Benefits Plan

(a) The basic plan shall be the minimum level of benefits an employee is required to purchase and shall include the basic medical plan, the basic dental plan, the basic life plan, and the basic disability plan as referenced in 74 O.S.Supp.2006, § 1371 unless an employee opts not to choose any benefits pursuant to 74 O.S.Supp.2007, § 1370(A). The Plan Administrator shall establish all the terms, conditions, and details necessary to communicate and administer these plans. The EGID shall offer the basic medical plan of benefits as an indemnity plan. All benefits plans, whether offered by the EGID, a health maintenance organization or others shall at least meet the minimum requirements of the basic plan. The Plan Administrator shall evaluate all benefit plans to determine if this requirement has been satisfied.

(b) Only those benefit plans officially offered by the Plan Administrator shall be considered a part of the Flexible Benefits Plan. In addition to the basic plan the Plan Administrator may elect to offer other optional benefit plans. The Plan Administrator shall evaluate and select optional plans for inclusion in the Flexible Benefits Plan.

(c) Each year the Plan Administrator shall contract with each insurance provider other than the EGID. In lieu of a contract, the Plan Administrator shall deliver a letter of understanding each year to the EGID outlining the basic plan to allow the EGID to administer the EGID's offered benefit plans adopted as part of the basic plan. The EGID shall provide the Plan Administrator a complete description of any enhanced benefit plans the EGID elects to offer. The Plan Administrator shall determine that these elected plans meet the minimum benefit levels of the basic plan. All insurance providers shall provide claims and other financial information as the Plan Administrator may require.

Okla. Admin. Code § 260:40-7-32

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