State government; Oklahoma Employee Insurance and Benefits Act; statutory references; effective date.

An Act
ENROLLED HOUSE
BILL NO. 2108 By: Osburn of the House

and

Gillespie of the Senate

An Act relating to state government; amending 74 O.S.
2021, Sections 1304.1, as amended by Section 1,
Chapter 241, O.S.L. 2024, 1305.1, 1306.1, 1306.6,
1307, 1307.1, 1307.2, 1307.3, 1308, 1308.1, 1309,
1310.1, 1310.2, 1311, 1311.1, 1312, 1312.1, 1312.2,
1312.3, 1314.3, 1314.5, 1315, 1315.1, 1316.1, 1316.2,
as amended by Section 5, Chapter 245, O.S.L. 2024,
1316.3, 1317, 1320, 1321, as amended by Section 6,
Chapter 245, O.S.L. 2024, 1323, 1324, 1325, 1326,
1327, 1328, and 1329 (74 O.S. Supp. 2024, Sections
1304.1, 1316.2, and 1321), which relate to the
Oklahoma Employee Insurance and Benefits Act;
updating statutory references; and providing an
effective date.

SUBJECT: State government

BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:

SECTION 1. AMENDATORY 74 O.S. 2021, Section 1304.1, as
amended by Section 1, Chapter 241, O.S.L. 2024 (74 O.S. Supp. 2024,
Section 1304.1), is amended to read as follows:

Section 1304.1. A. The State and Education Employees Group
Insurance Board and the Oklahoma State Employees Benefits Council
are hereby abolished. Wherever the State and Education Employees
Group Insurance Board and the Oklahoma State Employees Benefits
Council are referenced in law, that reference shall be construed to
mean the Oklahoma Employees Insurance and Benefits Board.

B. There is hereby created the Oklahoma Employees Insurance and
Benefits Board.
ENR. H. B. NO. 2108 Page 2

C. The chair and vice-chair shall be elected by the Board
members at the first meeting of the Board and shall preside over
meetings of the Board and perform other duties as may be required by
the Board. Upon the resignation or expiration of the term of the
chair or vice-chair, the members shall elect a chair or vice-chair.
The Board shall elect one of its members to serve as secretary.

D. The Board shall consist of seven (7) members to be appointed
as follows:

1. The State Insurance Commissioner, or designee;

2. Four members shall be appointed by the Governor;

3. One member shall be appointed by the Speaker of the Oklahoma
House of Representatives; and

4. One member shall be appointed by the President Pro Tempore
of the Oklahoma State Senate.

E. The appointed members shall:

1. Have demonstrated professional experience in investment or
funds management, public funds management, public or private group
health or pension fund management, or group health insurance
management;

2. Be licensed to practice law in this state and have
demonstrated professional experience in commercial matters; or

3. Be licensed by the Oklahoma Accountancy Board to practice in
this state as a public accountant or a certified public accountant.

In making appointments that conform to the requirements of this
subsection, at least one but not more than three members shall be
appointed each from paragraphs 2 and 3 of this subsection by the
combined appointing authorities.

F. Each member of the Board shall serve a term of four (4)
years from the date of appointment.

G. Members of the Board shall be subject to the following:

ENR. H. B. NO. 2108 Page 3
1. The appointed members shall each receive compensation of
Five Hundred Dollars ($500.00) per month. Appointed members who
fail to attend a regularly scheduled meeting of the Board shall not
receive the related compensation;

2. The appointed members shall be reimbursed for their
expenses, according to the State Travel Reimbursement Act, as are
incurred in the performance of their duties, which shall be paid
from the Health Insurance Reserve Fund;

3. In the event an appointed member does not attend at least
seventy-five percent (75%) of the regularly scheduled meetings of
the Board during a calendar year, the appointing authority may
remove the member;

4. A member may also be removed for any other cause as provided
by law;

5. No Board member shall be individually or personally liable
for any action of the Board; and

6. Participation on the Board is contingent upon maintaining
all necessary annual training as may be required through the Health
Insurance Portability and Accountability Act of 1996, Medicare
contracting requirements or other statutory or regulatory
guidelines.

H. The Board shall meet as often as necessary to conduct
business but shall meet no less than four times a year, with an
organizational meeting to be held prior to December 1, 2012. The
organizational meeting shall be called by the Insurance
Commissioner. A majority of the members of the Board shall
constitute a quorum for the transaction of business, and any
official action of the Board must have a favorable vote by a
majority of the members of the Board present.

I. Except as otherwise provided in this subsection, no member
of the Board shall be a lobbyist registered in this state as
provided by law, or be employed directly or indirectly by any firm
or health care provider under contract to the State and Education
Employees Group Insurance Board, the Oklahoma State Employees
Benefits Council, or the Oklahoma Employees Insurance and Benefits
Board, or any benefit program under its jurisdiction, for any goods
or services whatsoever. Any physician member of the Board shall not
be subject to the provisions of this subsection.
ENR. H. B. NO. 2108 Page 4

J. Any vacancy occurring on the Board shall be filled for the
unexpired term of office in the same manner as provided for in
subsection D of this section.

K. The Board shall act in accordance with the provisions of the
Oklahoma Open Meeting Act, the Oklahoma Open Records Act and the
Administrative Procedures Act.

L. The Administrative Director of the Courts shall designate
grievance panel members as shall be necessary. The members of the
grievance panel shall consist of two attorneys licensed to practice
law in this state and one state-licensed health care professional or
health care administrator who has at least three (3) years practical
experience, has had or has admitting privileges to a hospital in
this state, has a working knowledge of prescription medication, or
has worked in an administrative capacity at some point in his or her
career. The state health care professional shall be appointed by
the Governor. At the Governor's discretion, one or more qualified
individuals may also be appointed as an alternate to serve on the
grievance panel in the event the Governor's primary appointee
becomes unable to serve.

M. The Office of Management and Enterprise Services Oklahoma
Health Care Authority shall work in conjunction with the Office of
Management and Enterprise Services to determine state employee
benefit elections and eligibility, and the Oklahoma Health Care
Authority shall have the following duties, responsibilities and
authority with respect to the administration of the flexible
benefits plan authorized pursuant to the State Employees Flexible
Benefits Act and the Oklahoma State Employees Benefits Act:

1. To construe and interpret the plan, and decide all questions
of eligibility in accordance with the Oklahoma State Employees
Benefits Act and 26 U.S.C.A., Section 1 et seq.;

2. To select those benefits which shall be made available to
participants under the plan, according to the Oklahoma State
Employees Benefits Act, and other applicable laws and rules;

3. To prescribe procedures to be followed by participants in
making elections and filing claims under the plan;

4. Beginning with the plan year which begins on January 1,
2013, to select and contract with one or more providers to offer a
ENR. H. B. NO. 2108 Page 5
group TRICARE Supplement product to eligible employees who are
eligible TRICARE beneficiaries. Any membership dues required to
participate in a group TRICARE Supplement product offered pursuant
to this paragraph shall be paid by the employee. As used in this
paragraph, "TRICARE" means the Department of Defense health care
program for active duty and retired service members and their
families;

5. To prepare and distribute information communicating and
explaining the plan to participating employers and participants.
Health Maintenance Organizations Health maintenance organizations or
other third-party insurance vendors may be directly or indirectly
involved in the distribution of communicated information to
participating state agency employers and state employee participants
subject to the following condition: the Board shall verify all
marketing and communications information for factual accuracy prior
to distribution;

6. To receive from participating employers and participants
such information as shall be necessary for the proper administration
of the plan, and any of the benefits offered thereunder;

7. To furnish the participating employers and participants such
annual reports with respect to the administration of the plan as are
reasonable and appropriate;

8. To keep reports of benefit elections, claims and
disbursements for claims under the plan;

9. To negotiate for best and final offer through competitive
negotiation with the assistance and through the purchasing
procedures adopted by the Office of Management and Enterprise
Services and contract with federally qualified health maintenance
organizations under the provisions of 42 U.S.C., Section 300e et
seq., or with Health Maintenance Organizations health maintenance
organizations granted a certificate of authority by the Insurance
Commissioner pursuant to the Health Maintenance Reform Act of 2003
for consideration by participants as an alternative to the health
plans offered by the Oklahoma Employees Insurance and Benefits
Board, and to transfer to the health maintenance organizations such
funds as may be approved for a participant electing health
maintenance organization alternative services. The Board may also
select and contract with a vendor to offer a point-of-service plan.
An HMO may offer coverage through a point-of-service plan, subject
to the guidelines established by the Board. However, if the Board
ENR. H. B. NO. 2108 Page 6
chooses to offer a point-of-service plan, then a vendor that offers
both an HMO plan and a point-of-service plan may choose to offer
only its point-of-service plan in lieu of offering its HMO plan.
The Board may, however, renegotiate rates with successful bidders
after contracts have been awarded if there is an extraordinary
circumstance. An extraordinary circumstance shall be limited to
insolvency of a participating health maintenance organization or
point-of-service plan, dissolution of a participating health
maintenance organization or point-of-service plan or withdrawal of
another participating health maintenance organization or point-of-
service plan at any time during the calendar year. Nothing in this
section of law shall be construed to permit either party to
unilaterally alter the terms of the contract;

10. To retain as confidential information the initial Request
For Proposal offers as well as any subsequent bid offers made by the
health plans prior to final contract awards as a part of the best
and final offer negotiations process for the benefit plan;

11. To promulgate administrative rules for the competitive
negotiation process;

12. To require vendors offering coverage to provide such
enrollment and claims data as is determined by the Board. The Board
shall be authorized to retain as confidential any proprietary
information submitted in response to the Board's Request For
Proposal. Provided, however, that any such information requested by
the Board from the vendors shall only be subject to the
confidentiality provision of this paragraph if it is clearly
designated in the Request For Proposal as being protected under this
provision. All requested information lacking such a designation in
the Request For Proposal shall be subject to Section 24A.1 et seq.
of Title 51 of the Oklahoma Statutes. From health maintenance
organizations, data provided shall include the current Health Plan
Employer Data and Information Set (HEDIS);

13. To authorize the purchase of any insurance deemed necessary
for providing benefits under the plan including indemnity dental
plans, provided that the only indemnity health plan selected by the
Board shall be the indemnity plan offered by the Board, and to
transfer to the Board such funds as may be approved for a
participant electing a benefit plan offered by the Board. All
indemnity dental plans shall meet or exceed the following
requirements:

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a. they shall have a statewide provider network,

b. they shall provide benefits which shall reimburse the
expense for the following types of dental procedures:

(1) diagnostic,

(2) preventative,

(3) restorative,

(4) endodontic,

(5) periodontic,

(6) prosthodontics,

(7) oral surgery,

(8) dental implants,

(9) dental prosthetics, and

(10) orthodontics, and

c. they shall provide an annual benefit of not less than
One Thousand Five Hundred Dollars ($1,500.00) for all
services other than orthodontic services, and a
lifetime benefit of not less than One Thousand Five
Hundred Dollars ($1,500.00) for orthodontic services;

14. To communicate deferred compensation programs as provided
in Section 1701 of this title;

15. To assess and collect reasonable fees from contracted
health maintenance organizations and third-party insurance vendors
to offset the costs of administration;

16. To accept, modify or reject elections under the plan in
accordance with the Oklahoma State Employees Benefits Act and 26
U.S.C.A., Section 1 et seq.;

17. To promulgate election and claim forms to be used by
participants;

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18. To adopt rules requiring payment for medical and dental
services and treatment rendered by duly licensed hospitals,
physicians and dentists. Unless the Board has otherwise contracted
with the out-of-state health care provider, the Board shall
reimburse for medical services and treatment rendered and charged by
an out-of-state health care provider at least at the same percentage
level as the network percentage level of the fee schedule
established by the Oklahoma Employees Insurance and Benefits Board
if the insured employee was referred to the out-of-state health care
provider by a physician or it was an emergency situation and the
out-of-state provider was the closest in proximity to the place of
residence of the employee which offers the type of health care
services needed. For purposes of this paragraph, health care
providers shall include, but not be limited to, physicians,
dentists, hospitals and special care facilities;

19. To enter into a contract with out-of-state providers in
connection with any PPO or hospital or medical network plan which
shall include, but not be limited to, special care facilities and
hospitals outside the borders of the State of Oklahoma. The
contract for out-of-state providers shall be identical to the in-
state provider contracts. The Board may negotiate for discounts
from billed charges when the out-of-state provider is not a network
provider and the member sought services in an emergency situation,
when the services were not otherwise available in the State of
Oklahoma or when the Administrator appointed by the Board approved
the service as an exceptional circumstance;

20. To create the establishment of external appeals procedures
for complaints by insured employees in the two following manners:

a. independent review organizations, accredited by a
national accrediting body, shall act as appeals bodies
for complaints by insured employees regarding adverse
benefit determinations based on:

(1) medical judgment,

(2) whether the insurer is complying with the
surprise billing and cost-sharing protections set
forth in Sections 2799A-1 and 2799A-2 of the
Public Health Services Act, 42 U.S.C. 201 et
seq., and

(3) a recission in coverage,
ENR. H. B. NO. 2108 Page 9

b. a three-member grievance panel, which shall act as an
appeals body for complaints by insured employees
regarding all other issues.

The appeals procedures provided by this paragraph shall be the
exclusive remedies available to insured employees having complaints
against the insurer. The appeals procedures of the three-member
grievance panel shall be subject to the Oklahoma Administrative
Procedures Act, including provisions thereof for review of agency
decisions by the district court. The grievance panel shall schedule
a hearing within sixty (60) days from the date the grievance panel
receives a written request for a hearing unless the panel orders a
continuance for good cause shown. Upon written request by the
insured employee to the grievance panel and received not less than
ten (10) days before the hearing date, the grievance panel shall
cause a full stenographic record of the proceedings to be made by a
competent court reporter at the insured employee's expense; and

21. To intercept monies owing to plan participants from other
state agencies, when those participants in turn owe money to the
Office of Management and Enterprise Services Oklahoma Health Care
Authority, and to ensure that the participants are afforded due
process of law.

N. Except for a breach of fiduciary obligation, a Board member
shall not be individually or personally responsible for any action
of the Board.

O. The Board shall operate in an advisory capacity to the
Office of Management and Enterprise Services Oklahoma Health Care
Authority.

P. The members of the Board shall not accept gifts or
gratuities from an individual organization with a value in excess of
Ten Dollars ($10.00) per year. The provisions of this section shall
not be construed to prevent the members of the Board from attending
educational seminars, conferences, meetings or similar functions.

SECTION 2. AMENDATORY 74 O.S. 2021, Section 1305.1, is
amended to read as follows:

Section 1305.1. (1) The Director of the Office of Management
and Enterprise Services Chief Executive Officer (CEO) of the
Oklahoma Health Care Authority and the Oklahoma Employees Insurance
ENR. H. B. NO. 2108 Page 10
and Benefits Board shall discharge their duties with respect to the
Oklahoma Employees Insurance and Benefits Act, the State Employees
Flexible Benefits Act and the State Employees Disability Program Act
solely in the interest of said Acts acts and:

(a) for the exclusive purpose of:

(i) providing benefits to the participants and their
dependents, and

(ii) defraying reasonable expenses of administering the
Oklahoma Employees Insurance and Benefits Act, the
State Employees Flexible Benefits Act and the State
Employees Disability Program Act;

(b) with the care, skill, prudence, and diligence under the
circumstances then prevailing that a prudent person acting in a like
capacity and familiar with such matters would use in the conduct of
an enterprise of a like character and with like aims;

(c) by diversifying investments so as to minimize the risk of
large losses, unless under the circumstances it is clearly prudent
not to do so; and

(d) in accordance with the laws, documents and instruments
governing the Oklahoma Employees Insurance and Benefits Act, the
State Employees Flexible Benefits Act and the State Employees
Disability Program Act.

(2) The Office Authority may procure insurance indemnifying the
members of the Board and the Director CEO from personal loss or
accountability from liability resulting from action or inaction.

(3) The Director CEO may establish an investment committee.
The investment committee shall be composed of not more than three
(3) members of the Board selected by the Director CEO. The
committee shall make recommendations to the full Board on all
matters related to the choice of custodians and managers of the
assets of the Office of Management and Enterprise Services Oklahoma
Health Care Authority relating to the Oklahoma Employees Insurance
and Benefits Act, on the establishment of investment and fund
management guidelines, and in planning future investment policy.
The committee shall have no authority to act on behalf of the Board
or Director CEO in any circumstances whatsoever. No recommendation
of the committee shall have effect as an action of the Board or
ENR. H. B. NO. 2108 Page 11
Director CEO nor take effect without the approval of the Board or
Director CEO.

(4) The Office of Management and Enterprise Service Oklahoma
Health Care Authority, based on recommendation of the Board shall
retain qualified investment managers to provide for the investment
of the monies received by the Office Authority. The investment
managers shall be chosen by a solicitation of proposals on a
competitive bid basis pursuant to standards set by the Board.
Subject to the overall investment guidelines set by the Board, the
investment managers shall have full discretion in the management of
those monies of the Office Authority allocated to the investment
managers. The Board shall oversee the management of those monies
not specifically allocated to the investment managers. The monies
of the Office Authority allocated to the investment managers shall
be actively managed by the investment managers, which may include
selling investments and realizing losses if such action is
considered advantageous to longer term return maximization. Because
of the total return objective, no distinction shall be made for
management and performance evaluation purposes between realized and
unrealized capital gains and losses.

(5) Funds and revenues for investment by the investment
managers or the Office of Management and Enterprise Services
Oklahoma Health Care Authority shall be placed with a custodian
recommended by the Board. The custodian shall be a bank or trust
company offering pension fund master trustee and master custodial
services. The custodian shall be chosen by a solicitation of
proposals on a competitive bid basis pursuant to standards set by
the Board. In compliance with the investment policy guidelines of
the Board, the custodian bank or trust company shall be
contractually responsible for ensuring that all monies of the Office
Authority are invested in income-producing investment vehicles at
all times. If a custodian bank or trust company has not received
direction from the investment managers of the Office Authority as to
the investment of the monies of the Office Authority in specific
investment vehicles, the custodian bank or trust company shall be
contractually responsible to the Office Authority for investing the
monies in appropriately collateralized short-term interest-bearing
investment vehicles.

(6) Prior to August 1 of each year, the Board shall develop a
written investment plan for the monies received by the Office
Authority.

ENR. H. B. NO. 2108 Page 12
(7) The Administrator shall compile annual financial statements
of all the activity of the Office Authority on a calendar year
basis. The financial statements shall be compiled pursuant to
accounting principles generally accepted in the United States. The
report shall include several relevant measures of investment value,
including acquisition cost and current fair market value with
appropriate summaries of total holdings and returns. The report
shall contain combined and individual rate of returns of the
investment managers by category of investment, over periods of time.
The report shall be distributed to the Board and the Director of the
Office of Management and Enterprise Services CEO of the Oklahoma
Health Care Authority.

SECTION 3. AMENDATORY 74 O.S. 2021, Section 1306.1, is
amended to read as follows:

Section 1306.1. A. The Office of Management and Enterprise
Services Oklahoma Health Care Authority shall have the right of
subrogation to recover any payments made for injury to an employee
or dependent caused by a third party's wrongful act or negligence.
The Office Authority shall have the authority to waive or reduce
subrogation in individual cases when the exercise of the right of
subrogation would create an extreme financial hardship on the
employee or dependent.

B. Subrogation will exist only to the extent of actual claims
paid.

C. If an employee or dependent has prejudiced the Office's
Authority's right of subrogation by releasing the responsible party
prior to submitting claims to the Office Authority, the claims may
be denied by the Office Authority. If claims are submitted and paid
after the employee or dependent has released the responsible party,
the Office Authority shall be entitled to bring an action against
the employee, dependent, or their assignees, for any such claims
paid and for additional costs incurred by the Office Authority
including, but not limited to: interest, administrative and
adjudicative costs, and attorney fees.

SECTION 4. AMENDATORY 74 O.S. 2021, Section 1306.6, is
amended to read as follows:

Section 1306.6. The Director of the Office of Management and
Enterprise Services Chief Executive Officer of the Oklahoma Health
Care Authority, in accordance with administering the Medical Expense
ENR. H. B. NO. 2108 Page 13
Liability Revolving Fund pursuant to Section 746.1 of Title 19 of
the Oklahoma Statutes, shall employ, appoint, or otherwise designate
the necessary personnel to carry out the duties of the fund.

SECTION 5. AMENDATORY 74 O.S. 2021, Section 1307, is
amended to read as follows:

Section 1307. A. The specifications drawn by the Office of
Management and Enterprise Services Oklahoma Health Care Authority
for the Health Insurance Plan health insurance plan shall provide
for comprehensive hospital medical and surgical benefits. The
Health Insurance Plan health insurance plan may limit coverage for a
particular illness, disease, injury or condition; but, except for
such limits, shall not exclude or limit particular services or
procedures that can be provided for the diagnosis and treatment of
an illness, disease, injury or condition, so long as the services
and procedures provided are of sound efficacy, are medically
necessary, and fall within the licensed scope of practice of the
practitioner providing same. The Health Insurance Plan health
insurance plan may contract with providers for specific services
based on levels of outcomes defined by the Office Authority and
achieved by the provider. The Health Insurance Plan health
insurance plan may provide for the application of deductibles and
copayment or coinsurance provisions that are based on contracts with
providers for specific services based on levels of outcomes or cost.

B. The Life Insurance Plan life insurance plan shall include
Accidental Death and Dismemberment Benefits and additional optional
life insurance coverage.

SECTION 6. AMENDATORY 74 O.S. 2021, Section 1307.1, is
amended to read as follows:

Section 1307.1. No employee or dependent who participates in an
HMO a health maintenance organization (HMO) through the Oklahoma
Employees Insurance and Benefits Act shall be denied the right of
changing the primary care physician to any other primary care
physician within the HMO. The employee or dependent shall notify
the HMO in writing of any change in the choice of primary care
physician forty-five (45) days in advance of the change by certified
mail with return receipt requested. Any such change in a primary
care physician shall not be subject to the approval of the HMO, the
Office of Management and Enterprise Services Oklahoma Health Care
Authority or state agency.

ENR. H. B. NO. 2108 Page 14
SECTION 7. AMENDATORY 74 O.S. 2021, Section 1307.2, is
amended to read as follows:

Section 1307.2. On and after November 1, 1996, the Office of
Management and Enterprise Services Oklahoma Health Care Authority
shall include coverage for equipment, supplies and related services
for the treatment of Type I, Type II, and gestational diabetes as
provided by and pursuant to the provisions of Section 6060.2 of
Title 36 of the Oklahoma Statutes.

SECTION 8. AMENDATORY 74 O.S. 2021, Section 1307.3, is
amended to read as follows:

Section 1307.3. Unless the Office of Management and Enterprise
Services Oklahoma Health Care Authority has otherwise contracted
with an out-of-state provider, the Office Authority shall pay for
medical services and treatment rendered by an out-of-state provider
at the same level paid to an in-state provider if the insured was
referred to the out-of-state provider by a physician or it was an
emergency situation and the out-of-state provider which offers the
type of services needed is the closest provider in proximity to the
place of residence of the employee.

SECTION 9. AMENDATORY 74 O.S. 2021, Section 1308, is
amended to read as follows:

Section 1308. (1) Any employee eligible for membership in the
Health Insurance Plan health insurance plan, Dental Insurance Plan
dental insurance plan or Life Insurance Plan life insurance plan
upon its effective date shall be enrolled in the plan unless the
employee elects not to be enrolled within thirty (30) days of the
effective dates. The employee shall be advised of Health
Maintenance Organization health maintenance organization (HMO)
prepaid plans available as an alternative to the state self-insured
Health Insurance Plan health insurance plan. The Office of
Management and Enterprise Services Oklahoma Health Care Authority
shall establish the procedure by which eligible employees not
electing to be enrolled initially in the Health Insurance Plan
health insurance plan, Dental Insurance Plan dental insurance plan
or Life Insurance Plan life insurance plan may be subsequently
enrolled.

(2) Any eligible employee who is employed after the effective
dates of the Health Insurance Plan health insurance plan, Dental
Insurance Plan dental insurance plan and Life Insurance Plan life
ENR. H. B. NO. 2108 Page 15
insurance plan or HMO plans approved by the Office Authority may
become enrolled on the first day of the second month of employment.

SECTION 10. AMENDATORY 74 O.S. 2021, Section 1308.1, is
amended to read as follows:

Section 1308.1. (1) An educational entity may extend the
benefits of the health insurance plan, the dental insurance plan,
and the life insurance plan to education employees employed by the
entity. The benefits of the plans for an education employee shall
be the same and shall include the same plan options as would be made
available to a state employee participating in the plan that resided
at the same location. Notwithstanding the provisions of Section
1308.2 of this title, a period shall exist for enrolling education
entities from April 1, 1989 through October 1, 1991, whereby
education employees of a participating education entity may be
enrolled, pursuant to this act, during the entities' initial
enrollment period, regardless of preexisting conditions. The Office
of Management and Enterprise Services Oklahoma Health Care Authority
shall adopt rules and regulations for enrollment by which education
entities may apply to participate in the insurance plans. Once an
education entity becomes a participant in the health and dental
insurance plans offered through the Oklahoma Employees Insurance and
Benefits Act, the education entity may withdraw from participation,
in a manner prescribed by the Office Authority. If a school
district is participating in the health and dental insurance plans
pursuant to the Oklahoma Employees Insurance and Benefits Act,
Sections 1301 through 1329.1 1329 of this title, the employees of
the school district who are eligible to participate in the health
and dental plans, at such time as the school district may withdraw
from such participation, may require the board of education of the
school district to call an election to allow the employees to vote
as to whether the school district shall continue participation in
the health and dental insurance plans offered through the Oklahoma
Employees Insurance and Benefits Act. Upon the filing with the
board of education of a petition calling for such an election which
is signed by no less than thirty percent (30%) of the eligible
employees of the school district, the board of education shall call
an election for the purpose of determining whether the school
district shall continue participation in the health and dental
insurance plans offered through the Oklahoma Employees Insurance and
Benefits Act. The election shall be held within thirty (30) days of
the filing of the petition. If a majority of those eligible
employees voting at the election vote to continue participation in
the health and dental insurance plans offered through the Oklahoma
ENR. H. B. NO. 2108 Page 16
Employees Insurance and Benefits Act, the board of education shall
be prohibited from withdrawing the school district from such
participation. If a majority of those eligible employees voting at
the election vote against continued participation in the health and
dental insurance plans offered through the Oklahoma Employees
Insurance and Benefits Act, the board of education of the school
district shall apply to discontinue such participation within thirty
(30) days of the election and within the times the school district
is authorized to withdraw from participation in accordance with
rules established for withdrawal by the Office Authority.

(2) Except as otherwise provided in this subsection, when an
education entity participates in the health and dental insurance
plans offered through the Oklahoma Employees Insurance and Benefits
Act, all employees shall be advised of Health Maintenance
Organizations health maintenance organizations (HMO) prepaid plans
available as an alternative to the state self-insured health
insurance plan. Eligible part-time education employees, at the
option of the employee, may enroll in the plans either at the time
the education entity begins participation in the plans or, if later,
upon a showing of insurability to the satisfaction of the Office
Authority.

(3) Any employee of an education entity participating in the
health and dental insurance plans offered through the Oklahoma
Employees Insurance and Benefits Act who is employed after the
education entity began said participation may be enrolled in the
health and dental insurance plans or HMO plans approved by the
Office Authority on the first day of the second month of employment.

(4) Upon initial enrollment of an institution of higher
education to participate in the health and dental insurance plans
offered through the Oklahoma Employees Insurance and Benefits Act,
all individuals presently insured by said institution's present
group health insurance plan shall become enrolled in said state
plans for the remaining period of said institution's contractual
liabilities.

(5) Education employees who shall be absent from the teaching
service because of election or appointment as a local, state, or
national education association officer shall be allowed to retain
coverage pursuant to the Oklahoma Employees Insurance and Benefits
Act upon the payment of the full cost of the coverage at the rate
and under such terms and conditions established by the Office
Authority.
ENR. H. B. NO. 2108 Page 17

(6) Except as otherwise provided by law, an educational entity
may cease to participate in the Oklahoma Employees Insurance and
Benefits Act but provide health insurance coverage through another
insurance carrier. The subsequent carrier shall provide coverage to
the employees of the educational entity who terminated employment
with a retirement benefit, with a vested benefit, or who have ten
(10) or more years of service with a participating educational
entity but did not have a vested benefit through the retirement
system of the educational entity, if the election to retain health
insurance coverage was made within thirty (30) days of termination
of employment. Coverage shall also be provided to the eligible
dependents of the employees if an election to retain coverage is
made within thirty (30) days of termination of employment.

SECTION 11. AMENDATORY 74 O.S. 2021, Section 1309, is
amended to read as follows:

Section 1309. A. Any eligible employee may elect to have a
dependent or dependents of the employee covered by the Health
Insurance Plan health insurance plan and Dental Insurance Plan
dental insurance plan or by any available Health Maintenance
Organization health maintenance organization (HMO) approved by the
Office of Management and Enterprise Services Oklahoma Health Care
Authority. The employee may elect to cover all dependent children
and not elect to cover the spouse of the employee. Such election
shall be made at the time the employee becomes enrolled in the Plan,
under such procedures as the Office Authority may establish. If
dependent coverage is not elected or if the employee elects to cover
all dependent children and not the spouse of the employee at the
time an employee becomes enrolled in the Plan, dependent coverage or
coverage for the spouse cannot be elected until the next enrollment
period or until a qualifying event has occurred as established by
the Office Authority. Such subsequent election of dependent
coverage shall be made under such conditions as the Office Authority
may impose. If electing not to cover the spouse, the employee shall
submit a statement signed by both the employee and the spouse
acknowledging their choice not to provide insurance coverage for the
spouse under the Health Insurance Plan health insurance plan and
Dental Insurance Plan dental insurance plan or approved HMO plans.

B. Any employee with dependent coverage, as provided in this
section, who has a change in the number of dependents may at the
time of such change increase or decrease the number of dependents
covered by the Health Insurance Plan health insurance plan and
ENR. H. B. NO. 2108 Page 18
Dental Insurance Plan dental insurance plan or approved HMO plans,
under procedures established by the Office Authority.

C. Any employee who has no eligible dependents at the time the
employee becomes enrolled may elect dependent coverage at the time
the dependency status of the employee changes under procedures
established by the Office Authority.

SECTION 12. AMENDATORY 74 O.S. 2021, Section 1310.1, is
amended to read as follows:

Section 1310.1. A. If a certified employee elects health care
coverage under a plan offered by a school district, including a plan
offered by the Office of Management and Enterprise Services Oklahoma
Health Care Authority or a self-insured plan offered by the school
district, then a school district shall pay no less than one hundred
percent (100%) of the premium amount for the HealthChoice (HI)
option plan for an individual offered by the Office Authority.

The amount a school district is required to pay pursuant to this
subsection shall be reduced by the flexible benefit allowance
provided for in Section 26-105 of Title 70 of the Oklahoma Statutes.

B. The premium for education entities that participate in the
health and dental insurance plans offered through the Oklahoma
Employees Insurance and Benefits Act shall be the same as paid by
state agencies for said plans.

C. All education entities that participate in the insurance
plans offered through the Oklahoma Employees Insurance and Benefits
Act shall forward the appropriate premiums for each employee to the
Office Authority no later than the tenth day of each month following
the month for which payment is due. Nothing shall prohibit a school
district from forwarding appropriate premiums to the Office
Authority prior to the month for which payment is due.

SECTION 13. AMENDATORY 74 O.S. 2021, Section 1310.2, is
amended to read as follows:

Section 1310.2. A school district shall pay fifty percent (50%)
of the cost of the individual health care premium amount for school
district employees who are not otherwise covered pursuant to Section
1310.1 of this title or Section 26-105 of Title 70 of the Oklahoma
Statutes, if such employee elects health care coverage under a plan
offered by a school district, including a plan offered by the Office
ENR. H. B. NO. 2108 Page 19
of Management and Enterprise Services Oklahoma Health Care Authority
or a self-insured plan offered by the school district.

SECTION 14. AMENDATORY 74 O.S. 2021, Section 1311, is
amended to read as follows:

Section 1311. The amount of monthly contribution to be made by
employees enrolled in the Insurance Plans insurance plans shall be
deducted from the monthly salaries of such employees and remitted to
the Office of Management and Enterprise Services Oklahoma Health
Care Authority. The procedure for such deductions and remittances
shall be established by the Director Chief Executive Officer of the
Oklahoma Health Care Authority.

SECTION 15. AMENDATORY 74 O.S. 2021, Section 1311.1, is
amended to read as follows:

Section 1311.1. The amount of monthly contribution to be made
by persons who are drawing disability benefits under Section 1331 et
seq. of this title and who are enrolled in the Insurance Plans
insurance plans shall be deducted from the monthly disability
benefits of such persons and remitted to the Office of Management
and Enterprise Services Oklahoma Health Care Authority. The
procedures for such deductions and remittances shall be established
by the Office Authority.

SECTION 16. AMENDATORY 74 O.S. 2021, Section 1312, is
amended to read as follows:

Section 1312. (1) Except as otherwise provided by law, all
employee and employer contributions, appropriations and dividend
payments related to the health and dental plans administered by the
Director of the Office of Management and Enterprise Services Chief
Executive Officer of the Oklahoma Health Care Authority shall be
deposited in a fund in the State Treasury which is hereby created
and which shall be known as the Health and Dental Insurance Reserve
Fund. The money in such fund shall be invested by the Oklahoma
Employees Insurance and Benefits Board in the manner specified in
Section 1305.1 of this title. Investment income of the fund shall
be added to the fund. Money payable to the claims administrator and
all expenses in connection with the plans shall be paid from the
fund. The Board shall have responsibility for management of the
fund.

ENR. H. B. NO. 2108 Page 20
(2) All monies in the Health and Dental Insurance Reserve Fund
that are reserves for the life insurance plan administered by the
Office Authority shall be transferred to the Life Insurance Reserve
Fund on July 1, 1989.

SECTION 17. AMENDATORY 74 O.S. 2021, Section 1312.1, is
amended to read as follows:

Section 1312.1. There is hereby created in the State Treasury a
Revolving Fund for the Oklahoma Employees Insurance and Benefits
Plan. The revolving fund shall consist of funds transferred from
the Health and Dental Insurance Reserve Fund and the Life Insurance
Reserve Fund for operational expenses of the State Health and Life
Insurance Plan state health and life insurance plan and monies
assessed from or collected for and due a Health Maintenance
Organization health maintenance organization (HMO) as approved by
the Office of Management and Enterprise Services Oklahoma Health
Care Authority. Expenditures from said funds shall be made pursuant
to the laws of the state and statutes relating to the Plan plan.
This revolving fund shall be a continuing fund, not subject to
fiscal year limitations, and shall be under the control and
management of the Office Authority.

SECTION 18. AMENDATORY 74 O.S. 2021, Section 1312.2, is
amended to read as follows:

Section 1312.2. (1) There is hereby created in the State
Treasury, the Life Insurance Reserve Fund. Except as otherwise
provided by law, all contributions, appropriations, transfers,
dividend payments, and investment income of the fund received from
or for the benefit of the life insurance plan administered by the
Office of Management and Enterprise Services Oklahoma Health Care
Authority shall be deposited in the reserve fund.

The monies in said reserve fund shall be invested by the
Oklahoma Employees Insurance and Benefits Board in the manner
specified in Section 1305.1 of this title. The Board shall have
responsibility for management of the fund.

Money payable to the claims administrator and all expenses in
connection with the life insurance plan shall be paid from the
reserve fund.

(2) All monies in the Life Insurance Reserve Fund that are
reserves for the health and dental plans administered by the Office
ENR. H. B. NO. 2108 Page 21
of Management and Enterprise Services Oklahoma Health Care Authority
shall be transferred to the Health and Dental Insurance Reserve Fund
on July 1, 1989.

SECTION 19. AMENDATORY 74 O.S. 2021, Section 1312.3, is
amended to read as follows:

Section 1312.3. There is hereby created in the State Treasury,
the Oklahoma Employees Insurance and Benefits Clearing Fund. The
monies paid to the Oklahoma Employees Insurance and Benefits
Clearing Fund pursuant to Section 1310 of this title shall be
distributed as follows:

1. The first Thirty-one Million Five Hundred Thousand Dollars
($31,500,000.00) received after the effective date of this act July
1, 1991, during the fiscal year beginning July 1, 1996, shall be
distributed to the Oklahoma State Regents for Higher Education; and

2. The balance thereof shall be distributed to and deposited in
the appropriate reserve fund as directed by the Office of Management
and Enterprise Services Oklahoma Health Care Authority.

SECTION 20. AMENDATORY 74 O.S. 2021, Section 1314.3, is
amended to read as follows:

Section 1314.3. (1) All otherwise eligible employees hired by
the Oklahoma Employment Security Commission after the effective date
of this act May 30, 1990, shall participate in the State Plan state
plan and shall not be entitled to the supplemental health insurance
for which provision is made in this act the Oklahoma Employees
Insurance and Benefits Act nor to any other Commission benefit plan
not generally available to state employees, and no other provisions
of this act shall apply to such future hirees.

(2) All otherwise eligible Commission employees not
participating in the Agency Plan agency plan as of the effective
date of this act May 30, 1990, shall be enrolled in the State Plan
state plan on July 1, 1990. Said nonparticipating Commission
employees shall not be entitled to the supplemental health insurance
for which provision is made in this act.

(3) All Commission employees, retirees and dependents
participating in the Agency Plan agency plan as of the effective
date of this act May 30, 1990, shall be permitted to transfer to the
State Plan state plan and receive the supplemental insurance
ENR. H. B. NO. 2108 Page 22
benefits for which provision is made in Section 1314.4 of this title
at such time as the supplemental insurance is available. If not
sooner transferred, all Agency Plan agency plan participants shall
be transferred to the State Plan state plan on January 1, 1991.
Such mandatory transfer shall occur simultaneously with any
cancellation by the insurance provider of the Agency Plan agency
plan, occurring prior to January 1, 1991.

(4) All Commission employees, retirees and dependents enrolling
in or transferring to the State Plan state plan under the provisions
of this section shall be given the opportunity to participate in all
options under the State Plan state plan at the time of their
enrollment or transfer.

(5) For active employees of the Commission, the Commission
shall pay the same monthly premium toward employee-only coverage as
that set by the Oklahoma Health Care Authority and approved by the
Office of Management and Enterprise Services and paid by the other
state agencies participating in the state health insurance program.
For retirees of the Commission who retired pursuant to the
provisions of the Oklahoma Public Employees Retirement System, the
Oklahoma Public Employees Retirement System shall pay the same
monthly contribution towards premiums for regular or Medicare
supplement health insurance coverage for those retirees as the
amount paid towards the premiums for the Oklahoma Public Employees
Retirement System retirees from other agencies. For retirees of the
Commission who retired under the provisions of another retirement
plan, the Commission shall pay the same monthly contribution towards
premiums for regular or Medicare supplement health insurance
coverage for those retirees as the amount paid towards premiums by
the Oklahoma Public Employees Retirement System for retirees of
other state agencies.

(6) Except as provided in this subsection, employees and
retirees of the Commission, and their dependents, shall be covered
under the dental and life insurance plans provided by the Office of
Management and Enterprise Services Oklahoma Health Care Authority
pursuant to the same provisions and premiums as apply to the
employees and retirees of other state agencies. Employees and
retirees may elect to keep their present agency offered life
insurance, in addition to the state life insurance. Any employee
who elects to keep their agency offered life insurance shall pay the
premium for the life insurance provided pursuant to the Oklahoma
Employees Insurance and Benefits Act. Any Commission retiree who
elects to participate in the life insurance program provided
ENR. H. B. NO. 2108 Page 23
pursuant to the Oklahoma Employees Insurance and Benefits Act shall
pay the premium for such coverage.

(7) In the event that the agency offered life insurance plan is
canceled by the insurer offering it, the Commission shall contract
with the Office Authority for replacement coverage equal to that
lost by said cancellation. The Office Authority is expressly
authorized and directed to enter into such a contract. The
Commission and the participants shall pay the full actuarial costs
and all reasonable administrative costs for such coverage. Said
actuarial and administrative costs shall be divided between the
Commission and the participants in the same ratio as premiums are
now divided for the agency offered life insurance. The Office
Authority shall maintain separate reserves for said coverage. On
January 1, 2005, the Commission shall convert the agency offered
life insurance to the life insurance plans provided by the Office
Authority pursuant to the same provisions and premiums as apply to
the employees and retirees of other state agencies. The Commission
may offer eligible employees an opportunity to voluntarily
relinquish their agency life insurance upon a payment to the
eligible employee, provided funds exist to do so.

SECTION 21. AMENDATORY 74 O.S. 2021, Section 1314.5, is
amended to read as follows:

Section 1314.5. A. The Oklahoma Employment Security Commission
shall attempt to obtain the supplemental health insurance described
in Section 1314.4 of this title through competitive procurement
under The Central Purchasing Act. If the Commission does not obtain
such supplemental health insurance in this manner, it shall contract
with the Office of Management and Enterprise Services Oklahoma
Health Care Authority for such coverage or the Commission may
provide the supplemental health insurance through a self-insurance
program.

B. If the Commission decides to contract with the Office
Authority for the supplemental health insurance coverage, the Office
Authority is expressly authorized and directed to enter into such a
contract and administer the supplemental benefit in such manner to
cause the least disruption to its systems and daily operations. The
supplemental benefit does not have to be offered as a supplemental
plan but can be combined with the state plan to be administered and
actuarially rated as a single plan. If this option is chosen, all
dependents of employees or former employees currently eligible for
the supplemental health insurance shall be included in the plan,
ENR. H. B. NO. 2108 Page 24
regardless of whether or not the dependents were previously included
in the plan, and this subsection will prevail over the provisions of
Section 1314.3 of this title. The Commission shall pay the full
actuarial cost to be determined by the Office Authority and all
reasonable administrative costs for such coverage, if provided by or
through the Office Authority. The Office Authority may consider the
utilization experience of the group participating in the benefit
when calculating the rate for providing the benefit. The Office
Authority shall maintain separate reserves for said coverage.

C. If the Commission decides to provide supplemental health
insurance through a self-insurance program, the Commission shall be
authorized to contract with a private company to provide claims
adjusting services for the supplemental health insurance claims
adjusting and processing.

SECTION 22. AMENDATORY 74 O.S. 2021, Section 1315, is
amended to read as follows:

Section 1315. A. Upon application in writing and subject to
any underwriting criteria that may be established by the Office of
Management and Enterprise Services Oklahoma Health Care Authority,
the Office Authority may extend the benefits of the Oklahoma
Employees Insurance and Benefits Plans to employees who are employed
in positions requiring actual performance of duty during not less
than one thousand (1,000) hours per year and to all full-time
employees of:

1. Any of the following groups which participate in the
Oklahoma Public Employees Retirement System:

a. county,

b. city,

c. town,

d. public trust for which the state is the primary
beneficiary, or

e. conservation districts; and

2. Any of the following groups:

a. county hospital,
ENR. H. B. NO. 2108 Page 25

b. rural water district, including employees and board
members,

c. sewer district,

d. gas district,

e. solid waste management district,

f. nonprofit water corporation employees and board
members,

g. conservancy district or master conservancy district
authorized by the provisions of Section 541 of Title
82 of the Oklahoma Statutes,

h. voluntary organization of Oklahoma local government
jurisdictions listed in Section 2003 of Title 62 of
the Oklahoma Statutes including any council created by
the voluntary organizations,

i. voluntary association designated to administer the
County Government Council as authorized in Section 7
of Title 19 of the Oklahoma Statutes,

j. statewide nonprofit entities representing employees of
the state or employees of local political subdivisions
who are eligible for insurance benefits authorized by
the provisions of the Oklahoma Employees Insurance and
Benefits Act, or

k. statewide nonprofit entities receiving state funds to
provide no cost legal services to low income and
senior citizens.

B. Applications to participate in the Oklahoma Employees
Insurance and Benefits Plans shall be approved by majority action of
the governing body of the groups listed in subsection A of this
section.

C. Groups listed in subsection A of this section participating
in the Oklahoma Employees Insurance and Benefits Plans shall pay all
costs attributable to their participation. The benefits of said
plans for a participant provided coverage pursuant to this section
ENR. H. B. NO. 2108 Page 26
shall be the same and shall include the same plan options as would
be made available to a state employee participating in the plan that
resided at the same location. The premium for participating groups
listed in subsection A of this section shall be the same as paid by
state and education employees.

D. Participating groups listed in subsection A of this section
shall not be required to offer dental insurance as defined in
paragraph 11 12 of Section 1303 of this title, or other insurance as
defined in paragraph 12 13 of Section 1303 of this title. However,
if dental insurance or any other insurance is offered, it must be
provided to all eligible employees. If an employee retires and
begins to receive benefits from the Oklahoma Public Employees
Retirement System or terminates service and has a vested benefit
with the Oklahoma Public Employees Retirement System, the employee
may elect, in the manner provided in Section 1316.2 of this title,
to participate in the dental insurance plan offered through the
Oklahoma Employees Insurance and Benefits Act within thirty (30)
days from the date of termination of employment. The employee shall
pay the full cost of the dental insurance.

E. 1. Any employee of a group listed in subsection A of this
section who retires or who has a vested benefit pursuant to the
Oklahoma Public Employees Retirement System may begin the health
insurance coverage if the employer of the employee is not a
participant of the Oklahoma Employees Insurance and Benefits Act and
does not offer health insurance to its employees. Such election by
the employee to begin coverage shall be made within thirty (30) days
from the date of termination of service.

2. Any employee of a group listed in subsection A of this
section who retires or who has a vested benefit pursuant to the
Oklahoma Public Employees Retirement System may begin or continue
the health insurance coverage if the employer of the employee is a
participant of the Oklahoma Employees Insurance and Benefits Act and
the election to begin or continue coverage is made within thirty
(30) days from the date of termination of service.

F. Any county, city, town, county hospital, public trust,
conservation district, or rural water, sewer, gas or solid waste
management district, or nonprofit water corporation, any of which of
the aforementioned groups is not a participating employer in the
Oklahoma Public Employees Retirement System, but which has employees
who are participating in the health, dental or life insurance plans
offered by or through the Oklahoma Employees Insurance and Benefits
ENR. H. B. NO. 2108 Page 27
Act on July 1, 1997, may continue to allow its current and future
employees to participate in such health, dental or life insurance
plans. Participation of such employees may also continue following
termination of employment if the employee has completed at least
eight (8) years of service with a participating employer and such an
election to continue in force is made within thirty (30) days
following termination of employment. Any retiree or terminated
employee electing coverage pursuant to this section shall pay the
full cost of the insurance.

G. An employee of a group listed in paragraph 2 of subsection A
of this section may continue in force health, dental and life
insurance coverage following termination of employment if the
employee has a minimum of eight (8) years of service with a
participating employer and the election to continue in force is made
within thirty (30) calendar days following termination of
employment.

H. Notwithstanding other provisions in this section, an
employer listed in subsection A of this section may cease to
participate in the Oklahoma Employees Insurance and Benefits Act but
provide health insurance coverage for its current and former
employees through another insurance carrier. The subsequent carrier
shall be responsible for providing coverage to the entity's
employees who terminated employment with a retirement benefit, with
a vested benefit, or who have eight (8) or more years of service
with a participating employer but did not have a vested benefit
through the Oklahoma Public Employees Retirement System, if the
election to retain health insurance coverage was made within thirty
(30) days of termination of employment. Coverage shall also be
provided to the eligible dependents of the employees if an election
to retain coverage is made within thirty (30) days of termination of
employment. Employees who terminate employment from an employer
covered by this paragraph subsection before December 31, 2001, and
elect coverage under the Oklahoma Employees Insurance and Benefits
Act, shall not be required to change insurance carriers in the event
that the employer changes its insurance carrier to a subsequent
carrier. The provisions of this subsection shall become effective
January 1, 2002.

I. Employers pursuant to subsection A of this section who
participate in the Oklahoma Public Employees Retirement System and
who offer health insurance coverage to their active employees, shall
offer health insurance coverage to those employees who retire from
the employer and also to those employees who terminate employment
ENR. H. B. NO. 2108 Page 28
and are eligible to elect a vested benefit in the System. Such
employers shall begin offering coverage to such employees on or
before January 1, 2004. Such employees who wish to continue
coverage shall make an election to retain health insurance coverage
within thirty (30) days of termination of employment. However,
former employees of such employers who have already retired or who
have terminated and are eligible to elect a vested benefit under the
Oklahoma Public Employees Retirement System, during the period
beginning January 1, 2002, and ending December 31, 2003, may make an
election to begin participation in the plans offered by the Office
Authority on or before December 31, 2003, in the same manner as
other participating retired or vested members. The employer,
assisted by the Oklahoma Public Employees Retirement System shall
notify by October 1, 2003, all members who have either retired from
the System or who are eligible to elect a vested benefit in the
System between January 1, 2002, through December 31, 2003, and who
were employed by an employer listed in subsection A of this section
of the member's potential eligibility to participate in such plans.
Each employer shall notify the Oklahoma Public Employees Retirement
System when an employee is retiring and makes the election pursuant
to this subsection to continue coverage under a plan offered by such
employer and when an employee terminates employment and is eligible
to elect a vested benefit in the System and such employee elects to
continue coverage under a plan offered by such employer. Such
employer shall also notify the Oklahoma Public Employees Retirement
System if a retired employee or an employee who is eligible to elect
a vested benefit in the System terminates such continued coverage.

J. Any group that begins participation in the Oklahoma
Employees Insurance and Benefits Plans after the effective date of
this act March 17, 1970, and that is not composed of state or
education employees must have one hundred percent (100%)
participation in the health plan offered pursuant to the Oklahoma
Employees Insurance and Benefits Act.

SECTION 23. AMENDATORY 74 O.S. 2021, Section 1315.1, is
amended to read as follows:

Section 1315.1. Upon election and application by the secretary
of a county election board and subject to any underwriting criteria
that may be established by the Office of Management and Enterprise
Services Oklahoma Health Care Authority, the Office Authority shall
extend the benefits of the Oklahoma Employees Insurance and Benefits
Plans to the secretary of each county election board, if the county
in which the secretary serves is not participating in such plans.
ENR. H. B. NO. 2108 Page 29

SECTION 24. AMENDATORY 74 O.S. 2021, Section 1316.1, is
amended to read as follows:

Section 1316.1. A. Any person who retires or who has elected
to receive a vested benefit under the provisions of the State of
Oklahoma retirement systems or persons who are currently drawing
disability benefits under Section 1331 et seq. of this title or who
meet each and every requirement of the State Employees Disability
Program or the spouse or dependent of any such employee may continue
in force the life insurance benefits authorized by this act the
Oklahoma Employees Insurance Benefits Act in a face amount of not
less than one-fourth (1/4) of the basic life insurance amount, if
such election to continue in force is made within thirty (30) days
from the time of severance. Persons electing to continue in force
life insurance benefits shall pay the full cost of the life
insurance and under such terms and conditions as established by the
Office of Management and Enterprise Services Oklahoma Health Care
Authority. Further, any such retiree may continue in force any
additional life insurance that was purchased prior to retirement at
an actuarially adjusted rate and under such terms and conditions as
established by the Office Authority.

Effective January 1, 2002, nonvested employees may also continue
their life insurance benefits as provided in this section following
termination of employment, if the employee has completed at least
eight (8) years of service with an employer participating in the
Oklahoma Public Employees Retirement System or at least ten (10)
years of service with an employer participating in the Teachers'
Retirement System of Oklahoma. The election to continue the
employee's life insurance in force must be made within thirty (30)
days after the date of termination.

B. Any retired employee who is receiving a benefit or
terminates employment with a vested benefit from the Teachers'
Retirement System of Oklahoma and who becomes enrolled in the health
insurance plan offered by the Oklahoma Employees Insurance and
Benefits Act, pursuant to subsection E of Section 5-117.5 of Title
70 of the Oklahoma Statutes, may elect to purchase life insurance
benefits in amounts and at a cost as provided for in this section.

C. In lieu of subsection A of this section, any person who
retires or who has elected to receive a vested benefit under the
provisions of the State of Oklahoma retirement systems and who is
participating in a health insurance plan, the dental insurance plan,
ENR. H. B. NO. 2108 Page 30
or the life insurance plan offered by the Office Authority,
including such persons who are currently drawing disability benefits
under Section 1331 et seq. of this title or who meet each and every
requirement of the State Employees Disability Program on or before
July 1, 1999, or the spouse of any such person may elect to purchase
life insurance benefits authorized by this subsection in a face
amount not to exceed Fifty Thousand Dollars ($50,000.00). Eligible
persons pursuant to this subsection shall make an election by
January 1, 2000, to purchase the life insurance coverage provided in
this subsection. Life insurance coverage pursuant to this
subsection shall depend upon providing satisfactory evidence of
insurability for the person who is to be covered. Life insurance
coverage, pursuant to this subsection, shall be purchased in blocks
of Five Thousand Dollars ($5,000.00). The premium for such life
insurance coverage shall be at a blended rate and shall be set by
the Authority and approved by the Office of Management and
Enterprise Services. The Office Authority shall promulgate rules
necessary for the implementation of the provisions of this
subsection.

SECTION 25. AMENDATORY 74 O.S. 2021, Section 1316.2, as
amended by Section 5, Chapter 245, O.S.L. 2024 (74 O.S. Supp. 2024,
Section 1316.2), is amended to read as follows:

Section 1316.2. A. Any employee, other than an education
employee, who retires pursuant to the provisions of the Oklahoma
Public Employees Retirement System or who has a vested benefit
pursuant to the provisions of the Oklahoma Public Employees
Retirement System may continue in force the health and dental
insurance benefits authorized by the provisions of the Oklahoma
Employees Insurance and Benefits Act, or other employer insurance
benefits if the employer does not participate in the plans offered
by the Office of Management and Enterprise Services Oklahoma Health
Care Authority, if such election to continue in force is made within
thirty (30) days from the date of termination of service. Except as
otherwise provided for in subsection H of this section, health and
dental insurance coverage may not be reinstated at a later time if
the election to continue in force is declined. Vested employees
other than education employees who have terminated service and are
not receiving benefits and effective July 1, 1996, nonvested persons
who have terminated service with more than eight (8) years of
participating service with a participating employer, who within
thirty (30) days from the date of termination of service elect to
continue such coverage, shall pay the full cost of the insurance
premium at the rate and pursuant to the terms and conditions
ENR. H. B. NO. 2108 Page 31
established by the Office Authority. Provided also, any employee
other than an education employee who commences employment with a
participating employer on or after September 1, 1991, who terminates
service with such employer on or after July 1, 1996, but who
otherwise has insufficient years of service to retire or terminate
service with a vested benefit pursuant to the provisions of the
Oklahoma Public Employees Retirement System or to elect to continue
coverage as a nonvested employee as provided in this section, but
who, immediately prior to employment with the participating
employer, was covered as a dependent on the health and dental
insurance policy of a spouse who was an active employee other than
an education employee, may count as part of his or her credited
service for the purpose of determining eligibility to elect to
continue coverage under this section, the time during which the
terminating employee was covered as such a dependent.

B. 1. Health insurance benefit plans offered pursuant to this
section shall include:

a. indemnity plans offered through the Office Authority,

b. managed care plans offered as alternatives to the
indemnity plans offered through the Office Authority,

c. Medicare supplements offered pursuant to the Oklahoma
Employees Insurance and Benefits Act,

d. Medicare risk-sharing contracts offered as
alternatives to the Medicare supplements offered
through the Office Authority. All Medicare risk-
sharing contracts shall be subject to a risk
adjustment factor, based on generally accepted
actuarial principles for adverse selection which may
occur, and

e. for the Oklahoma Public Employees Retirement System,
other employer-provided health insurance benefit plans
if the employer does not participate in the plans
offered pursuant to the Oklahoma Employees Insurance
and Benefits Act.

2. Health insurance benefit plans offered pursuant to this
section shall provide prescription drug benefits, except for plans
designed pursuant to the Medicare Prescription Drug Improvement and
Modernization Act, pursuant to 42 USCA Section 1395w-101, et seq.,
ENR. H. B. NO. 2108 Page 32
for which provision of prescription drug benefits is optional, and
except for plans offered pursuant to subparagraph e of paragraph 1
of this subsection.

C. 1. Designated public retirement systems shall contribute a
monthly amount towards the health insurance premium of certain
individuals receiving benefits from the public retirement system as
follows:

a. a retired employee, other than an education employee
or an employee who participates in the defined
contribution system administered by the Oklahoma
Public Employees Retirement System on or after
November 1, 2015, who is receiving benefits from the
Oklahoma Public Employees Retirement System after
September 30, 1988, shall have One Hundred Five
Dollars ($105.00), or the premium rate of the health
insurance benefit plan, whichever is less, paid by the
Oklahoma Public Employees Retirement System to the
Board or to another insurance carrier or other
qualified benefits administrator of the employer if
the employer does not participate in the plans offered
by the Office Authority in the manner specified in
subsection G of this section,

b. a retired employee or surviving spouse other than an
education employee who is receiving benefits from the
Oklahoma Law Enforcement Retirement System after
September 30, 1988, is under sixty-five (65) years of
age and is not otherwise eligible for Medicare shall
have the premium rate for the health insurance benefit
plan or One Hundred Five Dollars ($105.00), whichever
is less, paid by the Oklahoma Law Enforcement
Retirement System to the Office Authority in the
manner specified in subsection G of this section,

c. a retired employee other than an education employee
who is receiving benefits from the Oklahoma Law
Enforcement Retirement System after September 30,
1988, is sixty-five (65) years of age or older or who
is under sixty-five (65) years of age and is eligible
for Medicare shall have One Hundred Five Dollars
($105.00), or the premium rate of the health insurance
benefit plan, whichever is less, paid by the Oklahoma
Law Enforcement Retirement System to the Office
ENR. H. B. NO. 2108 Page 33
Authority in the manner specified in subsection G of
this section, and

d. a retired employee other than an education employee
who is receiving benefits from the Uniform Retirement
System for Justices and Judges after September 30,
1988, shall have One Hundred Five Dollars ($105.00),
or the premium rate of the health insurance plan,
whichever is less, paid by the Uniform Retirement
System for Justices and Judges to the Office Authority
in the manner specified in subsection G of this
section.

2. Premium payments made pursuant to this section shall be made
subject to the following conditions:

a. the health plan shall be authorized by the provisions
of the Oklahoma Employees Insurance and Benefits Act,
except that if an employer from which an employee
retired or with a vested benefit pursuant to the
provisions of the Oklahoma Public Employees Retirement
System does not participate in the plans authorized by
the provisions of the Oklahoma Employees Insurance and
Benefits Act, the health plan will be the health
insurance benefits of the employer from which the
individual retired or vested,

b. for plans offered by the Oklahoma Employees Insurance
and Benefits Act, the amount to be paid shall be
determined pursuant to the provisions of this
subsection and shall first be applied in whole or in
part to the prescription drug coverage premium. Any
remaining amount shall be applied toward the medical
coverage premium,

c. for all plans, if the amount paid by the public
retirement system does not cover the full cost of the
elected coverage, the individual shall pay the
remaining premium amount, and

d. payment shall be made by the retirement systems in the
manner specified under subsection G of this section.

D. For any member of the Oklahoma Law Enforcement Retirement
System killed in the line of duty, whether the member was killed in
ENR. H. B. NO. 2108 Page 34
the line of duty prior to May 18, 2005, or on or after May 18, 2005,
or if the member was on a disability leave status at the time of
death, the surviving spouse or dependents of such deceased member of
the Oklahoma Law Enforcement Retirement System may elect to continue
or commence health and dental insurance benefits, provided the
dependents pay the full cost of such insurance, and for deaths
occurring on or after July 1, 2002, such election is made within
thirty (30) days of the date of death. The eligibility for the
benefits shall terminate for the surviving children when the
children cease to qualify as dependents.

E. Effective July 1, 2004, a retired member of the Oklahoma Law
Enforcement Retirement System who retired from the System by means
of a personal and traumatic injury of a catastrophic nature and in
the line of duty and any surviving spouse of such retired member and
any surviving spouse of a member who was killed in the line of duty
shall have one hundred percent (100%) of the retired member's or
surviving spouse's health care premium cost, whether the member or
surviving spouse elects coverage under the Medicare supplement or
Medicare risk-sharing contract, paid by the Oklahoma Law Enforcement
Retirement System to the Office Authority in the manner specified in
subsection H of this section. For plans offered by the Office
Authority, such contributions will first be applied in whole or in
part to the prescription drug coverage premium, if any.

F. Dependents of a deceased employee who was on active work
status or on a disability leave at the time of death or of a
participating retardant or of any person who has elected to receive
a vested benefit under the Oklahoma Public Employees Retirement
System, the Uniform Retirement System for Justices and Judges or the
Oklahoma Law Enforcement Retirement System may continue the health
and dental insurance benefits in force, provided the dependents pay
the full cost of such insurance and they were covered as eligible
dependents at the time of such death and such election is made
within thirty (30) days of date of death. The eligibility for the
benefits shall terminate for the surviving children when the
children cease to qualify as dependents.

G. The amounts required to be paid by the Oklahoma Public
Employees Retirement System, the Uniform Retirement System for
Justices and Judges and the Oklahoma Law Enforcement Retirement
System pursuant to this section shall be forwarded no later than the
tenth day of each month following the month for which payment is due
by the Oklahoma Public Employees Retirement System Board of Trustees
or the Oklahoma Law Enforcement Retirement Board to the Office
ENR. H. B. NO. 2108 Page 35
Authority for deposit in the Health, Dental and Life Insurance
Reserve Fund or to another insurance carrier or other administrator
of qualified benefits of the employer as provided for in subsection
H of Section 1315 of this title.

H. Upon retirement from employment of the Board of Regents of
the University of Oklahoma, any person who was or is employed at the
George Nigh Rehabilitation Institute and who transferred employment
pursuant to Section 3427 of Title 70 of the Oklahoma Statutes, any
person who was employed at the Medical Technology and Research
Authority and who transferred employment pursuant to Section 7068 of
this title and any person who is a member of the Oklahoma Law
Enforcement Retirement System pursuant to the authority of Section
2-314 of Title 47 of the Oklahoma Statutes may participate in the
benefits authorized by the provisions of the Oklahoma Employees
Insurance and Benefits Act for retired participants including
health, dental and life insurance benefits, if such election to
participate is made within thirty (30) days from the date of
termination of service. Life insurance benefits for any such person
who transferred employment shall not exceed the coverage the person
had at the time of such transfer. Retirees who transferred
employment and who participate pursuant to this paragraph subsection
shall pay the premium for elected benefits less any amounts paid by
a state retirement system pursuant to this section.

SECTION 26. AMENDATORY 74 O.S. 2021, Section 1316.3, is
amended to read as follows:

Section 1316.3. A. Any person who retires pursuant to the
provisions of the Teachers' Retirement System of Oklahoma with at
least ten (10) years of creditable service or who has a vested
benefit with at least ten (10) years of creditable service, pursuant
to the provisions of the Teachers' Retirement System of Oklahoma may
continue in force the health and dental insurance benefits
authorized by the provisions of the Oklahoma Employees Insurance and
Benefits Act if such election to continue in force or begin is made
within thirty (30) days from the date of termination of service.
Except as provided in subsection E of Sections 5-117.5 and 14-108.1
of Title 70 of the Oklahoma Statutes and Section 840-2.27I of this
title and subsection K of this section, health and dental insurance
coverage may not be reinstated at a later time if the election to
continue in force or begin coverage is declined. Vested persons who
have terminated service and are not receiving benefits and effective
July 1, 1996, nonvested persons who have terminated service with
more than ten (10) years of participating service with a qualifying
ENR. H. B. NO. 2108 Page 36
employer, who within thirty (30) days from the date of termination
of service, elect to continue such coverage, shall pay the full cost
of said insurance premium at the rate and pursuant to the terms and
conditions established by the Office of Management and Enterprise
Services Oklahoma Health Care Authority.

B. 1. Health insurance benefit plans offered pursuant to this
section shall include:

a. indemnity plans offered through the Office Authority,

b. managed care plans offered as alternatives to the
indemnity plans,

c. Medicare supplements offered through the Office
Authority,

d. Medicare risk-sharing contracts offered as
alternatives to the Medicare supplements offered
through the Office Authority, and

e. any other employer-provided health insurance benefit
plans if the employer does not participate in the
plans offered pursuant to the Oklahoma Employees
Insurance and Benefits Act.

2. Health insurance benefit plans offered pursuant to this
section shall provide prescription drug benefits, except for plans
designed pursuant to the Medicare Prescription Drug Improvement and
Modernization Act of 2003, which may or may not contain prescription
drug benefits, for which provision of prescription drug benefits is
optional, and except for plans offered pursuant to subparagraph e of
paragraph 1 of this subsection.

C. A retired person who:

1. Is receiving benefits from the Teachers' Retirement System
of Oklahoma after September 30, 1988, is under sixty-five (65) years
of age and is not otherwise eligible for Medicare and pursuant to
subsection A of this section elects to begin or to continue the
health insurance plan;

2. Is receiving benefits from the Teachers' Retirement System
of Oklahoma after June 30, 1993, is under sixty-five (65) years of
age and is not otherwise eligible for Medicare and participates in a
ENR. H. B. NO. 2108 Page 37
health insurance plan provided by a participating education employer
of the Teachers' Retirement System of Oklahoma other than a health
insurance plan offered pursuant to the Oklahoma Employees Insurance
and Benefits Act or an alternative health plan offered pursuant to
the Oklahoma State Employees Benefits Act;

3. Is receiving benefits from the Teachers' Retirement System
of Oklahoma after September 30, 1988, made contributions to the
system and is sixty-five (65) years of age or older, or who is under
sixty-five (65) years of age and is eligible for Medicare and is a
participant in the Oklahoma Employees Insurance and Benefits Act and
elects coverage under the Medicare supplement offered by the Office
Authority; or

4. Is receiving benefits from the Teachers' Retirement System
of Oklahoma after June 30, 1993, made contributions to the system
and is sixty-five (65) years of age or older, or who is under sixty-
five (65) years of age and is eligible for Medicare and participates
in a health insurance plan provided by a participating education
employer of the Teachers' Retirement System of Oklahoma other than a
health insurance plan offered pursuant to the Oklahoma Employees
Insurance and Benefits Act or an alternative health plan offered
pursuant to the Oklahoma State Employees Benefits Act and elects
coverage under the Medicare supplement offered by the Office
Authority,

shall have the amount determined pursuant to subsection E of this
section, or the premium rate of the health insurance benefit plan,
whichever is less, paid by the Teachers' Retirement System of
Oklahoma. If the amount paid by the Teachers' Retirement System of
Oklahoma does not cover the full cost of the health insurance
premium, the retired person shall pay the remaining amount if the
retired person wants to continue the coverage.

D. The Teachers' Retirement System shall pay the amount due
pursuant to the provisions of subsection C of this section as
follows:

1. For those individuals participating in plans provided
through the Oklahoma Employees Insurance and Benefits Act, payment
shall be made to the Office Authority pursuant to the provisions of
subsection I of this section; or

2. For those individuals participating in plans provided
through a participating education employer of the Teachers'
ENR. H. B. NO. 2108 Page 38
Retirement System of Oklahoma other than a health insurance plan
offered pursuant to the Oklahoma Employees Insurance and Benefits
Act, payment shall be made to the education employer.

E. Beginning July 1, 2000, the maximum benefit payable by the
Teachers' Retirement System of Oklahoma on behalf of a retired
person toward said person's monthly premium for health insurance
shall be determined in accordance with the following schedule:

LESS THAN

25 YEARS BUT GREATER

LESS THAN GREATER THAN THAN 24.99

AVERAGE SALARY 15 YEARS OF 14.99 YEARS OF YEARS OF

USED FOR DETERMINING CREDITABLE CREDITABLE CREDITABLE

RETIREMENT ALLOWANCE SERVICE SERVICE SERVICE

Less than $20,000.00 $103.00 $104.00 $105.00

Less than $30,000.00 but
greater than $19,999.99 $102.00 $103.00 $104.00

Less than $40,000.00 but
greater than $29,999.99 $101.00 $102.00 $103.00

$40,000.00 or greater $100.00 $101.00 $102.00

For plans offered by the Office Authority, the amount paid
pursuant to this subsection shall first be applied to the
prescription drug coverage premium, if any. Any remaining amounts
shall be applied towards the medical coverage premium.

F. If a person retires and begins to receive benefits from the
Teachers' Retirement System of Oklahoma or terminates service and
has a vested benefit with the Teachers' Retirement System of
Oklahoma, the person may elect, in the manner provided in subsection
A of this section, to participate in the dental insurance plan
offered through the Oklahoma Employees Insurance and Benefits Act.
The person shall pay the full cost of the dental insurance.

ENR. H. B. NO. 2108 Page 39
G. Those persons who are receiving benefits from the Teachers'
Retirement System of Oklahoma and have health insurance coverage
which on the operative date of this section October 1, 1988, is
being paid by the education entity from which the person retired
shall make the election required in subsection A of this section
within thirty (30) days of the termination of said health insurance
coverage. The person making the election shall give the Office
Authority certified documentation satisfactory to the Office
Authority of the termination date of the other health insurance
coverage.

H. Dependents of a deceased education employee who was on
active work status or on a disability leave at the time of death or
of a participating retirant or of any person who has elected to
receive a vested benefit under the Teachers' Retirement System of
Oklahoma may continue the health and dental insurance benefits in
force provided said dependents pay the full cost of such insurance
and they were covered as eligible dependents at the time of such
death and such election is made within thirty (30) days of date of
death. The eligibility for said benefits shall terminate for the
surviving children when said children cease to qualify as
dependents.

I. The amounts required to be paid by the Teachers' Retirement
System of Oklahoma pursuant to this section shall be forwarded no
later than the tenth day of each month following the month for which
payment is due by the Board of Trustees of the Teachers' Retirement
System of Oklahoma to the Office Authority for deposit in the
Education Employees Group Insurance Reserve Fund.

J. The Teachers' Retirement System of Oklahoma shall provide
the Office Authority information concerning the employers of retired
and vested members necessary to allow the Office Authority to track
eligibility for continued coverage.

K. Upon retirement from employment with the Board of Regents of
the University of Oklahoma, any person who is or was employed at the
George Nigh Rehabilitation Institute and who transferred employment
pursuant to Section 3427 of Title 70 of the Oklahoma Statutes, any
person who was employed at the Medical Technology and Research
Authority and who transferred employment pursuant to Section 7068 of
this title, and any person who is a member of the Oklahoma Law
Enforcement Retirement System pursuant to the authority of Section
2-314 of Title 47 of the Oklahoma Statutes may participate in the
benefits authorized by the provisions of the Oklahoma Employees
ENR. H. B. NO. 2108 Page 40
Insurance and Benefits Act for retired participants, including
health, dental and life insurance benefits, if such election to
participate is made within thirty (30) days from the date of
termination of employment. Life insurance benefits for any such
person who transferred employment shall not exceed the coverage the
person had at the time of such transfer. Retirees who are persons
transferred employment and who participate pursuant to this
paragraph subsection shall pay the premium for elected benefits less
any amounts paid by the retirement system pursuant to this section.

SECTION 27. AMENDATORY 74 O.S. 2021, Section 1317, is
amended to read as follows:

Section 1317. Any legally blind person who is licensed by the
Department of Rehabilitation Services as a vending stand operator or
managing operator shall be eligible for membership in the Health
Insurance Plan health insurance plan, Dental Insurance Plan dental
insurance plan and Life Insurance Plan life insurance plan referred
to in the Oklahoma Employees Insurance and Benefits Act. Enrollment
in the Plan shall be optional with each operator pursuant to the
rules prescribed by the Office of Management and Enterprise Services
Oklahoma Health Care Authority. Any payments required to be made
for enrollees in the Plan shall be payable by the operator in such
manner as may be determined by the Department of Rehabilitation
Services; provided, that the Department may, in its discretion, make
all or a part of such payments.

SECTION 28. AMENDATORY 74 O.S. 2021, Section 1320, is
amended to read as follows:

Section 1320. A. For purposes of administering the Oklahoma
Employees Insurance and Benefits Act, the Director Chief Executive
Officer (CEO) of the Office of Management and Enterprise Services
Oklahoma Health Care Authority is authorized to hire and appoint an
Administrator who shall be in the unclassified service and shall
serve at the pleasure of the Director CEO of the Office of
Management and Enterprise Services Oklahoma Health Care Authority.

B. The Director CEO of the Office of Management and Enterprise
Services Oklahoma Health Care Authority may hire a director of
internal audit and one attorney licensed to practice law in this
state. The attorney hired by the Oklahoma Employees Insurance and
Benefits Board shall have not less than five (5) years of experience
in matters related to the insurance industry. The Director CEO
shall directly supervise the duties of the director of internal
ENR. H. B. NO. 2108 Page 41
audit, and shall not delegate the supervision to the Administrator
or any other employee. In addition to duties assigned by the
Director CEO, the director of internal audit is authorized to audit
all records of health providers and pharmacists who enter into any
contract with the Board in order to ensure compliance with said
contract provisions.

The Director CEO shall employ such persons as are necessary to
administer the provisions of the Oklahoma Employees Insurance and
Benefits Act, the State Employees Flexible Benefits Act and the
State Employees Disability Program Act. The Director CEO may employ
a maximum of two attorneys for purposes of administering the
Oklahoma Employees Insurance and Benefits Act. The Administrator or
one of the deputy administrators shall have not less than seven (7)
years of group health insurance administration experience on a
senior managerial level.

C. The Director CEO shall not contract for private legal
counsel except for extraordinary situations other than normal day to
day situations, and when approved by the Attorney General. The
Director CEO may contract with a nonemployee consulting actuary, a
nonemployee medical consultant and a nonemployee dental consultant
subject to competitive bid at least every three (3) years. The
Director CEO may contract with health care providers for a level of
reimbursement for the payment of claims incurred by the plan
participants. The Director CEO may at its request use the services
of the office Office of the Attorney General and the actuarial
services of any actuary employed by the Insurance Commissioner and
may also seek the advice and counsel of the Insurance Commissioner
of the State of Oklahoma or any employee of the Office of the
Insurance Commissioner.

SECTION 29. AMENDATORY 74 O.S. 2021, Section 1321, as
amended by Section 6, Chapter 245, O.S.L. 2024 (74 O.S. Supp. 2024,
Section 1321), is amended to read as follows:

Section 1321. A. The Office of Management and Enterprise
Services Oklahoma Health Care Authority shall have the authority to
determine all rates and life, dental and health benefits. All rates
shall be compiled in a comprehensive Schedule of Benefits. The
Schedule of Benefits shall be available for inspection during
regular business hours at the Office of Management and Enterprise
Services Oklahoma Health Care Authority. The Office Authority shall
have the authority to annually adjust the rates and benefits based
on claim experience.
ENR. H. B. NO. 2108 Page 42

B. The premiums for such insurance plans offered for the next
plan year shall be established as follows:

1. For active employees and their dependents, the Office's
Authority's premium determination shall be made no later than the
bid submission date for health maintenance organizations set by the
Oklahoma Employees Insurance and Benefits Board, which shall be set
in August no later than the third Friday of that month; and

2. For all other covered members and dependents, the Office's
Authority's and the health maintenance organizations' premium
determinations shall be no later than the fourth Friday of
September.

C. The CEO of the Authority shall review for approval all rates
and life, dental, and health benefits for the state sponsored plans
recommended by the Oklahoma Employees Insurance and Benefits Board.
If approved by the CEO of the Authority, those rates and benefits
along with the final health maintenance organizations’ rates and
benefits shall be sent to the Director of the Office of Management
and Enterprise Services for final approval.

D. The Office may approve a mid-year adjustment requested by
the Authority provided the need for an adjustment is substantiated
by an actuarial determination or more current experience rating.
The only publication or notice requirements that shall apply to the
Schedule of Benefits shall be those requirements provided in the
Oklahoma Open Meeting Act and within this section. It is the intent
of the Legislature that the benefits provided not include cosmetic
dental procedures except for certain orthodontic procedures as
adopted by the Director Chief Executive Officer of the Authority.

SECTION 30. AMENDATORY 74 O.S. 2021, Section 1323, is
amended to read as follows:

Section 1323. Any person who shall knowingly make any false
statement, or who shall falsify or permit to be falsified any record
necessary for carrying out the intent of the Oklahoma Employees
Insurance and Benefits Act, Sections 1301 through 1329.1 1329 of
this title, for the purpose of committing fraud, shall be guilty of
a misdemeanor, and upon conviction shall be punished by a fine not
exceeding Five Thousand Dollars ($5,000.00) or by imprisonment for
not exceeding one (1) year or by both the fine and imprisonment.
The Office of Management and Enterprise Services Oklahoma Health
ENR. H. B. NO. 2108 Page 43
Care Authority shall have the right to audit participating employer
groups to verify eligibility for any member and/or dependent and may
require proof of eligibility upon demand.

SECTION 31. AMENDATORY 74 O.S. 2021, Section 1324, is
amended to read as follows:

Section 1324. A. All health benefit plans that are offered by
the Office of Management and Enterprise Services Oklahoma Health
Care Authority shall provide coverage for side effects that are
commonly associated with radical retropubic prostatectomy surgery,
including, but not limited to impotence and incontinence, and for
other prostate-related conditions.

B. The Office Authority shall provide notice to each insured or
enrollee under the plan regarding the coverage required by this
section in the plan's evidence of coverage, and shall provide
additional written notice of the coverage to the insured or enrollee
as follows:

1. In the next mailing made by the plan to the employee; or

2. As part of the enrollment information packet sent to the
enrollee.

C. The Office Authority shall promulgate any rules or actions
necessary to implement the provisions of this section.

SECTION 32. AMENDATORY 74 O.S. 2021, Section 1325, is
amended to read as follows:

Section 1325. The Office of Management and Enterprise Services
Oklahoma Health Care Authority shall schedule a hearing thirty (30)
days prior to adopting any major change in the reimbursement rates
or methodology. The Office Authority shall notify health care
providers who provide services pursuant to a contract with the
Office Authority at least fifteen (15) days prior to the hearing.
The notice shall include proposed changes to the reimbursement rates
or methodology. The Office Authority shall also inform such health
care providers at the hearing of any proposed changes to the
reimbursement rates or methodology. At the hearing the Office
Authority shall provide an open forum for such health care providers
to comment on the proposed changes.

ENR. H. B. NO. 2108 Page 44
SECTION 33. AMENDATORY 74 O.S. 2021, Section 1326, is
amended to read as follows:

Section 1326. The Office of Management and Enterprise Services
Oklahoma Health Care Authority shall make available, upon request,
copies of relevant fee schedules to participating health care
providers.

SECTION 34. AMENDATORY 74 O.S. 2021, Section 1327, is
amended to read as follows:

Section 1327. A. All health benefit plans offered by the
Office of Management and Enterprise Services Oklahoma Health Care
Authority which provide for services for vision care or medical
diagnosis and treatment for the eye shall allow optometrists to be
providers of those services. All such health benefit plans shall
also require equal payment for the same services provided by an
optometrist if the services are within the scope of practice of
optometry.

B. With respect to optometric services, any health benefit plan
offered by the Office Authority which uses a gatekeeper or
equivalent for referrals for services for vision care or for medical
diagnosis and treatment of the eye shall require such covered
services be provided on a referral basis within the medical group or
network at the request of an enrollee who has a condition requiring
vision care or medical diagnosis and treatment of the eye if:

1. A referral is necessitated in the judgment of the primary
care physician; and

2. Treatment for the condition falls within the licensed scope
of practice of an optometrist.

C. All health benefit plans offered by the Office Authority
shall have a defined set of standards and procedures for selecting
providers, including specialists, to serve enrollees. The standards
and procedures shall be drafted in such a manner that they are
applicable to all categories of providers and shall be utilized by
the health maintenance organization in a manner that is without bias
for or discrimination against a particular category or categories of
providers.

D. No health benefit plan specified by this section shall
require a provider to have hospital privileges if hospital
ENR. H. B. NO. 2108 Page 45
privileges are not usual and customary for the services the provider
provides.

E. Nothing in this section shall be construed to:

1. Prohibit a health benefit plan offered by the Office
Authority which provides for services for vision care or medical
diagnosis and treatment for the eye from determining the adequacy of
the size of its network;

2. Prohibit an optometrist from agreeing to a fee schedule;

3. Limit, expand, or otherwise affect the scope of practice of
optometry; or

4. Alter, repeal, modify or affect the laws of this state
except where such laws are in conflict or are inconsistent with the
express provisions of this section.

F. Existing health benefit plans offered by the Office
Authority shall comply with the requirements of this section upon
issuance or renewal on or after the effective date of this act
November 1, 2000.

SECTION 35. AMENDATORY 74 O.S. 2021, Section 1328, is
amended to read as follows:

Section 1328. A. The contracted claims administrator for the
Office of Management and Enterprise Services Oklahoma Health Care
Authority shall reimburse all clean claims of an enrollee, an
assignee of the enrollee, or a health care provider within forty-
five (45) calendar days after receipt of the claim by the entity.

B. As used in this section, "clean claim" means a claim that
has no defect or impropriety, including a lack of any required
substantiating documentation, or particular circumstance requiring
special treatment that impedes prompt payment.

C. 1. If a claim or any portion of a claim is determined to
have defects or improprieties, including a lack of any required
substantiating documentation, or a particular circumstance requiring
special treatment, the enrollee, assignee of the enrollee, or health
care provider shall be notified in writing within thirty (30)
calendar days after receipt of the claim by the contracted claims
administrator for the Office Authority. The written notice shall
ENR. H. B. NO. 2108 Page 46
specify the portion of the claim that is causing a delay in
processing and explain any additional information or corrections
needed. Failure of the Office's Authority's claims administrator to
provide the enrollee, assignee of the enrollee, or health care
provider with such notice shall constitute prima facie evidence that
the claim will be paid in accordance with the terms of the health
benefit claims administration contract.

2. The portion of the claim that is accurate shall be paid
within forty-five (45) calendar days after receipt of the claim by
the claims administrator for the Office Authority.

D. Upon receipt of the additional information or corrections
which led to the claim's being delayed and a determination that the
information is accurate, the claims administrator for the Office
Authority shall either pay or deny the claim or a portion of the
claim within forty-five (45) calendar days.

E. Payment shall be considered made on:

1. The date a draft or other valid instrument which is
equivalent to the amount of the payment is placed in the United
States mail in a properly addressed, postpaid envelope; or

2. If not so posted, the date of delivery.

F. An overdue payment shall bear simple interest at the rate of
ten percent (10%) per year.

G. In the event litigation should ensue based upon such a
claim, the prevailing party shall be entitled to recover a
reasonable attorney fee to be set by the court and taxed as costs
against the party or parties who do not prevail.

SECTION 36. AMENDATORY 74 O.S. 2021, Section 1329, is
amended to read as follows:

Section 1329. The Office of Management and Enterprise Services
Oklahoma Health Care Authority shall contract with a vendor to make
available a health savings account to all enrollees in the
HealthChoice qualified high-deductible health plan. Any employer or
employee contributions to the health savings account shall be
allowable as a remittance to the vendor through payroll deduction in
conjunction with the employer's Section 125 Plan and shall not be
subject to any assessment of administrative fees by the Office of
ENR. H. B. NO. 2108 Page 47
Management and Enterprise Services Oklahoma Health Care Authority or
any state agency for remittance to the vendor. The State of
Oklahoma and the Office of Management and Enterprise Services
Oklahoma Health Care Authority shall take necessary measures to make
any employer or employee health savings account contributions
permissible under the state's Section 125 Plan.

SECTION 37. This act shall become effective November 1, 2025.

ENR. H. B. NO. 2108 Page 48
Passed the House of Representatives the 15th day of May, 2025.

Presiding Officer of the House
of Representatives

Passed the Senate the 22nd day of April, 2025.

Presiding Officer of the Senate

OFFICE OF THE GOVERNOR
Received by the Office of the Governor this ____________________
day of ___________________, 20_______, at _______ o'clock _______ M.
By: _________________________________
Approved by the Governor of the State of Oklahoma this _________
day of ___________________, 20_______, at _______ o'clock _______ M.

_________________________________
Governor of the State of Oklahoma

OFFICE OF THE SECRETARY OF STATE
Received by the Office of the Secretary of State this __________
day of ___________________, 20_______, at _______ o'clock _______ M.
By: _________________________________