Title 74 — Title 74 — State Government

to Commissioner. A. The Oklahoma Health Care Authority shall submit to the Insurance Commissioner the following information regarding utilization review performed by employees of the Authority: 1. A utilization review plan that includes: a. an adequate summary description of revi…

74 O.S. § 1306.3 Repealed by Laws 2012, c. 303, § 21, eff. Nov. 1, 2012

74 O.S. § 1306.4 Repealed by Laws 2012, c. 303, § 21, eff. Nov. 1, 2012

contracts - Mutual consent. A network provider facility or physician contract, or any part or section of it, may be amended at any time during the term of the contract only by mutual written consent of duly authorized representatives of the Oklahoma Health Care Authority and the …

Fund. The Chief Executive Officer of the Oklahoma Health Care Authority, in accordance with administering the Medical Expense Liability Revolving Fund pursuant to Section 746.1 of Title 19 of the Oklahoma Statutes, shall employ, appoint, or otherwise designate the necessary perso…

A. The specifications drawn by the Oklahoma Health Care Authority for the health insurance plan shall provide for comprehensive hospital medical and surgical benefits. The health insurance plan may limit coverage for a particular illness, disease, injury or condition; but, except…

No employee or dependent who participates in 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 depe…

On and after November 1, 1996, the 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 …

providers. Unless the Oklahoma Health Care Authority has otherwise contracted with an out-of-state provider, the 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 …

(1) Any employee eligible for membership in the health insurance plan, dental insurance plan or 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 sha…

life insurance plans. (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 sh…

Any person eligible to begin coverage in the health insurance plan pursuant to the State and Education Employees Group Insurance Act shall not be subject to a preexisting condition exclusion if the person was continuously covered under a previous group health insurance plan, was …

Any active employee eligible to participate or who is a participant may opt out of the state's basic plan as outlined in Sections 1370 and 1371 of this title, or may opt out of the health and dental basic plan options only, and retain the life and disability plan benefits, provid…

A. Any eligible employee may elect to have a dependent or dependents of the employee covered by the health insurance plan and dental insurance plan or by any available health maintenance organization (HMO) approved by the Oklahoma Health Care Authority. The employee may elect to …

Any dependent shall be allowed to remain covered as a dependent under the State and Education Employees Group Insurance Act up to the age of twenty-five (25) years. Added by Laws 2006, c. 231, § 4, eff. July 1, 2006. Amended by Laws 2008, c. 415, § 14, eff. July 1, 2008. NOTE: La…

A. Except as provided in subsection B of this section, each state agency participating in the Group Insurance Plans shall appropriate and pay to the appropriate reserve fund an amount to be set by the Oklahoma Employees Insurance and Benefits Board for each employee other than ed…

insurance premiums. A. If a certified employee elects health care coverage under a plan offered by a school district, including a plan offered by the Oklahoma Health Care Authority or a self-insured plan offered by the school district, then a school district shall pay no less tha…

of premium payable by district. 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 Oklah…

The amount of monthly contribution to be made by employees enrolled in the insurance plans shall be deducted from the monthly salaries of such employees and remitted to the Oklahoma Health Care Authority. The procedure for such deductions and remittances shall be established by t…

benefits. 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 shall be deducted from the monthly disability benefits of such persons and remitted to the O…

74 O.S. § 1311.2 Repealed by Laws 2003, c. 8, § 9, eff. July 1, 2003

(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 Chief Executive Officer of the Oklahoma Health Care Authority shall be deposited in a fund in the Stat…

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 expen…

(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 …

Fund. 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 Th…

Except as provided in Section 483 of Title 40 of the Oklahoma Statutes, the provisions of the State and Education Employees Group Insurance Act, Section 1301 et seq. of this title, shall not apply to the employees and officers of The Oklahoma State System of Higher Education nor …

Education - Participation - Payroll deductions. The Oklahoma Employment Security Commission and the Oklahoma State System of Higher Education have provided and may continue to provide hospital and medical benefits, accident, health, and life insurance, or any of the aforesaid, in…

As used in Sections 1 through 5 of this act: (a) "Agency Plan" means the health insurance program offered by the Oklahoma Employment Security Commission to its employees as of the effective date of this act. The Agency Plan presently conforms to the Federal Plan; (b) "State Plan"…

Employer contributions - Preexisting conditions - Satisfaction of deductible - Dental and life insurance plans. (1) All otherwise eligible employees hired by the Oklahoma Employment Security Commission after May 30, 1990, shall participate in the state plan and shall not be entit…

(1) The Oklahoma Employment Security Commission shall provide supplemental health insurance, in the manner provided in Section 1314.5 of this title for Agency Plan participants. Such supplemental insurance shall cover material differences between the coverage under the State Plan…

insurance. 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 heal…

utility districts, nonprofit entities, and other local service agencies. A. Upon application in writing and subject to any underwriting criteria that may be established by the Oklahoma Health Care Authority, the Authority may extend the benefits of the Oklahoma Employees Insuranc…

Upon election and application by the secretary of a county election board and subject to any underwriting criteria that may be established by the Oklahoma Health Care Authority, the Authority shall extend the benefits of the Oklahoma Employees Insurance and Benefits Plans to the …

Election. 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 require…

terminated service - Law enforcement retirement system members killed, injured in line of duty - Continuance of health and dental insurance benefits. A. Any employee, other than an education employee, who retires pursuant to the provisions of the Oklahoma Public Employees Retirem…

employees - Retirement or other termination of service - Continuation of health and dental insurance benefits. 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 veste…

Eligibility. 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, dental insurance plan and life insurance plan referred to in the Okla…

insured. No former employee who is reemployed by a participating entity within twenty-four (24) months after the date of termination of previous employment shall be enrolled in the Oklahoma Employees Insurance and Benefits Plan authorized by Sections 1301 through 1329.1 of this t…

2004.

attorneys, and other personnel - Service contracts. A. For purposes of administering the Oklahoma Employees Insurance and Benefits Act, the Chief Executive Officer (CEO) of the Oklahoma Health Care Authority is authorized to hire and appoint an Administrator who shall be in the u…

OS 74-1321v1 (SB 1310, Laws 2024, c. 123, § 5) OS 74-1321v2 (HB 2108, Laws 2025, c. 379, § 29)

A. The Oklahoma Health Care Authority shall have the authority to determine all rates and life, dental and health benefits for state-sponsored plans. All rates shall be compiled in a comprehensive Schedule of Benefits. The Schedule of Benefits shall be available for inspection du…

A. The 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 hour…

All information, documents, medical reports and copies thereof contained in a member's insurance file shall be treated as confidential information and shall not be released or made available or open to public inspection without the prior written consent and authorization of the i…

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 of this title, for the purpose of committing f…

related conditions. A. All health benefit plans that are offered by the 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…

The Oklahoma Health Care Authority shall schedule a hearing thirty (30) days prior to adopting any major change in the reimbursement rates or methodology. The Authority shall notify health care providers who provide services pursuant to a contract with the Authority at least fift…

The Oklahoma Health Care Authority shall make available, upon request, copies of relevant fee schedules to participating health care providers. Added by Laws 1999, c. 209, § 3, eff. July 1, 1999. Amended by Laws 2012, c. 304, § 970; Laws 2025, c. 379, § 33, eff. Nov. 1, 2025.

Authority — Optometrists to be permitted to provide services for vision care or medical diagnosis and treatment for the eye. A. All health benefit plans offered by the Oklahoma Health Care Authority which provide for services for vision care or medical diagnosis and treatment for…

A. The contracted claims administrator for the 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…