reglab/housing_qa huggingface dataset:
74 OK Stat § 74-1305.2 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1305.2. Fiduciaries - Duties, powers and responsibilities.

|(1) A fiduciary with respect to the State and Education Employees Group Insurance Board shall not cause the Board to engage in a transaction if the fiduciary knows or should knowthat such transaction constitutes a direct or indirect: |(a) sale or exchange, or leasing of any property from the Board to a party in interest for less than adequate consideration or from a party in interest to the Board for more than adequate consideration;(b) lending of money or other extension of credit from the Board to a party in interest without the receipt of adequate security and a reasonable rate of interest, or from a party in interest to the Board with provision of excessive security or an unreasonably high rate of interest;(c) furnishing of goods, services or facilities from the Board to a party in interest for less than adequate consideration, or from a party in interest to the Board for more than adequate consideration; or(d) transfer to, or use by or for the benefit of, a party in interest of any assets of the Board for less than adequate consideration.(2) A fiduciary with respect to the Board shall not:(a) deal with the assets of the Board in the fiduciary's own interest or for the fiduciary's own account;(b) in the fiduciary's individual or any other capacity act in any transaction involving the Board on behalf of a party whose interests are adverse to the interests of the Board or the interests of its participants or beneficiaries; or(c) receive any consideration for the fiduciary's own personal account from any party dealing with the Board in connection with a transaction involving the assets of the Board.(3) A fiduciary with respect to the Board may:(a) invest all or part of the assets of the Board in deposits which bear a reasonable interest rate in a bank or similar financial institution supervised by the United States or a state, if such bank or other institution is a fiduciary of such plan; or(b) provide any ancillary service by a bank or similar financial institution supervised by the United States or a state, if such bank or other institution is a fiduciary of such plan.(4) A person or a financial institution is a fiduciary with respect to the Board to the extent that the person or the financial institution:(a) exercises any discretionary authority or discretionary control respecting management of the Board or exercises any authority or control respecting management or disposition of the assets of the Board;(b) renders investment advice for a fee or other compensation, direct or indirect, with respect to any monies or other property of the Board, or has any authority or responsibility to do so; or(c) has any discretionary authority or discretionary responsibility in the administration of the Board.Added by Laws 1989, c. 318, § 7, operative July 1, 1989.
74 OK Stat § 74-1306.1 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1306.1. Board - Right of subrogation in certain cases - Extent - Release of responsible party.

|A. The Office of Management and Enterprise Services 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 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 right of subrogation by releasing the responsible party prior to submitting claims to the Office, the claims may be denied by the Office. If claims are submitted and paid after the employee or dependent has released the responsible party, the Office 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 including, but not limited to: interest, administrative and adjudicative costs, and attorney fees.Added by Laws 1990, c. 244, § 4, emerg. eff. May 21, 1990. Amended by Laws 2012, c. 304, § 937.
74 OK Stat § 74-1306.2 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1306.2. Information regarding utilization review - Submission to Commissioner.

|A. The Director of the Office of Management and Enterprise Services shall submit to the Insurance Commissioner the following information regarding utilization review performed by employees of the Office: |1. A utilization review plan that includes:a.an adequate summary description of review standards, protocol and procedures to be used in evaluating proposed or delivered hospital and medical care,b.assurances that the standards and criteria to be applied in review determinations are established with input from health care providers representing major areas of specialty and certified by the boards of the various American medical specialties, andc.the provisions by which patients or health care providers may seek reconsideration or appeal of adverse decisions concerning requests for medical evaluation, treatment or procedures;2. The type and qualifications of the personnel either employed or under contract to perform the utilization review;3. The procedures and policies to ensure that an employee of the Office is reasonably accessible to patients and health care providers five (5) days a week during normal business hours, such procedures and policies to include as a requirement a toll-free telephone number to be available during said business hours;4. The policies and procedures to ensure that all applicable state and federal laws to protect the confidentiality of individual medical records are followed;5. The policies and procedures to verify the identity and authority of personnel performing utilization review by telephone;6. A copy of the materials designed to inform applicable patients and health care providers of the requirements of the utilization review plan;7. The procedures for receiving and handling complaints by patients, hospitals and health care providers concerning utilization review; and8. Procedures to ensure that after a request for medical evaluation, treatment, or procedures has been rejected in whole or in part and in the event a copy of the report on said rejection is requested, a copy of the report of the personnel performing utilization review concerning the rejection shall be mailed by the insurer, postage prepaid, to the ill or injured person, the treating health care provider, hospital or to the person financially responsible for the patient's bill within fifteen (15) days after receipt of the request for the report.B. The Office shall pay an annual fee to the Insurance Commissioner of Five Hundred Dollars ($500.00).Added by Laws 1991, c. 294, § 17, eff. Nov. 1, 1991. Amended by Laws 2012, c. 304, § 938.
74 OK Stat § 74-1306.5 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1306.5. Amendment of network provider facility or physician 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 Office of Management and Enterprise Services and the facility or physician. |Added by Laws 2002, c. 198, § 1, eff. July 1, 2002. Amended by Laws 2012, c. 304, § 939.
74 OK Stat § 74-1306.6 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1306.6. Administration of Medical Expense Liability Revolving Fund.

|The Director of the Office of Management and Enterprise Services, 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 personnel to carry out the duties of the fund. |Added by Laws 2003, c. 319, § 6. Amended by Laws 2012, c. 304, § 940.
74 OK Stat § 74-1307 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1307. Specifications - Limitations on benefits - Exceptions.

|A. The specifications drawn by the Office of Management and Enterprise Services 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 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 may contract with providers for specific services based on levels of outcomes defined by the Office and achieved by the provider. The 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 shall include Accidental Death and Dismemberment Benefits and additional optional life insurance coverage.Added by Laws 1967, c. 374, § 7, emerg. eff. May 23, 1967. Amended by Laws 1970, c. 70, § 6, emerg. eff. March 17, 1970; Laws 1977, c. 261, § 6, emerg. eff. June 17, 1977; Laws 1982, c. 333, § 6, emerg. eff. June 1, 1982; Laws 1990, c. 244, § 5, emerg. eff. May 21, 1990; Laws 1991, c. 171, § 1, eff. July 1, 1991; Laws 2011, c. 326, § 1, eff. Nov. 1, 2011; Laws 2012, c. 304, § 941; Laws 2015, c. 58, § 1, eff. Nov. 1, 2015.
74 OK Stat § 74-1307.1 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1307.1. Change of primary care physician within HMO.

|No employee or dependent who participates in an 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 or state agency. |Added by Laws 1988, c. 199, § 3, emerg. eff. June 9, 1988. Amended by Laws 2001, c. 197, § 2, emerg. eff. May 7, 2001; Laws 2012, c. 304, § 942.
74 OK Stat § 74-1307.2 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1307.2. Diabetes treatment - Equipment, supplies and services.

|On and after November 1, 1996, the Office of Management and Enterprise Services 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. |Added by Laws 1996, c. 125, § 2, eff. Nov. 1, 1996. Amended by Laws 2012, c. 304, § 943.
74 OK Stat § 74-1307.3 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1307.3. Payment for services provided by out-of-state providers.

|Unless the Office of Management and Enterprise Services has otherwise contracted with an out-of-state provider, the Office 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. |Added by Laws 1998, c. 312, § 1, eff. July 1, 1998. Amended by Laws 2001, c. 68, § 2, eff. July 1, 2001; Laws 2012, c. 304, § 944.
74 OK Stat § 74-1308 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1308. Enrollment in Plan.

|(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 shall be advised of Health Maintenance Organization prepaid plans available as an alternative to the state self-insured Health Insurance Plan. The Office of Management and Enterprise Services shall establish the procedure by which eligible employees not electing to be enrolled initially in the Health Insurance Plan, Dental Insurance Plan or Life Insurance Plan may be subsequently enrolled. |(2) Any eligible employee who is employed after the effective dates of the Health Insurance Plan, Dental Insurance Plan and Life Insurance Plan or HMO plans approved by the Office may become enrolled on the first day of the second month of employment.Added by Laws 1967, c. 374, § 8, emerg. eff. May 23, 1967. Amended by Laws 1970, c. 70, § 7, emerg. eff. March 17, 1970; Laws 1977, c. 261, § 7, emerg. eff. June 17, 1977; Laws 1982, c. 333, § 7, emerg. eff. June 1, 1982; Laws 1985, c. 230, § 4, emerg. eff. July 8, 1985; Laws 1988, c. 165, § 7, operative July 1, 1988; Laws 2001, c. 197, § 3, emerg. eff. May 7, 2001; Laws 2004, c. 345, § 3, eff. July 1, 2004; Laws 2012, c. 304, § 945.
74 OK Stat § 74-1308.2 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1308.2. Persons not subject to preexisting condition exclusion.

|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 eligible to use military medical facilities, or was eligible to use Indian health services medical facilities. |Added by Laws 1989, c. 322, § 5, emerg. eff. May 26, 1989.
74 OK Stat § 74-1308.3 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1308.3. Basic health plan – Opting out.

|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, provided that the participant is currently covered by a separate group health insurance plan or will be covered by a separate group health insurance plan at or before the beginning of the next plan year. Any active employee eligible to participate or who is a participant opting out of coverage pursuant to this section shall provide proof of the separate health insurance plan participation and sign an affidavit attesting that the participant is currently covered and does not require state-provided health insurance each plan year. Any active employee opting out of the state's basic plan or the health and dental basic plan options pursuant to this section shall receive One Hundred Fifty Dollars ($150.00) in lieu of the flexible benefit amount the employee would be otherwise eligible to receive. Any savings realized by the state as a result of a participant opting out of health insurance plan coverage shall be retained by the state. |Added by Laws 2011, c. 326, § 2, eff. Nov. 1, 2011. Amended by Laws 2012, c. 352, § 1, eff. Nov. 1, 2012; Laws 2013, c. 266, § 3, eff. Nov. 1, 2013.
74 OK Stat § 74-1309 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1309. Dependents.

|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 Office of Management and Enterprise Services. 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 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. Such subsequent election of dependent coverage shall be made under such conditions as the Office 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 and 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 and Dental Insurance Plan or approved HMO plans, under procedures established by the Office.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.Added by Laws 1967, c. 374, § 9, emerg. eff. May 23, 1967. Amended by Laws 1982, c. 333, § 8, emerg. eff. June 1, 1982; Laws 1985, c. 230, § 5, emerg. eff. July 8, 1985; Laws 1999, c. 339, § 2, eff. July 1, 1999; Laws 2001, c. 197, § 4, emerg. eff. May 7, 2001; Laws 2012, c. 304, § 947.
74 OK Stat § 74-1309.1 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1309.1. Coverage for dependents up to age of 25.

|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: Laws 2008, c. 344, § 12 repealed by Laws 2009, c. 2, § 37, emerg. eff. March 12, 2009.
74 OK Stat § 74-1310 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1310. Payment to funds.

|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 education employees per month enrolled in said Plans, from funds appropriated to said agency or from other funds available to such agency for operational purposes. |B. During the fiscal year ending June 30, 1997, each state agency participating in the Insurance Plans shall appropriate and pay to the State Employees Group Insurance Clearing Fund an amount to be set by the Board for each employee other than education employees per month enrolled in said Plans, from funds appropriated to said agency or from other funds available to such agency for operational purposes.Added by Laws 1967, c. 374, § 10, emerg. eff. May 23, 1967. Amended by Laws 1969, c. 71, § 1, emerg. eff. July 1, 1969; Laws 1970, c. 70, § 8, emerg. eff. March 17, 1970; Laws 1982, c. 333, § 9, emerg. eff. June 1, 1982; Laws 1986, c. 150, § 5, emerg. eff. April 29, 1986; Laws 1988, c. 165, § 9, operative July 1, 1988; Laws 1989, c. 318, § 8, operative July 1, 1989; Laws 1991, c. 263, § 8, operative July 1, 1991; Laws 1996, c. 275, § 1, eff. Sept. 1, 1996; Laws 2012, c. 304, § 948.
74 OK Stat § 74-1310.1 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1310.1. Certified employees - Payment of health and dental 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 Office of Management and Enterprise Services 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. |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 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 prior to the month for which payment is due.Added by Laws 1988, c. 165, § 10, operative July 1, 1988. Amended by Laws 1998, c. 380, § 10, emerg. eff. June 9, 1998; Laws 2002, c. 282, § 4, eff. July 1, 2002; Laws 2003, c. 415, § 33, eff. July 1, 2003; Laws 2004, c. 373, § 1, eff. July 1, 2004; Laws 2012, c. 321, § 2, eff. July 1, 2012; Laws 2013, c. 15, § 115, emerg. eff. April 8, 2013.NOTE: Laws 2012, c. 304, § 949 repealed by Laws 2013, c. 15, § 116, emerg. eff. April 8, 2013.
74 OK Stat § 74-1310.2 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1310.2. Health care coverage under school district plan - Cost 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 Oklahoma Statutes, if such 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 or a self-insured plan offered by the school district. |Added by Laws 2002, c. 418, § 3, eff. July 1, 2002. Amended by Laws 2012, c. 304, § 950.
74 OK Stat § 74-1311 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1311. Payroll deductions.

|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 Office of Management and Enterprise Services. The procedure for such deductions and remittances shall be established by the Director. |Added by Laws 1967, c. 374, § 11, emerg. eff. May 23, 1967. Amended by Laws 1970, c. 70, § 9, emerg. eff. March 17, 1970; Laws 1982, c. 333, § 10, emerg. eff. June 1, 1982; Laws 1986, c. 150, § 6, emerg. eff. April 29, 1986; Laws 2012, c. 304, § 951.
74 OK Stat § 74-1311.1 (2021)
2021 Oklahoma Statutes|Title 74. State Government|§74-1311.1. Deduction of contributions from monthly disability 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 Office of Management and Enterprise Services. The procedures for such deductions and remittances shall be established by the Office. |Added by Laws 1986, c. 150, § 7, emerg. eff. April 29, 1986. Amended by Laws 2012, c. 304, § 952.