Oklahoma Administrative Code › Title 260 - Office of Management and Enterprise Services › Chapter 40 - Employee Benefits Department › Subchapter 37 - Competitive Bidding Criteria and Procedures for Contracts Awarded for Flexible Benefits Plans › Section 260:40-37-10 - Excessive Price

Current through Vol. 41, No. 20, July 1, 2024
(a) The EBD shall
				have the authority to reject the bid, or to restrict enrollment in any benefits
				plan, for which the EBD determines the benefit price to be excessive. The EBD
				shall have the authority to reject any plan that does not meet the bid
				requirements. One way to restrict enrollment is to freeze enrollment in the
				plan's membership as determined to be in the best interests of the State and
				the members.
(b) Factors considered
				by the EBD in determining excessive price may include, but are not limited to
				utilization data and loss ratios on the State group business, a comparison to
				other carriers proposed prices and/or other employers' plans and prices,
				actuarial analyses or underwriting principles. The EBD may at its discretion,
				solicit a multi-part RFP which shall be designated as such. As a condition to
				be eligible to bid on Part II of the RFP, the EBD shall require Bidders to
				provide information requested in Part I of the RFP. In the event a Bidder fails
				to provide the information in Part I of the RFP, the EBD shall not consider the
				Bidder's response to the Part II of the RFP. The EBD shall retain as
				confidential, any proprietary information submitted by a Bidder pursuant to
				this paragraph.
(c) Each year, the
				EBD shall specify in the RFP issued by the EBD all excessive price factors that
				shall be considered by the EBD for that year's selection of benefit plan
				options. Benefits plans that bid on the RFP are deemed by the EBD to have read
				and accepted all excessive price factors contained in the RFP.
(d) Although the EBD shall have the authority
				to reject the bid, or to restrict enrollment in any benefits plan, for which
				the EBD determines the benefit price to be excessive, the EBD shall have no
				duty to do so. Despite the fact that the EBD may determine the benefit price to
				be excessive, the EBD nevertheless may choose not to reject the bid or restrict
				enrollment for reasons the EBD determines at that time to be in the best
				interests of the State and the members. The determining reasons will include,
				coverage areas where the number of other benefits plans are limited; total
				number of benefits plans offered; provider networks; employee participation
				displacement; uniformity of choices for all eligible employee groups; and
				premiums charged by competing plans.
(e) The particular factors that are specified
				in the RFP issued by the EBD for determining excessive price may vary from year
				to year. The specification of particular factors in prior year(s) shall serve
				as no precedent of the factors that may be specified in subsequent year(s).
				Similarly, the failure of the EBD in prior year(s) to reject a bid or restrict
				enrollment in any benefits plan for which the EBD determines the benefit price
				to be excessive, shall serve as no precedent as to the action the EBD may take
				in subsequent year(s).