1 STATE OF OKLAHOMA
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2 2nd Session of the 59th Legislature (2024)
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3 SENATE BILL 1310 By: McCortney
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6 AS INTRODUCED
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7 An Act relating to state employee benefits; amending
7 74 O.S. 2021, Sections 1304.1, 1305.1, 1306.1,
8 1306.2, 1306.5, 1306.6, 1307.1, 1308.1, 1309, 1310.1,
8 1310.2, 1312, 1314.3, 1314.5, 1315, 1315.1, 1316.1,
9 1316.2, 1316.3, 1317, 1318, 1321, 1323, 1371, and
9 1374, which relate to the Oklahoma Employees
10 Insurance and Benefits Act; transferring certain
10 powers and duties to the Oklahoma Employees Insurance
11 and Benefits Board; directing implementation;
11 providing for certain state-offered plans to be
12 maintained within Office of Management and Enterprise
12 Services; modifying requirements of Board membership;
13 conforming language; modifying plan selection
13 requirements by Board; updating statutory language;
14 updating statutory references; providing an effective
14 date; and declaring an emergency.
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17 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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18 SECTION 1. AMENDATORY 74 O.S. 2021, Section 1304.1, is
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19 amended to read as follows:
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20 Section 1304.1. A. The State and Education Employees Group
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21 Insurance Board and the Oklahoma State Employees Benefits Council
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22 are hereby abolished. Wherever the State and Education Employees
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23 Group Insurance Board and the Oklahoma State Employees Benefits
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 1 Council are referenced in law, that reference shall be construed to
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2 mean the Oklahoma Employees Insurance and Benefits Board.
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3 B. 1. There is hereby created the Oklahoma Employees Insurance
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4 and Benefits Board. The Board shall have authority to administer
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5 and negotiate benefits plans pursuant to the Oklahoma Employees
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6 Insurance and Benefits Act. On and after the effective date of this
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7 act, all powers and duties existing within the Office of Management
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8 and Enterprise Services for the purposes described herein shall be
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9 transferred to the Board.
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10 2. The provisions of this act shall apply to the plan year
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11 beginning January 1, 2025.
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12 3. The Office shall provide staff and administrative support as
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13 needed to the Board. Any reference herein to staff members of the
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14 Board shall be construed as staff of the Office provided to the
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15 Board.
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16 4. The Office shall continue to offer and maintain the state-
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17 administered health insurance plan, life insurance plan, and dental
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18 benefits plan and shall be subject to the requirements of this act.
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19 C. The chair and vice-chair vice chair shall be elected by the
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20 Board members at the first meeting of the Board and shall preside
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21 over meetings of the Board and perform other duties as may be
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22 required by the Board. Upon the resignation or expiration of the
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23 term of the chair or vice-chair vice chair, the members shall elect
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 1 a chair or vice-chair vice chair. The Board shall elect one of its
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2 members to serve as secretary.
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3 D. The Board shall consist of seven (7) members to be appointed
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4 as follows:
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5 1. The State Insurance Commissioner, or designee;
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6 2. Four members shall be appointed by the Governor, one of whom
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7 shall be presently insured by a plan administered by the Board;
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8 3. One member shall be appointed by the Speaker of the Oklahoma
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9 House of Representatives; and
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10 4. One member shall be appointed by the President Pro Tempore
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11 of the State Senate.
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12 E. The appointed members shall All appointed members of the
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13 Board, except for the appointee who is presently insured as
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14 referenced in paragraph 2 of subsection D, shall:
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15 1. Have demonstrated professional experience in investment or
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16 funds management, public funds management, public or private group
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17 health or pension fund management, or group health insurance
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18 management;
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19 2. Be licensed to practice law in this state and have
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20 demonstrated professional experience in commercial matters; or
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21 3. Be licensed by the Oklahoma Accountancy Board to practice in
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22 this state as a public accountant or a certified public accountant.
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23 In making appointments that conform to the requirements of this
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24 subsection, at least one but not more than three members shall be
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 1 appointed each from paragraphs 2 and 3 of this subsection by the
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2 combined appointing authorities.
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3 F. Each member of the Board shall serve a term of four (4)
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4 years from the date of appointment.
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5 G. Members of the Board shall be subject to the following:
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6 1. The appointed members shall each receive compensation of
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7 Five Hundred Dollars ($500.00) per month. Appointed members who
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8 fail to attend a regularly scheduled meeting of the Board shall not
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9 receive the related compensation;
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10 2. The appointed members shall be reimbursed for their
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11 expenses, according to the State Travel Reimbursement Act, as are
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12 incurred in the performance of their duties, which shall be paid
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13 from the Health and Dental Insurance Reserve Fund;
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14 3. In the event an appointed member does not attend at least
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15 seventy-five percent (75%) of the regularly scheduled meetings of
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16 the Board during a calendar year, the appointing authority may
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17 remove the member;
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18 4. A member may also be removed for any other cause as provided
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19 by law;
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20 5. No Board member shall be individually or personally liable
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21 for any action of the Board; and
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22 6. Participation on the Board is contingent upon maintaining
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23 all necessary annual training as may be required through the Health
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24 Insurance Portability and Accountability Act of 1996, Medicare
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 1 contracting requirements or other statutory or regulatory
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2 guidelines.
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3 H. The Board shall meet as often as necessary to conduct
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4 business but shall meet no less than four times a year, with an
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5 organizational meeting to be held prior to December 1, 2012. The
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6 organizational meeting shall be called by the Insurance
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7 Commissioner. A majority of the members of the Board shall
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8 constitute a quorum for the transaction of business, and any
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9 official action of the Board must have a favorable vote by a
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10 majority of the members of the Board present.
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11 I. Except as otherwise provided in this subsection, no member
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12 of the Board shall be a lobbyist registered in this state as
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13 provided by law, or be employed directly or indirectly by any firm
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14 or health care provider under contract to the State and Education
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15 Employees Group Insurance Board, the Oklahoma State Employees
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16 Benefits Council, or the Oklahoma Employees Insurance and Benefits
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17 Board, or any benefit program under its jurisdiction, for any goods
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18 or services whatsoever. Any physician member of the Board shall not
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19 be subject to the provisions of this subsection.
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20 J. Any vacancy occurring on the Board shall be filled for the
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21 unexpired term of office in the same manner as provided for in
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22 subsection D of this section.
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 1 K. The Board shall act in accordance with the provisions of the
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2 Oklahoma Open Meeting Act, the Oklahoma Open Records Act and the
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3 Administrative Procedures Act.
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4 L. The Administrative Director of the Courts shall designate
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5 grievance panel members as shall be necessary. The members of the
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6 grievance panel shall consist of two attorneys licensed to practice
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7 law in this state and one state licensed state-licensed health care
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8 professional or health care administrator who has at least three (3)
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9 years years’ practical experience, has had or has admitting
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10 privileges to a hospital in this state, has a working knowledge of
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11 prescription medication, or has worked in an administrative capacity
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12 at some point in their career. The state health care professional
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13 shall be appointed by the Governor. At the Governor’s discretion,
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14 one or more qualified individuals may also be appointed as an
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15 alternate to serve on the grievance panel in the event the
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16 Governor’s primary appointee becomes unable to serve.
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17 M. The Office of Management and Enterprise Services Board shall
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18 have the following duties, responsibilities and authority with
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19 respect to the administration of the flexible benefits plan
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20 authorized pursuant to the State Employees Flexible Benefits Act:
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21 1. To construe and interpret the plan, and decide all questions
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22 of eligibility in accordance with the Oklahoma State Employees
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23 Benefits Act and 26 U.S.C.A., Section 1 et seq.;
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 1 2. To select those benefits which shall be made available to
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2 participants under the plan, according to the Oklahoma State
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3 Employees Benefits Act, and other applicable laws and rules;
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4 3. To prescribe procedures to be followed by participants in
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5 making elections and filing claims under the plan;
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6 4. Beginning with the plan year which begins on January 1,
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7 2013, to select and contract with one or more providers to offer a
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8 group TRICARE Supplement product to eligible employees who are
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9 eligible TRICARE beneficiaries. Any membership dues required to
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10 participate in a group TRICARE Supplement product offered pursuant
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11 to this paragraph shall be paid by the employee. As used in this
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12 paragraph, “TRICARE” means the Department of Defense health care
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13 program for active duty and retired service members and their
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14 families;
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15 5. To prepare and distribute information communicating and
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16 explaining the plan to participating employers and participants.
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17 Health Maintenance Organizations maintenance organizations (HMOs) or
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18 other third-party insurance vendors may be directly or indirectly
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19 involved in the distribution of communicated information to
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20 participating state agency employers and state employee participants
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21 subject to the following condition: the Board shall verify all
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22 marketing and communications information for factual accuracy prior
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23 to distribution;
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 1 6. To receive from participating employers and participants
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2 such information as shall be necessary for the proper administration
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3 of the plan, and any of the benefits offered thereunder;
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4 7. To furnish the participating employers and participants such
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5 annual reports with respect to the administration of the plan as are
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6 reasonable and appropriate;
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7 8. To keep reports of benefit elections, claims and
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8 disbursements for claims under the plan;
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9 9. To negotiate for best and final offer through competitive
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10 negotiation with the assistance and through the purchasing
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11 procedures adopted by the Office of Management and Enterprise
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12 Services and contract with federally qualified health maintenance
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13 organizations under the provisions of 42 U.S.C., Section 300e et
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14 seq., or with Health Maintenance Organizations health maintenance
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15 organizations granted a certificate of authority by the Insurance
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16 Commissioner pursuant to the Health Maintenance Reform Organization
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17 Act of 2003 for consideration by participants as an alternative to
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18 the health plans offered by the Oklahoma Employees Insurance and
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19 Benefits Board, and to transfer to the health maintenance
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20 organizations such funds as may be approved for a participant
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21 electing health maintenance organization alternative services. The
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22 Board may also select and contract with a vendor to offer a point-
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23 of-service plan. An HMO may offer coverage through a point-of-
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24 service plan, subject to the guidelines established by the Board.
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 1 However, if the Board chooses to offer a point-of-service plan, then
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2 a vendor that offers both an HMO plan and a point-of-service plan
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3 may choose to offer only its point-of-service plan in lieu of
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4 offering its HMO plan. The Board may, however, renegotiate rates
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5 with successful bidders after contracts have been awarded if there
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6 is an extraordinary circumstance. An extraordinary circumstance
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7 shall be limited to insolvency of a participating health maintenance
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8 organization or point-of-service plan, dissolution of a
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9 participating health maintenance organization or point-of-service
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10 plan or withdrawal of another participating health maintenance
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11 organization or point-of-service plan at any time during the
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12 calendar year. Nothing in this section of law shall be construed to
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13 permit either party to unilaterally alter the terms of the contract;
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14 10. To retain as confidential information the initial Request
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15 For Proposal request for proposal offers as well as any subsequent
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16 bid offers made by the health plans prior to final contract awards
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17 as a part of the best and final offer negotiations process for the
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18 benefit plan;
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19 11. To promulgate administrative rules for the competitive
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20 negotiation process;
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21 12. To require vendors offering coverage to provide such
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22 enrollment and claims data as is determined by the Board. The Board
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23 shall be authorized to retain as confidential any proprietary
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24 information submitted in response to the Board’s Request For
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 1 Proposal request for proposal. Provided, however, that any such
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2 information requested by the Board from the vendors shall only be
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3 subject to the confidentiality provision of this paragraph if it is
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4 clearly designated in the Request For Proposal request for proposal
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5 as being protected under this provision. All requested information
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6 lacking such a designation in the Request For Proposal request for
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7 proposal shall be subject to Section 24A.1 et seq. of Title 51 of
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8 the Oklahoma Statutes. From health maintenance organizations, data
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9 provided shall include the current Health Plan Employer Data and
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10 Information Set (HEDIS);
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11 13. To authorize the purchase of any insurance deemed necessary
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12 for providing benefits under the plan including indemnity dental
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13 plans, provided that the only indemnity health plan selected by the
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14 Board shall be the indemnity plan offered by the Board, and to
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15 transfer to the Board such funds as may be approved for a
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16 participant electing a benefit plan offered by the Board. All
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17 indemnity dental plans shall meet or exceed the following
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18 requirements:
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19 a. they shall have a statewide provider network,
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20 b. they shall provide benefits which shall reimburse the
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21 expense for the following types of dental procedures:
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22 (1) diagnostic,
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23 (2) preventative,
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24 (3) restorative,
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 1 (4) endodontic,
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2 (5) periodontic,
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3 (6) prosthodontics,
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4 (7) oral surgery,
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5 (8) dental implants,