The
Oklahoma State and Education Employees Group Insurance Board
For Plan Year January
1 through December 31, 2009
Audio
CDs and CD versions for PC of the handbooks have been prepared and are
available at the Oklahoma Library for the Blind and Physically Handicapped
(OLBPH). Contact the OLBPH at 1-405-521-3514 or toll-free 1-800-523-0288. TDD
users call 1-405-521-4672.
Plan Identification
Information and Notice
Outline of HealthChoice Life Plan
Benefits
Summary Schedule of Basic and Supplemental
Life Benefits
Summary Schedule of Dependent Life
Benefits
Summary Schedule of Accidental Death
and Dismemberment Benefits
Benefit Guidelines,
Exclusions, and Limitations
Changes to Coverage After Initial Enrollment
Surviving Dependents’
Right to Continue Life Insurance Coverage
Revised
January 2009
HealthChoice
Term Life Insurance Plan
Oklahoma
State and Education Employees Group Insurance Board (OSEEGIB)
3545
NW 58th Street, Ste 110
Oklahoma
City, OK 73112
1-405-717-8701
or toll-free 1-800-543-6044
Member
Services and Provider Directory
1-405-717-8780
or toll-free 1-800-752-9475
TDD:
1-405-949-2281 or toll-free 1-866-447-0436
Fax:
1-405-717-8942
Website:
www.sib.ok.gov or www.healthchoiceok.com
EDS
Administrative Services, LLC
Correspondence,
Claim Filing, and Claim Review Address
PO
Box 24870
Oklahoma
City, OK 73124-0870
1-405-416-1800
or toll-free 1-800-782-5218
TDD:
1-405-416-1525 or toll-free 1-800-941-2160
The
Oklahoma State and Education Employees Group Insurance Board (OSEEGIB) provides
dental benefits to eligible state, education, and local government employees,
former employees, survivors, and their dependents in accordance with the
provisions of Oklahoma Statutes, Title 74, Sections 1301, et seq. The
information provided in this handbook is a summary of the benefits, conditions,
limitations, and exclusions of the HealthChoice Dental Plan. It should not be
considered an all-inclusive listing.
OSEEGIB
Plan benefits are subject to conditions, limitations, and exclusions. These
conditions, limitations, and exclusions are described and located in Oklahoma
Statutes, OSEEGIB Rules, and Administrative Procedures adopted by the Plan
Administrator. You may obtain a copy of the official OSEEGIB Rules from the
Office of the Oklahoma Secretary of State. A copy of the Administrative
Procedures may be obtained from the OSEEGIB.
PLEASE
READ THIS HANDBOOK CAREFULLY
A
dispute concerning information contained within any OSEEGIB handbook or any
other written materials, including any letters, bulletins, notices, or other
written document, or oral communication, regardless of the source, shall be
resolved by a strict application of OSEEGIB Rules or benefit administration
procedures and guidelines as adopted by the Plan. Erroneous, incorrect,
misleading, or obsolete language contained within any handbook, other written
document, or oral communication, regardless of the source, is of no effect
under any circumstance.
This
life insurance handbook replaces and supersedes any life insurance handbook
previously issued to you. This life insurance handbook will in turn be
superseded by any subsequent life handbook issued to you by OSEEGIB.
OSEEGIB
offers eligible current employees of participating employers a $20,000 basic
term life policy, called Basic Life. An additional supplemental term life
policy, called Supplemental Life, is available if you need more coverage. By
enrolling in Supplemental Life, you can purchase additional coverage on
yourself in $20,000 increments. The maximum amount of coverage available Is
$300,000 or five times your current annual salary, whichever is less.
Both
Basic Life and Supplemental Life provide you up to $20,000 of Accidental Death
and Dismemberment coverage as part of the policy.
Your
life benefits also include a Waiver of Premium for all life coverage in force
should you become disabled and remain disabled for longer than 30 days. Refer
to Waiver of Premium section for
additional information.
If
you elect Basic Life for yourself, you also have the option of electing
dependent life coverage for your spouse and eligible dependent children. There
are three levels of dependent coverage available. Refer to the Summary
Schedule of Dependent Life Benefits section for additional information.
If
you meet eligibility requirements, you may keep any portion of life insurance
coverage in effect when you terminate employment; however, coverage for former
employees does not include Accidental Death and Dismemberment benefits or
Waiver of Premium.
The
Basic Life benefit amount is $20,000. This amount will be paid to your
beneficiary, or beneficiaries in the event of your death. Basic Life coverage
includes Accidental Death and Dismemberment benefits and Waiver of Premium.
Refer to the Accidental Death and Dismemberment
Benefits
and Waiver of Premium sections for more information.
Guaranteed
Issue refers to the set amount of Supplemental Life coverage that is available
to you during your initial enrollment without providing a Life Insurance
Application. This amount is available to you only during the first 30 days you
are eligible to enroll in the Plan. Guaranteed Issue is equal to two times your
current annual salary, with the total rounded up to the next $20,000 increment.
Coverage elected during the initial offering, up to the Guaranteed Issue amount,
is effective on the first day of the month following the day you become
eligible.
Example
– Your salary is $23,000. Multiply $23,000 by 2, which equals $46,000, then
round this amount up to the next amount divisible by $20,000, or $60,000. This
is the maximum Guaranteed Issue amount.
All
coverage above Guaranteed Issue, and any coverage purchased after the initial
enrollment period, require you to provide a Life Insurance Application, which
is subject to approval. Supplemental Life coverage above the Guaranteed Issue
will be effective the first day of the month following approval of your Life
Insurance Application. Refer to the Changes to Coverage section for details.
If
you enroll in Basic Life, you may also enroll in Supplemental Life.
Supplemental
Life coverage must be purchased in $20,000 increments and is subject to an
approved Life Insurance Application.
The
first $20,000 of Supplemental Life includes Accidental Death and Dismemberment
benefits.
Supplemental
Life benefits are in addition to the $20,000 that you have through Basic Life.
The
maximum amount of coverage available is the lesser of
$300,000, or
Five times your current annual salary. This
amount is rounded up to the next $20,000 increment.
An
example of how to arrive at the maximum life insurance benefit based on your
salary follows.
Example
– Your salary is $23,000. Multiply $23,000 by five, which is $115,000. Then
round this amount up to the next amount of Supplemental Life coverage available
to you ($60,000 Guaranteed Issue plus $60,000 additional Supplemental Life).
If
you do not elect life insurance coverage during the initial enrollment, you may
apply for coverage during the annual Option Period. Your Life Insurance
Application must be approved before coverage is effective.
If
you meet eligibility requirements, you may keep any life insurance coverage in
effect when you terminate employment. Former employees can keep or reduce
benefits in $5,000 increments. You may keep as little as $5,000 to the full
amount of the life coverage you had at the time you ended employment.
Coverage
for former employees does not include Accidental Death and Dismemberment
benefits or Waiver of Premium.
Any
life coverage you elect at termination of employment may later be decreased in
$5,000 increments or canceled.
Example
– At retirement, you elect to keep $30,000 of life coverage. At a later date,
you may choose to decrease your coverage to $25,000 or $20,000 or any other
$5,000 increment, or you could cancel coverage entirely.
You
cannot reinstate any coverage that you have canceled unless you return to work
with a participating employer and meet all eligibility requirements. Refer to
the Reinstatement of Coverage section.
Note
– Prior to July, 1, 2002, no more than $15,000 of Basic Life insurance coverage
could be kept after termination of employment.
If
you enrolled in Basic Life, you also have the option to elect dependent life
insurance for your eligible dependents. There are three levels of coverage from
which to choose – Low Option, Standard Option, or Premier Option. The amounts
of Dependent Life coverage are
For a covered spouse - $6,000
For a covered child age 6 months to 25 years
- $3,000
For a covered child from live birth to age 6
months - $1,000*
For a covered spouse - $10,000
For a covered child age 6 months to 25 years
- $5,000
For a covered child from live birth to age 6
months - $1,000*
For a covered spouse - $20,000
For a covered child age 6 months to 25 years
- $10,000
For a covered child from live birth to age 6
months - $1,000*
*There
are no benefits payable for stillborn children.
Accidental
Death and Dismemberment benefits and Waiver of Premium do not apply to Dependent
Life coverage.
During
your initial enrollment, you may elect any level of Dependent Life. Thereafter,
coverage may only be added or changed during the annual Option Period or within
30 days of a dependent losing other group life insurance coverage.
A
Life Insurance Application is not required to add dependent life insurance.
Dependent
Life covers all eligible dependents. The premium cost is the same whether you
have one dependent or several; however, you must name all the dependents to be
covered.
Note
– Eligible dependent children may be covered by more than one parent if both
parents are enrolled in Basic Life.
If
you are eligible to keep life insurance coverage following your termination of
employment, you may also keep any Dependent Life coverage in force on eligible
dependents in $500 increments.
Be
aware that dependent life insurance premiums for former employees are per
covered dependent.
Dependent
Life coverage does not include Accidental Death and Dismemberment benefits or Waiver
of Premium.
Basic
Life and the first $20,000 of Supplemental Life include Accidental Death and Dismemberment
- AD&D – coverage.
Accidental
Death and Dismemberment benefits are available only to current employees and
the benefits are –
With Basic Life $20,000
With Supplemental Life $20,000
With Basic Life $20,000
With Supplemental Life $20,000
With Basic Life $10,000
With Supplemental Life $10,000
Benefits
for loss of life as a result of an accident require that the insured’s death
occur at the time of, or within 90 days immediately following the date of the
accident. The insured’s death must be the direct result of the accident.
An
employee with $20,000 Basic Life and the first $20,000 Supplemental Life is
involved in a serious car accident and later dies.
If the employee dies within 15 days of the
accident and death is a result of injuries caused by the accident, the
beneficiaries would receive $80,000. The standard benefit would be $40,000 and
the Accidental Death benefit would be $40,000.
If the employee dies 97 days following the
accident, even if death is a result of injuries caused by the accident, the
beneficiaries would receive $40,000. The beneficiaries would receive only the
standard benefit because the death occurred after the 90-day limit for AD&D
benefits.
If the employee suffers a heart attack and
dies 36 days following the accident and the heart attack was not caused by the
accident, the beneficiaries would receive $40,000. The beneficiaries would
receive only the standard benefit because the employee’s death was not a direct
result of the accident.
Loss
of limb means severance of the limb from the body, at or above the wrist or at
or above the ankle, at the time of or within 90 days immediately following the
date of the accident.
Loss
of sight means full, irreversible, and non-correctable loss of sight at the
time of or within 90 days immediately following the date of the accident.
An
employee with Basic Life coverage is involved in an accident and loses a hand.
The accidental dismemberment benefit will pay $10,000. If the employee is also
enrolled in Supplemental Life, additional benefits of $10,000 will be paid. The
accidental dismemberment benefit pays per loss, as described previously.
Some
limitations may apply. Refer to the Benefit Guidelines, Exclusions, and Limitations section.
Accidental
Death and Dismemberment benefits are not available to former employees or their
dependents.
Your
coverage includes a Waiver of Premium benefit if you become disabled. You must
provide a physician’s certification of your disability and submit an
Application for Life Premium Waiver. The waiver can be requested at any time
after you have been disabled for 30 consecutive days and if approved, will
become effective the first of the month following receipt of the application by
OSEEGIB. Your waiver ends when you are no longer disabled, return to duty,
terminate employment, or your employer ceases to participate in the
HealthChoice Life Insurance Plan. While the waiver is in effect, you are not
required to pay premiums for your life insurance coverage. Waiver of Premium
never applies retroactively.
Waiver
of Premium is not applicable to dependents.
Waiver
of Premium is not available to former employees or their dependents.
There
are no benefits payable under the Life Insurance Plan during the first 24
months of coverage when death is the result of suicide. The 24-month exclusion
period will apply to any additional increases in life coverage, but will not
affect any coverage that has been in force longer than 24 months.
There
are no benefits for Accidental Death and Dismemberment as the result of –
Suicide, attempted suicide, intentional
self-destruction, or intentional self-inflicted injury while sane or insane
Committing an assault or felony, including
participation as an aggressor in a riot or insurrection
Wholly or partly, directly or indirectly, by
disease, physical or mental, or by medical or surgical treatment, or the
diagnosis of any of the above
Wholly or partly, directly or indirectly, by
bacterial infection, other than septic infection, other than septic infection
of and through a visible wound, sustained solely through external and
accidental means
Any narcotic, drug, poison, gas, or fumes, voluntarily
taken, administered, absorbed, or inhaled, unless prescribed for the exclusive
use of the deceased, or administered by a licensed provider for a legal purpose
Hang gliding, sky diving, or flying
experimental aircraft
In
the event of your death, benefits will be paid to your beneficiaries in a lump
sum. It is important that you name your beneficiaries when you enroll and keep
your beneficiaries up to date. You may change your beneficiaries at any time,
but you must file a written request for a change. Beneficiary forms can be
obtained from your employer, OSEEGIB, or from our website at www.sib.ok.gov/ or www.healthchoiceok.com. If no beneficiary is listed,
proceeds will be paid to your estate.
Members
should be aware that HealthChoice has no option but to pay life proceeds to the
beneficiaries listed in our files as of the date of death.
Proceeds
for Dependent Life coverage are always paid to the primary member.
The
Life Insurance Claim Form can be obtained by calling the life claims
administrator. Mail claim forms, and an original or certified copy of the Death
Certificate to the life claims administrator. Refer to the Plan Identification Information and Notice section.
Claims
must be received no later than the last day of the calendar year following the year
the claim was incurred.
Exceptions
to this rule can be made when it can be shown that it was not reasonably
possible to furnish proof of loss within the specified time and that the proof
was furnished as soon as reasonably possible.
If
a claim is denied in whole or in part for any reason, beneficiaries have the
right to have that claim reviewed.
Requests
for review of a denied claim, along with any appropriate additional
information, must be submitted in writing to the life claims administrator.
Refer to the Plan Identification
Information and Notice section.
If
your claim remains denied after a claims review, that decision may be appealed
to the Grievance Panel by contacting
The
Legal Grievance Department
3545
NW 58th Street, Suite 110
Oklahoma
City, OK 73112
Or
call 1-405-717-8701 or toll-free 1-800-543-6044
TDD
users call 1-405-949-2281 or toll-free 1-866-447-0436
The
Grievance Panel is an independent review group established by statute – 74 O.S.
Section 1306-6.
Beneficiaries
may submit a request for a Grievance Panel hearing and represent themselves in
these proceedings. Otherwise, only attorneys licensed to practice in Oklahoma
are permitted to submit a hearing request on behalf of individuals or represent
them through the hearing process - 75 O.S. Section 310-5.
All
claim reviews and final decisions of the Grievance Panel are made as quickly as
possible. After exhausting the claim review and grievance procedures, an appeal
may be pursued in Oklahoma District Court.
Upon
receipt of a claim for life benefits, the plan will confirm the accuracy of the
information on which the policy was issued. In cases where insurance coverage
was obtained by false information, premiums for coverage above Guaranteed Issue
will be refunded. Coverage will be reduced to the maximum amount for which the member
was eligible under Guaranteed Issue.
If
the age of the insured has been misstated, the value of coverage and all plan
benefits will be equal to the coverage that paid premiums would have purchased
had the age been correctly stated.
Any
legal action to recover under this Plan must be brought pursuant to the
Administrative Procedures Act. Any action must be brought within three years
from the claim filing deadline.
Any
life insurance premiums due and payable at the time of the member’s death may
be withheld from life insurance benefits.
To
be eligible to elect Basic Life coverage, you must be
Working for a participating employer
Receiving compensation for services rendered
Listed on the employer’s payroll
Enrolled in one of the health plans offered
through OSEEGIB or have other verifiable group health coverage
State
and local government employees must be employed in a position requiring a
minimum of 1,000 hours per year and not classified as a temporary or seasonal
employee.
Education
employees must be eligible to participate in the Oklahoma Teachers’ Retirement
System and work a minimum of four hours per day or 20 hours per week.
Other
persons elected by popular vote – state and local government, board members of
education employers, rural water district board members, and county election
board secretaries.
Note
– Eligible board members that do not draw a salary are limited to $20,000 Basic
Life and $20,000 Supplemental Life coverage.
If
you declined member or dependent life coverage in the Plan because of other
group life coverage, you may request coverage within 30 days of your loss of
other group life coverage. You may enroll in the same amount of coverage you
lost, rounded up to the next $20,000 increment, without a Life Insurance
Application; however, you must provide proof of loss.
If
you terminate employment with a participating employer, you may keep all or a
portion of the life coverage in effect at the time of your termination, if you
qualify under one of the following conditions –
You have a vesting or retirement right through
one of the State of Oklahoma retirement systems
You have rights to temporary continuation of
insurance coverage as a result of termination of employment through a Reduction
in Force in accordance with state statute
You are currently drawing disability
benefits through the disability plan provided through OSEEGIB, or meet every
requirement of the disability program
Your employer participates with both OSEEGIB
and the Oklahoma Public Employees Retirement System – OPERS, and you have
completed eight years of service with your employer but do not have a vesting
right
Your employer participates with both OSEEGIB
and the Oklahoma Teachers’ Retirement System – TRS, and you have completed ten
years of service with your employer but do not have a vesting right; this
includes elected school board members
Your employer is a local government entity
participating with OSEEGIB but not with the Oklahoma Public Employees
Retirement System – OPERS, and you have a minimum of eight years of service
with the employer
Your employer is an educational entity
participating with OSEEGIB but not with the Oklahoma Teachers’ Retirement
System – TRS, and you have a minimum of ten years of service with the employer
Your
former employer must continue to participate in the Plan in order for you to
continue coverage.
If
you were a career tech employee or a common school employee who terminated
active employment on or after May 1, 1993, you may continue coverage through
the Plan as long as the school system from which you retired or vested
continues to participate in the Plan. If your school system terminates coverage
under the Plan, you must follow your school system to its new insurance
carrier.
If
you were an employee of an education entity other than a common school – e.g.,
higher education, charter school, etc., you may continue coverage through the
Plan as long as the education entity from which you retired or vested continues
to participate in the Plan. There is no grandfathered date for this type of
entity, so if your employer terminates coverage with the Plan, you must follow
your former employer to its new insurance carrier regardless of the date you
terminated active employment.
If
you were a local government employee who terminated active employment on or
after January 1, 2002, you may continue coverage through the Plan as long as
the employer from which you retired or vested continues to participate in the
Plan. Otherwise, if your local government entity terminates coverage with the
Plan, you must follow your former employer to its new insurance carrier.
Note
– You cannot reinstate coverage that you discontinue or allow to lapse unless
you return to work as an employee of a participating employer and maintain that
coverage for three years. Some reinstatement exceptions may apply if you are a
state employee who terminated employment as a result of a Reduction in Force –
RIF.
For
any group that joins the Plan after the grandfathered dates specified above,
all members, including current and former employees, must follow the group to
the new insurance carrier.
There
can be no break in coverage. Your election to keep coverage must be made within
30 calendar days following your termination of employment. If you do not elect
benefits within 30 days, you will not have a future opportunity to elect
coverage.
After
your initial enrollment, you may make additions to life coverage only during
the annual Option Period or within 30 days of the loss of other group life
coverage. Any increase in coverage, or reinstatement of coverage previously
canceled, requires an approved Life Insurance Application.
Upon
approval, you may increase your coverage until it reaches the maximum amount of
coverage available to you.
Any
decrease in coverage must be made during the annual Option Period unless
otherwise specified by your employer.
All
increase or decreases to coverage must be made in $20,000 increments.
Increasing
your coverage is not possible. Decreases to coverage, or elimination of
coverage, can be made during the annual Option Period by submitting the
appropriate forms. Decreases to coverage must be made in $5,000 increments.
Decreases to dependent coverage must be made in $500 increments.
At
retirement, a former employee kept life insurance coverage in the amount of
$30,000. At Option Period, he decides to decrease his coverage to $15,000. The
decrease equals three $5,000 units for a total of $15,000.
Note
– If you are in the process of a legal separation or divorce, it is important
you contact your legal representative for advice before making any changes to
your coverage.
Under
the Uniform Services Employment and Re-employment Rights Act of 1994 (USERRA),
coverage can be continued for up to 24 months. USERRA provides certain rights
and protections for all employees called to serve our nation. All branches of
the military, including the Army, Navy, Marines, Air Force, Coast Guard, all
Military Reserve units, and all National Guard units come under USERRA.
In
addition to health care provided by the military, you have the following three
choices regarding your current coverage.
1.
Keep all coverage. Your current employer is responsible for collecting and
forwarding all premiums to OSEEGIB.
2.
Discontinue all coverage except life insurance. You will be billed directly.
3.
Discontinue all member and dependent coverage.
Regardless
of whether you receive written or verbal military orders, the OSEEGIB staff
and/or your Insurance/Benefits coordinator will assist you in making any
benefits arrangements.
There
is no penalty for renewing coverage upon discharge from active duty if coverage
is elected within 30 days of the return to the same employment.
If
you are a member of a Military Reserve unit or the National Guard and
anticipate being called to active service, notify your Insurance/Benefits
Coordinator at work.
Your
coverage, as well as any dependent life coverage in force, will end the last
day of the month in which any one of the following events takes place.
1.
You terminate employment and do not continue coverage as a former employee.
2.
The Plan is terminated or your employer ceases to participate in the Plan.
3.
You fail to make premium payments. Coverage will end the last day of the month
for which premiums were paid.
Dependent
life coverage ends on the last day of the month in which your dependent becomes
ineligible for coverage.
When
a primary member who has dependent life insurance dies, a surviving spouse
and/or surviving dependent children may continue dependent life coverage. A
surviving spouse and/or surviving dependent children have 60 days following the
primary member’s death to notify OSEEGIB of the decision to continue life
insurance coverage. Additionally, a surviving spouse may elect to continue any
dependent life for children who were covered at the time of the primary
member’s death. The surviving spouse must elect to continue life coverage on
himself or herself in order to continue coverage on any dependent children.
At
the time of enrollment, a surviving spouse must name a beneficiary; however, a
surviving spouse is always the beneficiary of any life insurance proceeds for
covered dependent children.
A
surviving spouse is eligible to continue life insurance as long as premiums are
paid. Once coverage is terminated, it cannot be reinstated.
Surviving
dependents are eligible to continue life insurance as long as premiums are paid
or until dependents are no longer eligible. Once coverage is terminated, it
cannot be reinstated.
If
the primary member was an active employee at the time of his/her death, the
applicable premium rates will be the same as the current employee rate.
Until
a surviving spouse reaches age 65, or otherwise becomes Medicare eligible,
he/she will pay the current employee premium. A surviving spouse will pay one
premium and any surviving child/children will have a separate premium. Once a
surviving spouse becomes Medicare eligible, he/she will pay the premium rate
for retirees and any dependent children will continue to pay the current
employee rate.
If
the primary member was a former employee/retiree at the time of his/her death,
the applicable premium rates will be the same as those for former employees.
A
surviving spouse will pay one premium and each surviving child will have a
separate individual premium, just the same as it was prior to the primary
member’s death.
At
the time of enrollment, the surviving spouse must designate a beneficiary. The
surviving spouse is always the beneficiary of any life insurance proceeds for
covered dependent children.
Your
life insurance coverage may be restricted if you return to work for the same
participating employer within 24 months after you terminated your previous
employment. In this situation, the total life insurance coverage, including
Guaranteed Issue, available to you without an approved Life Insurance
Application cannot be greater than the total amount of coverage you had at the
time you terminated your original employment. This restriction does not apply
to dependent life coverage. For the purpose of this provision, all state
agencies are considered a single employer, the State of Oklahoma, that share
the same Section 125 plan.
Example
– As an employee of the Department of Transportation, you terminate your
employment on January 31, 2009. At that time, you kept $20,000 Basic Life and
$20,000 Supplemental Life coverage. Within 24 months, you go to work at the
Department of Human Services at a salary of $29,000. The maximum amount of
coverage available, without requiring a Life Insurance Application, will be
$40,000 – the amount you held at termination of your previous employment. If
you go to work for another participating employer at the same salary, you can enroll
in $20,000 Basic Life and $60,000 Supplemental Life without requiring a Life
Insurance Application. If you went to work in private industry and returned to
work for the State of Oklahoma or the same employer after 24 months, no
restriction would apply.
OSEEGIB
is a State of Oklahoma governmental agency created and governed by Oklahoma law
for the purpose of administering health, life, disability, and dental benefits
to state, local government, education, and employees of other groups designated
by statute, including each of the preceding groups’ respective retirees.
Oklahoma privacy laws and the federal Health Insurance Portability and
Accountability Act, HIPAA, govern privacy matters between OSEEGIB and its
participants concerning the privacy of identifiable health information. In some
cases Oklahoma law may govern the privacy of your personal health information
and in other HIPAA may govern. Information contained in an OSEEGIB member’s
file is confidential by law and we at OSEEGIB are committed to protecting this
information.
If
you believe your privacy rights have been violated, call 1-405-717-8701 or
toll-free 1-800-543-6044. TDD users call 1-405-949-2281 or toll-free 1-866-447-0436.
Please send written complaints to the OSEEGIB HIPAA Information Officer at 3545
NW 58th, Ste. 110, Oklahoma City, OK, 73112.
The
first $20,000 of term life insurance coverage available to you as an eligible
employee under this Plan.
Your
annual gross pay. Your current annual salary does not include overtime,
longevity, benefit allowances, or retirement contributions.
Your legal spouse (including common-law).
Your unmarried children up to age 25
provided you are primarily responsible for their support
Your dependent, regardless of age, who is
incapable of self-support, and who has a disability that was diagnosed before
the age of 25, subject to medical review and approval
Your stepchildren, provided you are
primarily responsible for their support, and regardless of residence if your
spouse has been ordered by the court to provide coverage and your spouse is
also being covered.
Other dependent children; in the absence of
a federal income tax return listing the children as dependents, you will be
required to provide and have approved a Declaration of Dependency form
If your employed spouse is enrolled
separately in one of the OSEEGIB plans, children may be covered under either
parent’s health, dental, or vision plan, but not both. The spouse and children
may, however, be covered for dependent life by both employees.
An
employee of a participating employer who receives compensation for services
rendered and is listed on that employer’s payroll. This includes persons
elected by popular vote (i.e., board members for education and elected
officials of state and local government, state employees, rural water district
board members, county election board secretaries, and any employee otherwise
eligible who is on approved leave without pay, not to exceed 24 months).
Education employees must be eligible to
participate in the Oklahoma Teachers’ Retirement System and work a minimum of
four hours per day or 20 hours per week
Local government employees, including rural
water districts, must be employed in a position requiring a minimum of 1,000
hours work per year
Two
times your current annual salary rounded up to the next $20,000. This is
available only during your initial enrollment. A Life Insurance Application is
not required.
The
30 days following your entry on duty date or date you become eligible with a
participating employer. An initial enrollment is not created when you transfer
employment between participating employers sharing the same Section 125 Plan;
e.g., state agency to state agency or school to school within the same
district.
Documentation
of medical fitness by an applicant.
The
annual time period established by OSEEGIB in which changes may be made to
coverage.
The
Oklahoma State and Education Employees Group Insurance Board.
Any
municipality, county, or education employer, or other state agency whose
employees or members are eligible to participate in any plan authorized by or
through the State and Education Employees Group Insurance Act.
The
HealthChoice Life Insurance Plan offered through OSEEGIB and described in this
handbook.
A
policy that furnishes life insurance for a limited period of time. If death
occurs during this period of time, insurance benefits are paid. If death occurs
after this policy has expired, no insurance benefits are paid. A term policy
has no cash surrender value.