SECTION 260:50-3-16. Participating entities

(a)   Participation in plans offered by EGID. Entities electing to participate in the dental, life, vision, or disability plans offered by EGID must participate in one of the authorized health plans, unless the Administrator grants a waiver. Coverage offered by EGID to eligible education employees will also be offered to all elected members of the school board for that entity.

(b)   Enrollment in group term life benefits. An entity may elect to participate in the group term life coverage offered by EGID. This includes basic and optional supplemental life coverage for the employee and dependent life coverage. Entities electing to participate in the life plan offered by EGID must participate in the health plan, unless the Administrator grants a waiver.

(c)   Non-participating entities in other group plans. The group plans offered by EGID shall not be offered to any entity which is participating in any other group insurance program, regardless of the percentage or number of employees eligible to enroll, unless the Administrator grants a waiver.

(d)   Right of Board to approve or deny applications for coverage. EGID shall retain the right to approve or deny any employer group applications for coverage. Upon approval, coverage will become effective at 12:01 a.m. on the first [1^st] day of the month following the month in which approval is granted unless a subsequent month is requested and approved in advance.

(e)   Coverage without preexisting conditions. When an entity enrolls all employees of the new entity are covered without penalty for preexisting conditions.

(f)   Enrollment of all individuals presently insured. Upon the group initial enrollment of an institution of higher education, all individuals presently insured by the institution's previous group health plan may become enrolled. If any such individual does not meet the eligibility requirements of this plan, they are eligible for coverage only for the remaining period of the institution's contractual liability. The institution must provide written proof of its contractual liability at the time of said individual's enrollment.

(g)   Attestation of continuous coverage for retirees. Upon beginning or reinstating participation in health coverage offered by EGID, the entity must provide EGID with an attestation that retirees over age sixty-five [65] that will gain coverage through EGID have had continuous creditable coverage for prescription drugs (coverage that is at least as good as Medicare's) since the retirees became eligible for Medicare. The entity must provide an accurate list of any retiree over age sixty-five [65] that does not meet this requirement in order for EGID to properly report uncovered months to Medicare.

[Source: Added at 31 Ok Reg 1390, eff 9-12-14; Amended at 36 Ok Reg 1620, eff 1-1-20]