STATE OF OKLAHOMA

1st Session of the 52nd Legislature (2009)

SENATE BILL 398	By:	Crain

AS INTRODUCED

An Act relating to state government; amending 74 O.S. 2001, Section 1370, as last amended by Section 5, Chapter 269, O.S.L. 2007 (74 O.S. Supp. 2008, Section 1379), which relates to the flexible benefit allowance; modifying flexible benefit allowance amount; requiring participants to pay a monthly premium; providing for reduction in monthly premium if certain conditions are met; creating the State Employee Wellness Premium Discount Program; providing for wellness premium discount if certain baseline readings are submitted by certain date; providing for wellness premium discount based on certain actions; providing for codification; and providing an effective date.

BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1.     AMENDATORY     74 O.S. 2001, Section 1370, as last amended by Section 5, Chapter 269, O.S.L. 2007 (74 O.S. Supp. 2008, Section 1379), is amended to read as follows:
Section 1370.  A.  Subject to the requirement that a participant must elect the default benefits, the basic plan, or is a person who has retired from a branch of the United States military and has been provided with health care through a federal plan, to the extent that it is consistent with federal law, and provides proof of this coverage, flexible benefit dollars may be used to purchase any of the benefits offered by the Oklahoma State Employees Benefits Council under the flexible benefits plan.  A participant who has provided proof of other coverage as described in this subsection shall not receive flexible benefit dollars if the person elects not to purchase any benefits.  A participant’s flexible benefit dollars for a plan year shall consist of the sum of (1) flexible benefit allowance credited to a participant by the participating employer, and (2) pay conversion dollars elected by a participant.
B.  Each participant shall be credited annually with a specified amount as a flexible benefit allowance which shall be available for the purchase of benefits.  The amount of the flexible benefit allowance credited to each participant shall be communicated to him or her prior to the enrollment period for each plan year.
C.  Except as provided in subsection D of this section, for the plan year ending December 31, 2001, and each plan year thereafter, the amount of a participant’s benefit allowance, which shall be the total amount the employer contributes for the payment of insurance premiums or other benefits, shall be:
1.  The greater of Two Hundred Sixty-two Dollars and nineteen cents ($262.19) per month or an amount equal to the sum of the average monthly premiums of all high option health insurance plans, excluding the point-of-service plans, the average monthly premiums of the dental plans, the monthly premium of the disability plan, and the monthly premium of the basic life insurance plan offered to state employees or the amount determined by the Council based on a formula for determining a participant’s benefit credits consistent with the requirements of 26 U.S.C., Section 125(g)(2) and regulations thereunder less Fifty Dollars ($50.00) which will be paid by the participant pursuant to this section; or
2.  The greater of Two Hundred Twenty-four Dollars and sixty-nine cents ($224.69) per month or an amount equal to the sum of the average monthly premiums of all high option health insurance plans, excluding the point-of-service plans, the average monthly premiums of the dental plans, the monthly premium of the disability plan, and the monthly premium of the basic life insurance plan offered to state employees less Fifty Dollars ($50.00) which will be paid by the participant pursuant to this section plus one of the additional amounts as follows for participants who elect to include one or more dependents:
a.	for a spouse, seventy-five percent (75%) of the average price of all high option benefit plans, excluding the point-of-service plans, available for coverage of a spouse,
b.	for one child, seventy-five percent (75%) of the average price of all high option benefit plans available, excluding the point-of-service plans, for coverage of one child,
c.	for two or more children, seventy-five percent (75%) of the average price of all high option benefit plans available, excluding the point-of-service plans, for coverage of two or more children,
d.	for a spouse and one child, seventy-five percent (75%) of the average price of all high option benefit plans available, excluding the point-of-service plans, for coverage of a spouse and one child, or
e.	for a spouse and two or more children, seventy-five percent (75%) of the average price of all high option benefit plans available, excluding the point-of-service plans, for coverage of a spouse and two or more children.
D.  To the extent that it is consistent with federal law, for an employee who is an eligible TRICARE beneficiary and has opted not to purchase health care coverage and who purchases a group TRICARE Supplemental product, the amount of the participant’s benefit allowance shall be equal to the sum of the monthly premium of the group TRICARE Supplemental product purchased by the participant, if any, the average monthly premiums of the dental plans, the monthly premium of the disability plan, and the monthly premium of the basic life insurance plan offered to state employees or the amount determined by the Council based on a formula for determining a participant’s benefit credits consistent with the requirements of 26 U.S.C., Section 125(g)(2) and regulations thereunder.  To the extent that it is consistent with federal law, for each eligible dependent of an employee who is an eligible TRICARE beneficiary and has opted not to purchase health care coverage, if the employee purchases a group TRICARE Supplemental product on behalf of the dependent, the benefit allowance shall be equal to seventy-five percent (75%) of the monthly premium of the group TRICARE Supplemental product purchased by the participant on behalf of the dependent.
E.  This section shall not prohibit payments for supplemental health insurance coverage made pursuant to Section 1314.4 of this title or payments for the cost of providing health insurance coverage for dependents of employees of the Grand River Dam Authority.
F.  If a participant desires to buy benefits whose sum total of benefit prices is in excess of his or her flexible benefit allowance, the participant may elect to use pay conversion dollars to purchase such excess benefits.  Pay conversion dollars may be elected through a salary reduction agreement made pursuant to the election procedures of Section 1371 of this title.  The elected amount shall be deducted from the participant’s compensation in equal amounts each pay period over the plan year.  On termination of employment during a plan year, a participant shall have no obligation to pay the participating employer any pay conversion dollars allocated to the portion of the plan year after the participant’s termination of employment.
G.  If a participant elects benefits whose sum total of benefit prices is less than his or her flexible benefit allowance, he or she shall receive any excess flexible benefit allowance as taxable compensation.  Such taxable compensation will be paid in substantially equal amounts each pay period over the plan year.  On termination during a plan year, a participant shall have no right to receive any such taxable cash compensation allocated to the portion of the plan year after the participant’s termination.  Nothing herein shall affect a participant’s obligation to elect the minimum benefits or to accept the default benefits of the plan with corresponding reduction in the sum of his or her flexible benefit allowance equal to the sum total benefit price of such minimum benefits or default benefits.
H.  For the plan year beginning January 1, 2011, and each plan year thereafter, each participant shall be required to contribute Fifty Dollars ($50.00) per month towards their health insurance premiums.  The participant’s contribution to the health insurance premium shall be deducted from payroll on a pretax basis as permitted under Section 125 of the Internal Revenue Code.  The monthly contribution provided for in this subsection may be reduced by Twenty-five Dollars ($25.00) per month if the participant is certified by the Council as a non-tobacco user and by Twenty-Five Dollars ($25.00) per month if the participant qualifies for the wellness premium discount provided for in Section 2 of this act.
SECTION 2.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 1376 of Title 74, unless there is created a duplication in numbering, reads as follows:
A.  There is hereby created the State Employee Wellness Premium Discount Program.
B.  Beginning January 1, 2011, any participant shall be eligible for a Twenty-five Dollar ($25.00) per month wellness premium discount off the single coverage provided the participant if the participant has submitted baseline readings for the health risk factors of blood pressure, cholesterol, glucose and body mass index.  These health risk factors may be provided to the Oklahoma State Employees Benefits Council through the submission of a physician certification form no later than November 30, 2010.
C.  Beginning, January 1, 2012, any participant can receive the wellness premium discount if:
1.  The participant has been deemed not at risk by the Council based on the reported health risk factors; or
2.  The participant has been deemed at risk by the Council based on the reported health risk factors and has:
a.	submitted a statement from a physician stating that:
(1)	the participant has been counseled regarding the health risk factors,
(2)	the participant has a medical condition that prevents the participant from improving the health risk factors, or
b.	participated and completed one of the Council’s approved wellness programs, or
c.	reported improvement in the health risk factors through self-management.
D.  At risk participants are eligible for a physician referral waiving any required copay.
SECTION 3.  This act shall become effective November 1, 2009.

52-1-64	ARE	1/6/2009 12:31:43 PM