Oklahoma § 74-1332 - Establishment of plan - Contents - Participation Administration - Funding - Coverage - Grievance procedure - Claims

§ 74-1332. Establishment of plan - Contents - Participation Administration - Funding - Coverage - Grievance procedure - Claims

administration.

A. The Oklahoma Employees Insurance and Benefits Board shall

establish a Disability Insurance Program for state employees. The

program shall consist of a long-term disability plan and a short-

Oklahoma Statutes - Title 74. State Government

term disability plan. Participation in the program shall be limited

to state employees who have been state employees for a period of not

less than one (1) month and who are eligible for enrollment in the

Health Insurance Plan administered by the Board. No state employee

shall be eligible to receive any benefits from the long-term

disability program unless the state employee has used all of the

sick leave of the employee. The Board shall promulgate such rules

as are necessary for adoption and administration of the Disability

Insurance Program, including but not limited to benefit eligibility

requirements, methods for computing benefit amounts, benefits

amounts, and verification of medical and health status of employees

applying for or receiving benefits.

B. The Disability Insurance Program shall be funded from

appropriations made by the Legislature. Employees shall not be

required to make contributions to participate in the program.

C. Employee disability insurance coverage shall begin on March

1, 1986.

D. The Board shall establish a grievance procedure by which a

three-member grievance panel established in the same manner as

specified in Section 1304.1 of this title shall act as an appeals

body for complaints regarding the allowance and payment of claims,

eligibility, and other matters. The grievance procedure provided by

this subsection shall be the exclusive remedy available to persons

having complaints against the insurer. Such grievance procedure

shall be subject to the Oklahoma Administrative Procedures Act,

including provisions for the review of agency decisions by the

district court. The grievance panel shall schedule a hearing

regarding the allowance and payment of claims, eligibility and other

matters within sixty (60) days from the date the grievance panel

receives a written request for a hearing. Upon written request to

the grievance panel received not less than ten (10) days before the

hearing date, the grievance panel shall cause a full stenographic

record of the proceedings to be made by a licensed or certified

court reporter at the insured employee's expense.

E. The Board may establish a claim processing division for

claims administration or may contract for claims administration

services with a private insurance carrier or a company that

specializes in claims administration of any insurance that the Board

may be directed to offer.

Added by Laws 1985, c. 203, § 109, operative July 1, 1985. Amended

by Laws 1986, c. 150, § 20, emerg. eff. April 29, 1986; Laws 1989,

c. 322, § 10, operative July 1, 1989; Laws 1991, c. 86, § 1, eff.

July 1, 1991; Laws 1992, c. 367, § 9, eff. July 1, 1992; Laws 2000,

c. 353, § 49, eff. Nov. 1, 2000; Laws 2001, c. 197, § 8, emerg. eff.

May 7, 2001; Laws 2024, c. 245, § 7, eff. Nov. 1, 2024.

Oklahoma Statutes - Title 74. State Government