Oklahoma § 74-1374 - Vision plans

§ 74-1374. Vision plans

A. For the plan year beginning January 1, 2017, and for each

year thereafter, it shall be the responsibility of the Office of

Management and Enterprise Services to offer vision plans to

participants during the open enrollment period. Providers of plans

eligible for selection shall submit information requested by the

Office of Management and Enterprise Services. For the plan year

beginning January 1, 2022, and for each year thereafter, the Office

of Management and Enterprise Services shall have the authority to

renew vision plan contracts with plan providers for succeeding oneyear terms if the provider had a contract for the immediately

preceding year. The Office of Management and Enterprise Services

may, at its discretion, require the provider to submit information

including, but not limited to, rate schedules, contact information

for the plan, policy limits and applicable deductibles and billing

practices of the plan prior to the renewal. Plans eligible for

selection shall meet or exceed the following criteria:

1. Has in place a statewide network of at least one hundred

fifty providers. "Providers", for purposes of this section, means

Optometrists (OD), Ophthalmologists (MD), and Ophthalmologists (DO)

which shall be counted once regardless of the number of locations

where they may practice. Optical shops and retail optical locations

shall not be listed as providers. The company offering the vision

plan must have a direct relationship with each provider on its

panel, and may not lease, borrow, or otherwise obtain use of a

provider panel from another company. This would not prevent a

company from offering its plan through one corporate entity and

administering the plan or provider panel through another legal

entity of the same organization so long as the entity receiving

premiums remains legally responsible for the payment of benefits.

Providers must be actively engaged in providing the services offered

under the vision plan they represent;

Oklahoma Statutes - Title 74. State Government

2. Has operated in Oklahoma for at least five (5) years;

provided, that an immediately prior operation in Oklahoma of a

nonsurviving corporation that merges into an affiliated corporation

shall be counted in determining whether the surviving corporation

has operated a plan in Oklahoma for five (5) years;

3. Is properly licensed, registered, certified or authorized to

operate its business in this state by the Insurance Department.

Vision plans must be offered by the company administering the plan,

not by an agent or third party. A company shall offer only one

vision plan and rate schedule for each plan year;

4. Presents accurate product information in a reproducible

format not to exceed two pages; and

5. Vision plans must provide an examination, frames and lenses,

and/or contact lenses and some form of indemnified payment to the

contracted providers for each component of the benefits, i.e., the

exam, frames and lenses and/or contact lenses. This does not

eliminate discounted supplementary benefits under a qualified plan,

so long as such benefits pertain to vision care.

B. Any administrative fees imposed by the Office of Management

and Enterprise Services shall be applied equally to all qualified

vision plans. There shall be no additional requirements imposed on

a vision plan other than the proper licensing, certification or

authorization to operate its business by the Oklahoma Insurance

Department.

C. No more than two Oklahoma-based vision care benefits

companies that meet the criteria as specified in subsection A of

this section and no more than two out-of-state vision care benefits

companies that meet the criteria as specified in subsection A of

this section shall be offered as vendors for enrollment in any state

employee benefit offering. For purposes of this subsection, an

"Oklahoma-based vision care benefits company" shall be defined as

follows:

1. A vision care benefits company that has a home office,

customer service and administration located within the State of

Oklahoma and is subject to Oklahoma state income taxes; or

2. A vision care benefits company that has a majority of

ownership interest held either directly or indirectly by residents

of the State of Oklahoma and is subject to Oklahoma state income

taxes.

D. In the event the number of vision companies submitting

offerings exceeds the amount permitted under subsection C of this

section, the Office of Management and Enterprise Services shall have

the authority to reject excess offerings based upon failures to meet

bid requirements or for providing lesser value for the State of

Oklahoma.

Added by Laws 2002, c. 501, § 1, eff. July 1, 2002. Amended by Laws

2003, c. 113, § 1, eff. July 1, 2003; Laws 2004, c. 310, § 1, eff.

Oklahoma Statutes - Title 74. State Government

July 1, 2004; Laws 2006, c. 231, § 9, eff. July 1, 2006; Laws 2012,

c. 304, § 982; Laws 2016, c. 303, § 1; Laws 2018, c. 26, § 1, emerg.

eff. April 12, 2018; Laws 2021, c. 78, § 1, eff. Nov. 1, 2021.