Okla. Admin. Code § 260:50-3-8

Current through Vol. 42, No. 8, January 2, 2025
Section 260:50-3-8 - Refunds
(a)Refunds of premium overpayments. Any refund of payment for any premium overpayment shall be made only when EGID is notified in writing of the overpayment.
(b)Administrative Error. Refunds for overpayment due to administrative error, as limited and defined in the rules in this title, of the Insurance/Benefits Coordinator or the payroll clerk for EGID, shall be made at one hundred percent [100%].
(c)Refunds on behalf of employees. Refunds on behalf of employees shall be paid to the appropriate party. For an entity to receive a refund, the entity must have a credit balance.
(d)Inaccurate or erroneous information. If EGID finds that materially erroneous, false, inaccurate, or misleading information was intentionally submitted in order to obtain a specific coverage, then:
(1) For optional or supplemental life insurance coverage in excess of any guaranteed amounts of coverage, EGID shall extinguish its liability by tendering a refund of premiums paid to the insured or the beneficiary;
(2) Health or dental coverage would be canceled retroactive to the effective date of the coverage obtained by the misrepresentation. Refunded premiums would be reduced by any claims paid by HealthChoice.
(e)Medicare eligibility. There shall be no refund of premiums for prior months during which the member was eligible for Medicare, and written notice was not provided to EGID. An exception shall be made for individuals who are retroactively awarded Medicare coverage by the Social Security Administration, when written notice of the retroactive award is provided to EGID within thirty [30] days after the member's notification of the Social Security Administration award. A member's sixty-fifth [65th] birthday is considered automatic notification of Medicare eligibility.
(f)Deceased member. All refunds for overpayment resulting from the death of an employee or former employee will be capped at the overpayment amount received by EGID within twenty four [24] months of notification.

Okla. Admin. Code § 260:50-3-8

Adopted by Oklahoma Register, Volume 31, Issue 24, September 2, 2014, eff. 9/12/2014
Amended by Oklahoma Register, Volume 34, Issue 24, September 1, 2017, eff. 1/1/2018
Amended by Oklahoma Register, Volume 35, Issue 24, September 4, 2018, eff. 1/1/2019
Amended by Oklahoma Register, Volume 37, Issue 24, September 1, 2020, eff. 9/11/2020
Amended by Oklahoma Register, Volume 39, Issue 24, September 1, 2022, eff. 9/11/2022