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Oklahoma - Compensation & Benefit Legislation

OKLAHOMA - AASHOWME

Demonstrates www.BenefitsReview.com™ site. Illustrates insurance carriers' coverages within the State.

 

OKLAHOMA - ADOPTED CHILD HEALTH CARE MANDATE

OBRA 1993 (Federal) requires group health plans to honor medical and child support orders. Also, plans must treat adopted children like biological children covered by the plan, and plans are precluded from applying pre-existing condition exclusions to an adopted child where no such exclusion applies to a newborn biological child. Health plans that covered the cost of pediatric vaccines as of May 1, 1993, and fail to continue that level of coverage, will be subject to an excise tax penalty applicable to plans that fail to meet the health care continuation coverage requirements under OBRA 1993.

 

Mandatory coverage of birth of adopted children including transportation is included in state's newborn health care mandate.

 

Preventive care for children: No.

 

(Oklahoma Stat. tit. 36 Sections 6058, 6059)

 

OKLAHOMA - ALCOHOLISM & DRUG ABUSE

State reports no statutory requirements.

 

OKLAHOMA - CAFETERIA PLAN TAX LAWS

State income tax, unemployment insurance tax on salary reduction: State Unemployment Insurance law has no specific provision on cafeteria plans, but employer and employee contributions toward health and accident benefits, term life insurance (provided the employee cannot elect cash instead of the insurance benefit or assign the benefit), and a Section 401(k) plan are specifically excluded from wages under state Unemployment Insurance law and may be excluded even when provided through a cafeteria plan.

 

OKLAHOMA - CONTINUATION OF COVERAGE CONVERSION

Events Triggering Continuation of Coverage:

 

OKLAHOMA - COORDINATION OF BENEFITS

Requires use of the birthday rule if coordinating benefits. Based on 1986 National Association of Insurance Commissioner Rules model. (Oklahoma Stat. Ann. tit. 36 Section 4405)

 

OKLAHOMA - COST-OF-LIVING

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian cost-of-living data and U.S. Automobile Cost Survey.

 

OKLAHOMA - DRUG TESTING AND EMPLOYEE ASSISTANCE BENEFITS

Who is Covered by Statute: All employers, employees, and applicants. Written policy is required.

 

Applicant Testing: Applicants may be requested or required to undergo testing upon conditional offer of employment, provided that testing is required of all applicants who receive a conditional offer for a particular employment classification.

 

Employee Testing: Employee testing is allowed when the employer has a reasonable suspicion of an employee violation, for post-accidental inquiries, for post-rehabilitation testing up to 2 years commencing with the employee's return to work, and as part of a routinely scheduled employee fitness-for-duty medical examination. Random testing is allowed for employees who are police officers, have drug interdiction responsibilities, are authorized to carry firearms, are involved in activities directly affecting the safety of others, or work in direct contact with inmates, juvenile delinquents, or children in state custody.

 

How Test Results are Used: Applicant refusal to undergo test or a confirmed positive test result may be used as a basis for refusal to hire. Employee may be discharge for refusal to undergo test or for a confirmed positive test. Employer cannot request or require test if an EAP is not provided.

 

Enforcement of Statutes: Enforcement is by civil action within 2 years of the person's discovery of the alleged willful violation or of the exhaustion of any internal administrative remedies.

Employee Remedies: Employee or applicant may seek injunctive relief; compensatory damages, including employment, reinstatement, promotion, payment of lost wages, and reinstatement to full benefits and seniority rights; court costs; and attorney's fees.

 

Employer Penalties: Willful and knowing violation of this act is a misdemeanor punishable by a fine of $100 - $5,000 or imprisonment for not more than 1 year, or both.

 

Who Pays for Testing: Employer shall pay all costs of drug testing and employees shall be compensated at their regular rate for time involved in drug testing.

 

Employee Assistance Benefits: Drug or alcohol testing shall not be requested or required of employee unless employer provides an employee assistance program.

 

Other Requirements: Test results are to remain confidential and kept separate from other personnel records.

 

(Oklahoma Stat. Ann. tit. 40, Sections 551-565.)

 

OKLAHOMA - GROUP HEALTH CODE ADDITIONS (MANDATED)

Adopted Children: Policies providing family coverage must cover adopted children as of the moment the child is legally in custody of the insured. Effective November 1, 1997, coverage of adopted children must include medically necessary care and treatment of conditions existing prior to the date of placement; coverage is not required for medical treatments rendered prior to the date of placement. Coverage must include the actual and documented medical costs associated with the birth of adopted children who are 18 months of age or younger. (1221, 1997) (Oklahoma Stat. Ann. tit. 36 Section 6059.)

 

Childhood Immunizations: Effective November 1, 1997, group policies (HMOs included) in place on or after January 1, 1998, which provide dependent coverage for childhood immunizations for each dependent child from birth through the date on which such child becomes 18 years old. Immunizations -- free of deductibles, co-payments or co-insurance requirements -- must be provided to dependent children for diphtheria, hepatitis B, measles, mumps, pertussis, polio, rubella, tetanus, varicella, haemophils influenza type B, hepatitis A, and for other conditions as subsequently required by the State Board of Health. (S277, 1977) (Oklahoma Stat. Ann. tit. 36, Section 6060.4.)

 

Coverage Continuation and Conversion: Group policies must provide continuation of up to 30 days to employees whose coverage is terminated for themselves and their dependents. (Oklahoma Stat. Ann. tit. 36, Section 4509.) Group policies must provide conversion rights to employees who terminate employment for themselves and their dependents and to spouses and dependents whose eligibility ceases due to death of the insured or dissolution of marriage. (Oklahoma Stat. Ann. tit. 36 Section 4502.1A.)

 

Diabetes: Group policies, including HMOs and PPOs, must provide coverage for medically necessary diabetic equipment, podiatric health care services, and self-management training. Benefits must be paid for the following diabetic equipment and supplies: blood glucose monitors, test strips for glucose monitors, visual reading and urine testing strips, insulin, injection aids, cartridges for the legally blind, syringes, insulin pumps, insulin infusion devices, oral agents for controlling blood sugar, podiatric appliances to prevent diabetes complications. Diabetes self-management training may take place in an outpatient setting and must be supervised by a licensed physician or other authorized health care provider. The State Board of Health must annually update a list of medically necessary diabetic equipment and health care provider services. (H3021, 1996) (Oklahoma Stat. Ann. tit. 36, Section 6060.1)

 

Disclosure of Terms: Health care plans, including managed care plans and PPOs, must disclose their manner of calculating and limiting co-payments, and also must disclose provisions concerning plan applications, penalties, promulgation of rules, codification, and effective date. (S1166, 1996) (Oklahoma Stat. Ann. tit. 36, Section 6052.)

 

Health Maintenance Organizations: A managed care plan that has no participating provider for a covered benefit requiring a specialist must arrange for a referral to a specialist with expertise in covering the benefit. If a managed care plan refers a person to a nonparticipating specialist, services provided pursuant to a treatment plan must be provided at no additional cost to the covered person beyond what the person would otherwise be required to pay for within-network treatment. (Oklahoma Stat. Ann. Tit. 36 Section 2550.2)

 

Benefit plans subject to the Oklahoma Managed Care External Review Act must establish internal appeals procedures for review of medical care provided. Procedural rules must include expedited internal review procedures for emergency situations. An insured person or the insured person's designee must pay $50 to the health benefit plan toward the cost of an external review. (Oklahoma Stat. Ann. Tit. 36 Section 2528.4)

 

Hearing Aids and Audiological Services: Group health plans must provide for audiological services and hearing aids for children up to 13 years of age. (Oklahoma Stat. Ann. tit. 36 Section 6060.7)

 

Mammography Screening: Policies must cover such screening, as described. (Oklahoma Stat. Ann. tit. 36 Section 6060.)

 

Mastectomy: Effective November 1, 1997, group policies in place on or after January 1, 1998, which provide medical or surgical coverage for treatments for breast cancer of other breast conditions must cover not less than 48 hours of inpatient care following a mastectomy and not less than 24 hours of inpatient care following a lymph node dissection. Shorter hospitalization stays following breast surgery are appropriate if so determined by an attending physician in consultation with a patient. Also, coverage must be provided for reconstructive breast surgery performed on a diseased breast as a result of a partial or total mastectomy as well as reconstructive breast surgery performed on a non-diseased breast to establish symmetry. Coverage for reconstructive surgery on a non-diseased breast in contingent upon such surgery taking place within 24 months of reconstructive surgery on a diseased breast. (H1532, 1997) (Oklahoma Stat. Ann. tit. 36 Section 6060.4.)

 

Maternity: Health care policies, including HMOs and PPOs, which provide maternity benefits, must cover inpatient hospital or birthing center care for a mother and her newborn baby for a minimum of 48 hours following a vaginal birth; inpatient hospital care must be covered for a mother and her newborn baby for a minimum of 96 hours following a Caesarean section. Hospital stays of shorter duration are allowable for services related to maternity and new born care provided that licensed health care providers determine that health conditions of mothers and their babies fall within certain medical guidelines. In cases of vaginal deliveries which occur at home or in birthing centers, mothers and newborns are entitled to one home visit within 48 hours of childbirth by a licensed health care provider. Home visits must include physical assessments of mothers and babies; parental education including information about childhood immunizations; training or assistance with breast or bottle feeding, and clinical testing which is medically necessary. Instead of receiving a home visit, a mother may opt to obtain care at the facility of the plan or the provider. (H2348, 1996) (Oklahoma Stat. Ann. tit. 36 Section 6060.1.)

 

Newborns: Policies providing family coverage must provide benefits for newborns from the moment of birth for injury or sickness, including treatment of medically diagnosed congenital defects, birth abnormalities, and transportation to the nearest hospital capable of necessary treatment. (Oklahoma Stat. Ann. tit. 36, Section 6058.)

 

Policies for Small Employers: As a condition of transacting business in the state, every small employer carrier must offer to small employers at least two health benefit plans -- basic and standard. Such plan may include cost containment features such as utilization review, case management, selective contracting with providers, and other managed care provisions. In addition, health benefit plans covering small employers must comply wit certain provisions regarding limitations on benefits for pre-existing conditions, late enrollees, uniform coverage requirements, minimum participation requirements, and restriction of coverage or benefits, among other things. A small employer is eligible for coverage if it employed at least two but fewer than 50 employees within the state on at least 50 percent of its working days during the preceding calendar year. (Oklahoma Stat. Ann. tit. 36 Sections 6511-6518.)

 

Prostate Cancer Screening: State employees group insurers must provide coverage for side effects commonly associated with radical retropubic prostatectomy surgery. (Oklahoma Stat. Ann. tit. 36 Section 1284)

 

Health plans offered, issued, or renewed on or after January 1, 2000, which provide coverage to men age 40 or older, must offer coverage for annual prostate screenings for the early detection of prostate cancer. (Oklahoma Stat. Ann. tit. 36 Section 6060.7)

 

Providers: Chiropractors, podiatrists, psychologists, clinical social workers, and optometrists: Costs for services must be covered if the provider is licensed, the service is within the provider's scope of services, and the service is covered by the policy. (Oklahoma Stat. Ann. tit. 36 Sections 3634, 6051.)

 

OKLAHOMA - GROUP HEALTH FOR SMALL EMPLOYERS

For insurance plans offered to small employers:

 

OKLAHOMA - GROUP LIFE CODE ADDITIONS

Employer required to pay part of premium: No.

 

Percent of employees who must elect coverage (if employees pay part of premium): 75%.

 

Percent of employees who must be covered if employer pays all of premium: 100%.

 

Minimum number of employees in group plan: 10.

 

Employer prohibited as beneficiary: Yes.

 

Grace period (days): 31.

 

Mandatory conversion: Yes.

 

Other provisions: None.

 

(Oklahoma Stat. tit. 36, Sections 4101, 4103)

 

OKLAHOMA - HOLIDAYS

January 1, Washington's Birthday (or 3rd Monday in February), Memorial Day (or last Monday in May), July 4, Labor Day (or 1st Monday in September), Veterans Day, and December 25 are state holidays in all 50 states and in the District of Columbia. Other holidays under State law include: Martin Luther King's birthday (or 3rd Monday in January), Thanksgiving, Sunday. Other: Any day designated by President or Governor. If any holiday (except Sunday) falls on Sunday, following Monday is a holiday. (Oklahoma Stat. tit. 25, Sections 82.1, 82.2, 82.4, 84, 87, 90.3, 90.4, 90.5, 90.6, 90.8)

 

OKLAHOMA - IMMIGRATION (PREVAILING WAGE POLICY)

See U.S. Federal General Administrative Letter 1-2000

 

OKLAHOMA - JURY DUTY & WITNESS TIME OFF

Employer Restriction For Discharging Employee For Taking Leave For Jury Service: Yes.

 

Remedies and Penalties: Violator is guilty of a misdemeanor punishable by a fine not to exceed $5,000. Employee may bring civil action for actual damages, including past and future lost wages, mental anguish, reasonable costs in securing alternative employment, and exemplary damages.

 

Other Requirements: None reported. (Oklahoma Stat. Ann. tit. 39, Sections 34, 35.)

 

Employer Restriction For Discharging Employee For Taking Leave to be a Witness: State reports no statutory requirements.

 

Remedies and Penalties: State reports no statutory requirements.

 

Other Requirements: State reports no statutory requirements.

 

OKLAHOMA - LEAVES OF ABSENCE

Employers Subject to Leave Laws: State employers.

 

Criteria for Eligibility: Employed for minimum of 6 months.

 

Maximum length of leave: 12 weeks in any 12 month period.

 

Paid Leave: State does not require paid leave.

 

Acceptable Reasons for Leave: Birth/adoption of a child or to care for family member.

 

Employment Guarantees After Leave: Entitled to reinstatement in the same position held prior to leave.

 

Use of Vacation or other Time-off Benefits: Employee may first use any other benefits before receiving leave.

 

Certification Required: Employer may require certification of illness if leave is to care for a family member.

 

Effect Of Leave on Other Benefits: Employee pays premiums for continued health and life benefits.

 

Effect of Seniority Accrual During Leave: State reports no statutory requirements.

 

Minimum Requirements for Notification to Employer: Reasonable notice is required, if possible.

 

Conditions for Denial of a Request For Leave: State reports no statutory requirements.

 

(Oklahoma Stat. Ann. tit. 74 Sections 840.7c, 840.7d.)

 

See U.S. Federal Family and Medical Leave Act

 

OKLAHOMA - LONG TERM DISABILITY CODE ADDITIONS

State does not require employer to provide long term disability benefits; although many employers do in order to remain competitive in hiring/retention of employees.

 

See LEAVES OF ABSENCE (above), WORKERS' COMPENSATION (below) and U.S. Federal Americans With Disabilities Act

 

OKLAHOMA - MANDATED PROVIDERS

Optometrists, chiropractors, dentists, psychologists, podiatrists, and social workers. Mandatory coverage for osteopaths. (Oklahoma Stat. Tit. 36, Sections 3634, 4404, 6051, 6054, 6051, 6055)

 

OKLAHOMA - MENTAL HEALTH CARE

State reports no statutory requirements.

 

OKLAHOMA - MINIMUM WAGE

Refer to the Federal minimum wage: $5.15 per hour (effective September 1, 1997).

 

Exemptions: Certain professionals, agriculture workers, domestics, and outside sales. Students, apprentices, and handicapped workers in special environments may be exempt by special certificate. (Oklahoma Stat. tit. 40, Sections 197.2, 197.4, 197.11)

 

See U.S. Minimum Wage

 

OKLAHOMA - NEW HIRE REPORTING

Who is required to report: All employers.

 

Who must be reported: All employees and rehires.

 

Exempt from reporting: No exemptions.

 

Form(s) to file: W-4 form.

 

Filing deadline: Within 20 days of hire.

 

Employer information to be included: Name, address, and federal EIN.

 

Employee information to be included: Name, address, SSN, and date of hire.

 

Penalty for failure to report: -

 

(Oklahoma Stat. Ann. tit. 40, Section 2-802)

 

OKLAHOMA - NEWBORN CARE MANDATE

Mandated coverage including transportation of newborns.

 

Preventive care for children: No. (Oklahoma Stat. tit. 36 Sections 6058, 6059)

 

OKLAHOMA - OVERTIME COMPENSATION REQUIREMENTS

State reports no statutory requirements.

 

OKLAHOMA - PARENTAL LEAVE

See U.S. Federal Family and Medical Leave Act

 

OKLAHOMA - PRE-EXISTING CONDITIONS

State reports no statutory requirements.

 

See U.S. Federal Health Insurance Portability & Accountability Act

 

OKLAHOMA - PROTECTED CLASSIFICATIONS

Age:  Yes, age 40 and over.

Race:   Yes.

Color:   Yes.

National Origin:  Yes.

Ancestry:  Yes.

Religion:   Yes.

Sex:   Yes.

Pregnancy:  No specific law. State has expressed policy against discrimination.

Sexual Harassment:  No specific law. State has expressed policy against discrimination.

 

(Oklahoma Stat. tit. 25, Sections 1201, 1301-1306, 1311;tit. 74, Sections 840-2.9, 954.)

 

OKLAHOMA - SALARY SURVEY

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian wages & salaries (covering 3,000 positions).

 

OKLAHOMA - SHORT TERM DISABILITY CODE ADDITIONS

State does not require employer or employee participation in short term disability plans.

 

OKLAHOMA - TERMINATION & SEVERANCE PAY

Date pay is due if employee is discharged: Payday.

 

Date due if employee resigns: Payday.

 

Wages: Yes. (Wages include commissions.)

 

Vacation Pay: Yes.

 

Holiday: Yes.

 

Sick leave: Yes.

 

Severance: Yes.

 

(Oklahoma Stat. tit. 40, Sections 1651.1, 165.3 See Biggs v. Surrey Broadcasting Co., 811 P.2d 111 (OK App. 1991))

 

OKLAHOMA - UNEMPLOYMENT TAX

Employer Contributions:

 

 

Voluntary Contribution Provision: No.

 

(Oklahoma Stat. Ann. tit. 40 Sections 3-103, 3-109, 3-113, 3-301, 3-502.)

 

OKLAHOMA - VACATION PAY

See TERMINATION & SEVERANCE PAY (above)

 

OKLAHOMA - VOTING TIME OFF

2 hours (more if employee lives far away), if employee does not have 3 consecutive hours while polls are open. (Oklahoma Stat. Ann. tit. 26 Sections 7-101, 16-106.)

 

OKLAHOMA - WORKERS' COMPENSATION

Private Employers: Mandatory as to all employments. Elective as to 10% shareholders, partners, sole proprietors, and owner/operator truckers.

 

Public Employers: Mandatory coverage to state, counties, cities, or municipalities except where equivalent schemes are in force.

 

Exceptions: Domestics and casual employees of homeowner whose annual payroll is under $10,000, worker covered by federal law, agricultural/horticultural employer whose annual payroll is under $100,000, real estate salespersons and brokers.

 

Special Coverage Provisions: Excludes certain persons sentenced to public service, assigned to work release or private prison industry programs.

 

(U.S. Chamber of Commerce, 1994 Analysis of Workers' Compensation Laws.)