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Plan Year 2013 January 1 through December 31, 2013 It’s Time to Select Your Benefits for Plan Year 2013 This Option Period Enrollment Packet includes: • Your personalized Option Period Enrollment/Change Form • Plan Changes for 2013 • Monthly Premium Chart • Plan Contact Information • Health Savings Account information from American Fidelity Health Services Administration The Employee Benefit Options Guide is available to you online at www.sib.ok.gov or www.healthchoiceok.com. If you need a printed version of the Employee Benefit Options Guide, you can request one by: • Completing the online request form available on the HealthChoice website. • Calling OSEEGIB Member Services at 1-405-717-8780 or toll-free 1-800-752-9475. TDD users call 1-405-949-2281 or toll-free 1-866-447-0436. You will need your OSEEGIB member ID number located in Section A of your Option Period Enrollment/ Change Form. Important: Be sure you make your request for a printed version of the Employee Benefit Options Guide early enough to receive it, make your benefit selections, and return your Option Period Enrollment/Change Form by your Insurance Coordinator’s due date. 2013 PLAN CHANGES Health Plan Changes HealthChoice Health Plans To enroll or remain enrolled in the HealthChoice High or Basic Plan for Plan Year 2013, you must attest that you and your covered dependents are tobacco-free by completing the HealthChoice High and Basic Plans Tobacco-Free Attestation for Plan Year 2013 as part of the Option Period enrollment process. The Attestation is available to you: • Online at www.sib.ok.gov or www.healthchoiceok.com • By calling HealthChoice Member Services at 1-405-717-8780 or toll-free 1-800-752-9475. TDD users call 1-405-949-2281 or toll-free 1-866-447-0436. If you cannot complete the tobacco-free Attestation because you and/or your covered dependents are not tobacco-free, you can still qualify for the HealthChoice High or HealthChoice Basic plan if you can provide one of the following reasonable alternatives: • Show proof of an attempt to quit using tobacco by enrolling in the quit tobacco program available through the Oklahoma Tobacco Helpline and Alere Wellbeing AND completing three coaching calls or • Provide a letter from your doctor indicating it is not medically advisable for you or your covered dependents to quit tobacco. If you do not complete the tobacco-free Attestation or complete one of the reasonable alternatives as defined above, you will automatically be enrolled in the HealthChoice High Alternative or Basic Alternative Plan, and your annual deductible and out-of-pocket limit will be $250 higher. #2750
|Okla State Agency||
Management and Enterprise Services, Oklahoma Office of
|Okla Agency Code||
|Title||Option period enrollment packet, 2013|
|Alternative title||OP packet with AF flyer|
|Publisher||Office of Management and Enterprise Services|
|Publication number||SB-22136 0512|
Government employees' health insurance--Oklahoma.
Employee fringe benefits--Oklahoma.
Oklahoma--Officials and employees.
|Purpose||This Option Period Enrollment Packet includes: Your personalized Option Period Enrollment/Change Form; Plan Changes for 2013; Monthly Premium Chart; Plan Contact Information; Health Savings Account information from American Fidelity Health Services Administration|
|Contents||Plan Year 2013; title from weblink;|
|OkDocs Class#||M500.1 E59p 2013|
|Digital Format||PDF, Adobe Reader required|
|ODL electronic copy||Downloaded from agency website:|
|Rights and Permissions||This Oklahoma state government publication is provided for educational purposes under U.S. copyright law. Other usage requires permission of copyright holders.|