If you are not on the employee’s account as an authorized representative, we cannot discuss ANY details with you about their account. The employee can add you as an authorized representative by logging into their account and clicking on the "Go" button in the change box on the bottom right.

For Employers – This applies to those listed as a contact person or business owner.

For Agents – This applies to those listed as Agent of Record (AOR).

For Employees – We can only speak to the member unless the account has an authorized rep listed to act on their behalf.

Regular Hours (excluding holidays):

Monday - 8 a.m. - 5 p.m.
Tuesday - 8 a.m. - 5 p.m.
Wednesday - 8 a.m. - 5 p.m.
Thursday - 10:30 a.m. - 5 p.m.
Friday - 8 a.m. - 5 p.m.

August 2021 - Agent News

In this email...

• Documentation Submission
• SoonerCare Contact Information
• Reapplying for ESI
• Eligibility when Transitioning from SoonerCare Back to ESI
• Qualified Benefit Plans on OHCA Website
• Income Guidelines
• American Indian/Alaska Native Update
• Public Health Emergency Coverage Extended through October 31, 2021

Documentation Submission

Please do not submit documentation for employees through the employer portal, as it will not be processed. If employees have documentation to submit, they should submit through their member portal, by email or by fax.

SoonerCare Contact Information

For agents and employers who wish to speak with the SoonerCare helpline regarding general questions, the best way to get through is to dial 800-987-7767, select option 1, then option 3, and option 3 again. This should get you through to a live representative.

Reapplying for ESI

If an employee becomes over income for SoonerCare and needs to transition back to ESI, they will need to reapply. 

When the transition moved people from ESI to SoonerCare, the Insure Oklahoma box was unchecked on the applications and it will need to be rechecked for eligibility to be considered.

Eligibility when Transitioning from SoonerCare Back to ESI

It has come to our attention that there have been some cases where income has been updated on applications within the 12-day end date period, ending SoonerCare in the first few days of a month, pushing ESI out to the next month and leaving a gap in coverage. 

Example: income updated Aug. 23. SoonerCare ends Sept. 4 and ESI begins Oct. 1. If you become aware of a case, please contact us.

Note: if the gap in coverage is due to the application being updated prior to the 12-day period, we cannot backdate ESI.

Qualified Benefit Plans on OHCA Website

Oklahoma Health Care Authority is currently undergoing changes to our website. During this time, the Qualified Benefit Plan list is not able to be updated. If you have a plan that seems to meet IO criteria but can’t find it on the website, please contact us so we can verify for you.

Income Guidelines

With Medicaid expansion, Insure Oklahoma does now have a minimum income requirement. The income guidelines, including the minimum can be found below.

American Indian/Alaska Native Update

You may notice any new rate letters you receive for employees who are American Indian or Alaska Native (AI/AN) now have an employee share of $0. This is because AI/AN members do not have to pay a premium (317:45-9-4). The employee share on these cases has been rolled into the State Subsidy amount so there will be no extra burden on your company. If you have any questions, please do not hesitate to call our helpline at 888-365-3742. 

Public Health Emergency Coverage Extended through October 31, 2021

The PHE period is being extended in 90 day increments by the federal government. The current date for extended coverage to end has been extended to October 31. However, we fully anticipate multiple 90 day extensions granted by the President to extend until the end of 2021. This is subject to change based on CMS guidance.