May 2022 - Agent/Employer News
ESI members may be eligible for out-of-pocket reimbursement for eligible medical and pharmacy expenses. Reimbursement may be made after the 5% CAP has been met. The CAP is figured on the annual gross household income listed on the member’s case.
For all eligible expenses as defined above in OAC 317:45-1-4(a), the member must submit the OHCA required form and all OHCA required documentation to substantiate that they incurred and paid the out-of-pocket expense. OHCA may request additional documentation at any time to support a member's request for reimbursement of eligible out-of-pocket expenses.
Due to a nationwide envelope and paper shortage, Insure Oklahoma is requesting all users update their email address and choose to receive electronic updates and letters to stay up-to-date about your account. All employer letters are available for viewing on the Employer Portal. All member letters are available for viewing on the Member Portal. Those receiving letters by mail will see significant delays in receiving those letters.
Employees must meet minimum ESI income guidelines to remain on ESI. Those under the minimum ESI income guidelines are moved automatically to Soonercare. W-2 wage earners' income is automatically updated quarterly through checks with the Oklahoma Employment Security Commission (OESC).
Any time your business has an insurance carrier change or rate effective date change, the two-page employer application must be submitted. The contact person or business owner’s signature is also required.
The federal government will soon require OHCA to reevaluate eligibility coverage for members, which means some may lose coverage. The expected date for this to happen is July 31.
While this date is subject to change, please make sure your employees’ case information is up-to-date and all requests for information are returned to OHCA as soon as possible.
Insure Oklahoma no longer sends out brochures for ESI. Brochures can be downloaded on the Insure Oklahoma Agents page by clicking the Order Brochures tab. |