In This Email:
With SoonerCare eligibility reviews continuing, it is important for you to make sure your information is up to date. Members who are still eligible for coverage but do not have their information up to date could also lose their benefits. Please confirm your information and documentation as soon as possible. Some items that may need to be updated could include:
- Household income
- Contact information (address, email address, phone number, etc.)
- Number of people living in your household
- Social security number(s)
- Missing documents
It is extremely important to make sure OHCA has the right address for you so we can reach you with important information about your SoonerCare benefits. If you receive a letter or email from the Oklahoma Health Care Authority saying there is missing information from you, please respond right away by updating your account at MySoonerCare.org.
Due to the public health emergency ending, Insure Oklahoma no longer backdates coverage for ESI members. The only exception would be if Insure Oklahoma made an error.
Insure Oklahoma has updated the qualified agent list on our website — visit the find an agent page for the latest. To be included in the list, you must have five active groups with employees enrolled with employer-sponsored insurance. The qualified agent list will be updated quarterly.
Qualified benefit plans (QBP) can be assigned through the employer portal for each employee and their dependents. Prior to assigning the QBP, be sure to review the employee’s eligibility date. Please do not assign the QBP until the month prior to the eligibility start date.
A qualified benefit plan that is participating in the Insure Oklahoma program as of November 1, 2022, may become a self-funded or self-insured benefit plan if the following conditions are met:
- The qualified benefit plan has continuously participated in the premium assistance program without interruption up to the date it becomes a self-funded or self-insured health care plan.
- The self-funded or self-insured benefit plan continues to be recognized as a benefit plan by the Oklahoma Insurance Department.
- The self-funded or self-insured benefit plan continues to cover all essential health benefits in addition to all other health benefits that are required under applicable federal law.
- The self-funded or self-inured benefit plan must have a monthly premium assessed and a rate schedule in order to be an approved business with the Insure Oklahoma program.
View the policy page to learn more.
Insure Oklahoma members who are below 210% of the federal poverty level (FPL) and become pregnant will move to the SoonerCare pregnancy benefit and receive 12 months of postpartum benefits if the pregnancy is reported in the member application. To receive postpartum coverage for 12 months, you must tell SoonerCare when one of the following occurs:
- When you become pregnant.
- If your due date changes.
- When your pregnancy ends.
Learn more about SoonerCare pregnancy services and postpartum coverage.
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 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 representative 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.
|
