Billing and Reconciliation

Billing and Reconciliation Processes
Web Enrollment
Get Help with Billing and Reconciliation
Billing and Reconciliation Processes

Definitions of Notices and Forms

The following notices and forms are related to monthly premium billing and reconciliation processes:

• Billing Statement – This is the monthly premium bill.
• Payment Voucher – This is the last page of the monthly Billing Statement. Please use this voucher to list all the checks and/or warrants sent as payment to OSEEGIB.
• Group Audit Report – This report lists insurance premium discrepancies for each employee.
• Discrepancy Report – This report is prepared by you to explain differences in the amounts billed to your employer and what is owed to OSEEGIB. Create a Discrepancy Report by copying your billing statement and indicating changes or corrections on the pages that list the employees who have discrepancy issues.
• Request for Insurance Premium Refund – This form is used to request a refund of premium overpayment.
• Late Notice – This email notice indicates a payment is past due.

Types of Billing Statements

Three types of Billing Statements are available: you can download your bill from OSEEGIB’s Web Enrollment System, or OSEEGIB can send you a paper bill or an electronic bill.

Billing Statement Retrieval via the Web Enrollment System
If you use OSEEGIB’s Web Enrollment System, you can access your original bill or estimated Billing Statement at any time. The manual you received during Web Enrollment Training has more information on the bill retrieval process.

Paper Billing Statement
OSEEGIB generates your billing on the first business day of each month. The Billing Statement for the current month’s coverage is mailed by the fifth business day of each month. The bill shows each employee’s name, SSN or member ID, the premium for each benefit, and total amount billed. You have the option to request your billing with either the SSN or member ID. If you prefer to retrieve your monthly billing by the Web Enrollment System and stop paper billing, please notify Web Support.

Electronic Billing Statement
Each month, you receive an Electronic Billing Statement via email from OSEEGIB that notifies you that your employer’s monthly bill is available through OSEEGIB’s Secure Portal. The Electronic Billing Statement shows each employee’s name, member ID, the premium for each benefit, and the total amount billed. The bill does not include adjustments made to coverage for previous months.

Contact Web Support at 1-405-717-8707 to request billing options.

The following steps can help ensure the payment process goes smoothly:

• Verify the insurance premiums deducted from your employees’ checks are correct
• Audit your Billing Statement to make sure it is accurate
• Collect premiums from any employees who are on leave
• Send your monthly premium payment to OSEEGIB by the 10th of the month following the month of coverage  (See OSEEGIB Rules 360:10-3-3.5)
• Maintain payroll records regarding premium deductions

Payment and Payment Vouchers

Payments are due by the 10th of the month following the month of coverage. Prompt payment of group premiums assures employees’ access to benefits.

Use the Payment Voucher included in your Billing Statement to list all checks and/or warrants you are sending to OSEEGIB. Warrants and/or checks listed on the voucher should equal the total amount due. If the totals do not match, please explain the difference and pencil in changes or corrections on a copy of your Billing Statement.

Please return the Payment Voucher, Discrepancy Report, and actual warrants and/or checks to:

Oklahoma State and Education
Employees Group Insurance Board
P.O. Box 269022
Oklahoma City, Oklahoma  73126-9022

OSEEGIB staff research all discrepancies listed on your Discrepancy Report. Discrepancies that cannot be resolved are listed on a Group Audit Report and returned to you. Review the Group Audit Report as soon as it’s received. For assistance, contact OSEEGIB Member Services.

Auditing the Billing Statement

Use the following steps to reconcile your group bill and payroll records:

1. Compare the amounts on your Billing Statement with your employer’s payroll records and identify any discrepancies. You must research discrepancies to determine if adjustments are needed.
2. Review premium adjustments to determine if they were calculated into the previous month’s payment. If not, premiums may be outstanding or a refund may be due.
3. Correct discrepancies by by changing your next payroll, correcting eligibility through the Web Enrollment System, or by mailing an Insurance Change Form, Insurance Termination Form, or Insurance Enrollment Form to OSEEGIB.
4. Prepare a Discrepancy Report. Copy your Billing Statement and indicate changes or corrections on the pages that list the employees with discrepancies.
5. Prepare warrants and/or checks for premium payment.
6. Submit a copy of your Discrepancy Report with your Payment Voucher.

Refunds

When possible, a premium overpayment should be handled through your payroll department by adjusting the employee’s withholding for the next payroll period.

Refunds are issued only after OSEEGIB is notified in writing of a premium overpayment. Notification must be made within 60 days of the date of the overpayment, unless the lack of notification is beyond your control as determined by OSEEGIB.

Complete a Request for Insurance Premium Refund form. This form is also available on the OSEEGIB website at www.sib.ok.gov or www.healthchoiceok.com. Go to “Insurance Coordinator” under “Coordinators”, then scroll down to “Insurance Coordinator forms”.

Refund requests are usually processed within 10 days. Any refund issued on behalf of an employee is paid directly to the employer.

Note: OSEEGIB will not process a refund request if our records do not indicate an adequate group credit or the refund does not meet the criteria listed in OSEEGIB Rules 360:10-3-7. A denied refund request is returned to you along with a cover letter explaining the reasons for denial.

Submit your Request for Insurance Premium Refund form and supporting documentation, such as an Insurance Change Form or an Insurance Termination Form, to:

OSEEGIB Accounting Division
P.O. Box 58010
Oklahoma City, Oklahoma  73157-8010

Note: Please send COBRA or retirement premiums in separately. They are processed individually and do not belong in the group payment.

Common Billing Issues

If a terminated or ineligible employee appears on your Billing Statement, do not make payment for that employee. Strike through the employee’s information and subtract their premium amount from the total due.

To the right of the employee premium line, indicate the termination date or the date the employee became ineligible. Send an Insurance Termination Form for the employee to OSEEGIB, or process the termination through the Web Enrollment System.

Note: Education employees who are terminating employment at the end of the school year can continue coverage until their contract ends.

If an eligible employee is not listed on the Billing Statement, verify the employee’s enrollment and the effective date of coverage using the Web Enrollment System or by calling Member Services. If information in the system is incorrect or missing, correct the information in the Web Enrollment System or submit an Insurance Enrollment Form to OSEEGIB.

Enter the employee’s name, member ID, and premium amount on the Billing Statement, and then add the premium to the total amount due.

If you have an employee whose premium amounts never seem to add up correctly, verify the employee’s coverage is correct using the Web Enrollment System or by contacting Member Services. If you discover the error within 30 days of the employee’s enrollment or change date, you can correct the error using the Web Enrollment System or by contacting Member Services.

If a coverage change is not reflected on your Billing Statement, the change may have been made after the bill was printed. Verify the correct coverage and effective date using the Web Enrollment System or by calling OSEEGIB Member Services.

Locate the employee’s name on the Billing Statement and change the amount billed to the correct amount. Always provide a brief explanation of the reason for the adjustment in the Explanation of Differences box; e.g., added a dependent child on 01/01/12.

Note: It is important that all forms are mailed or faxed, or the Web Enrollment System is updated as soon as possible. This includes all terminations, changes, and refunds.

An employee is eligible to continue coverage while on leave-without-pay for up to 24 months. The employee continues to be listed on your Billing Statement and it is the employee's responsibility to provide their premiums to you for forwarding to OSEEGIB.

Age-rated supplemental life premiums increase the first of the year following a birth date that advances a member into the next age bracket.

If a payment is returned for insufficient funds, OSEEGIB sends a letter to the IC requesting a replacement of funds by money order or cashier’s check.

An employee must have continuous coverage and premiums must be paid in full in order to enroll in Retirement, Vested, Disability, and COBRA.

Web Enrollment 

OSEEGIB offers a web-based enrollment application to all Insurance Coordinators (ICs). Using our Web Enrollment System, you can make real-time changes to employees’ coverage, print confirmation statements, and print/view both monthly premium bills and estimated future bills.

You must attend a training session and register with OSEEGIB to use this valuable tool. If you are interested in attending one of our Web Training sessions, please contact Web Support at 1-405-717-8707 or toll-free 1-800-543-6044, extension 8707 to enroll.

Get Help with Billing and Reconciliation 

If you need help with a billing or reconciliation issue, please contact OSEEGIB Member Services at 1-405-717-8780 OR TOLL-FREE 1-800-752-9475.