§ 74-1372. Claims for flexible spending account benefits - Notice of denial - Hearing.

The Office of Management and Enterprise Services shall be responsible for making all determinations as to the rights of any participant or any beneficiary of a participant to receive amounts under the flexible spending account benefits plan.  The Office shall prescribe forms and procedures for making claims for flexible spending account benefits under the plan.  Each person making a claim for benefits under the flexible spending account benefits plan shall also furnish the Office with such documents, evidence, data or information in support of such claim as the Oklahoma Employees Insurance and Benefits Board considers necessary or desirable.  If any claim for the flexible spending account benefits plan is wholly or partially denied, the claimant shall be given notice in writing of such denial within a reasonable period of time, but no later than forty-five (45) days after the claim is filed.

A claimant whose claim is denied shall have the right to a hearing before the Director of the Office of Management and Enterprise Services or hearing officer designated by the Director.  Written notification by a claimant for a hearing must be received by the executive director within ten (10) business days of notification of claim denial.  The hearing shall be conducted within thirty (30) days in accordance with the provisions of the Administrative Procedures Act.  The Office shall promulgate administrative rules establishing policies and procedures specific to the notice of denial, request for explanation, and hearing for flexible spending account benefit claims denial.

Added by Laws 1992, c. 400, § 12, eff. July 1, 1992.  Amended by Laws 2003, c. 369, § 1, eff. July 1, 2003; Laws 2012, c. 304, § 980.