OPEH&W Health Plan - Making Healthy Cheaper - Health - Dependent Deductible Reimbursement

Making Healthy Cheaper
50% Dependent Child Reimbursement

The OPEH&W Health Plan will reimburse deductible amounts met in-excess of 50% of the plan year in-network deductible per covered dependent child per plan year.

How to Apply
		Applications must be made no later than 3-months after the end of the plan year
		Complete the Dependent Child Deductible Reimbursement Form
		2022-23 Plan Year - Dependent Child Deductible Reimbursement Form
		2021-22 Plan Year - Dependent Child Deductible Reimbursement Form
		Attach an Explanation of Benefits (EOB) from BlueCross & BlueShield
		Ensure it shows the total amount of deductible the dependent child met during the plan year
		Mail the completed Dependent Child Deductible Reimbursement Form and the EOB to:
		OPEH&W Health Plan 3851 E Tuxedo Blvd, Suite C Bartlesville OK 74006
		Reimbursement checks are mailed directly to the Member

Plan Specific Qualfication & Reimbursement
Qualification and reimbursement amounts vary according and the health plan option the dependent child was enrolled under. For the 2022-23 Plan Year, they are as follows:
		Diamond, meet more than $500 and get reimbursed the amount met between $500 and $1,000
		Platinum, meet more than $875 and get reimbursed the amount met between $875 and $1,750
		Gold, meet more than $1,625 and get reimbursed the amount met between $1,625 and $3,250
		Silver, meet more than $1,125 and get reimbursed the amount met between $1,125 and $2,250
		Bronze, meet more than $2,125 and get reimbursed the amount met between $2,125 and $4,250