The OPEH&W Health Plan will reimburse up to $500 each plan year for out-of-pocket costs incurred for a covered dependent child for covered services received at an emergency room, urgent care facility or minor emergency center for an accidental injury.

How to Apply
Request must be submitted by the member
Request must be made no later than 3-months after the end of the plan year
Complete the Dependent Child Accident Reimbursement Form



Attach an Explanation of Benefits (EOB) from BlueCross & BlueShield
Ensure it shows the accident claim the dependent child had during the plan year
Mail the completed Dependent Child Accident 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