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  Historical Overview
  2025-26 Plan Year
  2024-25 Plan Year
  2023-24 Plan Year
  2022-23 Plan Year
  2021-22 Plan Year
  2020-21 Plan Year
  2019-20 Plan Year
  2018-19 Plan Year
  2017-18 Plan Year
  2016-17 Plan Year
  2015-16 Plan Year
  2014-15 Plan Year
  2013-14 Plan Year
  2012-13 Plan Year
  2011-12 Plan Year
  2010-11 Plan Year
  2009-10 Plan Year
  2008-09 Plan Year

Historical Overview

Plan Year		OPEH&W %		National %
2025-26		4.5		9.0
2024-25		5.0^		9.0
2023-24		5.0		12.0
2022-23		9.5		22.5
2021-22		2.0*		5.7
2020-21		3.0		7.9
2019-20		4.0		6.9
2018-19		2.5		7.5
2017-18		7.4		8.0
2016-17		7.5		7.8
2015-16		0.0		3.9
2014-15		1.2*		5.3
2013-14		0.0		4.1
2012-13		5.0		6.1
2011-12		8.5		8.5
2010-11		6.0		6.9
2009-10		5.0		6.3
2008-09		5.0		6.0

* Increase applies only to Employee tier, Spouse and Child tiers unchanged.
^ Increase for Diamond, other health plan design increase were less.



Historical Detail

2025-26 Plan Year         4.5% Rate Increase
        9.0% National Trend
        Benefit Changes
             Launched OPEH&W Mobile App - Learn More  
             Added Free Virtual Check-Ups with $250 Deductible Credit with Catapult - Learn More  
             Added Free MRI, CT & PET Scans with Green Imaging - Learn More  
             Added Free X-Rays & Ultrasound with Green Imaging - Learn More  
             Added Mid Wife Coverage
             Added Adult Orthodontic Coverage

2024-25 Plan Year         5.0% Rate Increase
         Increase for Diamond, other health plan design increase were less.
        9.0% National Trend
        Benefit Changes
             Require Blue Distinction Centers for Major Medical Surgeries, applies to:
               Transplants
               Hip & Knee Surgeries
               Cardiac Surgeries
               Spinal Surgeries
               Only Applies to Scheduled Surgeries.
               Does Not Apply to Emergencies.
               No Out-of-Network Coverage Available.

             Allow Bariatric Surgeries
               Only for Members and Spouses.
               No Coverage for Dependent Children.
               Individual Must Be Enrolled for Health Coverage
                  through Employer for 2 Consecutive Years.
               Only available at BlueDistinction & BlueDistinction+ Providers.
               Currently in Oklahoma, these are Bailey, Integris & Norman.
               Only for Lap Bands & Gastric Sleeves
                  under the following procedure codes:
               Gastric Sleeve: 43775
               Lap Band: 43770, 43771, 43772, 43773,
                  43774, 43886, 43887, 43888 & S2083
               Eligibility Subject to Blue Cross’s Medical Policy
                  Criteria SUR 716.003 & SUR 716.006.
                  http://tinyurl.com/39fr8nzy  
               Coverage Subject to Deductible & Co-Insurance.

             Changes to Platinum Health Plan Option Design
               Changed In-Network Individual Deductible to $1,500
               Changed In-Network Family Max Deductible to $3,000
               Changed In-Network Individual Max Out-of-Pocket to $5,000
               Changed In-Network Family Max Out-of-Pocket to $10,000
               Changed Out-of-Network Individual Deductible to $30,000
               Changed Out-of-Network Family Max Deductible to $6,000
               Changed Out-of-Network Individual Max Out-of-Pocket to $10,000
               Changed Out-of-Network Family Max Out-of-Pocket to $20,000
               Change Pharmacy Preferred Brands Co-Pay to $55
               Change Pharmacy Non-Preferred Brands Co-Pay to $70


2023-24 Plan Year         5.0% Rate Increase
        12.0% National Trend
        Benefit Changes
              Added Coverage for Implants as a Major service to both the Standard & Enhanced coverage options
              Added Pelago - Tobacco, Vaping, Alcohol & Opioid Addiction Program
              Added Propeller - Asthma & COPD Program


2022-23 Plan Year         9.5% on Diamond
        22.5% National Trend
        Benefit Changes
              Added Essential Medical Eye Care to Vision Coverage

	Diamond		Platinum		Gold		Silver		Bronze
Medical Deductible Increased to	1,000		1,750		3,250		2,250		4,250
Medical Max Out-of-Pocket Increased to	5,000		6,000		7,000		7,000		7,500
Urgent Care Co-Pay Increased to	25		25		25		25		25
Primary Care Co-Pay Increased to	25		25		25		25		25
Rx Deductible Increased to	75		No Change		No Change		No Change		No Change
Rx Max Out-of-Pocket Increased to	2,500		2,500		2,500		No Change		No Change

2021-22 Plan Year         2.0% OPEH&W Rate Increase - Employee Tier Only
        5.7% National Trend
        Benefit Changes
              No Benefit Changes Made


2020-21 Plan Year         3.0% OPEH&W Rate Increase
        7.9% National Trend
        Benefit Changes
              Added Zero Out-of-Pocket Medical Procedures
              Added Health Advocacy Solutions from BlueCross
              Added Connect360 from Express Scripts
              Removed CAT/MRI $100 Failure to Call-In Penalty
              Added Free Cash Rewards for Members from Vitals
              Added Free Hypertension & High Cholesterol Program from Omada
              Added Free Diabetes Program from Livongo
              Added Free Physical Therapy Program from Hinge
              Added Free Fertility, Pregnancy & Parenting Support from Ovia
              Added Free Health & Wellness Program from Well onTarget
              Added Free Weight-Loss Program from Naturally Slim
              Added Enhanced Dental Plan


2019-20 Plan Year         4.0% OPEH&W Rate Increase
        6.9% National Trend
        Benefit Changes
              4 New Health Coverage Options Added - Platinum, Gold, Silver & Bronze. Existing Health Coverage Option re-named as Diamond
              Diamond Health Coverage Option - Rx Non-Preferred Brand Name Coverage Tier create with a $60 Co-Pay
              Diamond & Platinum Health Coverage Options - Medical In-Network Maximum Out-of-Pocket lowered to $3,000 for an Individual, upto a maximum of $6,000 for Families of 2 or more
              Diamond & Platinum Health Coverage Options - Medical Out-of-Network Maximum Out-of-Pocket lowered to $6,000 for an Individual, upto a maximum of $12,000 for Families of 2 or more


2018-19 Plan Year         2.5% Rate Increase
        7.5% National Trend
        Benefit Changes
              Added Orthodontic Dental Services (Dependent Children Only)
              $1,500 Lifetime Maximum
              50% Coinsurance
              Not Subject to Deductible
              No Waiting or Elimination Periods


2017-18 Plan Year         7.4% Rate Increase
        8.0% National Trend
        Benefit Changes
              In-Network Medical Plan Year Deductible for individuals unchanged at $750, family decreased to $1,500
              In-Network Medical Plan Year Max Out-of-Pocket for individuals increased to $5,000, family decreased to $10,000
              Out-of-Network Medical Plan Year Deductible for individuals increased to $1,500, family increased to $3,000
              Out-of-Network Medical Plan Year Max Out-of-Pocket for individuals increased to $10,000, family increased to $20,000
              In-Network Rx Plan Year Max Out-of-Pocket for individuals increased to $2,000, family decreased to $4,000
              Dependent Child Group Life Coverage regardless of age, a dependent child's group life benefit is now 10% of the emplpoyee's group life benefit. Previously, the maximum was $500 for dependent children under 6-months


2016-17 Plan Year         7.5% Rate Increase
        7.8% National Trend
        Benefit Changes
              In-Network Deductible increased to $750
              Out-of-Network Deductible decreased to $750
              Medical Network: Medical network changed from the BlueCross BlueChoice network to the BluePreferred network
              ConnectDME has been made the Health Plan’s vendor for medical equipment, it will provide medical equipment and supplies for Free
              CatapultHealth - Health Screenings has been made the Health Plan’s vendor for on-site Wellness Screenings, screenings remain free to the Member and Group, any member or spouse receiving a screening will receive a $250 reduction in medical deductible at the start of the following plan year
              MDLIVE provides $0 office visit co-pays for non-emergency face-to-face primary care services through mobile app or web interface or, $0 office visit co-pays for behavioral health services through the same mobile app or web interface
              Pre Service or Procedure Member Care with the Benefits Value Advisor is a free and optional service for use prior to receiving medical services or procedures. Assists with locating providers offering the higher quality outcomes and lowest out-of-pocket costs. Also, offers help and support in multiple related areas linked to the condition, service or procedure.


2015-16 Plan Year         0.0% Rate Increase
        3.9% National Trend
        Benefit Changes
              Specialty Drugs Coverage split into 3 cost tiers, Generics $10, Preferred Brands $60, Non-Preferred Brands $100
              Rx In-Network Out-of-Pocket Limit created Annual In-Network Out-of-Pocket Maximum of $1,900 per individual per plan year, up to a maximum of $5,700 for a family of 3 or more
              Rx Drug Exclusions added for some Brand Names where adirect thetapeutic alternatives exist


2014-15 Plan Year         1.5% Rate Increase
        5.3% National Trend
        Benefit Changes
              Medical In-Network Out-of-Pocket Limit created and set at $2,500 per individual per plan year, up to a maximum of $7,500 for a family of 3 or more
              Medical In-Network & Out-of-Network Co-Insurance separated
              Wigs or Other Scalp Prostheses' the play year maximum of $150 has been removed
              Dependent Maternity Care now covered
              Co-Pay for Specialty Rx increased from $40 to $60
              Nexium Over-The-Counter now covered at a $0 Co-Pay (with a prescription)
              Nasacort Over-The-Counter now covered at a $5 Co-Pay (with a prescription)
              Pre-Existing Conditions no longer considered
              Domestic Partnerships will now be allowed for same-gender Domestic Partnerships


2013-14 Plan Year         0.0% Rate Increase
        4.1% National Trend
        Benefit Changes
              Contraception Rx Co-Pay reduced from $10 to $0
              Smoking Cessation Drugs coverage added of 6-months each plan year at a $0 Co-Pay


2012-13 Plan Year         5.0% Rate Increase
        6.1% National Trend
        Benefit Changes
              Office Visit Co-Pay reduced from $25 to $20
              Medical In-Network Co-Insurance reduced from 30%/$3,000 to 20%/$2,000
              Dependent Child Deductible reimbursement added for amounts paid over $250


2011-12 Plan Year         8.5% Rate Increase
        8.5% National Trend
        Benefit Changes
              Rx Brand Name Deductible added for $50
              Medical Out-of-Network Deductible added at $1,000
              Office Visit Co-Pay added at $25 for Primary Care & $50 for Specialists
              Medical In-Network Co-Insurance increased from 20%/$2,000 to 30%/$3,000
              Lifetime & Plan Year Maximums limits removed


2010-11 Plan Year         6.0% Rate Increase
        6.9% National Trend
        Benefit Changes
              Deductible increased from $400 to $500
              Generic Rx Co-Pay increased from $5 to $10


2009-10 Plan Year         5.0% Rate Increase
        6.3% National Trend
        Benefit Changes
              No Benefit Changes Made


2008-09 Plan Year         5.0% Rate Increase
        6.0% National Trend
        Benefit Changes
              No Benefit Changes Made