| Invasive Cancer | ||
| Initial Benefit: | 100% of Benefit Amount | |
| Recurrence Benefit: | 100% of Initial Amount | |
| Non-Invasive Cancer | ||
| Initial Benefit: | 25% of Benefit Amount | |
| Recurrence Benefit: | 100% of Initial Amount | |
| Skin Cancer | ||
| Initial Benefit: | 5% of Benefit Amount (Not less than $250) | |
| Recurrence Benefit: | 100% of Initial Amount (Not less than $250) | |
| Health Screening Benefit |
| Benefit Amount: $50 |
| Payable if an eligible covered person takes one of the screening/prevention measures listed below. Times Payable per Calendar Year: 1 time per Employee, 1 time per Spouse/Domestic Partner, 1 time per Dependent Child. Eligible Screening / Prevention Measures: |
| Routine Health Check-Up Exam |
| Biopsies For Cancer |
| Blood Chemistry Panel |
| Blood Test To Determine Total Cholesterol |
| Blood Test To Determine Triglycerides |
| Bone Marrow Testing |
| Breast MRI |
| Breast Ultrasound |
| Breast Sonogram |
| Cancer Antigen 15-3 Blood Test For Breast Cancer (CA 15-3) |
| Cancer Antigen 125 Blood Test For Ovarian Cancer (CA 125) |
| Carcinoembryonic Antigen Blood Test For Colon Cancer (CEA) |
| Carotid Doppler |
| Chest X-Rays |
| Clinical Testicular Exam |
| Colonoscopy |
| Complete Blood Count (CBC) |
| Coronavirus Testing Skin Exam |
| Dental Exam |
| Digital Rectal Exam (DRE) |
| Doppler Screening For Cancer |
| Doppler Screening For Peripheral Vascular Disease |
| Echocardiogram |
| Electrocardiogram (EKG) |
| Electroencephalogram (EEG) |
| Endoscopy |
| Fasting Plasma Glucose Test |
| Fasting Blood Glucose Test |
| Flexible Sigmoidoscopy |
| Hearing Test |
| Hemoccult Stool Specimen |
| Hemoglobin A1c |
| Human Papillomavirus (HPV) Vaccination |
| Immunizations |
| Lipid Panel |
| Mammogram |
| Oral Cancer Screening |
| PAP Smears Or Thin Prep PAP Test |
| Prostate-Specific Antigen (PSA) Test |
| Serum Cholesterol Test To Determine Ldl And Hdl Levels |
| Serum Protein Electrophoresis |
| Skin Cancer Biopsy |
| Skin Cancer Screening |
| Stress Test On Bicycle Or Treadmill |
| Successful Completion Of Smoking Cessation Program |
| Tests For Sexually Transmitted Infections (STI's) |
| Thermography |
| Two-Hour Post-Load Plasma Glucose Test |
| Ultrasounds For Cancer Detection |
| Ultrasound Screening Of The Abdominal Aorta For Abdominal Aortic Aneurysms |
| Virtual Colonoscopy |
| Coverage & Rates shown are for the 2025/26 Plan Year, effective 7/1/2025 through 6/30/2026. |
| $15,000 of Coverage | ||||||||
| Attained | Employee | Employee | Employee | Employee, Spouse | ||||
| Age | Only | & Spouse | & Child(ren) | & Child(ren) | ||||
| Younger than 25 | 4.50 | 7.65 | 7.20 | 10.50 | ||||
| 25 - 29 | 4.95 | 8.40 | 7.65 | 11.10 | ||||
| 30 - 34 | 5.55 | 9.45 | 8.40 | 12.30 | ||||
| 35 - 39 | 7.65 | 12.90 | 10.35 | 15.60 | ||||
| 40 - 44 | 10.05 | 16.65 | 12.75 | 19.50 | ||||
| 45 - 49 | 13.80 | 22.35 | 16.50 | 25.05 | ||||
| 50 - 54 | 18.45 | 29.10 | 21.15 | 31.80 | ||||
| 55 - 59 | 25.95 | 40.05 | 28.65 | 42.75 | ||||
| 60 - 64 | 33.15 | 50.25 | 35.85 | 53.10 | ||||
| 65 - 69 | 39.30 | 59.55 | 42.00 | 62.40 | ||||
| 70 - 74 | 48.60 | 73.20 | 51.30 | 75.90 | ||||
| 75 & Older | 54.45 | 81.60 | 57.15 | 84.30 | ||||
| $30,000 of Coverage | ||||||||
| Attained | Employee | Employee | Employee | Employee, Spouse | ||||
| Age | Only | & Spouse | & Child(ren) | & Child(ren) | ||||
| Younger than 25 | 9.00 | 15.30 | 14.40 | 21.00 | ||||
| 25 -29 | 9.90 | 16.80 | 15.30 | 22.20 | ||||
| 30 - 34 | 11.10 | 18.90 | 16.80 | 24.60 | ||||
| 35 - 39 | 15.30 | 25.80 | 20.70 | 31.20 | ||||
| 40 - 44 | 20.10 | 33.30 | 25.50 | 39.00 | ||||
| 45 - 49 | 27.60 | 44.70 | 33.00 | 50.10 | ||||
| 50 - 54 | 36.90 | 58.20 | 42.30 | 63.60 | ||||
| 55 - 59 | 51.90 | 80.10 | 57.30 | 85.50 | ||||
| 60 - 64 | 66.30 | 100.50 | 71.70 | 106.20 | ||||
| 65 - 69 | 78.60 | 119.10 | 84.00 | 124.80 | ||||
| 70 - 74 | 97.20 | 146.40 | 102.60 | 151.80 | ||||
| 75 & Older | 108.90 | 163.20 | 114.30 | 168.60 | ||||
| Eligibility: |
| For eligible active employee members only. |
| Only available if Employer group allows this coverage to be offered. |
| Opportunities: |
| OPEH&W Initial Enrollment. |
| OPEH&W Annual Open Enrollment. |
| First Offering from OPEH&W. |
The only non-profit public trust health plan; owned, ran and for Oklahoma's local government organizations.