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Medicare Only Procedures

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Reminder: The only employees who will have a right to vote are members who are in continuous employment on or before April 1, 1986 who are employed on the date of the notice and date of the referendum and a member of a qualified retirement system.

All employees hired after March 31, 1986 are mandatorily covered by Medicare.

SSA requires that employees be given 90 days notice of the referendum and that each employee is given an opportunity to vote in a referendum to determine whether their services will be covered under Section 218 of the Social Security Act.

Interested agencies should contact Karen Lawrence or (405) 521-3555 with any questions regarding the referendum process. The State Administrator and The Social Security Administration will work together to answer any questions or concerns the employer or employees have before the referendum.

Oklahoma State and Local Government Agencies
Procedures for Conducting a Referendum for
Medicare only Coverage.

The procedures described below are primarily based on Oklahoma State statues 51 § 121-132.** and Section 218 of the Social Security Act and are a procedural statement of the State of Oklahoma, Department of Human Services, Division of Social Security., Oklahoma’s State Administrator for Social Security and Medicare coverage. All forms or sample forms may be found under Forms.

  1. Adopt resolution - Only the governing body of an entity can adopt a resolution requesting a referendum. The referendum process begins by adopting a written resolution to the Governor of Oklahoma to: 
    1. Request authorization for the Referendum.
    2. Establish the effective date of coverage.

  2. The agency submits:
    1. The original signed and properly certified resolution adopted by the governing body of the political subdivision. The person executing the resolution and the Section 218 agreement must have the authority to do so.
    2. A completed Section 218 coverage questionnaire. 
    3. A letter from the governing body addressed to the Governor requesting the authorization for the referendum. 

      The original documents should be mailed to:
      Oklahoma Department of Human Services
      Division of Social Security
      Attn: Karen Lawrence
      P. O. Box 25352
      Oklahoma City, OK 73125

  3. The Administrator will obtain the Governors signature, and then shall establish the date on which the referendum will be held.  The referendum must be held no less than 90 days after the date the Notice of Referendum is distributed to eligible employees. Absentee voting requires an additional 10 days.
    1. The Administrator shall provide the Notice of Referendum for distribution by the agency to all employees who are eligible to vote in the referendum. (Notice can be faxed or e-mailed to the agency)
    2. The notice may be given by personal delivery, e-mail or first class mail and must be posted on all bulletin boards maintained by the agency to give notice to all eligible employees.  Notice must be given to eligible employees on leave of absence or on active military duty.  If any doubt arises as to an employee's eligibility to participate in the referendum, a notice should be provided, and his or her status can be resolved later. The agency can require employees to initial a list indicating that they did receive the Notice of Referendum at least 90 days prior to the referendum date.

  4. Create list of employees - The agency shall prepare a listing (electronic format) with the names and Social Security numbers of the eligible employees who are members of the retirement system(s) on the date of the referendum, and were employed on the date the Notice of Referendum was posted.

  5. Conduct Workshops - The agency is encouraged to contact the State Administrator who will work in conjunction with the Social Security Administration to conduct workshops for the eligible employees during the 90-day notice period.
    1. The educational workshops should be offered to each eligible employee to inform them of the benefits that may accrue to them and their spouses if their services are covered under Medicare.
    2. Additionally, the educational workshops shall include an explanation of the tax liabilities to which they will be subject if coverage is chosen in the referendum process.

  6. Absentee Ballots
    1. Absentee ballots will be e-mailed to the employer up to 10 days prior to the referendum by the State Administrator.
    2. Any eligible employee who will not be present or who otherwise will be unable to indicate a choice on the referendum date may complete an absentee ballot.
    3. The absentee ballot must be requested and completed prior to the completion of the referendum.
    4. Failure to properly execute and return an absentee ballot shall be deemed a No vote.

  7. Conduct of the referendum - On the date established for the referendum, the State Administrator or representative will provide an opportunity to vote to each eligible member. The entity is responsible for supplying a suitable location.
    1. The ballots will be supplied by the State Administrator.
    2. The ballot will contain provisions for the election by the member whether he or she desires to be covered for Medicare or whether he or she desires to not be covered for Medicare.
    3. Failure to properly execute a ballot shall be deemed an election by the member to be a No vote.
    4. Oklahoma is a majority State. If 51 percent of the members vote Yes, all eligible members pay Medicare. If 51 percent of the members vote No, No employee not subject to mandatory Medicare pays the tax. 

  8. At the close of the referendum process the Administrator will:
    1. Provide a certification of Referendum which will consist of the vote count. Entity will know shortly after the referendum close if the referendum passed or failed.

  9. The Governor will certify that:
    1. The referendum was held by written ballot on the question of whether members of a retirement system wish coverage under the State of Oklahoma’s 218 Agreement;
    2. All qualifying members was given the opportunity to vote;
    3. All members of the system on the date the Notice of the Referendum was issued was given at least 90 days' notice regarding the referendum;
    4. The referendum was conducted under the supervision of the duly designated person; and

  10. Agreement/Plan
    1. After the referendum is conducted the Administrator will supply the Agreement/Plan to the agency for completion. The governing body may officially complete and sign the agreement/plan with the State of Oklahoma.
    2. Execution of Modification - Upon receipt of the executed agreement from the agency, The Administrator shall execute a modification to the Master Social Security Agreement between the State of Oklahoma and the Social Security Administration (SSA).

      Accompanying the state’s request will be certification to the federal government of the proper conduct of the referendum.

  11. Execution of Modification by SSA
    1. Upon receipt of a fully executed modification from SSA, The Administrator shall notify the agency of the date that coverage has been accepted by SSA. A fully executed copy of the agreement/plan and modification will be returned to the agency.
    2. The agreement/plan and modification to extend coverage must be fully executed within two years.

  12. Payment of applicable taxes
    1. The agency will initiate payment of the applicable taxes, if such payment has not been made, to the IRS based on the appropriate IRS instructions.  Generally, a lump sum payment of taxes is due one month after the end of the calendar quarter in which the Administrator is notified in writing by SSA that the modification for retroactive coverage has been approved.  
    2. Contact the Administrator for any assistance with payment.
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