(B) A multiple employer welfare arrangement that is
created | 23 |
pursuant to sections 1739.01 to 1739.22 of the Revised
Code and | 24 |
that operates a group self-insurance program shall
comply with all | 25 |
laws applicable to self-funded programs in this
state, including | 26 |
sections 3901.04, 3901.041, 3901.19 to 3901.26,
3901.38, 3901.381 | 27 |
to
3901.3814, 3901.40, 3901.45, 3901.46, 3902.01 to
3902.14, | 28 |
3923.282,
3923.30,
3923.301, 3923.38,
3923.581, 3923.63, 3924.031, | 29 |
3924.032,
and
3924.27
of the Revised Code. | 30 |
(D) A multiple employer welfare arrangement created
pursuant | 36 |
to sections 1739.01 to 1739.22 of the Revised Code shall
provide | 37 |
benefits only to individuals who are members, employees
of | 38 |
members, or the dependents of members or employees, or are | 39 |
eligible for continuation of coverage under section 1751.53 or | 40 |
3923.38 of the Revised Code or under Title X of the "Consolidated | 41 |
Omnibus Budget Reconciliation Act of 1985," 100 Stat. 227, 29 | 42 |
U.S.C.A. 1161, as amended. | 43 |
AExcept as provided by divisions (A)(2) and (3) of this | 64 |
section in
connection with the offering of coverage for diagnostic | 65 |
and treatment
services for biologically based mental illnesses, a | 66 |
health insuring corporation shall not offer coverage for
a health | 67 |
care service, defined as a basic health care service by
this | 68 |
division, unless it offers coverage for all listed basic
health | 69 |
care services. However,
this requirement does not apply to the | 70 |
coverage of beneficiaries
enrolled in Title XVIII of the "Social | 71 |
Security Act," 49 Stat. 620 (1935), 42
U.S.C.A. 301, as amended, | 72 |
pursuant
to a medicare contract, or to the
coverage of | 73 |
beneficiaries enrolled in the federal employee
health benefits | 74 |
program pursuant to 5
U.S.C.A. 8905, or to the coverage of | 75 |
beneficiaries enrolled in Title XIX of the
"Social Security Act," | 76 |
49 Stat. 620
(1935), 42 U.S.C.A. 301, as amended,
known as the | 77 |
medical assistance program or medicaid, provided by
the department | 78 |
of job and family services
under
Chapter 5111. of the Revised | 79 |
Code, or to
the coverage of beneficiaries under any federal health | 80 |
care
program regulated by a federal regulatory body, or to the | 81 |
coverage
of beneficiaries under any
contract covering officers or | 82 |
employees of the state that has
been entered into by the | 83 |
department of
administrative services. | 84 |
(2) A health insuring corporation may offer coverage for | 85 |
diagnostic and treatment services for biologically based mental | 86 |
illnesses without offering coverage for all other basic health | 87 |
care services. A health insuring corporation may offer coverage | 88 |
for diagnostic and treatment services for biologically based | 89 |
mental illnesses alone or in combination with one or more | 90 |
supplemental health care services. However, a health insuring | 91 |
corporation that offers coverage for any other basic health care | 92 |
service shall offer coverage for diagnostic and treatment services | 93 |
for biologically based mental illnesses in combination with the | 94 |
offer of coverage for all other listed basic health care services. | 95 |
(a) The health insuring corporation submits documentation | 101 |
certified by an independent member of the American academy of | 102 |
actuaries to the superintendent of insurance showing that actual | 103 |
claims for diagnostic and treatment services for biologically | 104 |
based mental illnesses incurred for a period of at least six | 105 |
months independently caused the health insuring corporation's | 106 |
costs for claims and administrative expenses for the coverage of | 107 |
basic health care services to increase by more than one per cent | 108 |
per year. | 109 |
(D) "Biologically based mental illnesses" means | 164 |
schizophrenia, schizoaffective disorder, major depressive | 165 |
disorder, bipolar disorder, paranoia and other psychotic | 166 |
disorders, obsessive-compulsive disorder, and panic disorder, as | 167 |
these terms are defined in the most recent edition of the | 168 |
diagnostic and statistical manual of mental disorders published by | 169 |
the American psychiatric association. | 170 |
(H)(I) "Emergency health
services" means those health care | 182 |
services that must be
available on a seven-days-per-week, | 183 |
twenty-four-hours-per-day
basis in order to prevent jeopardy to an | 184 |
enrollee's health
status that would occur if such services were | 185 |
not received as
soon as possible, and includes, where appropriate, | 186 |
provisions
for transportation and indemnity payments or service | 187 |
agreements
for out-of-area coverage. | 188 |
(K)(L) "Health care
facility" means any facility, except a | 196 |
health care
practitioner's office, that provides preventive, | 197 |
diagnostic,
therapeutic, acute convalescent, rehabilitation, | 198 |
mental health,
mental retardation, intermediate care, or skilled | 199 |
nursing
services. | 200 |
(N)(O) "Health insuring
corporation" means a corporation, as | 207 |
defined in division (G)(H) of this
section, that, pursuant to a | 208 |
policy, contract,
certificate, or agreement, pays for, reimburses, | 209 |
or provides,
delivers, arranges for, or otherwise makes available, | 210 |
basic
health care services, supplemental health care services, or | 211 |
specialty health care services, or a combination of basic health | 212 |
care services and either supplemental health care services or | 213 |
specialty
health care services, through either an open panel plan | 214 |
or a closed panel
plan. | 215 |
"Health insuring
corporation" does not include a limited | 216 |
liability company formed
pursuant to Chapter 1705. of
the Revised | 217 |
Code,
an insurer licensed under
Title
XXXIX of the
Revised
Code if | 218 |
that insurer offers
only open panel plans under which all | 219 |
providers and health care
facilities participating receive their | 220 |
compensation directly
from the insurer, a corporation formed by
or | 221 |
on behalf of a political subdivision or a department, office,
or | 222 |
institution of the state, or a public entity formed by or on | 223 |
behalf of
a board of county commissioners, a county
board of | 224 |
mental retardation and developmental disabilities,
an
alcohol and | 225 |
drug
addiction services board, a board of alcohol, drug addiction, | 226 |
and mental health services, or a community mental health board,
as | 227 |
those terms are used in Chapters 340. and 5126. of the
Revised | 228 |
Code.
Except as provided by division (D)
of section 1751.02 of
the | 229 |
Revised
Code, or as
otherwise provided by law, no
board, | 230 |
commission,
agency, or other entity under the control of a | 231 |
political
subdivision may accept insurance risk in providing for | 232 |
health
care services. However, nothing in this division shall be | 233 |
construed as prohibiting such entities from purchasing the | 234 |
services of a health insuring corporation or a third-party | 235 |
administrator licensed under Chapter 3959. of the Revised
Code. | 236 |
(O)(P) "Intermediary
organization" means a health delivery | 237 |
network or other entity
that contracts with licensed health | 238 |
insuring corporations or self-insured
employers, or both, to | 239 |
provide health care services, and that enters into
contractual | 240 |
arrangements with other entities for the provision
of health care | 241 |
services for the purpose of fulfilling the terms
of its contracts | 242 |
with the health insuring corporations and self-insured
employers. | 243 |
(2) No health insuring corporation may offer an open
panel | 255 |
plan, unless the health insuring corporation is also
licensed as | 256 |
an insurer under Title XXXIX of the
Revised Code, the health | 257 |
insuring corporation, on June 4,
1997,
holds a certificate of | 258 |
authority or license to
operate under Chapter 1736. or 1740. of | 259 |
the Revised Code, or an insurer licensed under
Title XXXIX of the | 260 |
Revised Code is
responsible for the out-of-network risk as | 261 |
evidenced by both an evidence of
coverage filing under section | 262 |
1751.11
of the Revised Code and a policy and
certificate filing | 263 |
under section 3923.02 of the
Revised Code. | 264 |
(U)(V) "Premium rate" means any set fee
regularly paid by a | 274 |
subscriber to a health insuring corporation. A "premium
rate"
does | 275 |
not include a one-time membership fee, an annual
administrative | 276 |
fee, or a nominal access fee, paid to a managed
health care system | 277 |
under which the recipient of health care
services remains solely | 278 |
responsible for any charges accessed for
those services by the | 279 |
provider or health care facility. | 280 |
(W)(X) "Provider" means any
natural person or partnership of | 288 |
natural persons who are
licensed, certified, accredited, or | 289 |
otherwise authorized in this
state to furnish health care | 290 |
services, or any professional
association organized under Chapter | 291 |
1785. of the Revised
Code, provided that nothing in
this chapter | 292 |
or other provisions of law shall be construed to
preclude a health | 293 |
insuring corporation, health care
practitioner, or organized | 294 |
health care group associated with a
health insuring corporation | 295 |
from employing certified nurse practitioners,
certified nurse | 296 |
anesthetists, clinical nurse specialists, certified nurse | 297 |
midwives, dietitians, physicians' assistants, dental assistants, | 298 |
dental
hygienists, optometric technicians, or other allied health | 299 |
personnel who are licensed, certified, accredited, or otherwise | 300 |
authorized in this state to furnish health care services. | 301 |
(X)(Y) "Provider sponsored
organization" means a corporation, | 302 |
as defined in division
(G) of this section, that is at least | 303 |
eighty per cent owned or
controlled
by one or more hospitals, as | 304 |
defined in section 3727.01 of the
Revised Code, or one or more | 305 |
physicians licensed
to practice medicine or surgery or osteopathic | 306 |
medicine and
surgery under Chapter 4731. of the Revised
Code, or | 307 |
any combination of such physicians and
hospitals. Such control is | 308 |
presumed to exist if at least eighty per cent
of the voting rights | 309 |
or governance rights of a provider
sponsored organization are | 310 |
directly or indirectly owned,
controlled, or otherwise held by any | 311 |
combination of the
physicians and hospitals described in this | 312 |
division. | 313 |
(AA)(BB) "Urgent care
services" means those health care | 323 |
services
that are
appropriately provided for an unforeseen | 324 |
condition of a
kind
that usually requires medical attention | 325 |
without delay but
that
does not pose a threat to the life, limb, | 326 |
or permanent health
of
the injured or ill person,
and may include | 327 |
such health care
services provided
out of the health insuring | 328 |
corporation's
approved service area
pursuant to indemnity payments | 329 |
or service
agreements. | 330 |
Sec. 1751.02. (A) Notwithstanding any law in this state to | 331 |
the
contrary, any
corporation, as defined in section 1751.01 of | 332 |
the
Revised Code, may apply to the
superintendent of insurance for | 333 |
a certificate of authority to
establish and operate a health | 334 |
insuring corporation. If the corporation
applying for a | 335 |
certificate of authority is a
foreign corporation domiciled in a | 336 |
state without laws
similar to those of this chapter,
the | 337 |
corporation must form a domestic corporation to apply for, obtain, | 338 |
and
maintain a certificate of authority under this chapter. | 339 |
(C) Except as provided by division (D) of this section,
no | 343 |
political subdivision or department, office, or
institution of | 344 |
this state, or corporation formed by or on behalf of any
political | 345 |
subdivision or department, office, or institution of this state, | 346 |
shall establish, operate, or perform the services of a health | 347 |
insuring
corporation.
Nothing in this
section shall be construed | 348 |
to preclude a board of county
commissioners, a county board of | 349 |
mental retardation and
developmental disabilities, an alcohol and | 350 |
drug addiction
services board, a board of alcohol, drug addiction, | 351 |
and mental
health services, or a community mental health board, or | 352 |
a public
entity formed by or on behalf of any of these boards, | 353 |
from using
managed care techniques in carrying out the board's or | 354 |
public
entity's duties pursuant to the requirements of
Chapters | 355 |
307., 329., 340., and
5126. of the Revised
Code. However, no such | 356 |
board
or public entity may operate so as to compete in the private | 357 |
sector with health insuring corporations holding certificates of | 358 |
authority under this chapter. | 359 |
(E) A health insuring
corporation shall operate in this state | 365 |
in compliance with this
chapter and Chapter 1753. of the Revised | 366 |
Code, and with sections
3702.51 to 3702.62 of the
Revised
Code, | 367 |
and shall operate in
conformity with its filings with the | 368 |
superintendent under this
chapter, including filings made pursuant | 369 |
to sections 1751.03,
1751.11, 1751.12, and 1751.31 of the
Revised | 370 |
Code. | 371 |
(F) An insurer licensed under Title XXXIX of
the
Revised Code | 372 |
need not obtain a certificate of
authority as a health insuring | 373 |
corporation to offer an open
panel plan as long as the providers | 374 |
and health care facilities
participating in the open panel plan | 375 |
receive their compensation
directly from the insurer. If the | 376 |
providers and health care
facilities participating in the open | 377 |
panel plan receive their
compensation from any person other than | 378 |
the insurer, or if the
insurer offers a closed panel plan, the | 379 |
insurer must obtain a
certificate of authority as a health | 380 |
insuring corporation. | 381 |
(G) An intermediary
organization need not obtain a | 382 |
certificate of authority as a
health insuring corporation, | 383 |
regardless of the method of reimbursement to the
intermediary | 384 |
organization,
as long as a health insuring
corporation or a | 385 |
self-insured employer maintains the ultimate responsibility
to | 386 |
assure delivery of all health care services required by the | 387 |
contract
between the health insuring corporation and the | 388 |
subscriber and
the laws of this state or between the self-insured | 389 |
employer and its
employees. | 390 |
Nothing in this section shall be construed to require any | 391 |
health care facility, provider, health delivery network, or | 392 |
intermediary organization that contracts with a health insuring | 393 |
corporation or self-insured employer, regardless of the method
of | 394 |
reimbursement to the health care facility, provider, health | 395 |
delivery network, or intermediary organization, to obtain a | 396 |
certificate of authority as a health insuring corporation under | 397 |
this chapter, unless otherwise provided, in the case of
contracts | 398 |
with a self-insured employer, by operation of the
"Employee | 399 |
Retirement
Income
Security
Act of 1974," 88
Stat. 829, 29
U.S.C.A. | 400 |
1001, as amended. | 401 |
(H) Any health delivery
network doing business in this state, | 402 |
including any
health delivery network that is functioning as an | 403 |
intermediary organization
doing business in this
state, that is | 404 |
not required to
obtain a certificate of authority under this | 405 |
chapter shall
certify to the superintendent annually, not later | 406 |
than the
first day of July, and shall
provide a statement signed | 407 |
by the highest ranking official which
includes the following | 408 |
information: | 409 |
(I) The superintendent
shall not issue a certificate of | 415 |
authority to a health insuring
corporation that is a provider | 416 |
sponsored organization unless all
health care plans to be offered | 417 |
by the health insuring
corporation provide basic health care | 418 |
services.
Substantially all of the physicians and hospitals with | 419 |
ownership or control of the provider sponsored organization, as | 420 |
defined in division (X) of
section 1751.01 of the Revised
Code, | 421 |
shall also be
participating providers for the provision of basic | 422 |
health care
services for health care plans offered by the provider | 423 |
sponsored
organization. If a health insuring corporation that is a | 424 |
provider sponsored organization offers health care plans that do | 425 |
not provide basic health care services, the health insuring | 426 |
corporation shall be deemed, for purposes of section 1751.35 of | 427 |
the Revised Code, to have failed to substantially
comply with this | 428 |
chapter. | 429 |
Sec. 3923.28. (A) Every policy of group sickness and | 443 |
accident insurance providing hospital, surgical, or medical | 444 |
expense coverage for other than specific diseases or accidents | 445 |
only, and delivered, issued for delivery, or renewed in this
state | 446 |
on or after January 1, 1979, and that provides coverage for
mental | 447 |
or emotional disorders, shall provide benefits for
services on an | 448 |
outpatient basis for each eligible person under
the policy who | 449 |
resides in this state for mental or emotional
disorders, or for | 450 |
evaluations, that are at least equal to five
hundred fifty dollars | 451 |
in any calendar year or twelve-month
period. The services shall
be | 452 |
legally performed by or under the
clinical supervision of a | 453 |
licensed physician or licensedauthorized under Chapter 4731. of | 454 |
the Revised Code to practice medicine and surgery or osteopathic | 455 |
medicine and surgery; a
psychologist licensed under Chapter 4732. | 456 |
of the Revised Code; a professional clinical counselor, | 457 |
professional counselor, or independent social worker licensed | 458 |
under Chapter 4757. of the Revised Code; or a clinical nurse | 459 |
specialist licensed under Chapter 4723. of the Revised Code whose | 460 |
nursing specialty is mental health, whether performed in
an | 461 |
office, in a hospital, or
in a community mental health facility
so | 462 |
long as the hospital or
community mental health facility is | 463 |
approved by the joint
commission on
accreditation of healthcare | 464 |
organizations, the council on accreditation for children and | 465 |
family services, the rehabilitation accreditation commission, or, | 466 |
until two years after
the effective date of this amendmentJune 6, | 467 |
2001,
certified by the
department of mental health
as being in | 468 |
compliance with standards
established under division
(H) of | 469 |
section 5119.01 of the Revised
Code. | 470 |
(1)
"Biologically based mental illness" means schizophrenia, | 514 |
schizoaffective disorder, major depressive disorder, bipolar | 515 |
disorder, paranoia and other psychotic disorders, | 516 |
obsessive-compulsive disorder, and panic disorder, as these terms | 517 |
are defined in the most recent edition of the diagnostic and | 518 |
statistical manual of mental disorders published by the American | 519 |
psychiatric association. | 520 |
(2)
"Policy of sickness and accident insurance" excludes
any | 521 |
hospital indemnity, medicare supplement, long-term care, | 522 |
disability income, one-time-limited-duration policy of not longer | 523 |
than six months, supplemental benefit, or other policy
that | 524 |
provides coverage for specific diseases or
accidents only; any | 525 |
policy or certificate of sickness and accident insurance that is | 526 |
underwritten by an insurer on an individual basis; any policy that | 527 |
provides coverage for workers' compensation claims compensable | 528 |
pursuant to Chapters 4121. and 4123. of the Revised Code; and any | 529 |
policy that provides coverage to beneficiaries enrolled in Title | 530 |
XIX of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. | 531 |
301, as amended, known as the medical assistance program or | 532 |
medicaid, as provided by the Ohio department of job and family | 533 |
services under Chapter 5111. of the Revised Code. | 534 |
(B)
Notwithstanding section 3901.71 of the
Revised
Code,
and | 535 |
subject to division (E) of this section, each group
policy of | 536 |
sickness
and accident insurance shall provide
benefits
for the | 537 |
diagnosis
and treatment of biologically based mental illnesses on | 538 |
the same
terms and
conditions as, and
shall provide benefits no | 539 |
less
extensive than,
those provided
under the policy of sickness | 540 |
and
accident insurance
for the
treatment and diagnosis of all | 541 |
other
physical diseases and
disorders, if both of the following | 542 |
apply: | 543 |
(1)
The biologically based mental illness is clinically | 544 |
diagnosed by a physician
authorized under Chapter 4731.
of the | 545 |
Revised
Code to practice
medicine and
surgery or osteopathic | 546 |
medicine and surgery; a
psychologist
licensed under Chapter 4732. | 547 |
of
the Revised
Code; a
professional clinical
counselor, | 548 |
professional counselor, or
independent social worker
licensed | 549 |
under Chapter 4757. of
the
Revised
Code; or a clinical nurse | 550 |
specialist licensed under
Chapter 4723. of the
Revised
Code whose | 551 |
nursing specialty is
mental health. | 552 |
(1) The insurer submits documentation certified by an | 583 |
independent member of the American academy of actuaries to the | 584 |
superintendent of insurance showing that actual claims for | 585 |
diagnostic and treatment services for biologically based mental | 586 |
illnesses incurred for a period of at least six months | 587 |
independently caused the insurer's costs for claims and | 588 |
administrative expenses for the coverage of all other physical | 589 |
diseases and disorders to increase by more than one per cent per | 590 |
year. | 591 |
(1)
"Biologically based mental illness" means schizophrenia, | 615 |
schizoaffective disorder, major depressive disorder, bipolar | 616 |
disorder, paranoia and other psychotic disorders, | 617 |
obsessive-compulsive disorder, and panic disorder, as these terms | 618 |
are defined in the most recent edition of the diagnostic and | 619 |
statistical manual of mental disorders published by the American | 620 |
psychiatric association. | 621 |
(B)
Notwithstanding section 3901.71 of the
Revised
Code, and | 627 |
subject to division (F) of this section,
each
plan of health | 628 |
insurance shall provide benefits for the
diagnosis
and treatment | 629 |
of biologically based mental illnesses on the same terms and | 630 |
conditions as,
and
shall
provide benefits no less extensive than, | 631 |
those provided
under
the plan of health insurance for the | 632 |
treatment and diagnosis
of
all other physical diseases and | 633 |
disorders, if both of the
following apply: | 634 |
(1)
The biologically based mental illness is clinically | 635 |
diagnosed by a physician
authorized under Chapter 4731.
of the | 636 |
Revised
Code to practice
medicine and
surgery or osteopathic | 637 |
medicine and surgery; a
psychologist
licensed under Chapter 4732. | 638 |
of
the Revised
Code; a
professional clinical
counselor, | 639 |
professional counselor, or
independent social worker
licensed | 640 |
under Chapter 4757. of
the
Revised
Code; or a clinical nurse | 641 |
specialist licensed under
Chapter 4723. of the
Revised
Code whose | 642 |
nursing specialty is
mental health. | 643 |
(D)
This section does
not apply to a plan of health
insurance | 652 |
if federal
law supersedes, preempts, prohibits, or
otherwise | 653 |
precludes its
application to such plans. This section does not | 654 |
apply to long-term care, hospital indemnity, disability income, or | 655 |
medicare supplement plans of health insurance, or to any other | 656 |
supplemental benefit plans of health insurance. | 657 |
(1) The insurer submits documentation certified by an | 678 |
independent member of the American academy of actuaries to the | 679 |
superintendent of insurance showing that actual claims for | 680 |
diagnostic and treatment services for biologically based mental | 681 |
illnesses incurred for a period of at least six months | 682 |
independently caused the insurer's costs for claims and | 683 |
administrative expenses for the coverage of all other physical | 684 |
diseases and disorders to increase by more than one per cent per | 685 |
year. | 686 |
Sec. 3923.30. Every person, the state and any of its | 709 |
instrumentalities, any county, township, school district, or
other | 710 |
political subdivisions and any of its instrumentalities,
and any | 711 |
municipal corporation and any of its instrumentalities,
which | 712 |
provides payment for health care benefits for any of its
employees | 713 |
resident in this state, which benefits are not provided
by | 714 |
contract with an insurer qualified to provide sickness and | 715 |
accident insurance, or a health insuring
corporation, shall | 716 |
include the following benefits in its plan of health care
benefits | 717 |
commencing on or after January 1, 1979: | 718 |
(1) Payments not less than five hundred fifty dollars in a | 724 |
twelve-month period, for services legally performed by or under | 725 |
the clinical supervision of a licensed physician or a licensed | 726 |
authorized under Chapter 4731. of the Revised Code to practice | 727 |
medicine and surgery or osteopathic medicine and surgery; a | 728 |
psychologist licensed under Chapter 4732. of the Revised Code; a | 729 |
professional clinical counselor, professional counselor, or | 730 |
independent social worker licensed under Chapter 4757. of the | 731 |
Revised Code; or a clinical nurse specialist licensed under | 732 |
Chapter 4723. of the Revised Code whose nursing specialty is | 733 |
mental health, whether performed in an office, in a hospital, or | 734 |
in
a community mental health facility so long as the hospital or | 735 |
community mental health facility is approved by the joint | 736 |
commission on accreditation of
healthcare organizations,
the | 737 |
council on accreditation for children and family services, the | 738 |
rehabilitation accreditation commission, or, until two years after | 739 |
the effective date of this amendmentJune 6, 2001, certified by | 740 |
the
department
of mental health as
being in compliance with | 741 |
standards
established
under division
(H)
of section 5119.01 of the | 742 |
Revised
Code; | 743 |
(1) Payments not less than five hundred fifty dollars in a | 778 |
twelve-month period for services legally performed by or under
the | 779 |
clinical supervision of a licensed physician or licensed | 780 |
psychologisthealth care professional identified in division | 781 |
(A)(1) of this section, whether performed in an office, or in a | 782 |
hospital or
a community mental health facility or alcoholism | 783 |
treatment
facility so long as the hospital, community mental | 784 |
health
facility, or alcoholism treatment facility is approved by | 785 |
the
joint commission on accreditation of hospitals or certified by | 786 |
the
department of health; | 787 |
(4) In order to qualify for participation under this | 794 |
division, every facility specified in this division shall have in | 795 |
effect a plan for utilization review and a plan for peer review | 796 |
and every person specified in this division shall have in effect
a | 797 |
plan for peer review. Such plans shall have the purpose of | 798 |
ensuring high quality patient care and efficient utilization of | 799 |
available health facilities and services. Such person or | 800 |
facilities shall also have in effect a program of rehabilitation | 801 |
or a program of rehabilitation and detoxification. | 802 |
(B) Every insurer that is authorized to write sickness and | 818 |
accident insurance in this state may offer group contracts of | 819 |
sickness and accident insurance to any charitable foundation that | 820 |
is certified as exempt from taxation under section 501(c)(3) of | 821 |
the "Internal Revenue Code of 1986," 100 Stat. 2085, 26 U.S.C.A. | 822 |
1, as amended, and that has the sole purpose of issuing | 823 |
certificates of coverage under these contracts to persons under | 824 |
the age of nineteen who are members of families that have incomes | 825 |
that are no greater than three hundred per cent of the official | 826 |
poverty line. | 827 |
Section 3. Section 1751.01 of the Revised Code, as amended | 841 |
by
this act, shall apply only to policies, contracts, and | 842 |
agreements that are delivered, issued for delivery, or renewed
in | 843 |
this state on or after the effective date of this act;
section | 844 |
3923.28 of the Revised Code, as amended
by this
act, shall apply | 845 |
only to policies of sickness and
accident
insurance on or after | 846 |
the
effective date of this act in accordance
with section 3923.01 | 847 |
of
the Revised Code; sections 3923.281 and 3923.282 of the Revised | 848 |
Code, as
enacted by this act,
shall apply only to policies of | 849 |
sickness and accident insurance and plans of health insurance
that | 850 |
are
established or modified in this state on or after the | 851 |
effective
date of this act; and section 3923.30 of the Revised | 852 |
Code, as amended by this act, shall apply only to public employee | 853 |
health plans established or modified in this state on or after the | 854 |
effective date of this act. | 855 |