(B) A multiple employer welfare arrangement that is
created | 27 |
pursuant to sections 1739.01 to 1739.22 of the Revised
Code and | 28 |
that operates a group self-insurance program shall
comply with all | 29 |
laws applicable to self-funded programs in this
state, including | 30 |
sections 3901.04, 3901.041, 3901.19 to 3901.26,
3901.38, 3901.381 | 31 |
to
3901.3814, 3901.40, 3901.45, 3901.46, 3902.01 to
3902.14, | 32 |
3923.282,
3923.30,
3923.301, 3923.38,
3923.581, 3923.63, 3924.031, | 33 |
3924.032,
and
3924.27
of the Revised Code. | 34 |
(D) A multiple employer welfare arrangement created
pursuant | 40 |
to sections 1739.01 to 1739.22 of the Revised Code shall
provide | 41 |
benefits only to individuals who are members, employees
of | 42 |
members, or the dependents of members or employees, or are | 43 |
eligible for continuation of coverage under section 1751.53 or | 44 |
3923.38 of the Revised Code or under Title X of the "Consolidated | 45 |
Omnibus Budget Reconciliation Act of 1985," 100 Stat. 227, 29 | 46 |
U.S.C.A. 1161, as amended. | 47 |
AExcept as provided by divisions (A)(2) and (3) of this | 68 |
section in
connection with the offering of coverage for diagnostic | 69 |
and treatment
services for biologically based mental illnesses, a | 70 |
health insuring corporation shall not offer coverage for
a health | 71 |
care service, defined as a basic health care service by
this | 72 |
division, unless it offers coverage for all listed basic
health | 73 |
care services. However,
this requirement does not apply to the | 74 |
coverage of beneficiaries
enrolled in Title XVIII of the "Social | 75 |
Security Act," 49 Stat. 620 (1935), 42
U.S.C.A. 301, as amended, | 76 |
pursuant
to a medicare contract, or to the
coverage of | 77 |
beneficiaries enrolled in the federal employee
health benefits | 78 |
program pursuant to 5
U.S.C.A. 8905, or to the coverage of | 79 |
beneficiaries enrolled in Title XIX of the
"Social Security Act," | 80 |
49 Stat. 620
(1935), 42 U.S.C.A. 301, as amended,
known as the | 81 |
medical assistance program or medicaid, provided by
the department | 82 |
of job and family services
under
Chapter 5111. of the Revised | 83 |
Code, or to
the coverage of beneficiaries under any federal health | 84 |
care
program regulated by a federal regulatory body, or to the | 85 |
coverage
of beneficiaries under any
contract covering officers or | 86 |
employees of the state that has
been entered into by the | 87 |
department of
administrative services. | 88 |
(2) A health insuring corporation may offer coverage for | 89 |
diagnostic and treatment services for biologically based mental | 90 |
illnesses without offering coverage for all other basic health | 91 |
care services. A health insuring corporation may offer coverage | 92 |
for diagnostic and treatment services for biologically based | 93 |
mental illnesses alone or in combination with one or more | 94 |
supplemental health care services. However, a health insuring | 95 |
corporation that offers coverage for any other basic health care | 96 |
service shall offer coverage for diagnostic and treatment services | 97 |
for biologically based mental illnesses in combination with the | 98 |
offer of coverage for all other listed basic health care services. | 99 |
(a) The health insuring corporation submits documentation | 105 |
certified by an independent member of the American academy of | 106 |
actuaries to the superintendent of insurance showing that incurred | 107 |
claims for diagnostic and treatment services for biologically | 108 |
based mental illnesses for a period of at least sixmonths | 109 |
independently caused the health insuring corporation's costs for | 110 |
claims and administrative expenses for the coverage of basic | 111 |
health care services to increase by more than one per cent per | 112 |
year. | 113 |
(D) "Biologically based mental illnesses" means | 173 |
schizophrenia, schizoaffective disorder, major depressive | 174 |
disorder, bipolar disorder, paranoia and other psychotic | 175 |
disorders, obsessive-compulsive disorder, and panic disorder, as | 176 |
these terms are defined in the most recent edition of the | 177 |
diagnostic and statistical manual of mental disorders published by | 178 |
the American psychiatric association. | 179 |
(H)(I) "Emergency health
services" means those health care | 191 |
services that must be
available on a seven-days-per-week, | 192 |
twenty-four-hours-per-day
basis in order to prevent jeopardy to an | 193 |
enrollee's health
status that would occur if such services were | 194 |
not received as
soon as possible, and includes, where appropriate, | 195 |
provisions
for transportation and indemnity payments or service | 196 |
agreements
for out-of-area coverage. | 197 |
(K)(L) "Health care
facility" means any facility, except a | 205 |
health care
practitioner's office, that provides preventive, | 206 |
diagnostic,
therapeutic, acute convalescent, rehabilitation, | 207 |
mental health,
mental retardation, intermediate care, or skilled | 208 |
nursing
services. | 209 |
(N)(O) "Health insuring
corporation" means a corporation, as | 216 |
defined in division (G)(H) of this
section, that, pursuant to a | 217 |
policy, contract,
certificate, or agreement, pays for, reimburses, | 218 |
or provides,
delivers, arranges for, or otherwise makes available, | 219 |
basic
health care services, supplemental health care services, or | 220 |
specialty health care services, or a combination of basic health | 221 |
care services and either supplemental health care services or | 222 |
specialty
health care services, through either an open panel plan | 223 |
or a closed panel
plan. | 224 |
"Health insuring
corporation" does not include a limited | 225 |
liability company formed
pursuant to Chapter 1705. of
the Revised | 226 |
Code,
an insurer licensed under
Title
XXXIX of the
Revised
Code if | 227 |
that insurer offers
only open panel plans under which all | 228 |
providers and health care
facilities participating receive their | 229 |
compensation directly
from the insurer, a corporation formed by
or | 230 |
on behalf of a political subdivision or a department, office,
or | 231 |
institution of the state, or a public entity formed by or on | 232 |
behalf of
a board of county commissioners, a county
board of | 233 |
mental retardation and developmental disabilities,
an
alcohol and | 234 |
drug
addiction services board, a board of alcohol, drug addiction, | 235 |
and mental health services, or a community mental health board,
as | 236 |
those terms are used in Chapters 340. and 5126. of the
Revised | 237 |
Code.
Except as provided by division (D)
of section 1751.02 of | 238 |
the
Revised
Code, or as
otherwise provided by law, no
board, | 239 |
commission,
agency, or other entity under the control of a | 240 |
political
subdivision may accept insurance risk in providing for | 241 |
health
care services. However, nothing in this division shall be | 242 |
construed as prohibiting such entities from purchasing the | 243 |
services of a health insuring corporation or a third-party | 244 |
administrator licensed under Chapter 3959. of the Revised
Code. | 245 |
(O)(P) "Intermediary
organization" means a health delivery | 246 |
network or other entity
that contracts with licensed health | 247 |
insuring corporations or self-insured
employers, or both, to | 248 |
provide health care services, and that enters into
contractual | 249 |
arrangements with other entities for the provision
of health care | 250 |
services for the purpose of fulfilling the terms
of its contracts | 251 |
with the health insuring corporations and self-insured
employers. | 252 |
(2) No health insuring corporation may offer an open
panel | 264 |
plan, unless the health insuring corporation is also
licensed as | 265 |
an insurer under Title XXXIX of the
Revised Code, the health | 266 |
insuring corporation, on June 4,
1997,
holds a certificate of | 267 |
authority or license to
operate under Chapter 1736. or 1740. of | 268 |
the Revised Code, or an insurer licensed under
Title XXXIX of the | 269 |
Revised Code is
responsible for the out-of-network risk as | 270 |
evidenced by both an evidence of
coverage filing under section | 271 |
1751.11
of the Revised Code and a policy and
certificate filing | 272 |
under section 3923.02 of the
Revised Code. | 273 |
(U)(V) "Premium rate" means any set fee
regularly paid by a | 283 |
subscriber to a health insuring corporation. A "premium
rate" does | 284 |
not include a one-time membership fee, an annual
administrative | 285 |
fee, or a nominal access fee, paid to a managed
health care system | 286 |
under which the recipient of health care
services remains solely | 287 |
responsible for any charges accessed for
those services by the | 288 |
provider or health care facility. | 289 |
(W)(X) "Provider" means any
natural person or partnership of | 297 |
natural persons who are
licensed, certified, accredited, or | 298 |
otherwise authorized in this
state to furnish health care | 299 |
services, or any professional
association organized under Chapter | 300 |
1785. of the Revised
Code, provided that nothing in
this chapter | 301 |
or other provisions of law shall be construed to
preclude a health | 302 |
insuring corporation, health care
practitioner, or organized | 303 |
health care group associated with a
health insuring corporation | 304 |
from employing certified nurse practitioners,
certified nurse | 305 |
anesthetists, clinical nurse specialists, certified nurse | 306 |
midwives, dietitians, physician assistants, dental assistants, | 307 |
dental
hygienists, optometric technicians, or other allied health | 308 |
personnel who are licensed, certified, accredited, or otherwise | 309 |
authorized in this state to furnish health care services. | 310 |
(X)(Y) "Provider sponsored
organization" means a corporation, | 311 |
as defined in division
(G)(H) of this section, that is at least | 312 |
eighty per cent owned or
controlled
by one or more hospitals, as | 313 |
defined in section 3727.01 of the
Revised Code, or one or more | 314 |
physicians licensed
to practice medicine or surgery or osteopathic | 315 |
medicine and
surgery under Chapter 4731. of the Revised
Code, or | 316 |
any combination of such physicians and
hospitals. Such control is | 317 |
presumed to exist if at least eighty per cent
of the voting rights | 318 |
or governance rights of a provider
sponsored organization are | 319 |
directly or indirectly owned,
controlled, or otherwise held by any | 320 |
combination of the
physicians and hospitals described in this | 321 |
division. | 322 |
(AA)(BB) "Urgent care
services" means those health care | 332 |
services that are
appropriately provided for an unforeseen | 333 |
condition of a kind
that usually requires medical attention | 334 |
without delay but that
does not pose a threat to the life, limb, | 335 |
or permanent health of
the injured or ill person,
and may include | 336 |
such health care services provided
out of the health insuring | 337 |
corporation's approved service area
pursuant to indemnity payments | 338 |
or service agreements. | 339 |
Sec. 1751.02. (A) Notwithstanding any law in this state to | 340 |
the
contrary, any
corporation, as defined in section 1751.01 of | 341 |
the
Revised Code, may apply to the
superintendent of insurance for | 342 |
a certificate of authority to
establish and operate a health | 343 |
insuring corporation. If the corporation
applying for a | 344 |
certificate of authority is a
foreign corporation domiciled in a | 345 |
state without laws
similar to those of this chapter,
the | 346 |
corporation must form a domestic corporation to apply for, obtain, | 347 |
and
maintain a certificate of authority under this chapter. | 348 |
(C) Except as provided by division (D) of this section,
no | 352 |
political subdivision or department, office, or
institution of | 353 |
this state, or corporation formed by or on behalf of any
political | 354 |
subdivision or department, office, or institution of this state, | 355 |
shall establish, operate, or perform the services of a health | 356 |
insuring
corporation.
Nothing in this
section shall be construed | 357 |
to preclude a board of county
commissioners, a county board of | 358 |
mental retardation and
developmental disabilities, an alcohol and | 359 |
drug addiction
services board, a board of alcohol, drug addiction, | 360 |
and mental
health services, or a community mental health board, or | 361 |
a public
entity formed by or on behalf of any of these boards, | 362 |
from using
managed care techniques in carrying out the board's or | 363 |
public
entity's duties pursuant to the requirements of
Chapters | 364 |
307., 329., 340., and
5126. of the Revised
Code. However, no such | 365 |
board
or public entity may operate so as to compete in the private | 366 |
sector with health insuring corporations holding certificates of | 367 |
authority under this chapter. | 368 |
(E) A health insuring
corporation shall operate in this state | 374 |
in compliance with this
chapter and Chapter 1753. of the Revised | 375 |
Code, and with sections
3702.51 to 3702.62 of the
Revised
Code, | 376 |
and shall operate in
conformity with its filings with the | 377 |
superintendent under this
chapter, including filings made pursuant | 378 |
to sections 1751.03,
1751.11, 1751.12, and 1751.31 of the
Revised | 379 |
Code. | 380 |
(F) An insurer licensed under Title XXXIX of
the
Revised Code | 381 |
need not obtain a certificate of
authority as a health insuring | 382 |
corporation to offer an open
panel plan as long as the providers | 383 |
and health care facilities
participating in the open panel plan | 384 |
receive their compensation
directly from the insurer. If the | 385 |
providers and health care
facilities participating in the open | 386 |
panel plan receive their
compensation from any person other than | 387 |
the insurer, or if the
insurer offers a closed panel plan, the | 388 |
insurer must obtain a
certificate of authority as a health | 389 |
insuring corporation. | 390 |
(G) An intermediary
organization need not obtain a | 391 |
certificate of authority as a
health insuring corporation, | 392 |
regardless of the method of reimbursement to the
intermediary | 393 |
organization,
as long as a health insuring
corporation or a | 394 |
self-insured employer maintains the ultimate responsibility
to | 395 |
assure delivery of all health care services required by the | 396 |
contract
between the health insuring corporation and the | 397 |
subscriber and
the laws of this state or between the self-insured | 398 |
employer and its
employees. | 399 |
Nothing in this section shall be construed to require any | 400 |
health care facility, provider, health delivery network, or | 401 |
intermediary organization that contracts with a health insuring | 402 |
corporation or self-insured employer, regardless of the method
of | 403 |
reimbursement to the health care facility, provider, health | 404 |
delivery network, or intermediary organization, to obtain a | 405 |
certificate of authority as a health insuring corporation under | 406 |
this chapter, unless otherwise provided, in the case of
contracts | 407 |
with a self-insured employer, by operation of the
"Employee | 408 |
Retirement
Income
Security
Act of 1974," 88
Stat. 829, 29
U.S.C.A. | 409 |
1001, as amended. | 410 |
(H) Any health delivery
network doing business in this state, | 411 |
including any
health delivery network that is functioning as an | 412 |
intermediary organization
doing business in this
state, that is | 413 |
not required to
obtain a certificate of authority under this | 414 |
chapter shall
certify to the superintendent annually, not later | 415 |
than the
first day of July, and shall
provide a statement signed | 416 |
by the highest ranking official which
includes the following | 417 |
information: | 418 |
(I) The superintendent
shall not issue a certificate of | 424 |
authority to a health insuring
corporation that is a provider | 425 |
sponsored organization unless all
health care plans to be offered | 426 |
by the health insuring
corporation provide basic health care | 427 |
services.
Substantially all of the physicians and hospitals with | 428 |
ownership or control of the provider sponsored organization, as | 429 |
defined in division (X) of
section 1751.01 of the Revised
Code, | 430 |
shall also be
participating providers for the provision of basic | 431 |
health care
services for health care plans offered by the provider | 432 |
sponsored
organization. If a health insuring corporation that is a | 433 |
provider sponsored organization offers health care plans that do | 434 |
not provide basic health care services, the health insuring | 435 |
corporation shall be deemed, for purposes of section 1751.35 of | 436 |
the Revised Code, to have failed to substantially
comply with this | 437 |
chapter. | 438 |
Sec. 3923.28. (A) Every policy of group sickness and | 452 |
accident insurance providing hospital, surgical, or medical | 453 |
expense coverage for other than specific diseases or accidents | 454 |
only, and delivered, issued for delivery, or renewed in this
state | 455 |
on or after January 1, 1979, and that provides coverage for
mental | 456 |
or emotional disorders, shall provide benefits for
services on an | 457 |
outpatient basis for each eligible person under
the policy who | 458 |
resides in this state for mental or emotional
disorders, or for | 459 |
evaluations, that are at least equal to five
hundred fifty dollars | 460 |
in any calendar year or twelve-month
period. The services shall
be | 461 |
legally performed by or under the
clinical supervision of a | 462 |
licensed physician or licensedauthorized under Chapter 4731. of | 463 |
the Revised Code to practice medicine and surgery or osteopathic | 464 |
medicine and surgery; a
psychologist licensed under Chapter 4732. | 465 |
of the Revised Code; a professional clinical counselor, | 466 |
professional counselor, or independent social worker licensed | 467 |
under Chapter 4757. of the Revised Code; or a clinical nurse | 468 |
specialist licensed under Chapter 4723. of the Revised Code whose | 469 |
nursing specialty is mental health, whether performed in
an | 470 |
office, in a hospital, or
in a community mental health facility
so | 471 |
long as the hospital or
community mental health facility is | 472 |
approved by the joint
commission on
accreditation of healthcare | 473 |
organizations, the council on accreditation for children and | 474 |
family services, the rehabilitation accreditation commission, or, | 475 |
until two years after
the effective date of this amendmentJune 6, | 476 |
2001,
certified by the
department of mental health
as being in | 477 |
compliance with standards
established under division
(H) of | 478 |
section 5119.01 of the Revised
Code. | 479 |
(1)
"Biologically based mental illness" means schizophrenia, | 523 |
schizoaffective disorder, major depressive disorder, bipolar | 524 |
disorder, paranoia and other psychotic disorders, | 525 |
obsessive-compulsive disorder, and panic disorder, as these terms | 526 |
are defined in the most recent edition of the diagnostic and | 527 |
statistical manual of mental disorders published by the American | 528 |
psychiatric association. | 529 |
(2)
"Policy of sickness and accident insurance" has the same | 530 |
meaning as in section 3923.01 of the Revised Code, but excludes | 531 |
any hospital indemnity, medicare supplement, long-term care, | 532 |
disability income, one-time-limited-duration policy of not longer | 533 |
than six months, supplemental benefit, or other policy
that | 534 |
provides coverage for specific diseases or
accidents only; any | 535 |
policy that provides coverage for workers' compensation claims | 536 |
compensable pursuant to Chapters 4121. and 4123. of the Revised | 537 |
Code; and any policy that provides coverage to beneficiaries | 538 |
enrolled in Title XIX of the "Social Security Act," 49 Stat. 620 | 539 |
(1935), 42 U.S.C.A. 301, as amended, known as the medical | 540 |
assistance program or medicaid, as provided by the Ohio department | 541 |
of job and family services under Chapter 5111. of the Revised | 542 |
Code. | 543 |
(B)
Notwithstanding section 3901.71 of the
Revised
Code,
and | 544 |
subject to division (E) of this section, every group
policy of | 545 |
sickness
and accident insurance shall provide
benefits
for the | 546 |
diagnosis
and treatment of biologically based mental illnesses on | 547 |
the same
terms and
conditions as, and
shall provide benefits no | 548 |
less
extensive than,
those provided
under the policy of sickness | 549 |
and
accident insurance
for the
treatment and diagnosis of all | 550 |
other
physical diseases and
disorders, if both of the following | 551 |
apply: | 552 |
(1)
The biologically based mental illness is clinically | 553 |
diagnosed by a physician
authorized under Chapter 4731.
of the | 554 |
Revised
Code to practice
medicine and
surgery or osteopathic | 555 |
medicine and surgery; a
psychologist
licensed under Chapter 4732. | 556 |
of
the Revised
Code; a
professional clinical
counselor, | 557 |
professional counselor, or
independent social worker
licensed | 558 |
under Chapter 4757. of
the
Revised
Code; or a clinical nurse | 559 |
specialist licensed under
Chapter 4723. of the
Revised
Code whose | 560 |
nursing specialty is
mental health. | 561 |
(1) The insurer submits documentation certified by an | 592 |
independent member of the American academy of actuaries to the | 593 |
superintendent of insurance showing that incurred claims for | 594 |
diagnostic and treatment services for biologically based mental | 595 |
illnesses for a period of at least six months independently caused | 596 |
the insurer's costs for claims and administrative expenses for the | 597 |
coverage of all other physical diseases and disorders to increase | 598 |
by more than one per cent per year. | 599 |
(1)
"Biologically based mental illness" means schizophrenia, | 623 |
schizoaffective disorder, major depressive disorder, bipolar | 624 |
disorder, paranoia and other psychotic disorders, | 625 |
obsessive-compulsive disorder, and panic disorder, as these terms | 626 |
are defined in the most recent edition of the diagnostic and | 627 |
statistical manual of mental disorders published by the American | 628 |
psychiatric association. | 629 |
(B)
Notwithstanding section 3901.71 of the
Revised
Code, and | 635 |
subject to division (F) of this section,
each
plan of health | 636 |
coverage shall provide benefits for the
diagnosis
and treatment
of | 637 |
biologically based mental illnesses on the same terms and | 638 |
conditions as,
and
shall
provide benefits no less extensive than, | 639 |
those provided
under
the plan of health coverage for the treatment | 640 |
and diagnosis
of
all other physical diseases and disorders, if | 641 |
both of the
following apply: | 642 |
(1)
The biologically based mental illness is clinically | 643 |
diagnosed by a physician
authorized under Chapter 4731.
of the | 644 |
Revised
Code to practice
medicine and
surgery or osteopathic | 645 |
medicine and surgery; a
psychologist
licensed under Chapter 4732. | 646 |
of
the Revised
Code; a
professional clinical
counselor, | 647 |
professional counselor, or
independent social worker
licensed | 648 |
under Chapter 4757. of
the
Revised
Code; or a clinical nurse | 649 |
specialist licensed under
Chapter 4723. of the
Revised
Code whose | 650 |
nursing specialty is
mental health. | 651 |
(D)
This section does
not apply to a plan of health
coverage | 660 |
if federal
law supersedes, preempts, prohibits, or
otherwise | 661 |
precludes its
application to such plans. This section does not | 662 |
apply to long-term care, hospital indemnity, disability income, or | 663 |
medicare supplement plans of health coverage, or to any other | 664 |
supplemental benefit plans of health coverage. | 665 |
(1) The employer submits documentation certified by an | 686 |
independent member of the American academy of actuaries to the | 687 |
superintendent of insurance showing that incurred claims for | 688 |
diagnostic and treatment services for biologically based mental | 689 |
illnesses for a period of at least six months independently caused | 690 |
the employer's costs for claims and administrative expenses for | 691 |
the coverage of all other physical diseases and disorders to | 692 |
increase by more than one per cent per year. | 693 |
Sec. 3923.30. Every person, the state and any of its | 704 |
instrumentalities, any county, township, school district, or
other | 705 |
political subdivisions and any of its instrumentalities,
and any | 706 |
municipal corporation and any of its instrumentalities,
which | 707 |
provides payment for health care benefits for any of its
employees | 708 |
resident in this state, which benefits are not provided
by | 709 |
contract with an insurer qualified to provide sickness and | 710 |
accident insurance, or a health insuring
corporation, shall | 711 |
include the following benefits in its plan of health care
benefits | 712 |
commencing on or after January 1, 1979: | 713 |
(1) Payments not less than five hundred fifty dollars in a | 719 |
twelve-month period, for services legally performed by or under | 720 |
the clinical supervision of a licensed physician or a licensed | 721 |
authorized under Chapter 4731. of the Revised Code to practice | 722 |
medicine and surgery or osteopathic medicine and surgery; a | 723 |
psychologist licensed under Chapter 4732. of the Revised Code; a | 724 |
professional clinical counselor, professional counselor, or | 725 |
independent social worker licensed under Chapter 4757. of the | 726 |
Revised Code; or a clinical nurse specialist licensed under | 727 |
Chapter 4723. of the Revised Code whose nursing specialty is | 728 |
mental health, whether performed in an office, in a hospital, or | 729 |
in
a community mental health facility so long as the hospital or | 730 |
community mental health facility is approved by the joint | 731 |
commission on accreditation of
healthcare organizations,
the | 732 |
council on accreditation for children and family services, the | 733 |
rehabilitation accreditation commission, or, until two years after | 734 |
the effective date of this amendmentJune 6, 2001, certified by | 735 |
the
department
of mental health as
being in compliance with | 736 |
standards
established
under division
(H)
of section 5119.01 of the | 737 |
Revised
Code; | 738 |
(1) Payments not less than five hundred fifty dollars in a | 773 |
twelve-month period for services legally performed by or under
the | 774 |
clinical supervision of a licensed physician or licensed | 775 |
psychologisthealth care professional identified in division | 776 |
(A)(1) of this section, whether performed in an office, or in a | 777 |
hospital or
a community mental health facility or alcoholism | 778 |
treatment
facility so long as the hospital, community mental | 779 |
health
facility, or alcoholism treatment facility is approved by | 780 |
the
joint commission on accreditation of hospitals or certified by | 781 |
the
department of health; | 782 |
(4) In order to qualify for participation under this | 789 |
division, every facility specified in this division shall have in | 790 |
effect a plan for utilization review and a plan for peer review | 791 |
and every person specified in this division shall have in effect
a | 792 |
plan for peer review. Such plans shall have the purpose of | 793 |
ensuring high quality patient care and efficient utilization of | 794 |
available health facilities and services. Such person or | 795 |
facilities shall also have in effect a program of rehabilitation | 796 |
or a program of rehabilitation and detoxification. | 797 |
(B) Every insurer that is authorized to write sickness and | 813 |
accident insurance in this state may offer group contracts of | 814 |
sickness and accident insurance to any charitable foundation that | 815 |
is certified as exempt from taxation under section 501(c)(3) of | 816 |
the "Internal Revenue Code of 1986," 100 Stat. 2085, 26 U.S.C.A. | 817 |
1, as amended, and that has the sole purpose of issuing | 818 |
certificates of coverage under these contracts to persons under | 819 |
the age of nineteen who are members of families that have incomes | 820 |
that are no greater than three hundred per cent of the official | 821 |
poverty line. | 822 |
Section 3. Section 1751.01 of the Revised Code, as amended | 836 |
by
this act, shall apply only to policies, contracts, and | 837 |
agreements that are delivered, issued for delivery, or renewed
in | 838 |
this state six months after the effective date of this act; | 839 |
section
3923.28 of the Revised Code, as amended
by this
act, shall | 840 |
apply only to policies of sickness and
accident
insurance six | 841 |
months after the
effective date of this act in accordance
with | 842 |
section 3923.01 of
the Revised Code; sections 3923.281 and | 843 |
3923.282 of the Revised Code, as
enacted by this act,
shall apply | 844 |
only to policies of sickness and accident insurance and plans of | 845 |
health coverage
that are
established or modified in this state six | 846 |
months after the
effective
date of this act; and section 3923.30 | 847 |
of the Revised Code, as amended by this act, shall apply only to | 848 |
public employee health plans established or modified in this state | 849 |
six months after the effective date of this act. | 850 |
(B) Except as provided in division (C) of this section, | 859 |
during the ninety-day period beginning on the effective date of | 860 |
this act, no person, political subdivision, or agency or | 861 |
instrumentality of this state shall establish, develop, or | 862 |
construct a special hospital in a county with a population of more | 863 |
than one hundred forty thousand but less than one hundred fifty | 864 |
thousand individuals. | 865 |
(D) The director of health may petition the court of common | 870 |
pleas of the county in which a special hospital is located for an | 871 |
order enjoining any person, political subdivision, or agency or | 872 |
instrumentality of this state from violating division (B) of this | 873 |
section. Irrespective of any other remedy the director may have in | 874 |
law or equity, the court may grant the order on a showing that the | 875 |
respondent named in the petition is violating division (B) of this | 876 |
section. | 877 |