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| To amend section 1739.05 and to enact sections | 1 |
| 1751.69, 3923.651, and 5111.017 of the Revised | 2 |
| Code to require certain health care plans to | 3 |
| provide benefits for colorectal examinations and | 4 |
| laboratory tests for cancer. | 5 |
| Section 1. That section 1739.05 be amended and sections | 6 |
| 1751.69, 3923.651, and 5111.017 of the Revised Code be enacted to | 7 |
| read as follows: | 8 |
| Sec. 1739.05. (A) A multiple employer welfare arrangement | 9 |
| that is created pursuant to sections 1739.01 to 1739.22 of the | 10 |
| Revised Code and that operates a group self-insurance program may | 11 |
| be established only if any of the following applies: | 12 |
| (1) The arrangement has and maintains a minimum enrollment of | 13 |
| three hundred employees of two or more employers. | 14 |
| (2) The arrangement has and maintains a minimum enrollment of | 15 |
| three hundred self-employed individuals. | 16 |
| (3) The arrangement has and maintains a minimum enrollment of | 17 |
| three hundred employees or self-employed individuals in any | 18 |
| combination of divisions (A)(1) and (2) of this section. | 19 |
| (B) A multiple employer welfare arrangement that is created | 20 |
| pursuant to sections 1739.01 to 1739.22 of the Revised Code and | 21 |
| that operates a group self-insurance program shall comply with all | 22 |
| laws applicable to self-funded programs in this state, including | 23 |
| sections 3901.04, 3901.041, 3901.19 to 3901.26, 3901.38, 3901.381 | 24 |
| to 3901.3814, 3901.40, 3901.45, 3901.46, 3902.01 to 3902.14, | 25 |
| 3923.282, 3923.30, 3923.301, 3923.38, 3923.581, 3923.63, 3923.651, | 26 |
| 3923.80, 3924.031, 3924.032, and 3924.27 of the Revised Code. | 27 |
| (C) A multiple employer welfare arrangement created pursuant | 28 |
| to sections 1739.01 to 1739.22 of the Revised Code shall solicit | 29 |
| enrollments only through agents or solicitors licensed pursuant to | 30 |
| Chapter 3905. of the Revised Code to sell or solicit sickness and | 31 |
| accident insurance. | 32 |
| (D) A multiple employer welfare arrangement created pursuant | 33 |
| to sections 1739.01 to 1739.22 of the Revised Code shall provide | 34 |
| benefits only to individuals who are members, employees of | 35 |
| members, or the dependents of members or employees, or are | 36 |
| eligible for continuation of coverage under section 1751.53 or | 37 |
| 3923.38 of the Revised Code or under Title X of the "Consolidated | 38 |
| Omnibus Budget Reconciliation Act of 1985," 100 Stat. 227, 29 | 39 |
| U.S.C.A. 1161, as amended. | 40 |
| Sec. 1751.69. (A) Notwithstanding section 3901.71 of the | 41 |
| Revised Code, each individual or group health insuring corporation | 42 |
| policy, contract, or agreement providing basic health care | 43 |
| services that is delivered, issued for delivery, or renewed in | 44 |
| this state shall provide benefits for the expenses of colorectal | 45 |
| cancer examinations and laboratory tests for colorectal cancer for | 46 |
| any symptomatic individual and any nonsymptomatic individual who | 47 |
| is either of the following: | 48 |
| (1) Fifty years of age or older; | 49 |
| (2) Less than fifty years of age and at high risk for | 50 |
| colorectal cancer according to the most recently published | 51 |
| colorectal cancer screening guidelines of the American cancer | 52 |
| society. | 53 |
| (B) The benefits provided under division (A) of this section | 54 |
| shall be provided for examinations and laboratory tests that are | 55 |
| performed in accordance with the most recently published | 56 |
| colorectal cancer screening guidelines of the American cancer | 57 |
| society. | 58 |
| (C) The benefits provided under division (A) of this section | 59 |
| shall be subject to the same terms and conditions, including | 60 |
| copayment charges, that apply to similar benefits provided under | 61 |
| the policy, contract, or agreement. | 62 |
| Sec. 3923.651. (A) Notwithstanding section 3901.71 of the | 63 |
| Revised Code, each individual or group policy of sickness and | 64 |
| accident insurance that is delivered, issued for delivery, or | 65 |
| renewed in this state and each public employee benefit plan that | 66 |
| is established or modified in this state shall provide benefits | 67 |
| for the expenses of colorectal cancer examinations and laboratory | 68 |
| tests for colorectal cancer for any symptomatic individual and any | 69 |
| nonsymptomatic individual who is either of the following: | 70 |
| (1) Fifty years of age or older; | 71 |
| (2) Less than fifty years of age and at high risk for | 72 |
| colorectal cancer according to the most recently published | 73 |
| colorectal cancer screening guidelines of the American cancer | 74 |
| society. | 75 |
| (B) The benefits provided under division (A) of this section | 76 |
| shall be provided for examinations and laboratory tests that are | 77 |
| performed in accordance with the most recently published | 78 |
| colorectal cancer screening guidelines of the American cancer | 79 |
| society. | 80 |
| (C) The benefits provided under division (A) of this section | 81 |
| shall be subject to the same terms and conditions, including | 82 |
| copayments and deductibles, that apply to similar benefits | 83 |
| provided under the policy or plan. | 84 |
| (D) This section does not apply to any policy that provides | 85 |
| coverage for specific diseases or accidents only, or to any | 86 |
| hospital indemnity, medicare supplement, medicare, tricare, | 87 |
| long-term care, disability income, one-time limited duration | 88 |
| policy of not longer than six months, or other policy that offers | 89 |
| only supplemental benefits. | 90 |
| Sec. 5111.017. (A) The provision of medical assistance under | 91 |
| this chapter shall include coverage of colorectal cancer | 92 |
| examinations and laboratory tests for cancer for any | 93 |
| nonsymptomatic individual who is either of the following: | 94 |
| (1) Fifty years of age or older; | 95 |
| (2) Less than fifty years of age and at high risk for | 96 |
| colorectal cancer according to the most recently published | 97 |
| colorectal cancer screening guidelines of the American cancer | 98 |
| society. | 99 |
| (B) The coverage provided under division (A) of this section | 100 |
| shall be provided for examinations and laboratory tests that are | 101 |
| performed in accordance with the most recently published cancer | 102 |
| screening guidelines of the American cancer society. | 103 |
| Section 2. That existing section 1739.05 of the Revised Code | 104 |
| is hereby repealed. | 105 |