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| To amend section 1739.05 and to enact sections | 1 |
| 1751.181, 3923.023, and 3923.024 of the Revised | 2 |
| Code to prohibit a health plan issuer from | 3 |
| considering gender when determining premium rates. | 4 |
| Section 1. That section 1739.05 be amended and sections | 5 |
| 1751.181, 3923.023, and 3923.024 of the Revised Code be enacted to | 6 |
| read as follows: | 7 |
| Sec. 1739.05. (A) A multiple employer welfare arrangement | 8 |
| that is created pursuant to sections 1739.01 to 1739.22 of the | 9 |
| Revised Code and that operates a group self-insurance program may | 10 |
| be established only if any of the following applies: | 11 |
| (1) The arrangement has and maintains a minimum enrollment of | 12 |
| three hundred employees of two or more employers. | 13 |
| (2) The arrangement has and maintains a minimum enrollment of | 14 |
| three hundred self-employed individuals. | 15 |
| (3) The arrangement has and maintains a minimum enrollment of | 16 |
| three hundred employees or self-employed individuals in any | 17 |
| combination of divisions (A)(1) and (2) of this section. | 18 |
| (B) A multiple employer welfare arrangement that is created | 19 |
| pursuant to sections 1739.01 to 1739.22 of the Revised Code and | 20 |
| that operates a group self-insurance program shall comply with all | 21 |
| laws applicable to self-funded programs in this state, including | 22 |
| sections 3901.04, 3901.041, 3901.19 to 3901.26, 3901.38, 3901.381 | 23 |
| to 3901.3814, 3901.40, 3901.45, 3901.46, 3902.01 to 3902.14, | 24 |
| 3923.023, 3923.24, 3923.282, 3923.30, 3923.301, 3923.38, 3923.581, | 25 |
| 3923.63, 3923.80, 3924.031, 3924.032, and 3924.27 of the Revised | 26 |
| 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. 1751.181. (A) No health insuring corporation shall | 41 |
| consider the gender of an applicant, enrollee, or subscriber in | 42 |
| determining the premium rate for a policy, contract, or agreement | 43 |
| that provides coverage for basic healthcare services. | 44 |
| (B) This section shall not apply to any insurance policy, | 45 |
| contract, or agreement that pertains solely to the following or | 46 |
| any combination of the following: | 47 |
| (1) Accident only; | 48 |
| (2) Credit; | 49 |
| (3) Dental; | 50 |
| (4) Disability income; | 51 |
| (5) Long-term care; | 52 |
| (6) Hospital indemnity; | 53 |
| (7) Medicare supplement; | 54 |
| (8) Specified disease; | 55 |
| (9) Vision care; | 56 |
| (10) A one-time, limited duration policy of not longer than | 57 |
| six months; | 58 |
| (11) Coverage issued as a supplement to liability insurance; | 59 |
| (12) Workers' compensation insurance; | 60 |
| (13) Automobile medical payment insurance; | 61 |
| (14) Insurance under which benefits are payable with or | 62 |
| without regard to fault and that is statutorily required to be | 63 |
| contained in any liability insurance policy or equivalent | 64 |
| self-insurance. | 65 |
| Sec. 3923.023. (A) No sickness and accident insurer shall | 66 |
| consider the gender of an applicant, policyholder, subscriber, or | 67 |
| member in determining the premium rate for a health benefit plan. | 68 |
| (B) As used in this section, "health benefit plan" has the | 69 |
| same meaning as in section 3924.01 of the Revised Code. | 70 |
| Sec. 3923.024. (A) No issuer of a public employee health | 71 |
| benefit plan shall consider the gender of an applicant, | 72 |
| policyholder, subscriber, or member in determining the premium | 73 |
| rate for a health benefit plan. | 74 |
| (B) As used in this section, "health benefit plan" has the | 75 |
| same meaning as in section 3924.01 of the Revised Code. | 76 |
| Section 2. That existing section 1739.05 of the Revised Code | 77 |
| is hereby repealed. | 78 |