As Passed by the House

130th General Assembly
Regular Session
2013-2014
Sub. S. B. No. 9


Senator Bacon 

Cosponsors: Senators Beagle, Hite, Jones, Seitz, Widener, Brown, Cafaro, Eklund, Lehner, Manning, Peterson, Smith 

Representatives Carney, Hackett, Henne, Huffman, Letson, Pillich, Sears, Wachtmann Speaker Batchelder 



A BILL
To amend section 1751.31 and to suspend sections 1
1751.15, 1751.16, 1751.17, 3923.122, 3923.58, 2
3923.581, 3923.582, 3923.59, 3924.07, 3924.08, 3
3924.09, 3924.10, 3924.11, 3924.111, 3924.12, 4
3924.13, and 3924.14 of the Revised Code to make 5
changes to the procedure for submission and review 6
of a health insuring corporation's solicitation 7
document, and to suspend the enforcement of the 8
Ohio Open Enrollment Program, the Ohio Health 9
Reinsurance Program, and the option for conversion 10
of a health insurance contract or policy under 11
certain circumstances during the period beginning 12
January 1, 2014, and expiring January 1, 2018.13


BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

       Section 1.  That section 1751.31 of the Revised Code be 14
amended to read as follows:15

       Sec. 1751.31.  (A) Any changes in a health insuring 16
corporation's solicitation document shall be filed with the 17
superintendent of insurance thirty days prior to use for 18
informational purposes, and shall comply with the requirements of 19
this section. TheIf the superintendent finds that any 20
solicitation document fails to comply with the requirements of 21
this section, the superintendent, within sixty days of filing, may 22
disapprove any solicitation document or require amendment to it on 23
any of the grounds stated in this section. Such disapproval shall 24
be effected by written notice to the health insuring corporation. 25
The notice shall state the grounds for disapproval and shall be 26
issued in accordance with Chapter 119. of the Revised Code.27

       (B) The solicitation document shall contain all information 28
necessary to enable a consumer to make an informed choice as to 29
whether or not to enroll in the health insuring corporation. The 30
information shall include a specific description of the health 31
care services to be available and the approximate number and type 32
of full-time equivalent medical practitioners. The information 33
shall be presented in the solicitation document in a manner that 34
is clear, concise, and intelligible to prospective applicants in 35
the proposed service area.36

       (C) Every potential applicant whose subscription to a health 37
care plan is solicited shall receive, at or before the time of 38
solicitation, a solicitation document approved by the 39
superintendent.40

       (D) Notwithstanding division (A) of this section, a health 41
insuring corporation may use a solicitation document that the 42
corporation uses in connection with policies for medicare 43
beneficiaries pursuant to a medicare risk contract or medicare 44
cost contract, or for policies for beneficiaries of the federal 45
employees health benefits program pursuant to 5 U.S.C.A. 8905, or 46
for policies for medicaid recipients, or for policies for 47
beneficiaries of any other federal health care program regulated 48
by a federal regulatory body, or for policies for beneficiaries of 49
contracts covering officers or employees of the state entered into 50
by the department of administrative services, if both of the 51
following apply:52

       (1) The solicitation document has been approved by the United 53
States department of health and human services, the United States 54
office of personnel management, the department of job and family 55
services, or the department of administrative services.56

       (2) The solicitation document is filed with the 57
superintendent of insurance prior to use and is accompanied by 58
documentation of approval from the United States department of 59
health and human services, the United States office of personnel 60
management, the department of job and family services, or the 61
department of administrative services.62

       (E) No health insuring corporation, or its agents or 63
representatives, shall use monetary or other valuable 64
consideration, engage in misleading or deceptive practices, or 65
make untrue, misleading, or deceptive representations to induce 66
enrollment. Nothing in this division shall prohibit incentive 67
forms of remuneration such as commission sales programs for the 68
health insuring corporation's employees and agents.69

       (F) Any person obligated for any part of a premium rate in 70
connection with an enrollment agreement, in addition to any right 71
otherwise available to revoke an offer, may cancel such agreement 72
within seventy-two hours after having signed the agreement or 73
offer to enroll. Cancellation occurs when written notice of the 74
cancellation is given to the health insuring corporation or its 75
agents or other representatives. A notice of cancellation mailed 76
to the health insuring corporation shall be considered to have 77
been filed on its postmark date.78

       (G) Nothing in this section shall prohibit healthy lifestyle 79
programs.80

       Section 2.  That existing section 1751.31 of the Revised Code 81
is hereby repealed.82

       Section 3.  (A) During the period beginning on January 1, 83
2014, and expiring January 1, 2018, the operation of sections 84
1751.15, 1751.16, 1751.17, 3923.122, 3923.58, 3923.581, 3923.582, 85
3923.59, 3924.07, 3924.08, 3924.09, 3924.10, 3924.11, 3924.111, 86
3924.12, 3924.13, and 3924.14 of the Revised Code are suspended. 87
The suspension shall take effect in accordance with the following:88

       (1) Carriers shall not be required to offer open enrollment 89
coverage under the Ohio Open Enrollment Program on or after 90
January 1, 2014. In addition, carriers shall not reinsure any 91
insurance policies with the Ohio Health Reinsurance Program during 92
the suspension of the Program on or after January 1, 2014.93

       (2) Notwithstanding this section, the Board of Directors of 94
the Ohio Health Reinsurance Program shall continue to have all of 95
the authority and protection provided by sections 3924.07 to 96
3924.14 of the Revised Code during the period beginning January 1, 97
2014, and ending December 31, 2014, in order to wind up the 98
affairs of the Ohio Health Reinsurance Program. This shall 99
include, but is not limited to, the receipt, processing, and 100
payment of all claims incurred on or before January 1, 2014, 101
assessments needed to fund the wind up of the Program, the refund 102
of any excess assessments, and the preparation of final audited 103
financial statements and tax returns.104

        (3) With respect to an open enrollment or conversion policy 105
or contract issued prior to January 1, 2014, a carrier may 106
terminate such policy or contract on or after January 1, 2014, if 107
the carrier does both of the following:108

       (a) Provides notice of termination to the policy or contract 109
holder at the time the policy is issued or at least ninety days 110
prior to the termination;111

       (b) Offers the policy or contract holder the option to 112
purchase other coverage offered by the insurer to be effective at 113
the time of the termination.114

       (4) Carriers shall not be required to include any option to 115
convert coverage as required by sections 1751.16, 1751.17, and 116
3923.122 of the Revised Code in any policy or contract issued on 117
or after January 1, 2014.118

       (B) If the amendments made by 42 U.S.C. 300gg-1 and 300gg-6, 119
regarding the requirements related to health insurance coverage, 120
do not take effect January 1, 2014, or become ineffective prior to 121
the expiration of the suspension on January 1, 2018, then sections 122
1751.15, 1751.16, 1751.17, 3923.122, 3923.58, 3923.581, 3923.582, 123
3923.59, 3924.07, 3924.08, 3924.09, 3924.10, 3924.11, 3924.111, 124
3924.12, 3924.13, and 3924.14 of the Revised Code, in either their 125
present form or as they are later amended, again become 126
operational.127