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S. B. No. 138 As IntroducedAs Introduced
128th General Assembly | Regular Session | 2009-2010 |
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A BILL
To amend section 1739.05 and to enact sections
1751.69 and 3923.85 of the Revised Code to require
certain insurers that provide coverage for cancer
chemotherapy treatment to provide coverage for
certain prescribed, orally administered anticancer
medication on a basis no less favorable than
intravenously administered or injected cancer
medications that are covered under the policy.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That section 1739.05 be amended and sections
1751.69 and 3923.85 of the Revised Code be enacted to read as
follows:
Sec. 1739.05. (A) A multiple employer welfare arrangement
that is created pursuant to sections 1739.01 to 1739.22 of the
Revised Code and that operates a group self-insurance program may
be established only if any of the following applies:
(1) The arrangement has and maintains a minimum enrollment
of
three hundred employees of two or more employers.
(2) The arrangement has and maintains a minimum enrollment
of
three hundred self-employed individuals.
(3) The arrangement has and maintains a minimum enrollment
of
three hundred employees or self-employed individuals in any
combination of divisions (A)(1) and (2) of this section.
(B) A multiple employer welfare arrangement that is
created
pursuant to sections 1739.01 to 1739.22 of the Revised
Code and
that operates a group self-insurance program shall
comply with all
laws applicable to self-funded programs in this
state, including
sections 3901.04, 3901.041, 3901.19 to 3901.26,
3901.38, 3901.381
to
3901.3814, 3901.40, 3901.45, 3901.46, 3902.01 to
3902.14,
3923.282,
3923.30,
3923.301, 3923.38,
3923.581, 3923.63, 3923.80,
3923.85,
3924.031,
3924.032,
and
3924.27
of the Revised Code.
(C) A multiple employer welfare arrangement created
pursuant
to sections 1739.01 to 1739.22 of the Revised Code shall
solicit
enrollments only through agents or solicitors licensed
pursuant to
Chapter 3905. of the Revised Code to sell or solicit
sickness and
accident insurance.
(D) A multiple employer welfare arrangement created
pursuant
to sections 1739.01 to 1739.22 of the Revised Code shall
provide
benefits only to individuals who are members, employees
of
members, or the dependents of members or employees, or are
eligible for continuation of coverage under section 1751.53 or
3923.38 of the Revised Code or under Title X of the "Consolidated
Omnibus Budget Reconciliation Act of 1985," 100 Stat. 227, 29
U.S.C.A. 1161, as amended.
Sec. 1751.69. Notwithstanding section 3901.71 of the Revised
Code, each individual or group health insuring corporation policy,
contract, or agreement providing basic health care services that
is delivered, issued for delivery, or renewed in this state that
provides coverage for cancer chemotherapy treatment shall provide
coverage for a prescribed, orally administered anticancer
medication used to kill or slow the growth of cancerous cells on a
basis no less favorable than intravenously administered or
injected cancer medications that are covered under the policy,
contract, or agreement.
Sec. 3923.85. Notwithstanding section 3901.71 of the Revised
Code, each individual or group policy of sickness and accident
insurance that is delivered, issued for delivery, or renewed in
this state or public employee benefit plan that is established or
modified in this state that provides coverage for cancer
chemotherapy treatment shall provide coverage for a prescribed,
orally administered anticancer medication used to kill or slow the
growth of cancerous cells on a basis no less favorable than
intravenously administered or injected cancer medications that are
covered under the policy or plan.
This section does not apply to the offer or renewal of any
individual or group policy of sickness and accident insurance that
provides coverage for specific diseases or accidents only, or to
any hospital indemnity, medicare supplement, medicare, tricare,
long-term care, disability income, one-time limited duration
policy of not longer than six months, or other policy that offers
only supplemental benefits.
Section 2. That existing section 1739.05 of the Revised Code
is hereby repealed.
Section 3. Sections 1751.69 and 3923.85 of the Revised Code,
as enacted by this act, shall apply only to policies, contracts,
agreements, and plans that are delivered, issued for delivery,
renewed, established, or modified in this state on or after the
effective date of this act.
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