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H. B. No. 551 As IntroducedAs Introduced
129th General Assembly | Regular Session | 2011-2012 |
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Representatives Garland, Antonio
Cosponsors:
Representatives Hagan, R., Phillips, Yuko, Lundy, Reece, Cera, Letson, Celeste, Fedor, Driehaus, Williams, Clyde, Pillich, Heard
A BILL
To amend section 1739.05 and to enact sections
1751.181, 3923.023, and 3923.024 of the Revised
Code to prohibit a health plan issuer from
considering gender when determining premium rates.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That section 1739.05 be amended and sections
1751.181, 3923.023, and 3923.024 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,
3923.023, 3923.24, 3923.282, 3923.30, 3923.301, 3923.38, 3923.581,
3923.63, 3923.80, 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. 1751.181. (A) No health insuring corporation shall
consider the gender of an applicant, enrollee, or subscriber in
determining the premium rate for a policy, contract, or agreement
that provides coverage for basic healthcare services.
(B) This section shall not apply to any insurance policy,
contract, or agreement that pertains solely to the following or
any combination of the following:
(10) A one-time, limited duration policy of not longer than
six months;
(11) Coverage issued as a supplement to liability insurance;
(12) Workers' compensation insurance;
(13) Automobile medical payment insurance;
(14) Insurance under which benefits are payable with or
without regard to fault and that is statutorily required to be
contained in any liability insurance policy or equivalent
self-insurance.
Sec. 3923.023. (A) No sickness and accident insurer shall
consider the gender of an applicant, policyholder, subscriber, or
member in determining the premium rate for a health benefit plan.
(B) As used in this section, "health benefit plan" has the
same meaning as in section 3924.01 of the Revised Code.
Sec. 3923.024. (A) No issuer of a public employee health
benefit plan shall consider the gender of an applicant,
policyholder, subscriber, or member in determining the premium
rate for a health benefit plan.
(B) As used in this section, "health benefit plan" has the
same meaning as in section 3924.01 of the Revised Code.
Section 2. That existing section 1739.05 of the Revised Code
is hereby repealed.
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