Bill Text: OH HB201 | 2013-2014 | 130th General Assembly | Engrossed

NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: To make changes relative to entries of satisfaction, to clarify the status of volunteer firefighters for purposes of the Patient Protection and Affordable Care Act, to make changes regarding coverage for a dependent child under a parent's health insurance plan and the hours of work needed to qualify for coverage under a small employer health benefit plan, to increase the duration of the health insurance considered to be short-term under certain insurance laws, and to make changes to the chemotherapy parity law.

Spectrum: Moderate Partisan Bill (Republican 25-6)

Status: (Passed) 2014-12-19 - Governor' Action [HB201 Detail]

Download: Ohio-2013-HB201-Engrossed.html
As Concurred by the House

130th General Assembly
Regular Session
2013-2014
Am. Sub. H. B. No. 201


Representative Butler 

Cosponsors: Representatives Adams, J., Terhar, Thompson, Hayes, Adams, R., Amstutz, Anielski, Beck, Bishoff, Blair, Blessing, Budish, Burkley, Conditt, Green, Hood, Huffman, Letson, Milkovich, Perales, Retherford, Sykes, Winburn Speaker Batchelder 

Senators Burke, Coley, Eklund, Jordan, Patton, Seitz 

A BILL
To amend sections 1739.061, 1751.14, 1751.69, 1
3923.022, 3923.24, 3923.241, 3923.281, 3923.57, 2
3923.58, 3923.601, 3923.65, 3923.83, 3923.85, 3
3924.01, and 5301.36 and to enact sections 4
505.377, 737.082, 737.222, and 5301.361 of the 5
Revised Code to make changes relative to entries 6
of satisfaction, to clarify the status of 7
volunteer firefighters for purposes of the Patient 8
Protection and Affordable Care Act, to make 9
changes regarding coverage for a dependent child 10
under a parent's health insurance plan and the 11
hours of work needed to qualify for coverage under 12
a small employer health benefit plan, to increase 13
the duration of the health insurance considered to 14
be short-term under certain insurance laws, and to 15
make changes to the chemotherapy parity law.16


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

       Section 1. That sections 1739.061, 1751.14, 1751.69, 17
3923.022, 3923.24, 3923.241, 3923.281, 3923.57, 3923.58, 3923.601, 18
3923.65, 3923.83, 3923.85, 3924.01, and 5301.36 be amended and 19
sections 505.377, 737.082, 737.222, and 5301.361 of the Revised 20
Code be enacted to read as follows:21

       Sec. 505.377.  A volunteer firefighter appointed pursuant to 22
this chapter is a bona fide volunteer and not an employee for 23
purposes of section 513 of the "Patient Protection and Affordable 24
Care Act," 124 Stat. 119 (2010), 26 U.S.C. 4980H, if, for 25
providing those fire protection services, the volunteer receives 26
any of the benefits provided in Chapter 146., 4121., or 4123. or 27
section 9.65, 505.23, 3333.26, 3923.13, or 4113.41 of the Revised 28
Code.29

       Sec. 737.082.  A volunteer firefighter appointed pursuant to 30
this chapter is a bona fide volunteer and not an employee for 31
purposes of section 513 of the "Patient Protection and Affordable 32
Care Act," 124 Stat. 119 (2010), 26 U.S.C. 4980H, if, for 33
providing those fire protection services, the volunteer receives 34
any of the benefits provided in Chapter 146., 4121., or 4123. or 35
section 9.65, 505.23, 3333.26, 3923.13, or 4113.41 of the Revised 36
Code.37

       Sec. 737.222.  A volunteer firefighter appointed pursuant to 38
this chapter is a bona fide volunteer and not an employee for 39
purposes of section 513 of the "Patient Protection and Affordable 40
Care Act," 124 Stat. 119 (2010), 26 U.S.C. 4980H, if, for 41
providing those fire protection services, the volunteer receives 42
any of the benefits provided in Chapter 146., 4121., or 4123. or 43
section 9.65, 505.23, 3333.26, 3923.13, or 4113.41 of the Revised 44
Code.45

       Sec. 1739.061. (A)(1) This section applies to both of the 46
following:47

       (a) A multiple employer welfare arrangement that issues or 48
requires the use of a standardized identification card or an 49
electronic technology for submission and routing of prescription 50
drug claims;51

        (b) A person or entity that a multiple employer welfare 52
arrangement contracts with to issue a standardized identification 53
card or an electronic technology described in division (A)(1)(a) 54
of this section.55

       (2) Notwithstanding division (A)(1) of this section, this 56
section does not apply to the issuance or required use of a 57
standardized identification card or an electronic technology for 58
the submission and routing of prescription drug claims in 59
connection with any of the following:60

       (a) Any program or arrangement covering only accident, 61
credit, dental, disability income, long-term care, hospital 62
indemnity, medicare supplement, medicare, tricare, specified 63
disease, or vision care; coverage under a 64
one-time-limited-duration policy of not longerthat is less than 65
sixtwelve months; coverage issued as a supplement to liability 66
insurance; insurance arising out of workers' compensation or 67
similar law; automobile medical payment insurance; or insurance 68
under which benefits are payable with or without regard to fault 69
and which is statutorily required to be contained in any liability 70
insurance policy or equivalent self-insurance.71

       (b) Coverage provided under the medicaid program.72

       (c) Coverage provided under an employer's self-insurance plan 73
or by any of its administrators, as defined in section 3959.01 of 74
the Revised Code, to the extent that federal law supersedes, 75
preempts, prohibits, or otherwise precludes the application of 76
this section to the plan and its administrators.77

       (B) A standardized identification card or an electronic 78
technology issued or required to be used as provided in division 79
(A)(1) of this section shall contain uniform prescription drug 80
information in accordance with either division (B)(1) or (2) of 81
this section.82

        (1) The standardized identification card or the electronic 83
technology shall be in a format and contain information fields 84
approved by the national council for prescription drug programs or 85
a successor organization, as specified in the council's or 86
successor organization's pharmacy identification card 87
implementation guide in effect on the first day of October most 88
immediately preceding the issuance or required use of the 89
standardized identification card or the electronic technology.90

        (2) If the multiple employer welfare arrangement or person 91
under contract with it to issue a standardized identification card 92
or an electronic technology requires the information for the 93
submission and routing of a claim, the standardized identification 94
card or the electronic technology shall contain any of the 95
following information:96

        (a) The name of the multiple employer welfare arrangement;97

        (b) The individual's name, group number, and identification 98
number;99

       (c) A telephone number to inquire about pharmacy-related 100
issues;101

        (d) The issuer's international identification number, labeled 102
as "ANSI BIN" or "RxBIN";103

        (e) The processor's control number, labeled as "RxPCN";104

        (f) The individual's pharmacy benefits group number if 105
different from the insured's medical group number, labeled as 106
"RxGrp."107

        (C) If the standardized identification card or the electronic 108
technology issued or required to be used as provided in division 109
(A)(1) of this section is also used for submission and routing of 110
nonpharmacy claims, the designation "Rx" is required to be 111
included as part of the labels identified in divisions (B)(2)(d) 112
and (e) of this section if the issuer's international 113
identification number or the processor's control number is 114
different for medical and pharmacy claims.115

        (D) Each multiple employer welfare arrangement described in 116
division (A) of this section shall annually file a certificate 117
with the superintendent of insurance certifying that it or any 118
person it contracts with to issue a standardized identification 119
card or electronic technology for submission and routing of 120
prescription drug claims complies with this section.121

       (E)(1) Except as provided in division (E)(2) of this section, 122
if there is a change in the information contained in the 123
standardized identification card or the electronic technology 124
issued to an individual, the multiple employer welfare arrangement 125
or person under contract with it to issue a standardized 126
identification card or an electronic technology shall issue a new 127
card or electronic technology to the individual.128

        (2) A multiple employer welfare arrangement or person under 129
contract with it is not required under division (E)(1) of this 130
section to issue a new card or electronic technology to an 131
individual more than once during a twelve-month period.132

        (F) Nothing in this section shall be construed as requiring a 133
multiple employer welfare arrangement to produce more than one 134
standardized identification card or one electronic technology for 135
use by individuals accessing health care benefits provided under a 136
multiple employer welfare arrangement.137

       Sec. 1751.14.  (A) Notwithstanding section 3901.71 of the 138
Revised Code, any policy, contract, or agreement for health care 139
services authorized by this chapter that is issued, delivered, or 140
renewed in this state and that provides that coverage of an 141
unmarried dependent child will terminate upon attainment of the 142
limiting age for dependent children specified in the policy, 143
contract, or agreement, shall also provide in substance both of 144
the following:145

        (1) Once an unmarried child has attained the limiting age for 146
dependent children, as provided in the policy, contract, or 147
agreement, upon the request of the subscriber, the health insuring 148
corporation shall offer to cover the unmarried child until the 149
child attains twenty-eighttwenty-six years of age if all of the 150
following are true:151

        (a) The child is the natural child, stepchild, or adopted 152
child of the subscriber.153

       (b) The child is a resident of this state or a full-time 154
student at an accredited public or private institution of higher 155
education.156

        (c) The child is not employed by an employer that offers any 157
health benefit plan under which the child is eligible for 158
coverage.159

       (d) The child is not eligible for coverage under the medicaid 160
program or the medicare program. 161

        (2) That attainment of the limiting age for dependent 162
children shall not operate to terminate the coverage of a 163
dependent child if the child is and continues to be both of the 164
following:165

       (a) Incapable of self-sustaining employment by reason of 166
mental retardation or physical handicap;167

       (b) Primarily dependent upon the subscriber for support and 168
maintenance.169

       (B) Proof of incapacity and dependence for purposes of 170
division (A)(2) of this section shall be furnished to the health 171
insuring corporation within thirty-one days of the child's 172
attainment of the limiting age. Upon request, but not more 173
frequently than annually, the health insuring corporation may 174
require proof satisfactory to it of the continuance of such 175
incapacity and dependency.176

       (C) Nothing in this section shall do any of the following:177

       (1) Require that any policy, contract, or agreement offer 178
coverage for dependent children or provide coverage for an 179
unmarried dependent child's children as dependents on the policy, 180
contract, or agreement;181

       (2) Require an employer to pay for any part of the premium 182
for an unmarried dependent child that has attained the limiting 183
age for dependents, as provided in the policy, contract, or 184
agreement;185

       (3) Require an employer to offer health insurance coverage to 186
the dependents of any employee.187

        (D) This section does not apply to any health insuring 188
corporation policy, contract, or agreement offering only 189
supplemental health care services or specialty health care 190
services.191

       (E) As used in this section, "health benefit plan" has the 192
same meaning as in section 3924.01 of the Revised Code and also 193
includes both of the following:194

        (1) A public employee benefit plan;195

        (2) A health benefit plan as regulated under the "Employee 196
Retirement Income Security Act of 1974," 29 U.S.C. 1001, et seq.197

       Sec. 1751.69.  (A) As used in this section, "cost sharing" 198
means the cost to an individual insured under an individual or 199
group health insuring corporation policy, contract, or agreement 200
according to any coverage limit, copayment, coinsurance, 201
deductible, or other out-of-pocket expense requirements imposed by 202
the policy, contract, or agreement.203

       (B) Notwithstanding section 3901.71 of the Revised Code and 204
subject to division (D) of this section, no individual or group 205
health insuring corporation policy, contract, or agreement 206
providing basic health care services or prescription drug services 207
that is delivered, issued for delivery, or renewed in this state, 208
if the policy, contract, or agreement provides coverage for cancer 209
chemotherapy treatment, shall fail to comply with either of the 210
following:211

       (1) The policy, contract, or agreement shall not provide 212
coverage or impose cost sharing for a prescribed, orally 213
administered cancer medication on a less favorable basis than the 214
coverage it provides or cost sharing it imposes for intraveneously 215
administered or injected cancer medications.216

       (2) The policy, contract, or agreement shall not comply with 217
division (B)(1) of this section by imposing an increase in cost 218
sharing solely for orally administered, intravenously 219
administered, or injected cancer medications.220

       (C) Notwithstanding any provision of this section to the 221
contrary, an individual or group health insuring corporation 222
policy, contract, or agreement shall be deemed to be in compliance 223
with this section if the cost sharing imposed under such a policy, 224
contract, or agreement for orally administered cancer treatments 225
does not exceed one hundred dollars per prescription fill. The 226
cost sharing limit of one hundred dollars per prescription fill 227
shall apply to a high deductible plan, as defined in 26 U.S.C. 228
223, or a catastrophic plan, as defined in 42 U.S.C. 18022, only 229
after the deductible has been met.230

       (D) The prohibitions in division (B) of this section do not 231
preclude an individual or group health insuring corporation 232
policy, contract, or agreement from requiring an enrollee to 233
obtain prior authorization before orally administered cancer 234
medication is dispensed to the enrollee.235

       (E) A health insuring corporation that offers coverage for 236
basic health care services is not required to comply with division 237
(B) of this section if all of the following apply:238

        (1) The health insuring corporation submits documentation 239
certified by an independent member of the American academy of 240
actuaries to the superintendent of insurance showing that 241
compliance with division (B)(1) of this section for a period of at 242
least six months independently caused the health insuring 243
corporation's costs for claims and administrative expenses for the 244
coverage of basic health care services to increase by more than 245
one per cent per year.246

        (2) The health insuring corporation submits a signed letter 247
from an independent member of the American academy of actuaries to 248
the superintendent of insurance opining that the increase in costs 249
described in division (E)(1) of this section could reasonably 250
justify an increase of more than one per cent in the annual 251
premiums or rates charged by the health insuring corporation for 252
the coverage of basic health care services.253

        (3)(a) The superintendent of insurance makes the following 254
determinations from the documentation and opinion submitted 255
pursuant to divisions (E)(1) and (2) of this section:256

        (i) Compliance with division (B)(1) of this section for a 257
period of at least six months independently caused the health 258
insuring corporation's costs for claims and administrative 259
expenses for the coverage of basic health care services to 260
increase more than one per cent per year.261

        (ii) The increase in costs reasonably justifies an increase 262
of more than one per cent in the annual premiums or rates charged 263
by the health insuring corporation for the coverage of basic 264
health care services.265

        (b) Any determination made by the superintendent under 266
division (E)(3) of this section is subject to Chapter 119. of the 267
Revised Code.268

       Sec. 3923.022.  (A) As used in this section:269

       (1)(a) "Administrative expense" means the amount resulting 270
from the following: the amount of premiums earned by the insurer 271
for sickness and accident insurance business plus the amount of 272
losses recovered from reinsurance coverage minus the sum of the 273
amount of claims for losses paid; the amount of losses incurred 274
but not reported; the amount incurred for state fees, federal and 275
state taxes, and reinsurance; and the incurred costs and expenses 276
related, either directly or indirectly, to the payment of 277
commissions, measures to control fraud, and managed care.278

       (b) "Administrative expense" does not include any amounts 279
collected, or administrative expenses incurred, by an insurer for 280
the administration of an employee health benefit plan subject to 281
regulation by the federal "Employee Retirement Income Security Act 282
of 1974," 88 Stat. 832, 29 U.S.C.A. 1001, as amended. "Amounts 283
collected or administrative expenses incurred" means the total 284
amount paid to an administrator for the administration and payment 285
of claims minus the sum of the amount of claims for losses paid 286
and the amount of losses incurred but not reported.287

       (2) "Insurer" means any insurance company authorized under 288
Title XXXIX of the Revised Code to do the business of sickness and 289
accident insurance in this state.290

       (3) "Sickness and accident insurance business" does not 291
include coverage provided by an insurer for specific diseases or 292
accidents only; any hospital indemnity, medicare supplement, 293
long-term care, disability income, one-time-limited-duration 294
policy of no longerthat is less than sixtwelve months, or other 295
policy that offers only supplemental benefits; or coverage 296
provided to individuals who are not residents of this state.297

       (4) "Individual business" includes both individual sickness 298
and accident insurance and sickness and accident insurance made 299
available by insurers in the individual market to individuals, 300
with or without family members or dependents, through group 301
policies issued to one or more associations or entities.302

       (B) Notwithstanding section 3941.14 of the Revised Code, each 303
insurer shall have aggregate administrative expenses of no more 304
than twenty per cent of the premium income of the insurer, based 305
on the premiums earned in that year on the sickness and accident 306
insurance business of the insurer.307

       (C)(1) Each insurer, on the first day of January or within 308
sixty days thereafter, shall annually prepare, under oath, and 309
deposit in the office of the superintendent of insurance a 310
statement of the aggregate administrative expenses of the insurer, 311
based on the premiums earned in the immediately preceding calendar 312
year on the sickness and accident insurance business of the 313
insurer. The statement shall itemize and separately detail all of 314
the following information with respect to the insurer's sickness 315
and accident insurance business:316

        (a) The amount of premiums earned by the insurer both before 317
and after any costs related to the insurer's purchase of 318
reinsurance coverage;319

       (b) The total amount of claims for losses paid by the insurer 320
both before and after any reimbursement from reinsurance coverage;321

        (c) The amount of any losses incurred by the insurer but not 322
reported by the insurer in the current or prior year;323

        (d) The amount of costs incurred by the insurer for state 324
fees and federal and state taxes;325

        (e) The amount of costs incurred by the insurer for 326
reinsurance coverage;327

        (f) The amount of costs incurred by the insurer that are 328
related to the insurer's payment of commissions;329

        (g) The amount of costs incurred by the insurer that are 330
related to the insurer's fraud prevention measures;331

        (h) The amount of costs incurred by the insurer that are 332
related to managed care; and333

        (i) Any other administrative expenses incurred by the 334
insurer.335

        (2) The statement also shall include all of the information 336
required under division (C)(1) of this section separately detailed 337
for the insurer's individual business, small group business, and 338
large group business.339

       (D) No insurer shall fail to comply with this section.340

       (E) If the superintendent determines that an insurer has 341
violated this section, the superintendent, pursuant to an 342
adjudication conducted in accordance with Chapter 119. of the 343
Revised Code, may order the suspension of the insurer's license to 344
do the business of sickness and accident insurance in this state 345
until the superintendent is satisfied that the insurer is in 346
compliance with this section. If the insurer continues to do the 347
business of sickness and accident insurance in this state while 348
under the suspension order, the superintendent shall order the 349
insurer to pay one thousand dollars for each day of the violation.350

       (F) Any money collected by the superintendent under division 351
(E) of this section shall be deposited by the superintendent into 352
the state treasury to the credit of the department of insurance 353
operating fund.354

       (G) The statement of aggregate expenses filed pursuant to 355
this section separately detailing an insurer's individual, small 356
group, and large group business shall be considered work papers 357
resulting from the conduct of a market analysis of an entity 358
subject to examination by the superintendent under division (C) of 359
section 3901.48 of the Revised Code, except that the 360
superintendent may share aggregated market information that 361
identifies the premiums earned as reported under division 362
(C)(1)(a) of this section, the administrative expenses reported 363
under division (C)(1)(i) of this section, the amount of 364
commissions reported under division (C)(1)(f) of this section, the 365
amount of taxes paid as reported under division (C)(1)(d) of this 366
section, the total of the remaining benefit costs as reported 367
under divisions (C)(1)(b) and (c) of this section, and the amount 368
of fraud and managed care expenses reported under divisions 369
(C)(1)(g) and (h) of this section.370

       Sec. 3923.24.  (A) Notwithstanding section 3901.71 of the 371
Revised Code, every certificate furnished by an insurer in 372
connection with, or pursuant to any provision of, any group 373
sickness and accident insurance policy delivered, issued for 374
delivery, renewed, or used in this state on or after January 1, 375
1972, every policy of sickness and accident insurance delivered, 376
issued for delivery, renewed, or used in this state on or after 377
January 1, 1972, and every multiple employer welfare arrangement 378
offering an insurance program, which provides that coverage of an 379
unmarried dependent child of a parent or legal guardian will 380
terminate upon attainment of the limiting age for dependent 381
children specified in the contract shall also provide in substance 382
both of the following:383

        (1) Once an unmarried child has attained the limiting age for 384
dependent children, as provided in the policy, upon the request of 385
the insured, the insurer shall offer to cover the unmarried child 386
until the child attains twenty-eighttwenty-six years of age if 387
all of the following are true:388

        (a) The child is the natural child, stepchild, or adopted 389
child of the insured.390

       (b) The child is a resident of this state or a full-time 391
student at an accredited public or private institution of higher 392
education.393

        (c) The child is not employed by an employer that offers any 394
health benefit plan under which the child is eligible for 395
coverage.396

       (d) The child is not eligible for the medicaid program or the 397
medicare program. 398

        (2) That attainment of the limiting age for dependent 399
children shall not operate to terminate the coverage of a 400
dependent child if the child is and continues to be both of the 401
following:402

       (a) Incapable of self-sustaining employment by reason of 403
mental retardation or physical handicap;404

       (b) Primarily dependent upon the policyholder or certificate 405
holder for support and maintenance.406

       (B) Proof of such incapacity and dependence for purposes of 407
division (A)(2) of this section shall be furnished by the 408
policyholder or by the certificate holder to the insurer within 409
thirty-one days of the child's attainment of the limiting age. 410
Upon request, but not more frequently than annually after the 411
two-year period following the child's attainment of the limiting 412
age, the insurer may require proof satisfactory to it of the 413
continuance of such incapacity and dependency.414

       (C) Nothing in this section shall require an insurer to cover 415
a dependent child who is mentally retarded or physically 416
handicapped if the contract is underwritten on evidence of 417
insurability based on health factors set forth in the application, 418
or if such dependent child does not satisfy the conditions of the 419
contract as to any requirement for evidence of insurability or 420
other provision of the contract, satisfaction of which is required 421
for coverage thereunder to take effect. In any such case, the 422
terms of the contract shall apply with regard to the coverage or 423
exclusion of the dependent from such coverage. Nothing in this 424
section shall apply to accidental death or dismemberment benefits 425
provided by any such policy of sickness and accident insurance.426

       (D) Nothing in this section shall do any of the following:427

       (1) Require that any policy offer coverage for dependent 428
children or provide coverage for an unmarried dependent child's 429
children as dependents on the policy;430

       (2) Require an employer to pay for any part of the premium 431
for an unmarried dependent child that has attained the limiting 432
age for dependents, as provided in the policy;433

       (3) Require an employer to offer health insurance coverage to 434
the dependents of any employee.435

        (E) This section does not apply to any policies or 436
certificates covering only accident, credit, dental, disability 437
income, long-term care, hospital indemnity, medicare supplement, 438
specified disease, or vision care; coverage under a 439
one-time-limited-duration policy of not longerthat is less than 440
sixtwelve months; coverage issued as a supplement to liability 441
insurance; insurance arising out of a workers' compensation or 442
similar law; automobile medical-payment insurance; or insurance 443
under which benefits are payable with or without regard to fault 444
and that is statutorily required to be contained in any liability 445
insurance policy or equivalent self-insurance.446

       (F) As used in this section, "health benefit plan" has the 447
same meaning as in section 3924.01 of the Revised Code and also 448
includes both of the following:449

        (1) A public employee benefit plan;450

        (2) A health benefit plan as regulated under the "Employee 451
Retirement Income Security Act of 1974," 29 U.S.C. 1001, et seq.452

       Sec. 3923.241. (A) Notwithstanding section 3901.71 of the 453
Revised Code, any public employee benefit plan that provides that 454
coverage of an unmarried dependent child will terminate upon 455
attainment of the limiting age for dependent children specified in 456
the plan shall also provide in substance both of the following:457

        (1) Once an unmarried child has attained the limiting age for 458
dependent children, as provided in the plan, upon the request of 459
the employee, the public employee benefit plan shall offer to 460
cover the unmarried child until the child attains twenty-eight461
twenty-six years of age if all of the following are true:462

        (a) The child is the natural child, stepchild, or adopted 463
child of the employee.464

       (b) The child is a resident of this state or a full-time 465
student at an accredited public or private institution of higher 466
education.467

        (c) The child is not employed by an employer that offers any 468
health benefit plan under which the child is eligible for 469
coverage.470

       (d) The child is not eligible for the medicaid program or the 471
medicare program. 472

       (2) That attainment of the limiting age for dependent 473
children shall not operate to terminate the coverage of a 474
dependent child if the child is and continues to be both of the 475
following:476

       (a) Incapable of self-sustaining employment by reason of 477
mental retardation or physical handicap;478

       (b) Primarily dependent upon the plan member for support and 479
maintenance.480

       (B) Proof of incapacity and dependence for purposes of 481
division (A)(2) of this section shall be furnished to the public 482
employee benefit plan within thirty-one days of the child's 483
attainment of the limiting age. Upon request, but not more 484
frequently than annually, the public employee benefit plan may 485
require proof satisfactory to it of the continuance of such 486
incapacity and dependency.487

       (C) Nothing in this section shall do any of the following:488

       (1) Require that any public employee benefit plan offer 489
coverage for dependent children or provide coverage for an 490
unmarried dependent child's children as dependents on the public 491
employee benefit plan;492

       (2) Require an employer to pay for any part of the premium 493
for an unmarried dependent child that has attained the limiting 494
age for dependents, as provided in the plan;495

       (3) Require an employer to offer health insurance coverage to 496
the dependents of any employee.497

       (D) This section does not apply to any public employee 498
benefit plan covering only accident, credit, dental, disability 499
income, long-term care, hospital indemnity, medicare supplement, 500
specified disease, or vision care; coverage under a 501
one-time-limited-duration policy of not longerthat is less than 502
sixtwelve months; coverage issued as a supplement to liability 503
insurance; insurance arising out of a workers' compensation or 504
similar law; automobile medical-payment insurance; or insurance 505
under which benefits are payable with or without regard to fault 506
and which is statutorily required to be contained in any liability 507
insurance policy or equivalent self-insurance.508

       (E) As used in this section, "health benefit plan" has the 509
same meaning as in section 3924.01 of the Revised Code and also 510
includes both of the following:511

        (1) A public employee benefit plan;512

        (2) A health benefit plan as regulated under the "Employee 513
Retirement Income Security Act of 1974," 29 U.S.C. 1001, et seq.514

       Sec. 3923.281.  (A) As used in this section:515

       (1) "Biologically based mental illness" means schizophrenia, 516
schizoaffective disorder, major depressive disorder, bipolar 517
disorder, paranoia and other psychotic disorders, 518
obsessive-compulsive disorder, and panic disorder, as these terms 519
are defined in the most recent edition of the diagnostic and 520
statistical manual of mental disorders published by the American 521
psychiatric association.522

       (2) "Policy of sickness and accident insurance" has the same 523
meaning as in section 3923.01 of the Revised Code, but excludes 524
any hospital indemnity, medicare supplement, long-term care, 525
disability income, one-time-limited-duration policy of not longer526
that is less than sixtwelve months, supplemental benefit, or 527
other policy that provides coverage for specific diseases or 528
accidents only; any policy that provides coverage for workers' 529
compensation claims compensable pursuant to Chapters 4121. and 530
4123. of the Revised Code; and any policy that provides coverage 531
to medicaid recipients.532

       (B) Notwithstanding section 3901.71 of the Revised Code, and 533
subject to division (E) of this section, every policy of sickness 534
and accident insurance shall provide benefits for the diagnosis 535
and treatment of biologically based mental illnesses on the same 536
terms and conditions as, and shall provide benefits no less 537
extensive than, those provided under the policy of sickness and 538
accident insurance for the treatment and diagnosis of all other 539
physical diseases and disorders, if both of the following apply:540

       (1) The biologically based mental illness is clinically 541
diagnosed by a physician authorized under Chapter 4731. of the 542
Revised Code to practice medicine and surgery or osteopathic 543
medicine and surgery; a psychologist licensed under Chapter 4732. 544
of the Revised Code; a licensed professional clinical counselor, 545
licensed professional counselor, independent social worker, or 546
independent marriage and family therapist licensed under Chapter 547
4757. of the Revised Code; or a clinical nurse specialist or 548
certified nurse practitioner licensed under Chapter 4723. of the 549
Revised Code whose nursing specialty is mental health.550

       (2) The prescribed treatment is not experimental or 551
investigational, having proven its clinical effectiveness in 552
accordance with generally accepted medical standards.553

       (C) Division (B) of this section applies to all coverages and 554
terms and conditions of the policy of sickness and accident 555
insurance, including, but not limited to, coverage of inpatient 556
hospital services, outpatient services, and medication; maximum 557
lifetime benefits; copayments; and individual and family 558
deductibles.559

       (D) Nothing in this section shall be construed as prohibiting 560
a sickness and accident insurance company from taking any of the 561
following actions:562

       (1) Negotiating separately with mental health care providers 563
with regard to reimbursement rates and the delivery of health care 564
services;565

       (2) Offering policies that provide benefits solely for the 566
diagnosis and treatment of biologically based mental illnesses;567

       (3) Managing the provision of benefits for the diagnosis or 568
treatment of biologically based mental illnesses through the use 569
of pre-admission screening, by requiring beneficiaries to obtain 570
authorization prior to treatment, or through the use of any other 571
mechanism designed to limit coverage to that treatment determined 572
to be necessary;573

       (4) Enforcing the terms and conditions of a policy of 574
sickness and accident insurance.575

       (E) An insurer that offers any policy of sickness and 576
accident insurance is not required to provide benefits for the 577
diagnosis and treatment of biologically based mental illnesses 578
pursuant to division (B) of this section if all of the following 579
apply:580

       (1) The insurer submits documentation certified by an 581
independent member of the American academy of actuaries to the 582
superintendent of insurance showing that incurred claims for 583
diagnostic and treatment services for biologically based mental 584
illnesses for a period of at least six months independently caused 585
the insurer's costs for claims and administrative expenses for the 586
coverage of all other physical diseases and disorders to increase 587
by more than one per cent per year. 588

       (2) The insurer submits a signed letter from an independent 589
member of the American academy of actuaries to the superintendent 590
of insurance opining that the increase described in division 591
(E)(1) of this section could reasonably justify an increase of 592
more than one per cent in the annual premiums or rates charged by 593
the insurer for the coverage of all other physical diseases and 594
disorders.595

       (3) The superintendent of insurance makes the following 596
determinations from the documentation and opinion submitted 597
pursuant to divisions (E)(1) and (2) of this section:598

       (a) Incurred claims for diagnostic and treatment services for 599
biologically based mental illnesses for a period of at least six 600
months independently caused the insurer's costs for claims and 601
administrative expenses for the coverage of all other physical 602
diseases and disorders to increase by more than one per cent per 603
year.604

       (b) The increase in costs reasonably justifies an increase of 605
more than one per cent in the annual premiums or rates charged by 606
the insurer for the coverage of all other physical diseases and 607
disorders.608

       Any determination made by the superintendent under this 609
division is subject to Chapter 119. of the Revised Code.610

       Sec. 3923.57.  Notwithstanding any provision of this chapter, 611
every individual policy of sickness and accident insurance that is 612
delivered, issued for delivery, or renewed in this state is 613
subject to the following conditions, as applicable:614

       (A) Pre-existing conditions provisions shall not exclude or 615
limit coverage for a period beyond twelve months following the 616
policyholder's effective date of coverage and may only relate to 617
conditions during the six months immediately preceding the 618
effective date of coverage.619

       (B) In determining whether a pre-existing conditions 620
provision applies to a policyholder or dependent, each policy 621
shall credit the time the policyholder or dependent was covered 622
under a previous policy, contract, or plan if the previous 623
coverage was continuous to a date not more than thirty days prior 624
to the effective date of the new coverage, exclusive of any 625
applicable service waiting period under the policy.626

       (C)(1) Except as otherwise provided in division (C) of this 627
section, an insurer that provides an individual sickness and 628
accident insurance policy to an individual shall renew or continue 629
in force such coverage at the option of the individual.630

       (2) An insurer may nonrenew or discontinue coverage of an 631
individual in the individual market based only on one or more of 632
the following reasons:633

       (a) The individual failed to pay premiums or contributions in 634
accordance with the terms of the policy or the insurer has not 635
received timely premium payments.636

       (b) The individual performed an act or practice that 637
constitutes fraud or made an intentional misrepresentation of 638
material fact under the terms of the policy.639

       (c) The insurer is ceasing to offer coverage in the 640
individual market in accordance with division (D) of this section 641
and the applicable laws of this state.642

       (d) If the insurer offers coverage in the market through a 643
network plan, the individual no longer resides, lives, or works in 644
the service area, or in an area for which the insurer is 645
authorized to do business; provided, however, that such coverage 646
is terminated uniformly without regard to any health 647
status-related factor of covered individuals.648

       (e) If the coverage is made available in the individual 649
market only through one or more bona fide associations, the 650
membership of the individual in the association, on the basis of 651
which the coverage is provided, ceases; provided, however, that 652
such coverage is terminated under division (C)(2)(e) of this 653
section uniformly without regard to any health status-related 654
factor of covered individuals.655

       An insurer offering coverage to individuals solely through 656
membership in a bona fide association shall not be deemed, by 657
virtue of that offering, to be in the individual market for 658
purposes of sections 3923.58 and 3923.581 of the Revised Code. 659
Such an insurer shall not be required to accept applicants for 660
coverage in the individual market pursuant to sections 3923.58 and 661
3923.581 of the Revised Code unless the insurer also offers 662
coverage to individuals other than through bona fide associations.663

       (3) An insurer may cancel or decide not to renew the coverage 664
of a dependent of an individual if the dependent has performed an 665
act or practice that constitutes fraud or made an intentional 666
misrepresentation of material fact under the terms of the coverage 667
and if the cancellation or nonrenewal is not based, either 668
directly or indirectly, on any health status-related factor in 669
relation to the dependent.670

       (D)(1) If an insurer decides to discontinue offering a 671
particular type of health insurance coverage offered in the 672
individual market, coverage of such type may be discontinued by 673
the insurer if the insurer does all of the following:674

       (a) Provides notice to each individual provided coverage of 675
this type in such market of the discontinuation at least ninety 676
days prior to the date of the discontinuation of the coverage;677

       (b) Offers to each individual provided coverage of this type 678
in such market, the option to purchase any other individual health 679
insurance coverage currently being offered by the insurer for 680
individuals in that market;681

       (c) In exercising the option to discontinue coverage of this 682
type and in offering the option of coverage under division 683
(D)(1)(b) of this section, acts uniformly without regard to any 684
health status-related factor of covered individuals or of 685
individuals who may become eligible for such coverage.686

       (2) If an insurer elects to discontinue offering all health 687
insurance coverage in the individual market in this state, health 688
insurance coverage may be discontinued by the insurer only if both 689
of the following apply:690

       (a) The insurer provides notice to the department of 691
insurance and to each individual of the discontinuation at least 692
one hundred eighty days prior to the date of the expiration of the 693
coverage.694

       (b) All health insurance delivered or issued for delivery in 695
this state in such market is discontinued and coverage under that 696
health insurance in that market is not renewed.697

       (3) In the event of a discontinuation under division (D)(2) 698
of this section in the individual market, the insurer shall not 699
provide for the issuance of any health insurance coverage in the 700
market and this state during the five-year period beginning on the 701
date of the discontinuation of the last health insurance coverage 702
not so renewed.703

       (E) Notwithstanding divisions (C) and (D) of this section, an 704
insurer may, at the time of coverage renewal, modify the health 705
insurance coverage for a policy form offered to individuals in the 706
individual market if the modification is consistent with the law 707
of this state and effective on a uniform basis among all 708
individuals with that policy form.709

       (F) Such policies are subject to sections 2743 and 2747 of 710
the "Health Insurance Portability and Accountability Act of 1996," 711
Pub. L. No. 104-191, 110 Stat. 1955, 42 U.S.C.A. 300gg-43 and 712
300gg-47, as amended.713

       (G) Sections 3924.031 and 3924.032 of the Revised Code shall 714
apply to sickness and accident insurance policies offered in the 715
individual market in the same manner as they apply to health 716
benefit plans offered in the small employer market.717

       In accordance with 45 C.F.R. 148.102, divisions (C) to (G) of 718
this section also apply to all group sickness and accident 719
insurance policies that are not sold in connection with an 720
employment-related group health plan and that provide more than 721
short-term, limited duration coverage.722

       In applying divisions (C) to (G) of this section with respect 723
to health insurance coverage that is made available by an insurer 724
in the individual market to individuals only through one or more 725
associations, the term "individual" includes the association of 726
which the individual is a member.727

       For purposes of this section, any policy issued pursuant to 728
division (C) of section 3923.13 of the Revised Code in connection 729
with a public or private college or university student health 730
insurance program is considered to be issued to a bona fide 731
association.732

       As used in this section, "bona fide association" has the same 733
meaning as in section 3924.03 of the Revised Code, and "health 734
status-related factor" and "network plan" have the same meanings 735
as in section 3924.031 of the Revised Code.736

       This section does not apply to any policy that provides 737
coverage for specific diseases or accidents only, or to any 738
hospital indemnity, medicare supplement, long-term care, 739
disability income, one-time-limited-duration policy of no longer740
that is less than sixtwelve months, or other policy that offers 741
only supplemental benefits.742

       Sec. 3923.58.  (A) As used in sections 3923.58 and 3923.59 of 743
the Revised Code:744

       (1) "Base rate" means, as to any health benefit plan that is 745
issued by a carrier in the individual market, the lowest premium 746
rate for new or existing business prescribed by the carrier for 747
the same or similar coverage under a plan or arrangement covering 748
any individual with similar case characteristics.749

        (2) "Carrier," "health benefit plan," and "MEWA" have the 750
same meanings as in section 3924.01 of the Revised Code.751

       (3) "Network plan" means a health benefit plan of a carrier 752
under which the financing and delivery of medical care, including 753
items and services paid for as medical care, are provided, in 754
whole or in part, through a defined set of providers under 755
contract with the carrier.756

       (4) "Ohio health care basic and standard plans" means those 757
plans established under section 3924.10 of the Revised Code.758

       (5) "Pre-existing conditions provision" means a policy 759
provision that excludes or limits coverage for charges or expenses 760
incurred during a specified period following the insured's 761
effective date of coverage as to a condition which, during a 762
specified period immediately preceding the effective date of 763
coverage, had manifested itself in such a manner as would cause an 764
ordinarily prudent person to seek medical advice, diagnosis, care, 765
or treatment or for which medical advice, diagnosis, care, or 766
treatment was recommended or received, or a pregnancy existing on 767
the effective date of coverage.768

       (B) Beginning in January of each year, carriers in the 769
business of issuing health benefit plans to individuals and 770
nonemployer groups, except individual health benefit plans issued 771
pursuant to sections 1751.16 and 3923.122 of the Revised Code, 772
shall accept applicants for open enrollment coverage, as set forth 773
in this division, in the order in which they apply for coverage 774
and subject to the limitation set forth in division (G) of this 775
section. Carriers shall accept for coverage pursuant to this 776
section individuals to whom both of the following conditions 777
apply:778

       (1) The individual is not applying for coverage as an 779
employee of an employer, as a member of an association, or as a 780
member of any other group.781

       (2) The individual is not covered, and is not eligible for 782
coverage, under any other private or public health benefits 783
arrangement, including the medicare program established under 784
Title XVIII of the "Social Security Act," 49 Stat. 620 (1935), 42 785
U.S.C.A. 301, as amended, or any other act of congress or law of 786
this or any other state of the United States that provides 787
benefits comparable to the benefits provided under this section, 788
any medicare supplement policy, or any continuation of coverage 789
policy under state or federal law.790

       (C) A carrier shall offer to any individual accepted under 791
this section the Ohio health care basic and standard plans or 792
health benefit plans that are substantially similar to the Ohio 793
health care basic and standard plans in benefit plan design and 794
scope of covered services.795

        A carrier may offer other health benefit plans in addition 796
to, but not in lieu of, the plans required to be offered under 797
this division. A basic health benefit plan shall provide, at a 798
minimum, the coverage provided by the Ohio health care basic plan 799
or any health benefit plan that is substantially similar to the 800
Ohio health care basic plan in benefit plan design and scope of 801
covered services. A standard health benefit plan shall provide, at 802
a minimum, the coverage provided by the Ohio health care standard 803
plan or any health benefit plan that is substantially similar to 804
the Ohio health care standard plan in benefit plan design and 805
scope of covered services.806

       For purposes of this division, the superintendent of 807
insurance shall determine whether a health benefit plan is 808
substantially similar to the Ohio health care basic and standard 809
plans in benefit plan design and scope of covered services.810

       (D)(1) Health benefit plans issued under this section may 811
establish pre-existing conditions provisions that exclude or limit 812
coverage for a period of up to twelve months following the 813
individual's effective date of coverage and that may relate only 814
to conditions during the six months immediately preceding the 815
effective date of coverage. A health insuring corporation may 816
apply a pre-existing condition provision for any basic health care 817
service related to a transplant of a body organ if the transplant 818
occurs within one year after the effective date of an enrollee's 819
coverage under this section except with respect to a newly born 820
child who meets the requirements for coverage under section 821
1751.61 of the Revised Code.822

       (2) In determining whether a pre-existing conditions 823
provision applies to an insured or dependent, each policy shall 824
credit the time the insured or dependent was covered under a 825
previous policy, contract, or plan if the previous coverage was 826
continuous to a date not more than sixty-three days prior to the 827
effective date of the new coverage, exclusive of any applicable 828
service waiting period under the policy.829

       (E) Premiums charged to individuals under this section may 830
not exceed the amounts specified below:831

       (1) For calendar years 2010 and 2011, an amount that is two 832
times the base rate for coverage offered to any other individual 833
to which the carrier is currently accepting new business, and for 834
which similar copayments and deductibles are applied;835

       (2) For calendar year 2012 and every year thereafter, an 836
amount that is one and one-half times the base rate for coverage 837
offered to any other individual to which the carrier is currently 838
accepting new business and for which similar copayments and 839
deductibles are applied, unless the superintendent of insurance 840
determines that the amendments by this act to this section and 841
section 3923.581 of the Revised Code, have resulted in the 842
market-wide average medical loss ratio for coverage sold to 843
individual insureds and nonemployer group insureds in this state, 844
including open enrollment insureds, to increase by more than five 845
and one quarter percentage points during calendar year 2010. If 846
the superintendent makes that determination, the premium limit 847
established by division (E)(1) of this section shall remain in 848
effect. The superintendent's determination shall be supported by a 849
signed letter from a member of the American academy of actuaries.850

       (F) In offering health benefit plans under this section, a 851
carrier may require the purchase of health benefit plans that 852
condition the reimbursement of health services upon the use of a 853
specific network of providers.854

       (G)(1) A carrier shall not be required to accept new 855
applicants under this section if the total number of the carrier's 856
current insureds with open enrollment coverage issued under this 857
section calculated as of the immediately preceding thirty-first 858
day of December and excluding the carrier's medicare supplement 859
policies and conversion or continuation of coverage policies under 860
state or federal law and any policies described in division (L) of 861
this section meets the following limits:862

       (a) For calendar years 2010 and 2011, four per cent of the 863
carrier's total number of individual or nonemployer group insureds 864
in this state;865

       (b) For calendar year 2012 and every year thereafter, eight 866
per cent of the carrier's total number of insured individuals and 867
nonemployer group insureds in this state, unless the 868
superintendent of insurance determines that the amendments by this 869
act to this section and section 3923.581 of the Revised Code, have 870
resulted in the market-wide average medical loss ratio for 871
coverage sold to individual insureds and nonemployer group 872
insureds in this state, including open enrollment insureds, to 873
increase by more than five and one quarter percentage points 874
during calendar year 2010. If the superintendent makes that 875
determination, the enrollment limit established by division 876
(G)(1)(a) of this section shall remain in effect. The 877
superintendent's determination shall be supported by a signed 878
letter from a member of the American academy of actuaries.879

       (2) An officer of the carrier shall certify to the department 880
of insurance when it has met the enrollment limit set forth in 881
division (G)(1) of this section. Upon providing such 882
certification, the carrier shall be relieved of its open 883
enrollment requirement under this section as long as the carrier 884
continues to meet the open enrollment limit. If the total number 885
of the carrier's current insureds with open enrollment coverage 886
issued under this section falls below the enrollment limit, the 887
carrier shall accept new applicants. A carrier may establish a 888
waiting list if the carrier has met the open enrollment limit and 889
shall notify the superintendent if the carrier has a waiting list 890
in effect.891

       (H) A carrier shall not be required to accept under this 892
section applicants who, at the time of enrollment, are confined to 893
a health care facility because of chronic illness, permanent 894
injury, or other infirmity that would cause economic impairment to 895
the carrier if the applicants were accepted. A carrier shall not 896
be required to make the effective date of benefits for individuals 897
accepted under this section earlier than ninety days after the 898
date of acceptance, except that when the individual had prior 899
coverage with a health benefit plan that was terminated by a 900
carrier because the carrier exited the market and the individual 901
was accepted for open enrollment under this section within 902
sixty-three days of that termination, the effective date of 903
benefits shall be the date of enrollment.904

       (I) The requirements of this section do not apply to any 905
carrier that is currently in a state of supervision, insolvency, 906
or liquidation. If a carrier demonstrates to the satisfaction of 907
the superintendent that the requirements of this section would 908
place the carrier in a state of supervision, insolvency, or 909
liquidation, or would otherwise jeopardize the carrier's economic 910
viability overall or in the individual market, the superintendent 911
may waive or modify the requirements of division (B) or (G) of 912
this section. The actions of the superintendent under this 913
division shall be effective for a period of not more than one 914
year. At the expiration of such time, a new showing of need for a 915
waiver or modification by the carrier shall be made before a new 916
waiver or modification is issued or imposed.917

       (J) No hospital, health care facility, or health care 918
practitioner, and no person who employs any health care 919
practitioner, shall balance bill any individual or dependent of an 920
individual for any health care supplies or services provided to 921
the individual or dependent who is insured under a policy issued 922
under this section. The hospital, health care facility, or health 923
care practitioner, or any person that employs the health care 924
practitioner, shall accept payments made to it by the carrier 925
under the terms of the policy or contract insuring or covering 926
such individual as payment in full for such health care supplies 927
or services.928

       As used in this division, "hospital" has the same meaning as 929
in section 3727.01 of the Revised Code; "health care practitioner" 930
has the same meaning as in section 4769.01 of the Revised Code; 931
and "balance bill" means charging or collecting an amount in 932
excess of the amount reimbursable or payable under the policy or 933
health care service contract issued to an individual under this 934
section for such health care supply or service. "Balance bill" 935
does not include charging for or collecting copayments or 936
deductibles required by the policy or contract.937

       (K) A carrier may pay an agent a commission in the amount of 938
not more than five per cent of the premium charged for initial 939
placement or for otherwise securing the issuance of a policy or 940
contract issued to an individual under this section, and not more 941
than four per cent of the premium charged for the renewal of such 942
a policy or contract. The superintendent may adopt, in accordance 943
with Chapter 119. of the Revised Code, such rules as are necessary 944
to enforce this division.945

       (L) This section does not apply to any policy that provides 946
coverage for specific diseases or accidents only, or to any 947
hospital indemnity, medicare supplement, long-term care, 948
disability income, one-time-limited-duration policy of no longer949
that is less than sixtwelve months, or other policy that offers 950
only supplemental benefits.951

       (M) If a carrier offers a health benefit plan in the 952
individual market through a network plan, the carrier may do both 953
of the following:954

       (1) Limit the individuals that may apply for such coverage to 955
those who live, work, or reside in the service area of the network 956
plan;957

       (2) Within the service area of the network plan, deny the 958
coverage to individuals if the carrier has demonstrated both of 959
the following to the superintendent:960

       (a) The carrier will not have the capacity to deliver 961
services adequately to any additional individuals because of the 962
carrier's obligations to existing group contract holders and 963
individuals.964

       (b) The carrier is applying division (M)(2) of this section 965
uniformly to all individuals without regard to any health 966
status-related factors of those individuals.967

       (N) A carrier that, pursuant to division (M)(2) of this 968
section, denies coverage to an individual in the service area of a 969
network plan, shall not offer coverage in the individual market 970
within that service area for at least one hundred eighty days 971
after the date the carrier denies the coverage.972

       Sec. 3923.601. (A)(1) This section applies to both of the 973
following:974

       (a) A sickness and accident insurer that issues or requires 975
the use of a standardized identification card or an electronic 976
technology for submission and routing of prescription drug claims 977
pursuant to a policy, contract, or agreement for health care 978
services;979

        (b) A person that a sickness and accident insurer contracts 980
with to issue a standardized identification card or an electronic 981
technology described in division (A)(1)(a) of this section.982

       (2) Notwithstanding division (A)(1) of this section, this 983
section does not apply to the issuance or required use of a 984
standardized identification card or an electronic technology for 985
the submission and routing of prescription drug claims in 986
connection with any of the following:987

       (a) Any individual or group policy of sickness and accident 988
insurance covering only accident, credit, dental, disability 989
income, long-term care, hospital indemnity, medicare supplement, 990
medicare, tricare, specified disease, or vision care; coverage 991
under a one-time-limited-duration policy of not longerthat is 992
less than sixtwelve months; coverage issued as a supplement to 993
liability insurance; insurance arising out of workers' 994
compensation or similar law; automobile medical payment insurance; 995
or insurance under which benefits are payable with or without 996
regard to fault and which is statutorily required to be contained 997
in any liability insurance policy or equivalent self-insurance.998

       (b) Coverage provided under the medicaid program.999

       (c) Coverage provided under an employer's self-insurance plan 1000
or by any of its administrators, as defined in section 3959.01 of 1001
the Revised Code, to the extent that federal law supersedes, 1002
preempts, prohibits, or otherwise precludes the application of 1003
this section to the plan and its administrators.1004

       (B) A standardized identification card or an electronic 1005
technology issued or required to be used as provided in division 1006
(A)(1) of this section shall contain uniform prescription drug 1007
information in accordance with either division (B)(1) or (2) of 1008
this section.1009

        (1) The standardized identification card or the electronic 1010
technology shall be in a format and contain information fields 1011
approved by the national council for prescription drug programs or 1012
a successor organization, as specified in the council's or 1013
successor organization's pharmacy identification card 1014
implementation guide in effect on the first day of October most 1015
immediately preceding the issuance or required use of the 1016
standardized identification card or the electronic technology.1017

        (2) If the insurer or person under contract with the insurer 1018
to issue a standardized identification card or an electronic 1019
technology requires the information for the submission and routing 1020
of a claim, the standardized identification card or the electronic 1021
technology shall contain any of the following information:1022

        (a) The insurer's name;1023

        (b) The insured's name, group number, and identification 1024
number;1025

       (c) A telephone number to inquire about pharmacy-related 1026
issues;1027

        (d) The issuer's international identification number, labeled 1028
as "ANSI BIN" or "RxBIN";1029

        (e) The processor's control number, labeled as "RxPCN";1030

        (f) The insured's pharmacy benefits group number if different 1031
from the insured's medical group number, labeled as "RxGrp."1032

        (C) If the standardized identification card or the electronic 1033
technology issued or required to be used as provided in division 1034
(A)(1) of this section is also used for submission and routing of 1035
nonpharmacy claims, the designation "Rx" is required to be 1036
included as part of the labels identified in divisions (B)(2)(d) 1037
and (e) of this section if the issuer's international 1038
identification number or the processor's control number is 1039
different for medical and pharmacy claims.1040

        (D) Each sickness and accident insurer described in division 1041
(A) of this section shall annually file a certificate with the 1042
superintendent of insurance certifying that it or any person it 1043
contracts with to issue a standardized identification card or 1044
electronic technology for submission and routing of prescription 1045
drug claims complies with this section.1046

       (E)(1) Except as provided in division (E)(2) of this section, 1047
if there is a change in the information contained in the 1048
standardized identification card or the electronic technology 1049
issued to an insured, the insurer or person under contract with 1050
the insurer to issue a standardized identification card or an 1051
electronic technology shall issue a new card or electronic 1052
technology to the insured.1053

        (2) An insurer or person under contract with the insurer is 1054
not required under division (E)(1) of this section to issue a new 1055
card or electronic technology to an insured more than once during 1056
a twelve-month period.1057

        (F) Nothing in this section shall be construed as requiring 1058
an insurer to produce more than one standardized identification 1059
card or one electronic technology for use by insureds accessing 1060
health care benefits provided under a policy of sickness and 1061
accident insurance.1062

       Sec. 3923.65.  (A) As used in this section:1063

       (1) "Emergency medical condition" means a medical condition 1064
that manifests itself by such acute symptoms of sufficient 1065
severity, including severe pain, that a prudent layperson with 1066
average knowledge of health and medicine could reasonably expect 1067
the absence of immediate medical attention to result in any of the 1068
following:1069

       (a) Placing the health of the individual or, with respect to 1070
a pregnant woman, the health of the woman or her unborn child, in 1071
serious jeopardy;1072

       (b) Serious impairment to bodily functions;1073

       (c) Serious dysfunction of any bodily organ or part.1074

       (2) "Emergency services" means the following:1075

       (a) A medical screening examination, as required by federal 1076
law, that is within the capability of the emergency department of 1077
a hospital, including ancillary services routinely available to 1078
the emergency department, to evaluate an emergency medical 1079
condition;1080

       (b) Such further medical examination and treatment that are 1081
required by federal law to stabilize an emergency medical 1082
condition and are within the capabilities of the staff and 1083
facilities available at the hospital, including any trauma and 1084
burn center of the hospital.1085

       (B) Every individual or group policy of sickness and accident 1086
insurance that provides hospital, surgical, or medical expense 1087
coverage shall cover emergency services without regard to the day 1088
or time the emergency services are rendered or to whether the 1089
policyholder, the hospital's emergency department where the 1090
services are rendered, or an emergency physician treating the 1091
policyholder, obtained prior authorization for the emergency 1092
services.1093

       (C) Every individual policy or certificate furnished by an 1094
insurer in connection with any sickness and accident insurance 1095
policy shall provide information regarding the following:1096

       (1) The scope of coverage for emergency services;1097

       (2) The appropriate use of emergency services, including the 1098
use of the 9-1-1 system and any other telephone access systems 1099
utilized to access prehospital emergency services;1100

       (3) Any copayments for emergency services.1101

       (D) This section does not apply to any individual or group 1102
policy of sickness and accident insurance covering only accident, 1103
credit, dental, disability income, long-term care, hospital 1104
indemnity, medicare supplement, medicare, tricare, specified 1105
disease, or vision care; coverage under a one-time limited 1106
duration policy of no longerthat is less than sixtwelve months; 1107
coverage issued as a supplement to liability insurance; insurance 1108
arising out of workers' compensation or similar law; automobile 1109
medical payment insurance; or insurance under which benefits are 1110
payable with or without regard to fault and which is statutorily 1111
required to be contained in any liability insurance policy or 1112
equivalent self-insurance. 1113

       Sec. 3923.83. (A)(1) This section applies to both of the 1114
following:1115

       (a) A public employee benefit plan that issues or requires 1116
the use of a standardized identification card or an electronic 1117
technology for submission and routing of prescription drug claims 1118
pursuant to a policy, contract, or agreement for health care 1119
services;1120

        (b) A person or entity that a public employee benefit plan 1121
contracts with to issue a standardized identification card or an 1122
electronic technology described in division (A)(1)(a) of this 1123
section.1124

       (2) Notwithstanding division (A)(1) of this section, this 1125
section does not apply to the issuance or required use of a 1126
standardized identification card or an electronic technology for 1127
the submission and routing of prescription drug claims in 1128
connection with either of the following:1129

       (a) Any individual or group policy of insurance covering only 1130
accident, credit, dental, disability income, long-term care, 1131
hospital indemnity, medicare supplement, medicare, tricare, 1132
specified disease, or vision care; coverage under a 1133
one-time-limited-duration policy of not longerthat is less than 1134
sixtwelve months; coverage issued as a supplement to liability 1135
insurance; insurance arising out of workers' compensation or 1136
similar law; automobile medical payment insurance; or insurance 1137
under which benefits are payable with or without regard to fault 1138
and which is statutorily required to be contained in any liability 1139
insurance policy or equivalent self-insurance.1140

       (b) Coverage provided under the medicaid program.1141

       (B) A standardized identification card or an electronic 1142
technology issued or required to be used as provided in division 1143
(A)(1) of this section shall contain uniform prescription drug 1144
information in accordance with either division (B)(1) or (2) of 1145
this section.1146

        (1) The standardized identification card or the electronic 1147
technology shall be in a format and contain information fields 1148
approved by the national council for prescription drug programs or 1149
a successor organization, as specified in the council's or 1150
successor organization's pharmacy identification card 1151
implementation guide in effect on the first day of October most 1152
immediately preceding the issuance or required use of the 1153
standardized identification card or the electronic technology.1154

        (2) If the public employee benefit plan or person under 1155
contract with the plan to issue a standardized identification card 1156
or an electronic technology requires the information for the 1157
submission and routing of a claim, the standardized identification 1158
card or the electronic technology shall contain any of the 1159
following information:1160

        (a) The plan's name;1161

        (b) The insured's name, group number, and identification 1162
number;1163

       (c) A telephone number to inquire about pharmacy-related 1164
issues;1165

        (d) The issuer's international identification number, labeled 1166
as "ANSI BIN" or "RxBIN";1167

        (e) The processor's control number, labeled as "RxPCN";1168

        (f) The insured's pharmacy benefits group number if different 1169
from the insured's medical group number, labeled as "RxGrp."1170

        (C) If the standardized identification card or the electronic 1171
technology issued or required to be used as provided in division 1172
(A)(1) of this section is also used for submission and routing of 1173
nonpharmacy claims, the designation "Rx" is required to be 1174
included as part of the labels identified in divisions (B)(2)(d) 1175
and (e) of this section if the issuer's international 1176
identification number or the processor's control number is 1177
different for medical and pharmacy claims.1178

        (D)(1) Except as provided in division (D)(2) of this section, 1179
if there is a change in the information contained in the 1180
standardized identification card or the electronic technology 1181
issued to an insured, the public employee benefit plan or person 1182
under contract with the plan to issue a standardized 1183
identification card or electronic technology shall issue a new 1184
card or electronic technology to the insured. 1185

       (2) A public employee benefit plan or person under contract 1186
with the plan is not required under division (D)(1) of this 1187
section to issue a new card or electronic technology to an insured 1188
more than once during a twelve-month period.1189

       (E) Nothing in this section shall be construed as requiring a 1190
public employee benefit plan to produce more than one standardized 1191
identification card or one electronic technology for use by 1192
insureds accessing health care benefits provided under a health 1193
benefit plan.1194

       Sec. 3923.85.  (A) As used in this section, "cost sharing" 1195
means the cost to an individual insured under an individual or 1196
group policy of sickness and accident insurance or a public 1197
employee benefit plan according to any coverage limit, copayment, 1198
coinsurance, deductible, or other out-of-pocket expense 1199
requirements imposed by the policy or plan.1200

       (B) Notwithstanding section 3901.71 of the Revised Code and 1201
subject to division (D) of this section, no individual or group 1202
policy of sickness and accident insurance that is delivered, 1203
issued for delivery, or renewed in this state and no public 1204
employee benefit plan that is established or modified in this 1205
state shall fail to comply with either of the following:1206

       (1) The policy or plan shall not provide coverage or impose 1207
cost sharing for a prescribed, orally administered cancer 1208
medication on a less favorable basis than the coverage it provides 1209
or cost sharing it imposes for intraveneously administered or 1210
injected cancer medications.1211

       (2) The policy or plan shall not comply with division (B)(1) 1212
of this section by imposing an increase in cost sharing solely for 1213
orally administered, intravenously administered, or injected 1214
cancer medications.1215

       (C) Notwithstanding any provision of this section to the 1216
contrary, a policy or plan shall be deemed to be in compliance 1217
with this section if the cost sharing imposed under such a policy 1218
or plan for orally administered cancer treatments does not exceed 1219
one hundred dollars per prescription fill. The cost sharing limit 1220
of one hundred dollars per prescription fill shall apply to a high 1221
deductible plan, as defined in 26 U.S.C. 223, or a catastrophic 1222
plan, as defined in 42 U.S.C. 18022, only after the deductible has 1223
been met.1224

       (D)(1) The prohibitions in division (B) of this section do 1225
not preclude an individual or group policy of sickness and 1226
accident insurance or public employee benefit plan from requiring 1227
an insured or plan member to obtain prior authorization before 1228
orally administered cancer medication is dispensed to the insured 1229
or plan member.1230

       (2) Division (B) of this section does not apply to the offer 1231
or renewal of any individual or group policy of sickness and 1232
accident insurance that provides coverage for specific diseases or 1233
accidents only, or to any hospital indemnity, medicare supplement, 1234
disability income, or other policy that offers only supplemental 1235
benefits.1236

       (E) An insurer that offers any sickness and accident 1237
insurance or any public employee benefit plan that offers coverage 1238
for basic health care services is not required to comply with 1239
division (B) of this section if all of the following apply:1240

        (1) The insurer or plan submits documentation certified by an 1241
independent member of the American academy of actuaries to the 1242
superintendent of insurance showing that compliance with division 1243
(B)(1) of this section for a period of at least six months 1244
independently caused the insurer or plan's costs for claims and 1245
administrative expenses for the coverage of basic health care 1246
services to increase by more than one per cent per year.1247

        (2) The insurer or plan submits a signed letter from an 1248
independent member of the American academy of actuaries to the 1249
superintendent of insurance opining that the increase in costs 1250
described in division (E)(1) of this section could reasonably 1251
justify an increase of more than one per cent in the annual 1252
premiums or rates charged by the insurer or plan for the coverage 1253
of basic health care services.1254

        (3)(a) The superintendent of insurance makes the following 1255
determinations from the documentation and opinion submitted 1256
pursuant to divisions (E)(1) and (2) of this section:1257

        (i) Compliance with division (B)(1) of this section for a 1258
period of at least six months independently caused the insurer or 1259
plan's costs for claims and administrative expenses for the 1260
coverage of basic health care services to increase more than one 1261
per cent per year.1262

        (ii) The increase in costs reasonably justifies an increase 1263
of more than one per cent in the annual premiums or rates charged 1264
by the insurer or plan for the coverage of basic health care 1265
services.1266

        (b) Any determination made by the superintendent under 1267
division (E)(3) of this section is subject to Chapter 119. of the 1268
Revised Code.1269

       Sec. 3924.01.  As used in sections 3924.01 to 3924.14 of the 1270
Revised Code:1271

       (A) "Actuarial certification" means a written statement 1272
prepared by a member of the American academy of actuaries, or by 1273
any other person acceptable to the superintendent of insurance, 1274
that states that, based upon the person's examination, a carrier 1275
offering health benefit plans to small employers is in compliance 1276
with sections 3924.01 to 3924.14 of the Revised Code. "Actuarial 1277
certification" shall include a review of the appropriate records 1278
of, and the actuarial assumptions and methods used by, the carrier 1279
relative to establishing premium rates for the health benefit 1280
plans.1281

       (B) "Adjusted average market premium price" means the average 1282
market premium price as determined by the board of directors of 1283
the Ohio health reinsurance program either on the basis of the 1284
arithmetic mean of all carriers' premium rates for an OHC plan 1285
sold to groups with similar case characteristics by all carriers 1286
selling OHC plans in the state, or on any other equitable basis 1287
determined by the board.1288

       (C) "Base premium rate" means, as to any health benefit plan 1289
that is issued by a carrier and that covers at least two but no 1290
more than fifty employees of a small employer, the lowest premium 1291
rate for a new or existing business prescribed by the carrier for 1292
the same or similar coverage under a plan or arrangement covering 1293
any small employer with similar case characteristics.1294

       (D) "Carrier" means any sickness and accident insurance 1295
company or health insuring corporation authorized to issue health 1296
benefit plans in this state or a MEWA. A sickness and accident 1297
insurance company that owns or operates a health insuring 1298
corporation, either as a separate corporation or as a line of 1299
business, shall be considered as a separate carrier from that 1300
health insuring corporation for purposes of sections 3924.01 to 1301
3924.14 of the Revised Code.1302

       (E) "Case characteristics" means, with respect to a small 1303
employer, the geographic area in which the employees work; the age 1304
and sex of the individual employees and their dependents; the 1305
appropriate industry classification as determined by the carrier; 1306
the number of employees and dependents; and such other objective 1307
criteria as may be established by the carrier. "Case 1308
characteristics" does not include claims experience, health 1309
status, or duration of coverage from the date of issue.1310

       (F) "Dependent" means the spouse or child of an eligible 1311
employee, subject to applicable terms of the health benefits plan 1312
covering the employee.1313

       (G) "Eligible employee" means an employee who works a normal 1314
work week of twenty-fivethirty or more hours. "Eligible employee" 1315
does not include a temporary or substitute employee, or a seasonal 1316
employee who works only part of the calendar year on the basis of 1317
natural or suitable times or circumstances.1318

       (H) "Health benefit plan" means any hospital or medical 1319
expense policy or certificate or any health plan provided by a 1320
carrier, that is delivered, issued for delivery, renewed, or used 1321
in this state on or after the date occurring six months after 1322
November 24, 1995. "Health benefit plan" does not include policies 1323
covering only accident, credit, dental, disability income, 1324
long-term care, hospital indemnity, medicare supplement, specified 1325
disease, or vision care; coverage under a 1326
one-time-limited-duration policy of no longerthat is less than 1327
sixtwelve months; coverage issued as a supplement to liability 1328
insurance; insurance arising out of a workers' compensation or 1329
similar law; automobile medical-payment insurance; or insurance 1330
under which benefits are payable with or without regard to fault 1331
and which is statutorily required to be contained in any liability 1332
insurance policy or equivalent self-insurance.1333

       (I) "Late enrollee" means an eligible employee or dependent 1334
who enrolls in a small employer's health benefit plan other than 1335
during the first period in which the employee or dependent is 1336
eligible to enroll under the plan or during a special enrollment 1337
period described in section 2701(f) of the "Health Insurance 1338
Portability and Accountability Act of 1996," Pub. L. No. 104-191, 1339
110 Stat. 1955, 42 U.S.C.A. 300gg, as amended.1340

       (J) "MEWA" means any "multiple employer welfare arrangement" 1341
as defined in section 3 of the "Federal Employee Retirement Income 1342
Security Act of 1974," 88 Stat. 832, 29 U.S.C.A. 1001, as amended, 1343
except for any arrangement which is fully insured as defined in 1344
division (b)(6)(D) of section 514 of that act.1345

       (K) "Midpoint rate" means, for small employers with similar 1346
case characteristics and plan designs and as determined by the 1347
applicable carrier for a rating period, the arithmetic average of 1348
the applicable base premium rate and the corresponding highest 1349
premium rate.1350

       (L) "Pre-existing conditions provision" means a policy 1351
provision that excludes or limits coverage for charges or expenses 1352
incurred during a specified period following the insured's 1353
enrollment date as to a condition for which medical advice, 1354
diagnosis, care, or treatment was recommended or received during a 1355
specified period immediately preceding the enrollment date. 1356
Genetic information shall not be treated as such a condition in 1357
the absence of a diagnosis of the condition related to such 1358
information.1359

       For purposes of this division, "enrollment date" means, with 1360
respect to an individual covered under a group health benefit 1361
plan, the date of enrollment of the individual in the plan or, if 1362
earlier, the first day of the waiting period for such enrollment.1363

       (M) "Service waiting period" means the period of time after 1364
employment begins before an employee is eligible to be covered for 1365
benefits under the terms of any applicable health benefit plan 1366
offered by the small employer.1367

       (N)(1) "Small employer" means, in connection with a group 1368
health benefit plan and with respect to a calendar year and a plan 1369
year, an employer who employed an average of at least two but no 1370
more than fifty eligible employees on business days during the 1371
preceding calendar year and who employs at least two employees on 1372
the first day of the plan year.1373

       (2) For purposes of division (N)(1) of this section, all 1374
persons treated as a single employer under subsection (b), (c), 1375
(m), or (o) of section 414 of the "Internal Revenue Code of 1986," 1376
100 Stat. 2085, 26 U.S.C.A. 1, as amended, shall be considered one 1377
employer. In the case of an employer that was not in existence 1378
throughout the preceding calendar year, the determination of 1379
whether the employer is a small or large employer shall be based 1380
on the average number of eligible employees that it is reasonably 1381
expected the employer will employ on business days in the current 1382
calendar year. Any reference in division (N) of this section to an 1383
"employer" includes any predecessor of the employer. Except as 1384
otherwise specifically provided, provisions of sections 3924.01 to 1385
3924.14 of the Revised Code that apply to a small employer that 1386
has a health benefit plan shall continue to apply until the plan 1387
anniversary following the date the employer no longer meets the 1388
requirements of this division.1389

       (O) "OHC plan" means an Ohio health care plan, which is the 1390
basic, standard, or carrier reimbursement plan for small employers 1391
and individuals established in accordance with section 3924.10 of 1392
the Revised Code.1393

       Sec. 5301.36.  (A) Except in a county in which the county 1394
recorder has elected to require that all satisfactions of 1395
mortgages be recorded by separate instrument as allowed under 1396
section 5301.28 of the Revised Code, when recording a mortgage, 1397
county recorders shall leave space on the margin of the record for 1398
the entry of satisfaction, and record therein the satisfaction 1399
made on the mortgage, or permit the owner of the claim secured by 1400
the mortgage to enter such satisfaction. Such record shall have 1401
the same effect as the record of a release of the mortgage.1402

       (B) Within ninety days from the date of the satisfaction of a 1403
residential mortgage, the mortgagee shall record a release of the 1404
mortgage evidencing the fact of theits satisfaction in the 1405
appropriate county recorder's office and pay any fees required for 1406
the recording. The mortgagee may, by contract with the mortgagor, 1407
recover the cost of the fees required for the recording of the 1408
satisfaction by the county recorder.1409

       (C) If the mortgagee fails to comply with division (B) of 1410
this section, the mortgagor of the unrecorded satisfaction and the 1411
current owner of the real property to which the mortgage pertains1412
may recover, in a civil action, damages of two hundred fifty 1413
dollars. This division does not preclude or affect any other legal 1414
remedies or damages that may be available to the mortgagor.1415

       (D)(1) If upon the expiration of the ninety-day period 1416
described in division (B) of this section, the satisfaction of 1417
mortgage remains unrecorded, the current owner of the real 1418
property shall provide the mortgagee written notice, in accordance 1419
with the Rules of Civil Procedure, of the failure to enter the 1420
release of the mortgage of record. The notice shall be in 1421
substantially the following form:1422

"OHIO LAW REQUIRES A MORTGAGEE, WHETHER THE ORIGINAL MORTGAGEE OR 1423
ANY SUCCESSOR TO THE INTEREST OF THE ORIGINAL MORTGAGEE, TO RECORD 1424
A RELEASE OF A MORTGAGE EVIDENCING ITS SATISFACTION IN THE 1425
APPROPRIATE COUNTY RECORDER'S OFFICE AND TO PAY ANY FEES REQUIRED 1426
FOR THE RECORDING WITHIN A CERTAIN TIME PERIOD. (Name of 1427
mortgagor)'S MORTGAGE LOAN, (loan number or other loan 1428
identification), FOR PROPERTY LOCATED AT (property address), WAS 1429
SATISFIED ON (date of satisfaction). IT APPEARS YOU HAVE YET TO 1430
RECORD A RELEASE OF THIS MORTGAGE. FAILURE TO RECORD THE RELEASE 1431
WITHIN 15 DAYS OF RECEIVING THIS NOTICE MAY RESULT IN A CIVIL 1432
ACTION FILED AGAINST YOU TO RECOVER REASONABLE ATTORNEYS' FEES AND 1433
COSTS INCURRED IN SUCH AN ACTION OR OTHERWISE TO OBTAIN THE 1434
RECORDING, PLUS DAMAGES OF $100 FOR EACH DAY OF NONCOMPLIANCE NOT 1435
TO EXCEED $5,000 IN TOTAL DAMAGES."1436

       (2) Within fifteen days after delivery of the notice 1437
described in division (D)(1) of this section, the mortgagee shall 1438
record a release of the mortgage evidencing the fact of its 1439
satisfaction in the appropriate county recorder's office and pay 1440
any fees required for the recording. The mortgagee may, by 1441
contract with the mortgagor or current owner of the real property, 1442
recover the cost of the fees required for the recording of the 1443
satisfaction by the county recorder.1444

       (E) If the mortgagee fails to comply with division (D)(2) of 1445
this section after receiving the notice in accordance with 1446
division (D)(1) of this section, the current owner of the real 1447
property may recover, in a civil action, reasonable attorneys' 1448
fees and costs incurred in such an action or otherwise to obtain 1449
the recording of a satisfaction of mortgage plus damages of one 1450
hundred dollars for each day of noncompliance, not to exceed five 1451
thousand dollars in total damages.1452

       This division does not preclude or affect any other legal 1453
remedies or damages that may be available to the current owner.1454

       (F) A mortgagee that records a release of a mortgage 1455
evidencing the fact of its satisfaction within the time periods 1456
required by this section shall not be in violation of this 1457
section, or subject to damages or fees, due to the failure of a 1458
county recorder to timely process that release of mortgage.1459

       (G) A current owner may combine the civil actions described 1460
in divisions (C) and (E) of this section by bringing one action to 1461
collect for both damages, or may bring separate actions.1462

       (H) As used in this section, "residential mortgage" means an 1463
obligation to pay a sum of money evidenced by a note and secured 1464
by a lien upon:1465

       (1) "Mortgagee" includes the original mortgagee or any 1466
successor to or assignee of the original mortgagee.1467

       (2) realproperty located within this state containing two 1468
or fewer residential units or on which two or fewer residential 1469
units are to be constructed and shall include such an 1470
"Satisfaction" means that the obligation on a residential 1471
condominium or cooperative unit secured by a mortgage has been 1472
paid in full and the underlying obligation terminated, with no 1473
opportunities for future advancements.1474

       Sec. 5301.361. (A)(1) With respect to an unreleased 1475
commercial mortgage that has been satisfied more than ninety days 1476
prior to the effective date of this section, but not recorded, the 1477
mortgagee shall not be subject to a civil action or damages as 1478
described in division (C) of section 5301.36 of the Revised Code.1479

       (2) The current owner of the real property to which such a 1480
mortgage pertains shall provide the mortgagee the written notice 1481
described in division (D)(1) of section 5301.36 of the Revised 1482
Code not sooner than on the effective date of this section and may 1483
recover damages in a civil action for failure to comply with 1484
division (D)(2) of that section pursuant to division (E) of that 1485
section.1486

       (B)(1) With respect to an unreleased commercial mortgage that 1487
has been satisfied less than ninety days prior to the effective 1488
date of this section, but not recorded, the mortgagee shall not be 1489
subject to a civil action or damages as described in division (C) 1490
of section 5301.36 of the Revised Code.1491

       (2) The current owner of the real property to which such a 1492
mortgage pertains shall provide the mortgagee the written notice 1493
described in division (D)(1) of section 5301.36 of the Revised 1494
Code not sooner than on the ninetieth day after the mortgage was 1495
satisfied and may recover damages in a civil action for failure to 1496
comply with division (D)(2) of that section pursuant to division 1497
(E) of that section.1498

       (C)(1) With respect to an unreleased residential mortgage 1499
that has been satisfied, but not recorded, prior to the effective 1500
date of this section, the mortgagee shall be subject to a civil 1501
action or damages as described in division (C) of section 5301.36 1502
of the Revised Code for failure to comply with division (B) of 1503
that section.1504

       (2) If such a mortgage was satisfied more than ninety days 1505
prior to the effective date of this section, the current owner of 1506
the real property to which the mortgage pertains shall provide the 1507
mortgagee the written notice described in division (D)(1) of 1508
section 5301.36 of the Revised Code not sooner than on the 1509
effective date of this section and may recover damages in a civil 1510
action for failure to comply with division (D)(2) of that section 1511
pursuant to division (E) of that section. If such a mortgage was 1512
satisfied less than ninety days prior to the effective date of the 1513
section, the current owner shall provide the mortgagee the written 1514
notice described in division (D)(1) of section 5301.36 of the 1515
Revised Code not sooner than on the ninetieth day after the 1516
mortgage was satisfied and may recover damages in a civil action 1517
for failure to comply with division (D)(2) of that section 1518
pursuant to division (E) of that section. 1519

       (D) As used in this section, "mortgagee" has the same meaning 1520
as in section 5301.36 of the Revised Code.1521

       Section 2. That existing sections 1739.061, 1751.14, 1751.69, 1522
3923.022, 3923.24, 3923.241, 3923.281, 3923.57, 3923.58, 3923.601, 1523
3923.65, 3923.83, 3923.85, 3924.01, and 5301.36 of the Revised 1524
Code are hereby repealed.1525

       Section 3. Section 1751.14 and division (G) of section 1526
3924.01 of the Revised Code, as amended by this act, apply only to 1527
policies, contracts, and agreements that are delivered, issued for 1528
delivery, or renewed in this state on or after January 1, 2016. 1529
Division (A)(1) of section 3923.24 and division (A)(1) of section 1530
3923.241 of the Revised Code, as amended by this act, apply only 1531
to policies of sickness and accident insurance delivered, issued 1532
for delivery, or renewed in this state and public employee benefit 1533
plans or multiple employer welfare arrangement contracts and 1534
certificates that are established or modified in this state on or 1535
after January 1, 2016.1536

       Section 4. The General Assembly declares that the amendments 1537
made to section 3923.58 of the Revised Code by this act are not to 1538
supersede the suspension of the operation of this section enacted 1539
by Section 3 of Sub. S.B. 9 of the 130th General Assembly. Rather, 1540
it is the intent of the General Assembly to ensure consistency in 1541
Ohio Insurance Law should this suspension be nullified. 1542

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