Bill Title: To require certain insurers that provide coverage for cancer chemotherapy treatment to provide coverage for certain prescribed, orally administered anticancer medication on a basis no less favorable than intravenously administered or injected cancer medications that are covered under the policy.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2011-02-01 - To Insurance, Commerce, & Labor
[SB31 Detail]Download: Ohio-2011-SB31-Introduced.html
As Introduced
| 129th General Assembly | | Regular Session | | 2011-2012 |
| |
A BILL
| To amend section 1739.05 and to enact sections | 1 |
|
1751.69 and 3923.85 of the Revised Code to require | 2 |
|
certain insurers that provide coverage for cancer | 3 |
|
chemotherapy treatment to provide coverage for | 4 |
|
certain prescribed, orally administered anticancer | 5 |
|
medication on a basis no less favorable than | 6 |
|
intravenously administered or injected cancer | 7 |
|
medications that are covered under the policy. | 8 |
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
| Section 1. That section 1739.05 be amended and sections | 9 |
|
1751.69 and 3923.85 of the Revised Code be enacted to read as | 10 |
|
follows: | 11 |
| Sec. 1739.05. (A) A multiple employer welfare arrangement | 12 |
|
that is created pursuant to sections 1739.01 to 1739.22 of the | 13 |
|
Revised Code and that operates a group self-insurance program may | 14 |
|
be established only if any of the following applies: | 15 |
| (1) The arrangement has and maintains a minimum enrollment of | 16 |
|
three hundred employees of two or more employers. | 17 |
| (2) The arrangement has and maintains a minimum enrollment of | 18 |
|
three hundred self-employed individuals. | 19 |
| (3) The arrangement has and maintains a minimum enrollment of | 20 |
|
three hundred employees or self-employed individuals in any | 21 |
|
combination of divisions (A)(1) and (2) of this section. | 22 |
| (B) A multiple employer welfare arrangement that is created | 23 |
|
pursuant to sections 1739.01 to 1739.22 of the Revised Code and | 24 |
|
that operates a group self-insurance program shall comply with all | 25 |
|
laws applicable to self-funded programs in this state, including | 26 |
|
sections 3901.04, 3901.041, 3901.19 to 3901.26, 3901.38, 3901.381 | 27 |
|
to 3901.3814, 3901.40, 3901.45, 3901.46, 3902.01 to 3902.14, | 28 |
|
3923.24, 3923.282, 3923.30, 3923.301, 3923.38, 3923.581, 3923.63, | 29 |
|
3923.80, 3923.85, 3924.031, 3924.032, and 3924.27 of the Revised | 30 |
|
Code. | 31 |
| (C) A multiple employer welfare arrangement created pursuant | 32 |
|
to sections 1739.01 to 1739.22 of the Revised Code shall solicit | 33 |
|
enrollments only through agents or solicitors licensed pursuant to | 34 |
|
Chapter 3905. of the Revised Code to sell or solicit sickness and | 35 |
|
accident insurance. | 36 |
| (D) A multiple employer welfare arrangement created pursuant | 37 |
|
to sections 1739.01 to 1739.22 of the Revised Code shall provide | 38 |
|
benefits only to individuals who are members, employees of | 39 |
|
members, or the dependents of members or employees, or are | 40 |
|
eligible for continuation of coverage under section 1751.53 or | 41 |
|
3923.38 of the Revised Code or under Title X of the "Consolidated | 42 |
|
Omnibus Budget Reconciliation Act of 1985," 100 Stat. 227, 29 | 43 |
|
U.S.C.A. 1161, as amended. | 44 |
| Sec. 1751.69. Notwithstanding section 3901.71 of the Revised | 45 |
|
Code, each individual or group health insuring corporation policy, | 46 |
|
contract, or agreement providing basic health care services that | 47 |
|
is delivered, issued for delivery, or renewed in this state that | 48 |
|
provides coverage for cancer chemotherapy treatment shall provide | 49 |
|
coverage for a prescribed, orally administered anticancer | 50 |
|
medication used to kill or slow the growth of cancerous cells on a | 51 |
|
basis no less favorable than intravenously administered or | 52 |
|
injected cancer medications that are covered under the policy, | 53 |
|
contract, or agreement. | 54 |
| Sec. 3923.85. Notwithstanding section 3901.71 of the Revised | 55 |
|
Code, each individual or group policy of sickness and accident | 56 |
|
insurance that is delivered, issued for delivery, or renewed in | 57 |
|
this state or public employee benefit plan that is established or | 58 |
|
modified in this state that provides coverage for cancer | 59 |
|
chemotherapy treatment shall provide coverage for a prescribed, | 60 |
|
orally administered anticancer medication used to kill or slow the | 61 |
|
growth of cancerous cells on a basis no less favorable than | 62 |
|
intravenously administered or injected cancer medications that are | 63 |
|
covered under the policy or plan. | 64 |
| This section does not apply to the offer or renewal of any | 65 |
|
individual or group policy of sickness and accident insurance that | 66 |
|
provides coverage for specific diseases or accidents only, or to | 67 |
|
any hospital indemnity, medicare supplement, medicare, tricare, | 68 |
|
long-term care, disability income, one-time limited duration | 69 |
|
policy of not longer than six months, or other policy that offers | 70 |
|
only supplemental benefits. | 71 |
| Section 2. That existing section 1739.05 of the Revised Code | 72 |
|
is hereby repealed. | 73 |
| Section 3. Sections 1751.69 and 3923.85 of the Revised Code, | 74 |
|
as enacted by this act, shall apply only to policies, contracts, | 75 |
|
agreements, and plans that are delivered, issued for delivery, | 76 |
|
renewed, established, or modified in this state on or after the | 77 |
|
effective date of this act. | 78 |
