Ohio insurance laws

What it would do: Prohibits health plan issuers from increasing cost sharing, moving drugs to higher cost-share tiers, removing drugs from formularies, or limiting coverage during a plan year, except when FDA questions drug safety, manufacturer discontinues it, or wholesale acquisition cost increases over 5% plus inflation rate.

What it would do: Establishes paid family leave insurance as a new line of insurance in Ohio, allowing insurers licensed for disability income or life insurance to issue policies covering income loss due to childbirth, adoption, foster care placement, family member care, or military service situations.

What it would do: Amends Ohio insurance laws regarding consumer transactions, repair facilities, insurance agents, and investment limitations. Prohibits repair facilities from requiring consumers to sign contracts interfering with insurance policies or restricting legal actions, and establishes procedures for insurance company disputes with towing and storage facilities.

What it would do: Extends workers' compensation coverage to members of designated urban search and rescue teams rendering assistance in Ohio at the request of the state Emergency Management Agency Executive Director. Creates an intrastate mutual aid compact allowing political subdivisions to provide emergency assistance to each other.

What it would do: Establishes prior authorization requirements for health insurers, sickness and accident insurers, and Medicaid programs, including electronic submission standards, response timeframes of forty-eight hours for urgent care and ten calendar days for routine requests, twelve-month approvals for chronic condition drugs, and streamlined appeal processes.

What it would do: Modifies Ohio motor vehicle laws to define and regulate excess wear and use waivers, debt cancellation products, motor vehicle ancillary product protection contracts, and vehicle value protection agreements as non-insurance products, and establishes procedures for reporting uninsured drivers to the registrar of motor vehicles.

What it would do: Requires Medicaid providers of transportation services to provide annual proof of commercial automobile liability insurance, and requires Medicaid in-home care service providers to provide annual proof of liability insurance coverage of at least $250,000 per occurrence for bodily injury or death.

What it would do: Establishes a family and medical leave insurance program administered by the director of job and family services, funded by employee and employer premiums, providing up to eighteen weeks of benefits annually to eligible employees taking leave for serious health conditions, childbirth, adoption, family care, military exigencies, or covered service member care.

What it would do: Requires health benefit plans offering basic health care services to cover assisted reproductive technology and treatment for conditions impacting fertility on the same terms as other reproductive care, and requires Medicaid to provide equivalent coverage.

What it would do: Establishes a Prescription Drug Affordability Board and Stakeholder Council to review and set upper payment limits on prescription drugs meeting specified cost thresholds, and prohibits purchasers and payers from exceeding those limits.

What it would do: Prohibits health plan issuers from wrongfully denying, reducing, or terminating covered health care services or payments. Establishes a medical claims consumer assistance program, creates penalties up to $25,000 per violation plus double damages, and requires annual reporting on adverse benefit determinations.

What it would do: Amends Ohio's financial responsibility laws to change the deadline for reporting uninsured drivers from six months to ninety days after an accident, extend the hearing request period from thirty to sixty days, and eliminate ongoing SR-22 filing requirements for individuals who completed one year of filing by April 2024 or whose suspension was under specific provisions.

What it would do: Requires the superintendent of insurance to establish a reinsurance program for health benefit plans with an attachment point of $30,000, 80% coinsurance rate, and $250,000 coinsurance cap, funded by an innovation waiver and a 1% annual assessment on health insuring corporations' gross premiums.

What it would do: Requires health benefit plans and Medicaid to cover epinephrine and glucagon in any prescribed form for individuals eighteen and younger if medically necessary, and caps cost sharing at sixty dollars per package of two autoinjectors or equivalent dose.

What it would do: Requires health benefit plans and Medicaid to cover colorectal cancer screening tests for individuals age 21 and older, with cost-sharing limits not exceeding those for individuals age 45 and older.

What it would do: Prohibits health insurers and pharmacy benefit managers from setting copayments, cost sharing, and deductibles exceeding 40% of annual covered service costs or federal limits, and from conditioning coverage based on prescription drug financial assistance availability.

What it would do: Amends Ohio law governing surplus lines insurers by establishing eligibility criteria, requiring agents to conduct due diligence by contacting at least five authorized insurers before placing coverage with unauthorized insurers, and creating an insurance export list for coverages lacking general market availability.

What it would do: Requires health insurers, sickness and accident insurers, and public employee benefit plans in Ohio to cover scalp cooling systems for individuals receiving cancer chemotherapy treatment if they provide chemotherapy coverage. Directs Medicaid to cover scalp cooling systems for Medicaid recipients undergoing cancer chemotherapy.

What it would do: Requires health plan issuers and the Medicaid program to cover screening, diagnosis, and treatment of PANDAS and PANS, including diagnostic evaluation, immunomodulatory therapies, antimicrobial treatment, and therapeutic services, without step therapy, prior authorization, or severity thresholds.

What it would do: Prohibits Medicaid and state and local authority employee health insurance plans from covering gender reassignment surgery. Requires local authorities to certify compliance annually and imposes 25% local government fund reductions for noncompliance.

What it would do: Establishes transportation network company drivers as employees for workers' compensation purposes during passenger and dispatch platform time, requires companies to pay premiums based on driver hours, creates a driver resource center funded by fifteen-cent-per-trip fees, and establishes account deactivation appeal protections.

What it would do: Establishes definitions and requirements for dental benefit plans, including restrictions on payment methods, prior authorization procedures, and third-party access to provider networks, while prohibiting contractual waivers of these provisions.

What it would do: Requires health benefit plans and the Medicaid program to cover annual mental health well checks performed by licensed mental health professionals for enrolled children and adults to the same extent as annual physical health well checks.

What it would do: Prohibits health benefit plans and the Medicaid program from denying claims for dental services solely on the basis of the patient's age.