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Ohio Changes Rules for Health Insurance Coverage - COVID-19 Update

The Ohio Department of Insurance (ODI) has issued guidance pursuant to Governor Mike DeWine’s emergency declaration and March 9, 2020, order directing state agencies to implement procedures consistent with recommendations from the Department of Health. The ODI guidance applies to insurance companies, multiple employer welfare arrangements, non-federal governmental health plans, and other entities subject to the jurisdiction of the ODI.

Under Bulletin 2020-03, group health plan eligibility restrictions were lifted, premium increases limited, and rules for continuation of coverage expanded. Insurers must allow employers to continue coverage for employees who would otherwise be ineligible as a result of a reduction in hours worked. Further, any “active at work” provision will not operate to limit eligibility for coverage under a group health policy.

As for premium rates, insurers are prohibited from increasing premiums based on a reduction in enrollment due to COVID-19. Insurers also are mandated to provide insureds with the option to defer premiums for up to 60 days, interest-free.

For health plans with at least one active employee enrolled, all former employees are eligible for continuation coverage under COBRA (applicable to employers with 20 or more employees) or for 12 months under the Ohio continuation rules for smaller employers. For employees that lose coverage, there will also be a special enrollment period and waiver of certain enrollment procedures when coverage is purchased on the federal exchange.

Jackson Lewis P.C. © 2020National Law Review, Volume X, Number 83


About this Author

David M. Pixley Employee Benefits and ERISA  Lawyer Cleveland Jackson Lewis
Of Counsel

David M. Pixley is Of Counsel in the Cleveland, Ohio office of Jackson Lewis P.C. His practice focuses on employee benefits and ERISA litigation.

Mr. Pixley’s practice includes counseling clients on all aspects of employee benefits and ERISA litigation. His experience includes defending plans and fiduciaries in administrative proceedings, appeals, and litigation related to benefit claims and fiduciary obligations.

In addition to his extensive courtroom experience, Mr. Pixley routinely advises and counsels clients with regard to employee benefit plan...