Bill Text: OH SB31 | 2011-2012 | 129th General Assembly | Introduced

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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

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As Introduced

129th General Assembly Regular Session 2011-2012

S. B. No. 31

Senator Tavares 

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A BILL

To amend section 1739.05 and to enact sections

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1751.69 and 3923.85 of the Revised Code to require

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certain insurers that provide coverage for cancer

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chemotherapy treatment to provide coverage for

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certain prescribed, orally administered anticancer

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medication on a basis no less favorable than

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intravenously administered or injected cancer

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medications that are covered under the policy.

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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