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

Monday, March 23, 2020

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.

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