Effective: October 12, 2016
Latest Legislation: House Bill 158 - 131st General Assembly
(A) Notwithstanding section 3901.71 of the Revised Code, any policy, contract, or agreement for health care services authorized by this chapter that is issued, delivered, or renewed in this state and that provides that coverage of an unmarried dependent child will terminate upon attainment of the limiting age for dependent children specified in the policy, contract, or agreement, shall also provide in substance both of the following:
(1) Once an unmarried child has attained the limiting age for dependent children, as provided in the policy, contract, or agreement, upon the request of the subscriber, the health insuring corporation shall offer to cover the unmarried child until the child attains twenty-six years of age if all of the following are true:
(a) The child is the natural child, stepchild, or adopted child of the subscriber.
(b) The child is a resident of this state or a full-time student at an accredited public or private institution of higher education.
(c) The child is not employed by an employer that offers any health benefit plan under which the child is eligible for coverage.
(d) The child is not eligible for coverage under the medicaid program or the medicare program.
(2) That attainment of the limiting age for dependent children shall not operate to terminate the coverage of a dependent child if the child is and continues to be both of the following:
(a) Incapable of self-sustaining employment by reason of physical handicap or intellectual disability;
(b) Primarily dependent upon the subscriber for support and maintenance.
(B) Proof of incapacity and dependence for purposes of division (A)(2) of this section shall be furnished to the health insuring corporation within thirty-one days of the child's attainment of the limiting age. Upon request, but not more frequently than annually, the health insuring corporation may require proof satisfactory to it of the continuance of such incapacity and dependency.
(C) Nothing in this section shall do any of the following:
(1) Require that any policy, contract, or agreement offer coverage for dependent children or provide coverage for an unmarried dependent child's children as dependents on the policy, contract, or agreement;
(2) Require an employer to pay for any part of the premium for an unmarried dependent child that has attained the limiting age for dependents, as provided in the policy, contract, or agreement;
(3) Require an employer to offer health insurance coverage to the dependents of any employee.
(D) This section does not apply to any health insuring corporation policy, contract, or agreement offering only supplemental health care services or specialty health care services.
(E) As used in this section, "health benefit plan" has the same meaning as in section 3924.01 of the Revised Code and also includes both of the following:
(1) A public employee benefit plan;
(2) A health benefit plan as regulated under the "Employee Retirement Income Security Act of 1974," 29 U.S.C. 1001, et seq.
Structure Ohio Revised Code
Title 17 | Corporations-Partnerships
Chapter 1751 | Health Insuring Corporation Law
Section 1751.01 | Health Insuring Corporation Law Definitions.
Section 1751.02 | Applying for Certificate of Authority.
Section 1751.03 | Verification of Application.
Section 1751.04 | Review of Application and Documents by Superintendent.
Section 1751.05 | Issuance or Denial of Certificate of Authority.
Section 1751.06 | Powers Upon Obtaining Certificate.
Section 1751.07 | Responsibility for Funds.
Section 1751.08 | Inapplicability of Insurance Laws.
Section 1751.11 | Evidence of Coverage.
Section 1751.12 | Contractual Periodic Prepayment or Premium Rate.
Section 1751.13 | Contracts With Providers and Health Care Facilities.
Section 1751.14 | Termination of Coverage of Child.
Section 1751.18 | Cancelling or Failing to Renew Coverage.
Section 1751.19 | Complaint System.
Section 1751.20 | Unfair, Untrue, Misleading, or Deceptive Acts.
Section 1751.21 | Peer Review Committee.
Section 1751.25 | Investment of Funds.
Section 1751.26 | Investments in Real Estate.
Section 1751.27 | Deposit of Securities With Superintendent or Custodian.
Section 1751.271 | Medicaid Providers - Performance Bond.
Section 1751.31 | Changes in Corporation's Solicitation Document.
Section 1751.32 | Annual Report.
Section 1751.321 | Audit Report Filed Annually.
Section 1751.33 | Information to Be Provided to Subscribers.
Section 1751.34 | Examinations by Superintendent and Director.
Section 1751.35 | Suspension or Revocation of Certificate of Authority.
Section 1751.38 | Applicability of Other Laws.
Section 1751.40 | Insurance Companies Operating as Health Insuring Corporations.
Section 1751.42 | Rehabilitation, Liquidation, Supervision or Conservation of Corporation.
Section 1751.44 | Fees Paid to Superintendent of Insurance.
Section 1751.45 | Administrative Penalties - Violations.
Section 1751.46 | Recommendations for Expansion of Service Areas.
Section 1751.47 | Adopting Forms, Instructions and Manuals for Providing Financial Information.
Section 1751.51 | Restrictions on Choice of Providers.
Section 1751.52 | Confidentiality of Information.
Section 1751.521 | Medical Information Release.
Section 1751.53 | Continuing Coverage After Termination of Employment.
Section 1751.54 | Continuing Coverage After Reservist Called to Duty.
Section 1751.55 | Effect of Workers Compensation Coverage.
Section 1751.56 | Effect of Supplemental Sickness and Accident Insurance Policy.
Section 1751.57 | Conditions Applying to All Individual Health Insuring Corporation Contracts.
Section 1751.59 | Coverage of Adopted Children.
Section 1751.61 | Coverage for Newly Born Child.
Section 1751.62 | Screening Mammography - Cytologic Screening for Cervical Cancer.
Section 1751.63 | Long-Term Care Insurance.
Section 1751.65 | Health Insuring Corporation - Prohibited Activities.
Section 1751.66 | Prescription Drugs.
Section 1751.67 | Maternity Benefits.
Section 1751.68 | Provisions for Medication Synchronization for Enrollees.
Section 1751.70 | Authorization of Payroll Deductions for Public Employees.
Section 1751.71 | Accepting Payments for Cost of Policies, Contracts, and Agreements.
Section 1751.72 | Policy, Contract, or Agreement Containing a Prior Authorization Requirement.
Section 1751.73 | Implementing Quality Assurance Programs.
Section 1751.74 | Quality Assurance Program Requirements.
Section 1751.75 | Determination That Accreditation Constitutes Compliance.
Section 1751.77 | Utilization Review, Internal and External Review Procedure Definitions.
Section 1751.78 | Application of Provisions.
Section 1751.79 | Utilization Review Program Requirements.
Section 1751.80 | Implementing Utilization Review Programs.
Section 1751.811 | Internal and External Reviews.
Section 1751.82 | Reconsideration of Adverse Determination.
Section 1751.821 | Determination That Accreditation Constitutes Compliance.
Section 1751.822 | Cooperation With Utilization Review Program.
Section 1751.823 | Filing Certificate of Compliance.
Section 1751.83 | Maintaining Internal Review System.
Section 1751.84 | Coverage for Autism Spectrum Disorder.
Section 1751.85 | Information for Vision Care Services or Materials.
Section 1751.86 | Violation Deemed Unfair and Deceptive Act or Practice.
Section 1751.87 | Cause of Action Not Created.
Section 1751.89 | Medicare and Medicaid Exceptions.
Section 1751.90 | Coverage for Teledentistry.
Section 1751.91 | Reimbursement for Pharmacists Providing Health Care.