On March 20, 2020, the Ohio Department of Insurance issued a Bulletin providing relief to certain insurance regulations in Ohio. This Bulletin followed Governor Dewine’s directive that agencies implement procedures to help prevent or alleviate the public health threat from COVID-19. The Bulletin applies to all health insurance carriers that reimburse the costs of health care services under a health benefit plan in Ohio, including insurance companies, stop loss insurers, and non-federal governmental health plans. The changes will alleviate the impact of COVID-19 by making it easier for employees to remain on their employers’ health insurance plans, providing a grace period for employers to make premium payments, and relaxing standards for continuation of coverage as follows:
- Employee Eligibility: Insurers must permit employers to continue covering employees under group health insurance policies even if an employee would otherwise become ineligible for coverage due to a decrease in the employee’s hours worked per week. Insurers must permit employers to continue providing coverage to employees regardless of any “actively at work” hours requirement or similar eligibility requirements. Furthermore, insurers are prohibited from increasing premium rates based on a group’s decrease in enrollment or participation due to the impact of COVID-19.
- Grace Period for Premium Payment: Insurers are required to give policyholders the option of deferring their premium payments, interest free, for up to 60 days from each original premium due date.
- Continuation Coverage: Employees’ options for continuation coverage depend on the size of their employer. For employers with 20 or more employees, employees may elect to continue coverage under COBRA under the normal notice and election procedures as long as at least one person remains actively employed with the employer. For employers with fewer than 20 employees, employees may elect to continue coverage under state continuation coverage for up to twelve months if one person remains actively employed and enrolled in the plan. If no active employees remain covered under a plan, employees become eligible for a special enrollment period, as detailed below.
- Special Enrollment: Employees who lose coverage are eligible for a special enrollment period to enroll in new coverage. They may do so through the federal exchange or through outside insurance providers. Individuals who apply for coverage on the federal exchange may qualify for premium subsidies. Their coverage becomes effective the first day of the next month after enrollment. Insurers providing policies outside of the federal exchange must waive normal special enrollment procedures and allow applicants to obtain coverage effective the day after their loss of employment.
This Bulletin is specific to the State of Ohio and does not affect health insurance coverage outside of this state. It will remain in effect until the expiration of the State of Emergency declared by Governor Dewine on March 9, 2020.
Separately and finally, the Ohio Department of Job and Family Services has created this form to help expedite the unemployment claim process.
Z&R will continue to monitor the latest information governing Ohio employers and has created a resource center. Previous Z&R articles addressing employer requirements and considerations during the COVID-19 pandemic can be found here:
- Coronavirus Considerations for Employers
- Ohio Provides Some Cover for Employers and Employees in Wake of COVID-19
- Federal COVID-19 response mandates paid leave (for now)
- Application of the Worker Adjustment and Retraining Notification Act (“WARN”) to Closures Caused by the COVID-19 Pandemic
- Ohio BWC: Allows Deferment of Premium Payments and Addresses Compensability of Contracting COVID-19
*Lauren Drabic works in Z&R’s Cleveland office and regularly advises clients on all employment matters. If you have questions regarding the Ohio Department of Insurance Bulletin other employment-related matters, please contact Lauren at lmd@zrlaw.com or 216.696.4441.