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Ohio Permitting Deferral of Health Care Premiums for Employer Plans

Client Alert

Effective March 20, 2020 and continuing through the expiration of the state of emergency declared by Governor DeWine on March 9, 2020, the Ohio Department of Insurance is requiring all health insurance companies operating in Ohio to give their insureds the option of deferring premium payments coming due, interest free, for up to 60 calendar days from each original premium due date.  See Department of Insurance Bulletin 2020-03.

The Ohio Department of Insurance is also requiring insurers to:

  • permit employers to continue covering an employee under group policies even if the employee would otherwise become ineligible due to a decrease in hours worked per week; and
  • permit employers to continue providing coverage to employees under group policies regardless of any “actively at work” or similar eligibility requirements in the policy.

Additionally, the Ohio Department of Insurance is prohibiting insurers from increasing premium rates based on an employer group’s decreased enrollment or participation due to COVID-19. Click here for a link to the full bulletin.

If you have any questions, please contact Adam D. Fuller at adfuller@bmdllc.com, or feel free to contact your primary BMD Attorney.


Advanced Practice Providers and Telemedicine Start-Up Surge

Throughout the COVID-19 pandemic, we heard a lot about “surges” that happened all over the country regarding the virus. One of the other interesting “surges” we have followed is the “surge” in new healthcare business start-ups, particularly businesses owned by advanced practice providers, such as nurse practitioners, physician assistants, certified nurse midwives, clinical nurse specialists, and certified registered nurse anesthetists (“Advanced Practice Providers” or “APPs”). One of the hottest areas in the healthcare start-up surge has been the creation of practices that are telemedicine focused.

Ohio Department of Health Releases Updated Charge Limits for Medical Records

Under Ohio law, a healthcare provider or medical records company that receives a request for a copy of a patient's medical record may charge an amount in accordance with the limits set forth in Ohio Revised Code Section 3701.741. The allowable amounts are increased or decreased annually by the average percentage of increase or decrease in the consumer price index for all urban consumers, prepared by the United States Department of Labor, Bureau of Labor Statistics, for the immediately preceding calendar year over the calendar year immediately preceding that year, as reported by the Bureau. The Director of the Ohio Department of Health makes this determination and adjusts the amounts accordingly. The list is then published, here.

No Surprises Act Compliance (Published by NAMAS, 2/25/22)

The Department of Health and Human Services published three parts to the No Surprises Act towards the end of 2021, which took effect January 1, 2022. The Act is intended to protect consumers from “balance billing,” which occurs when a patient receives a bill with a higher price than they may have anticipated because they did not have knowledge that the provider or facility was out-of-network. The purpose of this article is to note certain requirements that compliance employees will need to be aware of at their facilities, including notice and consent, good faith estimates, and public disclosures.

No Surprises Act and You (Published in the SCMS Winter 2022 Newsletter)

Legislation has been adopted by the United States Congress and the Ohio Legislature known as the “No Surprises Act” which attempts to regulate billing by professionals and facilities to patients who are not in networks with those facilities or providers at those facilities. The federal bill was triggered by some sensational news stories of patients being billed for tens of thousands of dollars for emergency care when the hospital was out of the network under the patient’s insurance plans.

Are You Impacted by the Project Labor Agreement Executive Order?

Project Labor Agreements (PLAs) are a quasi-collective bargaining agreement between employers and unions. They establish the terms and conditions of employment, including dispute resolution. They are put into place on specific projects and apply to the contractor, whether it is union or non-union. Employees hired on the project will be treated as union.