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Ohio Order to Give Employers Premium Flexibility During State of Emergency

 March 22 2020     Shelly Hodges-Konys

On Friday, March 20, 2020, Lieutenant Governor Jon Husted on behalf of the Ohio Department of Insurance (ODOI) announced a requirement for insurers in the state to provide flexibility for employers and employees as they navigate the challenges presented by the current state of emergency due to the COVID-19 pandemic.  These regulations are temporary and intended to take effect immediately and conclude when the state of emergency is over. The rules apply to all group health plans in the state including health insurance carriers, stop loss carriers, multiple employer welfare arrangements (MEWAs), and other entities covered under the jurisdiction of the ODOI.

Premium Payment Grace Period

During this time, health insurers must allow their insureds to defer payment of premiums for up to 60 calendar days from the date they would otherwise be due. Insurers may not assess any interest during this time.  

Employee Eligibility

Insurers must also allow employers to continue to cover employees under group health plan coverage even if an employee would otherwise become ineligible under the terms of the plan due to a decrease in hours worked regardless of any actively-at-work provision contained in the policy.  Further, insurers are prohibited from increasing premiums due to a decrease in enrollment or participation in the plan. This flexibility is especially important for employers because insurance policies often contain enrollment or participation requirements that allow insurers to adjust premiums in the event of significant changes in the number of enrolled employees.

Continuation of Coverage

Employers with 20 or more employees must also be able to allow eligible employees to continue coverage in accordance with the Consolidated Omnibus Budget Reconciliation Act (COBRA) in accordance with normal notice and election procedures as long as at least one employee remains actively employed. The same holds true for employers with less than 20 employees that are subject to state continuation rules rather than COBRA.

Special Enrollment

Last, for employees that lose coverage must be offered a special enrollment to enroll in new coverage. Generally, coverage purchased through the federal marketplace program is effective the first of the month following the date of enrollment. Insurers offering policies outside of the marketplace are instructed to waive their normal procedures and make coverage effective the first day following loss of employment. 

 

Please contact your HORAN representative with any questions.