Ohio Senate Bill 9 Will Require Claims Reporting for Groups with 50+ Enrolled Employees
On Jan. 7, 2021, Gov. Mike DeWine signed Senate Bill 9 to enact Ohio Revised Code §3901.89. The new law's provisions take effect July 1, 2021 and will require health plan issuers to release certain claims data to groups with 50 or more full-time covered (enrolled) employees. It applies to fully insured groups and all non-federal government plans.
Employers must formally request the release of required claims. Health plan issuers must then provide the group's required claims data within 30 business days of receipt of their request to remain in compliance with the law. Health plan issuers are only required to release reports once per calendar year for any group.
Data included in these reports will include the below information for the current or prior policy period:
- Monthly enrollment
- Net claims paid or incurred by month medical and pharmacy
- Claims exceeding $30,000
Specific procedures for this new process will be shared in future broker updates. If you have any questions, please contact BUA