OHIO LEGISLATIVE SERVICE COMMISSION
Office of Research Legislative Budget
www.lsc.ohio.gov and Drafting Office
S.B. 220 Bill Analysis
134th General Assembly
Click here for S.B. 220’s Fiscal Note
Version: As Introduced
Primary Sponsors: Sens. Craig and Manning
Effective Date:
Andrew Little, Attorney
SUMMARY
 Prohibits a health plan issuer from imposing cost-sharing on a prescription insulin drug
in an amount that exceeds $35 for a 30-day supply.
DETAILED ANALYSIS
Insulin cost-sharing limit
In the case of a health plan issuer that provides coverage for a prescription insulin drug,
the bill prohibits the issuer from imposing cost sharing on the drug in an amount that exceeds
$35 for a 30-day supply. The bill specifies that its prohibition applies regardless of the amount
or type of insulin needed to fill the covered person’s prescription. The cost sharing must be
charged on a per-prescription-fill basis.1
Exemption from review by the Superintendent of Insurance
The bill’s provisions might be considered a mandated health benefit. Under
R.C. 3901.71, if the General Assembly enacts a provision for mandated health benefits, that
provision cannot be applied to any health benefit plan until the Superintendent of Insurance
determines that the provision can be applied fully and equally in all respects to employee
benefit plans subject to regulation by the federal “Employee Retirement Income Security Act of
1974,” (ERISA),2 and to employee benefit plans established or modified by the state or any of its
1 R.C. 3902.62.
2 29 United States Code (U.S.C.) 1001, as amended.
September 14, 2021
Office of Research and Drafting LSC Legislative Budget Office
political subdivisions. ERISA appears to preempt any state regulation of such plans.3 The bill
contains provisions that exempt its requirements from this restriction.4
Definitions
As used in this analysis:
 “Prescription insulin drug” is a prescription drug that contains insulin and is used to
treat diabetes.
 “Cost sharing” means the cost to a covered person under a health benefit plan
according to any copayment, coinsurance, deductible, or other out-of-pocket expense
requirement.
 “Covered person” means a person covered by a health benefit plan.
 “Health plan issuer” means an entity subject to Ohio’s insurance laws that contracts to
provide, pay for, or reimburse any of the costs of health care services. The term includes
a sickness and accident insurer, a health insuring corporation, a fraternal benefit society,
a self-funded multiple employer welfare arrangement, and a nonfederal, government
health plan. The term also includes a third party administrator to the extent that the
benefits the administrator is contracted to administer are subject to Ohio insurance
laws or to the Superintendent’s jurisdiction.5
HISTORY
Action Date
Introduced 08-30-21
S0220-I-134/ar
3 29 U.S.C. 1144.
4 R.C. 3902.62.
5 R.C. 3902.62 and R.C. 3902.50, not in the bill.
P a g e |2 S.B. 220
As Introduced