The proposed bill, H.B. No. 2025-2026, aims to establish network adequacy standards for health insurers in Ohio by enacting a new section, 3901.93, of the Revised Code. This section defines key terms such as "business day," "cost sharing," "covered benefit," and "network plan," among others. It mandates that health plan issuers maintain a network that provides sufficient access to providers and emergency services for all covered persons, including those who are low-income or medically underserved. The bill also outlines the criteria the superintendent of insurance must use to evaluate network adequacy, including provider ratios, geographic accessibility, and waiting times for appointments.

Additionally, the bill requires health plan issuers to establish processes to ensure covered persons can access in-network benefits even when out-of-network providers are necessary due to a lack of available in-network options. It mandates ongoing monitoring of provider capacity and the establishment of minimum provider numbers and travel limits. Health plan issuers must also file their network plans and access arrangements with the department of insurance, ensuring compliance with the new standards. The superintendent is empowered to adopt rules for the administration and enforcement of these provisions, ensuring that health insurers meet the established network adequacy requirements.