The proposed bill, H.B. No. 2025-2026, aims to establish network adequacy standards for health insurers in Ohio by enacting 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 a variety of providers, including those serving low-income and medically underserved populations, and ensures availability of emergency services at all times. The bill also outlines criteria for evaluating network adequacy, including provider ratios, geographic accessibility, and the ability to meet the needs of diverse populations.

Additionally, the bill requires health plan issuers to establish processes for ensuring covered persons can access benefits from out-of-network providers when necessary, while still maintaining an adequate network of in-network providers. It mandates that issuers monitor their networks continuously and report any material changes to the superintendent of insurance. Furthermore, the bill stipulates that health plan issuers must provide clear information to covered persons regarding their networks and services, including a provider directory and procedures for navigating the health plan. The superintendent is granted authority to adopt rules for the administration and enforcement of these standards.