The Fair Access to Medical Insurance for Local Youth and Families (FAMILY) Act proposes significant amendments to the Revised Code concerning health insurance premiums and benefits. Key changes include the removal of pre-existing condition and waiting period rules, mandating that insurers offer health benefit plans to small employers and their eligible employees and dependents. The bill establishes new sections that define essential health benefits and the operational conditions for health insuring corporations, particularly regarding basic health care services and biologically based mental illnesses. It also introduces new definitions, such as "intermediary organization" and "open panel plan," and clarifies the roles of health insuring corporations in enrolling individuals and contracting with providers.

Additionally, the bill enhances protections against discrimination based on health status-related factors, ensuring that health insuring corporations cannot cancel or fail to renew coverage due to such factors. It prohibits lifetime maximums on basic health care services and mandates coverage for emergency services without prior authorization. The legislation also sets specific cost-sharing limits for health plans and emphasizes preventive care by requiring coverage for evidence-based services without cost-sharing. Overall, the FAMILY Act aims to improve access to health insurance for local youth and families, particularly through equitable coverage options for small employers and their employees.

Statutes affected:
As Introduced: 1731.04, 1751.01, 1751.06, 1751.12, 1751.18, 1751.58, 1751.69, 3902.50, 3922.01, 3923.57, 3923.571, 3923.85, 3924.01, 3924.02, 3924.03, 3924.033, 3924.51, 4125.041