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. The bill removes existing provisions related to pre-existing conditions and waiting periods, while introducing new requirements for insurers to offer health benefit plans to small employers and their eligible employees, dependents, and retirees. It establishes minimum employer contributions toward premiums and mandates the continuation of coverage for qualified beneficiaries under the Federal Employee Retirement Income Security Act. Additionally, the bill expands the definition of "basic health care services" to include essential health benefits for large group market plans and clarifies coverage requirements for biologically based mental illnesses.

The legislation also introduces new definitions and provisions for health insuring corporations, including guidelines for premium rates and copayments to ensure they remain reasonable. It prohibits lifetime maximums on basic health care services and allows certain limits on inpatient hospital services. The bill enhances consumer protections by preventing discrimination based on health status-related factors and ensuring that health plans cannot deny coverage based on pre-existing conditions. Furthermore, it establishes cost-sharing limits for health plans, mandates coverage for preventive services without cost-sharing, and ensures equitable access to essential health benefits. Overall, the FAMILY Act aims to improve health insurance access and coverage for local youth and families while ensuring compliance with federal standards.

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