As Introduced

136th General Assembly

Regular Session H. B. No. 904

2025-2026

Representative Somani

Cosponsors: Representatives Brennan, Brownlee, Upchurch, McNally, Piccolantonio, Abdullahi

To enact sections 3902.81, 3902.82, and 3902.83 of the Revised Code to establish a reinsurance program.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section 1. That sections 3902.81, 3902.82, and 3902.83 of the Revised Code be enacted to read as follows:

Sec. 3902.81. (A) As used in sections 3902.81 to 3902.83 of the Revised Code, "health plan issuer" and "health benefit plan" have the same meanings as in section 3922.01 of the Revised Code.

(B) The superintendent of insurance shall establish and implement a reinsurance program designed to mitigate the impact of high risk individuals on rates for health benefit plans in this state.

(C) As part of the reinsurance program established under this section, the superintendent shall apply to the secretary of the United States department of health and human services for an innovation waiver under section 1332 of the "Patient Protection and Affordable Care Act," 42 U.S.C. 18052.

(D)(1) The reinsurance program shall provide reinsurance to health plan issuers that offer health benefit plans in this state. Based on funds available in the Ohio reinsurance fund established under section 3902.82 of the Revised Code, the reinsurance program has the following payment parameters:

(a) An attachment point of thirty thousand dollars;

(b) A coinsurance rate of eighty per cent;

(c) A coinsurance cap of two hundred fifty thousand dollars.

(2) The superintendent may adjust the payment parameters described in division (D)(1) of this section on an annual basis based on the amount of funds available in the Ohio reinsurance fund.

Sec. 3902.82. The Ohio reinsurance fund is created in the state treasury. The fund shall consist of any pass-through funds received as a result of the innovation waiver approved by the secretary of the United States department of health and human services under section 1332 of the "Patient Protection and Affordable Care Act," 42 U.S.C. 18052, any additional federal funds received to provide reinsurance under the reinsurance program established under section 3902.81 of the Revised Code, and funds collected under the assessment imposed on health insuring corporations under section 3902.83 of the Revised Code. The superintendent of insurance shall use the money in the fund to provide reinsurance to health plan issuers under the reinsurance program established under section 3902.81 of the Revised Code.

Sec. 3902.83. (A) As used in this section, "health insuring corporation" has the same meaning as in section 5168.75 of the Revised Code.

(B) For purposes of the reinsurance program established under section 3902.81 of the Revised Code, there is imposed an annual assessment on each health insuring corporation. The assessment amount shall equal one per cent of the health insuring corporation's gross premiums from the previous calendar year.

(C) Assessment amounts shall be deposited into the Ohio reinsurance fund established under section 3902.82 of the Revised Code and shall be used to provide reinsurance under the reinsurance program established under section 3902.81 of the Revised Code.