The Ohio Department of Insurance (ODI) has issued guidance pursuant to Governor Mike DeWine’s emergency declaration and March 9, 2020, order directing state agencies to implement procedures consistent with recommendations from the Department of Health. The ODI guidance applies to insurance companies, multiple employer welfare arrangements, non-federal governmental health plans, and other entities subject to the jurisdiction of the ODI.

Under Bulletin 2020-03, group health plan eligibility restrictions were lifted, premium increases limited, and rules for continuation of coverage expanded. Insurers must allow employers to continue coverage for employees who would otherwise be ineligible as a result of a reduction in hours worked. Further, any “active at work” provision will not operate to limit eligibility for coverage under a group health policy.

As for premium rates, insurers are prohibited from increasing premiums based on a reduction in enrollment due to COVID-19. Insurers also are mandated to provide insureds with the option to defer premiums for up to 60 days, interest-free.

For health plans with at least one active employee enrolled, all former employees are eligible for continuation coverage under COBRA (applicable to employers with 20 or more employees) or for 12 months under the Ohio continuation rules for smaller employers. For employees that lose coverage, there will also be a special enrollment period and waiver of certain enrollment procedures when coverage is purchased on the federal exchange.

Please contact a Jackson Lewis attorney if you have any questions.

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Photo of David M. Pixley David M. Pixley

David M. Pixley is a principal in the Cleveland, Ohio office of Jackson Lewis P.C. His practice focuses on employee benefits and ERISA litigation.

David’s practice includes counseling clients on all aspects of employee benefits and ERISA litigation involving single employer and multiemployer…

David M. Pixley is a principal in the Cleveland, Ohio office of Jackson Lewis P.C. His practice focuses on employee benefits and ERISA litigation.

David’s practice includes counseling clients on all aspects of employee benefits and ERISA litigation involving single employer and multiemployer benefit plans.

In addition to his extensive courtroom experience, David routinely advises and counsels clients with regard to employee benefit plan compliance, administration, participant disclosures, reporting and drafting requirements under ERISA, the Internal Revenue Code, ACA, HIPAA and COBRA. David assists clients in correcting errors under the IRS’ Employee Plans Compliance Resolution System and the DOL’s Voluntary Fiduciary Correction Program. He also advises employers and investors on multiemployer benefit plan issues that arise during a corporate restructuring and in the context of M&A transactions.

Prior to joining Jackson Lewis, David served as outside Fund Counsel to multiemployer pension and welfare plans and has extensive experience with employer withdrawal liability, payroll audits, and delinquent contribution matters. He routinely speaks and writes about the issues facing employers contributing to and exiting multiemployer plans.

At the Ohio State University, he was a member of the Rugby Football Club. After law school, prior to beginning his career as an attorney, David was deployed as a member of the Ohio Army National Guard and awarded the Global War on Terrorism Expeditionary Medal.