Am. Sub. S.B. No. 9 Summary

• Requires health plan issuers to release monthly claims data to group policyholders (covering 50+ full-time employees) within 30 business days of request, limited to once per calendar year.

• Mandates disclosure include net claims paid by month, monthly enrollment data, prescription claims information, and details on claims exceeding $30,000 (including claim identifier, amount paid, and diagnosis).

• Permits health plan issuers to require policyholders to execute liability waivers and provides civil immunity for issuers for subsequent use of disclosed data by third parties.

• Prohibits disclosure of individual identities or specific health conditions that would violate federal or state law; requires group policyholders to certify compliance with HIPAA requirements (45 C.F.R. 164.504(f)(2)) to receive protected health information.

• Classifies series of violations as unfair or deceptive practice under Ohio law; amendments to section 3904.13 authorize group policyholder disclosure as permitted exception; effective July 1, 2021.