H.B. No. 125 Summary

• Amends Ohio health insurance law to regulate premiums, benefits, and coverage requirements for health benefit plans across individual, small group, and large group markets.

• Establishes essential health benefits packages that must include ambulatory services, emergency care, hospitalization, maternity care, mental health services, prescription drugs, rehabilitation services, laboratory services, preventive care, and pediatric services.

• Implements rating restrictions limiting premium variations by age (no more than 3:1 ratio for adults) and tobacco use (no more than 1.5:1 ratio), while prohibiting variations based on health status.

• Prohibits lifetime and annual limits on essential health benefits and requires cost-sharing (copayments, deductibles, coinsurance) not to exceed 40% of total annual costs for covered services.

• Creates requirements for open enrollment periods, special enrollment periods for qualifying events, and prohibits pre-existing condition exclusions and denial of coverage based on health status.