Ohio § 3923.381

§ 3923.381.

(A) As used in this section: (1) “ Eligible person ” means any person who, at the time a reservist is called or ordered to active duty,

is covered under a group policy and is either of the following: (a) An employee who is a reservist called or ordered to active duty; (b) The spouse or a dependent child of an employee described in division (A)(1)(a) of

this section. (2) “ Group policy ” includes any group sickness and accident insurance policy that satisfies all of

the following: (a) The policy is delivered, issued for delivery, or renewed in this state on or after

April 17, 1991. (b) The policy covers employees for hospital, surgical, or major medical insurance on

an expense incurred or service basis, other than for specified diseases or accidental

injuries only. (c) The policy is in effect and covers an eligible person at the time a reservist is

called or ordered to active duty. (3) “ Reservist ” means a member of a reserve component of the armed forces of the United States.

“ Reservist ” includes a member of the Ohio national guard. (B) Every group policy shall provide that any eligible person may continue the coverage

under the policy for a period of eighteen months after the date on which the coverage

would otherwise terminate because the reservist is called or ordered to active duty. (C)(1) An eligible person may extend the eighteen-month period of continuation of coverage

to a thirty-six-month period of continuation of coverage, if any of the following

occurs during the eighteen-month period: (a) The death of the reservist; (b) The divorce or separation of a reservist from the reservist's spouse; (c) The cessation of dependency of a child pursuant to the terms of the policy. (2) The thirty-six-month period of continuation of coverage is deemed to begin on the

date on which the coverage would otherwise terminate because the reservist is called

or ordered to active duty. (3) The employer may begin the thirty-six-month period on the date of any occurrence

described in division (C)(1) of this section. (D) All of the following apply to any continuation of coverage, or the extension of any

continuation of coverage, provided under division (B) or (C) of this section: (1) The continuation of coverage shall provide the same benefits as those provided to

any similarly situated eligible person who is covered under the same group policy

and an employee who has not been called or ordered to active duty. (2) An employer shall notify each employee of the right of continuation of coverage at

the time of employment.  At the time the reservist is called or ordered to active duty, the employer shall

notify each eligible person of the requirements for the continuation of coverage. (3) Each certificate of coverage issued by an insurer to an employee under the group

policy shall include a notice of the eligible person's right of continuation of coverage. (4) An eligible person shall file a written election of continuation of coverage with

the employer and pay the employer the first contribution required under division (D)(5)

of this section.  The written election and payment must be received by the employer no later than

thirty-one days after the date on which the eligible person's coverage would otherwise

terminate.  If the employer notifies the eligible person of the right of continuation of coverage

after the date on which the eligible person's coverage would otherwise terminate,

the written election and payment must be received by the employer no later than thirty-one

days after the date of the notification. (5)(a) Except as provided in division (D)(5)(b) or (c) of this section, the eligible person

shall pay to the employer, on a monthly basis and in advance, the amount of contribution

required by the employer.  The amount shall not exceed one hundred two per cent of the group rate for the coverage

being continued under the group policy on the due date of each payment. (b) The employer may pay a portion or all of the eligible person's contribution. (c) A reservist called or ordered to active duty for less than thirty-one days shall

not be required to pay more than the eligible person's contribution, if any, for the

coverage. (E) The eligible person's right to any continuation of coverage, or the extension of

any continuation of coverage, provided under division (B) or (C) of this section ceases

on the date on which any of the following occurs: (1) The eligible person, whether as an employee or otherwise, enrolls in another group

policy or other group health plan or arrangement that does not contain any exclusion

or limitation with respect to any preexisting condition of that eligible person.  For purposes of division (E)(1) of this section, a group policy or other group health

plan or arrangement does not include the civilian health and medical program of the

uniformed services as defined in Public Law 99-661, 100 Stat. 3898 (1986) , 10 U.S.C.A. 1072 . (2) The period of either eighteen months provided under division (B) of this section

or thirty-six months provided under division (C) of this section expires. (3) The eligible person fails to make a timely payment of a required contribution, in

which case the coverage ceases at the end of the period of coverage for which contributions

were made. (4) The group policy, or participation under the group policy, is terminated, unless

the employer, in accordance with division (F) of this section, replaces the coverage

with similar coverage under another group policy or other group health plan or arrangement. (F) If the employer replaces the group policy with similar coverage as described in division

(E)(4) of this section, both of the following apply: (1) The eligible person is covered under the replacement coverage for the balance of

the period that the eligible person would have remained covered under the terminated

coverage if it had not been terminated. (2) The level of benefits under the replacement coverage is the same as the level of

benefits provided to any similarly situated eligible person who is covered under the

group policy and an employee who has not been called or ordered to active duty. (G) Upon the reservist's release from active duty and return to employment for the employer

by whom the reservist was employed at the time of being called or ordered to active

duty, both of the following apply: (1) Every eligible person is entitled, without any waiting period, to coverage under

the employer's group policy that is in effect at the time of the reservist's return

to employment. (2) Every eligible person is entitled to all benefits under the group policy described

in division (G)(1) of this section from the date of the original coverage under the

policy. (H)(1) No insurer shall fail to provide for a continuation of coverage, or an extension

of a continuation of coverage, in a group policy as required by and in accordance

with the terms and conditions set forth under this section. (2) No insurer shall fail to issue a certificate of coverage in compliance with division

(D)(3) of this section. (3) No employer shall fail to provide an employee or eligible person with notice of the

right to a continuation of coverage under a group policy in accordance with division

(D)(2) of this section. (I) Whoever violates division (H)(1), (2), or (3) of this section is deemed to have engaged

in an unfair and deceptive act or practice in the business of insurance under sections 3901.19 to 3901.26 of the Revised Code .