Ohio § 3924.02

§ 3924.02.

(A) An individual or group health benefit plan is subject to sections 3924.01 to 3924.06 of the Revised Code if it provides health care benefits covering at least two but no more than fifty

employees of a small employer, and if it meets either of the following conditions: (1) Any portion of the premium or benefits is paid by a small employer, or any covered

individual is reimbursed, whether through wage adjustments or otherwise, by a small

employer for any portion of the premium. (2) The health benefit plan is treated by the employer or any of the covered individuals

as part of a plan or program for purposes of section 106 or 162 of the “Internal Revenue

Code of 1986,” 100 Stat. 2085, 26 U.S.C.A. 1 , as amended. (B) Notwithstanding division (A) of this section, divisions (D) , (E)(2) , (F) , and (G) of section 3924.03 of the Revised Code and section 3924.04 of the Revised Code do not apply to health benefit policies that are not sold to owners of small businesses

as an employment benefit plan.  Such policies shall clearly state that they are not being sold as an employment

benefit plan and that the owner of the business is not responsible, either directly

or indirectly, for paying the premium or benefits. (C) Every health benefit plan offered or delivered by a carrier, other than a health

insuring corporation, to a small employer is subject to sections 3923.23 , 3923.231 , 3923.232 , 3923.233 , and 3923.234 of the Revised Code and any other provision of the Revised Code that requires the reimbursement, utilization,

or consideration of a specific category of a licensed or certified health care practitioner. (D) Except as expressly provided in sections 3924.01 to 3924.06 of the Revised Code , no health benefit plan offered to a small employer is subject to any of the following: (1) Any law that would inhibit any carrier from contracting with providers or groups

of providers with respect to health care services or benefits; (2) Any law that would impose any restriction on the ability to negotiate with providers

regarding the level or method of reimbursing care or services provided under the health

benefit plan; (3) Any law that would require any carrier to either include a specific provider or class

of provider when contracting for health care services or benefits, or to exclude any

class of provider that is generally authorized by statute to provide such care.