As Introduced
136th General Assembly
Regular Session H. B. No. 24
2025-2026
Representatives Callender, Sweeney
Cosponsors: Representatives Williams, Rader, Russo, Synenberg, Piccolantonio,
Brennan, Troy, Sigrist, Brewer, Grim, Lett, Baker, Cockley, Hall, D.
A B I LL
To amend sections 3923.33, 3923.331, 3923.332,
3923.337, 3923.338, 3923.339, and 3923.42 and to
enact section 3923.3310 of the Revised Code to
provide Medigap policies for Medicare-eligible
individuals under the age of 65.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 3923.33, 3923.331, 3923.332,
3923.337, 3923.338, 3923.339, and 3923.42 be amended and section
3923.3310 of the Revised Code be enacted to read as follows:
Sec. 3923.33. As used in section 3923.33 and sections
3923.331 to 3923.339 3923.3310 of the Revised Code:
(A) "Applicant" means:
(1) In the case of an individual medicare supplement
policy, the person who seeks to contract for insurance benefits;
and
(2) In the case of a group medicare supplement policy, the
proposed certificate holder.
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(B) "Certificate" means, for purposes of section 3923.33
and sections 3923.331 to 3923.339 3923.3310 of the Revised Code,
any certificate delivered or issued for delivery in this state
under a group medicare supplement policy.
(C) "Certificate form" means the form on which the
certificate is delivered or issued for delivery by the issuer.
(D) "Direct response insurance policy" means a medicare
supplement policy or certificate marketed without the direct
involvement of an insurance agent.
(E) "Issuer" includes insurance companies, fraternal
benefit societies, health insuring corporations, and any other
entities delivering or issuing for delivery in this state
medicare supplement policies or certificates.
(F) "Medicare" means the "Health Insurance for the Aged
Act," Title XVIII of the Social Security Amendments of 1965, 79
Stat. 291, 42 U.S.C.A. 1395, as then constituted or later
amended.
(G) "Medicare supplement policy" means a group or
individual policy of sickness and accident insurance or a
subscriber contract of health insuring corporations or any other
issuers, other than a policy issued pursuant to a contract under
section 1876 of the "Social Security Act," 49 Stat. 620 (1935),
42 U.S.C.A., 1395mm, as amended, or an issued policy under any
demonstration project specified in 42 U.S.C.A. 1395ss(g)(1),
which is advertised, marketed, or designed primarily as a
supplement to reimbursements under medicare for the hospital,
medical, or surgical expenses of persons eligible for medicare.
(H) "Policy form" means the form on which the policy is
delivered or issued for delivery by the issuer.
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Sec. 3923.331. (A) Except as otherwise provided in the
Revised Code, section 3923.33 and sections 3923.331 to 3923.339
3923.3310 of the Revised Code shall apply to:
(1) All medicare supplement policies delivered or issued
for delivery in this state on or after the effective date of
this amendment; and
(2) All certificates issued under group medicare
supplement policies, which certificates are delivered or issued
for delivery in this state on or after the effective date of
this amendment.
(B) Section 3923.33 and sections 3923.331 to 3923.339
3923.3310 of the Revised Code shall not apply to a policy of one
or more employers or labor organizations, or of the trustees of
a fund established by one or more employers or labor
organizations, or a combination thereof, for employees or former
employees, or a combination thereof, or for members or former
members, or a combination thereof, of the labor organizations.
(C) Except as otherwise provided in division (D) of
section 3923.334 of the Revised Code, section 3923.33 and
sections 3923.331 to 3923.339 3923.3310 of the Revised Code are
not intended to prohibit or apply to insurance policies or
health care benefit plans, including group conversion policies,
provided to medicare eligible persons, which policies are not
marketed or held to be medicare supplement policies or benefit
plans.
Sec. 3923.332. (A) No medicare supplement policy or
certificate in force in this state shall contain benefits that
duplicate benefits provided by medicare.
(B) Notwithstanding section 3923.04 of the Revised Code or
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any other provision of law of this state, a medicare supplement
policy or certificate shall not exclude or limit benefits for
losses incurred more than six months from the effective date of
coverage because it involved a preexisting condition. The policy
or certificate shall not define a preexisting condition more
restrictively than a condition for which medical advice was
given or treatment was recommended by or received from a
physician within six months before the effective date of
coverage.
(C) The superintendent of insurance shall adopt reasonable
rules to establish specific standards for policy provisions of
medicare supplement policies and certificates. The standards
shall be in addition to and in accordance with applicable laws
of this state, including sections 3923.03 to 3923.09 of the
Revised Code. No requirement in Title XVII or XXXIX of the
Revised Code relating to minimum required policy benefits, other
than the minimum standards contained in section 3923.33 and
sections 3923.331 to 3923.339 3923.3310 of the Revised Code,
shall apply to medicare supplement policies and certificates.
The standards may cover, but are not limited to:
(1) Terms of renewability;
(2) Initial and subsequent conditions of eligibility;
(3) Nonduplication of coverage;
(4) Probationary periods;
(5) Benefit limitations, exceptions, and reductions;
(6) Elimination periods;
(7) Requirements for replacement;
(8) Recurrent conditions; and
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(9) Definitions of terms.
(D) The superintendent shall adopt reasonable rules to
establish minimum standards for benefits, claims payment,
advertising and marketing practices and compensation
arrangements, and reporting practices, for medicare supplement
policies and certificates.
(E) The superintendent may adopt from time to time such
reasonable rules as are necessary to conform medicare supplement
policies and certificates to the requirements of federal law and
regulations promulgated thereunder, including but not limited
to:
(1) Requiring refunds or credits if the policies or
certificates do not meet loss ratio requirements;
(2) Establishing a uniform methodology for calculating and
reporting loss ratios;
(3) Assuring public access to policies, premiums, and loss
ratio information of issuers of medicare supplement insurance;
(4) Establishing a process for approving or disapproving
policy forms and certificate forms and proposed premium
increases;
(5) Establishing a policy for holding public hearings
prior to approval of premium increases; and
(6) Establishing standards for medicare select policies
and certificates.
(F) The superintendent may adopt reasonable rules that
specify prohibited policy provisions not otherwise specifically
authorized by any provision in the Revised Code that, in the
opinion of the superintendent, are unjust, unfair, or unfairly
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discriminatory to any person insured or proposed to be insured
under a medicare supplement policy or certificate.
Sec. 3923.337. All rules adopted pursuant to section
3923.33 and sections 3923.331 to 3923.339 3923.3310 of the
Revised Code shall be subject to Chapter 119. of the Revised
Code.
Sec. 3923.338. In addition to any other applicable
penalties for violations of Title XVII or XXXIX of the Revised
Code, the superintendent of insurance, pursuant to an
adjudication conducted in accordance with Chapter 119. of the
Revised Code, may issue an order requiring issuers violating any
provision of section 3923.33 or sections 3923.331 to 3923.339
3923.3310 of the Revised Code or rules adopted pursuant to those
sections to do either or both of the following:
(A) Cease marketing any medicare supplement policy or
certificate in this state that is related directly or indirectly
to the violation;
(B) Take such actions as are necessary to comply with
section 3923.33 and sections 3923.331 to 3923.339 3923.3310 of
the Revised Code.
Sec. 3923.339. If any provision of section 3923.33 or
sections 3923.331 to 3923.339 3923.3310 of the Revised Code or
the application thereof to any person or circumstances is for
any reason held to be invalid, the remainder of section 3923.33
and sections 3923.331 to 3923.339 3923.3310 of the Revised Code
and the application of such remainder to other persons or
circumstances shall not be affected thereby.
Sec. 3923.3310. (A) Not later than the first day of
January that immediately follows the effective date of this
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section, any issuer that offers coverage under a medicare
supplement policy to individuals sixty-five years of age or
older shall offer the same coverage to individuals younger than
sixty-five years of age who are eligible for and enrolled in
medicare by reason of disability or end stage renal disease.
(B) Any benefit, protection, policy, or procedure
applicable to coverage under a policy for an individual sixty-
five years or older shall also apply to coverage offered under
this section.
(C) The premiums for coverage offered under this section
to individuals who are sixty-four years of age or younger shall
not be higher than the premiums for a medicare supplement policy
offered to individuals sixty-five years of age.
(D)(1) Except as otherwise provided in division (D)(2) of
this section, an issuer shall comply with sections 3923.33 to
3933.3310 of the Revised Code when issuing policies under this
section.
(2) Notwithstanding any provision of the Revised Code to
the contrary, a policy issued under this section shall not
exclude or limit benefits for losses attributable to a
preexisting condition.
(E) An issuer shall offer to individuals younger than
sixty-five years of age who are eligible for and enrolled in
medicare by reason of disability or end stage renal disease an
open enrollment period for coverage offered under this section
that begins on the first day of January that immediately follows
the effective date of this section and ends on the immediately
following first day of July.
(F) Each year, a person who is already covered under a
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policy issued under this section may, within sixty days of the
person's date of birth, acquire a new medicare supplement policy
offering the same coverage as the person's existing policy from
a different issuer.
Sec. 3923.42. (A) Sections 3923.41 to 3923.48 of the
Revised Code may be cited as the "long-term care insurance act."
(B) Sections 3923.41 to 3923.48 of the Revised Code do not
supersede the obligations of entities subject to these sections
to comply with the substance of other applicable insurance laws
insofar as they do not conflict with these sections, except that
section 3923.33 and sections 3923.331 to 3923.339 3923.3310 of
the Revised Code and rules intended to apply to medicare
supplement insurance policies do not apply to long-term care
insurance. A policy that is not advertised, marketed, or offered
as long-term care insurance need not meet the requirements of
sections 3923.41 to 3923.48 of the Revised Code.
Section 2. That existing sections 3923.33, 3923.331,
3923.332, 3923.337, 3923.338, 3923.339, and 3923.42 of the
Revised Code are hereby repealed.
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