Key Takeaways
- Ohio mini-COBRA extends health coverage to employees of businesses with fewer than 20 employees
- Ohio mini-COBRA continuation coverage lasts up to 12 months
- Small group health plans must offer guaranteed issue and renewal
- Ohio requires mental health parity in group health plans
- HIPAA portability rules apply to group health coverage in Ohio
Ohio Group Health Insurance & COBRA
Ohio regulates group health insurance to ensure access and continuation of coverage for employees.
Federal COBRA Overview
Federal COBRA applies to employers with 20+ employees:
| COBRA Element | Federal Requirement |
|---|---|
| Employer Size | 20 or more employees |
| Coverage Duration | 18-36 months |
| Cost to Employee | Up to 102% of premium |
| Qualifying Events | Termination, divorce, death, Medicare |
Ohio Mini-COBRA
For smaller employers, Ohio provides mini-COBRA:
Ohio Mini-COBRA Requirements
| Element | Ohio Requirement |
|---|---|
| Employer Size | Fewer than 20 employees |
| Duration | Up to 12 months |
| Premium | Up to 102% of premium |
| Qualifying Events | Similar to federal COBRA |
Qualifying Events for Ohio Mini-COBRA
- Voluntary or involuntary termination (except gross misconduct)
- Reduction in hours
- Death of covered employee
- Divorce or legal separation
- Dependent child aging out
Exam Tip: Ohio mini-COBRA provides 12 months of continuation vs. 18-36 months under federal COBRA. Know the difference.
Election and Notice Requirements
Employer Obligations
| Obligation | Timeframe |
|---|---|
| Notify insurer | Within 30 days of event |
| Provide election notice | Per insurer requirements |
| Maintain coverage | During election period |
Employee Election
| Element | Requirement |
|---|---|
| Election period | 60 days from notice |
| Retroactive coverage | From date of loss |
| First payment | Within 45 days of election |
Small Group Health Insurance
Ohio regulates small group health insurance (2-50 employees):
Guaranteed Issue
| Requirement | Description |
|---|---|
| Acceptance | Must accept all small employers |
| No Pre-ex Exclusions | Cannot exclude pre-existing conditions |
| Rating Limits | Limited rating variations allowed |
Guaranteed Renewal
Small group health plans must renew unless:
- Non-payment of premium
- Fraud or misrepresentation
- Non-compliance with plan terms
- Insurer withdraws from market (with notice)
Mental Health Parity
Ohio requires mental health parity in group health plans:
Parity Requirements
| Element | Requirement |
|---|---|
| Benefits | Equal to medical/surgical |
| Cost-Sharing | Same copays, deductibles |
| Treatment Limits | No more restrictive |
| Preauthorization | No more burdensome |
Covered Conditions
- Mental health disorders
- Substance use disorders
- Behavioral health conditions
HIPAA Portability
Ohio enforces HIPAA portability requirements:
Certificate of Creditable Coverage
| Element | Requirement |
|---|---|
| Timing | Upon loss of coverage |
| Content | Period of coverage, gaps |
| Use | Reduce new plan waiting periods |
Portability Benefits
- Reduces pre-existing condition exclusions
- Credit for prior continuous coverage
- 63-day significant break in coverage rule
How long does Ohio mini-COBRA provide continuation coverage?
Which employers are subject to Ohio mini-COBRA requirements?
Under Ohio small group health insurance rules, insurers must:
What does Ohio's mental health parity law require for group health plans?
How long does an employee have to elect Ohio mini-COBRA coverage after receiving notice?