4113.11 Payment for health insurance by salary reduction. - Ohio Statutes

4113.11 Payment for health insurance by salary reduction.

(A) As specified in division (B) of this section and except as provided in divisions (C) and (F) of this section, all employers that employ ten or more employees shall adopt and maintain a cafeteria plan that allows the employer’s employees to pay for health insurance coverage by a salary reduction arrangement as permitted under section 125 of the Internal Revenue Code.

(B) Employers shall comply with the requirements of division (A) of this section as follows:

(1) For employers that employ more than five hundred employees, by not later than January 1, 2011, or six months after the superintendent of insurance adopts rules as required by division (E) of this section, whichever is later;

(2) For employers that employ one hundred fifty to five hundred employees, by not later than July 1, 2011, or twelve months after the superintendent adopts rules as required by division (E) of this section, whichever is later;

(3)For employers that employ ten to one hundred forty-nine employees,by not later than January 1, 2012, or eighteen months after the superintendent adopts rules as required by division (E) of this section, whichever is later.

(C)This section shall not apply to employers that, through other means than provided under this section, offer health insurance coverage, reimburse for health insurance coverage, or provide employees with opportunities to pay for health insurance with pre-tax dollars through other salary reduction arrangements.

(D)The health care coverage and quality council created under section 3923.90 of the Revised Code shall make recommendations to the superintendent for both of the following:

(1)Development of strategies to educate, assist, and conduct outreach to employers to simplify administrative processes with respect to creating and maintaining cafeteria plans, including, but not limited to, providing employers with model cafeteria plan documents and technical assistance on creating and maintaining cafeteria plans that conform with state and federal law;

(2)Development of strategies to educate, assist, and conduct outreach to employees with respect to finding, selecting, and purchasing a health insurance plan to be paid for through their employer’s cafeteria plan under this section.

(E)(1) The superintendent shall adopt rules in accordance with Chapter 119. of the Revised Code to implement and enforce this section, including the strategies recommended by the council pursuant to division (D) of this section.

(2) Prior to adopting rules under this division, the superintendent shall consult any federal agency that has oversight of cafeteria plans and employee welfare benefit plans, including the internal revenue service and the United States department of labor, and receive written confirmation that the rules adopted will permit employers to establish cafeteria plans in accordance with federal law. The written confirmation shall include a determination that individual policies purchased pursuant to this section do not need to comply with the group market rules established by the “Health Insurance Portability and Accountability Act of 1996.”

(F) The requirement provided in division (A) of this section does not apply if the superintendent does not receive written confirmation pursuant to division (E)(2) of this section that individual policies purchased pursuant to this section do not need to comply with the group market rules established by the “Health Insurance Portability and Accountability Act of 1996.”

(G)Nothing in this section shall be construed as requiring an employer to establish a cafeteria plan in a manner that would violate federal law, including the “Employee Retirement Income Security Act of 1974,” the “Consolidated Omnibus Budget Reconciliation Act of 1985,” or the “Health Insurance Portability and Accountability Act of 1996.” (H) As used in this section:

(1) “Cafeteria plan” has the same meaning as in section 125 of the Internal Revenue Code.

(2) “Employer” has the same meaning as in section 4113.51 of the Revised Code.

(3) “Employee” means an individual employed for consideration who works twenty-five or more hours per week or who renders any other standard of service generally accepted by custom or specified by contract as full-time employment, except for a public employee employed by a township or municipal corporation. In that case, “employee” means an individual hired with the expectation that the employee will work more than one thousand five hundred hours in any year unless full-time employment is defined differently in an applicable collective bargaining agreement.

Added by 128th General Assembly File No. 9, HB 1, § 101.01, eff. 10/16/2009.