Rule 123:1-71-02 | Administration of the fund.
(A) The director enters into a contract with administrators to administer the portion of the fund set aside to provide benefits specified in division (A) of section 124.82 of the Revised Code. Determination as to the qualifications of the administrators will be made by the director in consultation with the superintendent of insurance, and in consideration of the following factors:
(1) Cost of providing required administrative services;
(2) Claim service capability, including location of claim offices, nature of claim processing systems, claim payment turn-around time, and productivity of claim processors;
(3) Evidence of the effective exercise of claim control and cost containment capability;
(4) Experience with other large groups;
(5) Financial strength;
(6) Non-claim services provided; and
(7) The availability and cost of stop-loss coverage for the state.
(B) The state employee health benefit fund will be available without fiscal year limitation for the payment of benefits, premiums, subscription charges, and administrative costs as specified in section 124.87 of the Revised Code, and exist under the custody and supervision of the director, who will be responsible, under approved bonds, for all monies coming into and paid out of the fund in accordance with section 124.87 of the Revised Code, and ensure that the fund is actuarially sound.
(C) The following accounts will be maintained within the state employee health benefit fund:
(1) Administrative special account in the department of administrative services into which all contributions and other income will be credited and from which administrative costs, premiums, subscription charges, amounts available for investment or claims for benefits may be paid;
(2) Investment trust account to be maintained by the treasurer of state in the manner provided in paragraph (F) of this rule; and
(3) A claims payment account in the department of administrative services or in a financial institution or with the administrator from which claims for benefits may be paid by the director or by the administrator and from which the administrator may deduct appropriate administrative fees.
(D) The director transfers monies among the various accounts and instructs the treasurer of state to make investments in the manner provided for in paragraph (F) of this rule.
(E) Contributions will be credited to and constitute the state employee health benefit fund. Any amounts remaining in the state employee health benefit fund after all premiums, subscription charges, and other expenses have been paid will be retained in the fund as a special reserve for adverse claim fluctuation.
(F) Any amounts held by the state employee health benefit fund that are available for investment will be invested by the treasurer of the state. The amount in the investment trust account will be invested for a period not to exceed one year, for credit only to the state employee health benefit fund. Investments will be subject to the terms, conditions, limitations, and restrictions imposed under Chapter 3907. of the Revised Code upon domestic life insurance companies in the investment of their capital, surplus, and accumulations.
(G) All income derived from investments accrues to the fund. When monies are paid to the treasurer of state, the director submits an estimate of the date such monies are no longer available for investment. When the director wishes to withdraw monies from the trust account, the director submits a request for the withdrawal in writing to the treasurer of state, and such funds will be available to the director within thirty days after the treasurer's receipt of the request.
(H) Any necessary and reasonable cost incurred by the treasurer of state or the department of administrative services in administering these rules will be charged against the administrative special account established under paragraph (C)(1) of this rule.
Last updated August 1, 2022 at 8:39 AM
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