Ohio Administrative Code Search
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Rule 3901-5-02 | Continuing education provider.
... 3905.484 of the Revised Code to be a provider of insurance continuing education courses. (B) Authority This rule is promulgated pursuant to the authority vested in the superintendent under sections 3901.041, 3905.481, 3905.484 and 3905.486 of the Revised Code. (C) Definitions (1) "Authorized Provider Official" is the person designated by a provider as the individual responsible for the cond... |
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Rule 3901-5-02 | Continuing education provider.
...o review insurance continuing education provider applications. (B) Authority This rule is promulgated pursuant to the authority vested in the superintendent under sections 3901.041, 3905.26, 3905.28, and 3905.486 of the Revised Code. (C) Definitions (1) "Authorized Provider Official" is the person designated by a provider as the individual responsible for the conduct of a continuing education ... |
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Rule 3901-5-03 | Continuing education course.
... the superintendent, which includes the provider name, provider number, course name and course identification number, course completion date, student's name, national producer number (NPN), number of credits earned by each student, or any other information deemed necessary by the superintendent. (5) "Course Difficulty Level" is determined based on whether the course is designed for inexperien... |
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Rule 3901-5-03 | Continuing education course.
... the superintendent, which includes the provider name, provider number, course title, and course identification number, course completion date, participant's name, national producer number (NPN), number of credits earned by each participant, or any other information deemed necessary by the superintendent. (5) "Course Difficulty Level" is determined by whether the course is designed for inexpe... |
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Rule 3901-5-04 | Continuing education market practices/audit.
... criteria, standards and procedures for providers of continuing education (CE) programs. (B) Authority This rule is promulgated pursuant to the authority vested in the superintendent under sections 3901.041 and 3905.486 of the Revised Code. (C) Provider practices (1) A course must be offered and presented as approved. The failure to do so may result in a denial of CE credit for the course. (2... |
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Rule 3901-5-04 | Continuing education market practices/audit.
...criteria, standards, and procedures for providers of continuing education (CE) programs. (B) Authority This rule is promulgated pursuant to the authority vested in the superintendent under sections 3901.041, 3905.26, 3905.28, and 3905.486 of the Revised Code. (C) Providers must: (1) Offer and present a course as approved by the superintendent. Failure to do so may result in a denial of CE credit f... |
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Rule 3901-5-05 | Agent education violations.
... may subject a continuing education provider or agent to administrative actions. (B) Authority This rule is promulgated pursuant to the authority vested in the superintendent under sections 3901.041 and 3905.486 of the Revised Code. (C) Providers The following are violations of the pre-licensing education and continuing education statutes and rules: (1) Making any false, misleading or dec... |
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Rule 3901-5-05 | Agent education violations.
... can subject a continuing education provider or agent to administrative actions. (B) Authority This rule is promulgated pursuant to the authority vested in the superintendent under sections 3901.041 and 3905.486 of the Revised Code. (C) Providers The following are violations of the pre-licensing education and continuing education statutes and rules: (1) Making any false, misleading, or de... |
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Rule 3901-5-06 | Agent education fees.
...-transferable (D) Continuing education provider and course initial and renewal application fees (1) Every continuing education provider shall pay the fee established in paragraph (D)(2) of this rule. The fee is due with the submission of the provider application. Course fees, where applicable, shall be submitted with the course application. (2) The applicant shall select one of the fee options listed below. If the... |
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Rule 3901-5-06 | Agent education fees.
...-transferable (D) Continuing education provider and course initial and renewal application fees (1) Every continuing education provider will pay the fee established in paragraph (D)(2) of this rule. The fee is due with the submission of the provider application. Course fees, where applicable, will be submitted with the course application. (2) The applicant will select one of the fee options... |
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Rule 3901-5-07 | Regulation of agent pre-licensing education.
...used in this rule: (1) "Authorized provider official" means a person designated by a provider and approved by the superintendent as the person who is responsible for a provider's compliance with the pre-licensing education regulations and who is responsible for a provider's integrity and operation. This includes the responsibility for obtaining pre-license education provider, course and instructo... |
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Rule 3901-5-07 | Regulation of agent pre-licensing education.
...used in this rule: (1) "Authorized provider official" means a person designated by a provider and approved by the superintendent as the person who is responsible for a provider's compliance with the pre-licensing education regulations and who is responsible for a provider's integrity and operation. This includes the responsibility for obtaining pre-license education provider, course and instructo... |
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Rule 3901-5-13 | Insurance navigator certification and agent exchange requirements.
...nt for a: (1) Licensed health care provider or a hospital registered with the Ohio department of health; (2) Federally qualified health center or a federally qualified health center look-alike as defined in section 3701.047 of the Revised Code; (3) Non-profit organization whose primary purpose is the distribution of food stuffs, groceries, donated goods or purchased goods in their community... |
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Rule 3901-5-13 | Insurance navigator certification and agent exchange requirements.
...nt for a: (1) Licensed health care provider or a hospital registered with the Ohio department of health; (2) Federally qualified health center or a federally qualified health center look-alike as defined in section 3701.047 of the Revised Code; (3) Non-profit organization whose primary purpose is the distribution of food stuffs, groceries, donated goods or purchased goods in their community... |
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Rule 3901-6-13 | Suitability in annuity transactions.
...is rule. (5) "Continuing education provider" or "CE provider" means an individual or entity that is approved to offer continuing education courses pursuant to rule 3901-5-02 of the Administrative Code. (6) "FINRA" means the "Financial Industry Regulatory Authority" or a succeeding agency. (7) "Insurer" means a company, including a fraternal benefit society, required to be licensed under... |
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Rule 3901-8-01 | Coordination of benefits.
...owable expense. (d) Any expense that a provider by law or in accordance with a contractual agreement is prohibited from charging a covered person is not an allowable expense. (e) The definition of "allowable expense" may exclude certain types of coverage or benefits such as dental care, vision care, prescription drug or hearing aids. A plan that limits the application of "COB" to certain coverag... |
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Rule 3901-8-01 | Coordination of benefits.
...owable expense. (d) Any expense that a provider by law or in accordance with a contractual agreement is prohibited from charging a covered person is not an allowable expense. (e) The definition of "allowable expense" may exclude certain types of coverage or benefits such as dental care, vision care, prescription drug or hearing aids. A plan that limits the application of "COB" to certain coverag... |
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Rule 3901-8-02 | Provider discounts.
... from billed charges from a health care provider. (B) Authority This rule is issued pursuant to the authority vested in the superintendent of insurance under section 3901.041 of the Revised Code, general rule making authority; and sections 3901.19 to 3901.22 of the Revised Code, the unfair and deceptive acts statute. (C) Definitions (1) "Discount" means any negotiated reduction or variation from the schedule of b... |
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Rule 3901-8-02 | Provider discounts.
... from billed charges from a health care provider. (B) Authority This rule is promulgated pursuant to the authority vested in the superintendent of insurance under sections 3901.041 and 3901.19 to 3901.22 of the Revised Code. (C) Definitions (1) "Discount" means any negotiated reduction or variation from the schedule of billed charges (including capitation) that a health care provider otherwise wou... |
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Rule 3901-8-03 | Standardized health claim form rule.
...es its successors. (14) "Other provider" means a supplier of health care services or supplies not meeting the definition of health care practitioner or institutional care practitioner, including but not limited to a pharmacist, physician assistant, nurse aide, or supplier of durable medical equipment. (15) "Third-party payer" is as defined in section 3901.38 of the Revised Code. (D) Applica... |
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Rule 3901-8-04 | Accreditation of independent review organizations.
...clinical reviewer(s) or health care provider(s) do not have any prohibited affiliations as outlined in divisions (B) and (C)(1) of section 3922.14 of the Revised Code; (g) A description of the procedures to ensure that no conflict of interest exists in accordance with paragraph (G) of this rule; (h) A description of the quality assurance program as outlined in section 3922.14 of the Revised Code and... |
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Rule 3901-8-04 | Accreditation of independent review organizations.
...clinical reviewer(s) or health care provider(s) do not have any prohibited affiliations as outlined in divisions (B) and (C)(1) of section 3922.14 of the Revised Code. (g) A description of the procedures to ensure that no conflict of interest exists in accordance with paragraph (G) of this rule. (h) A description of the quality assurance program as outlined in section 3922.14 of the Revised Code and... |
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Rule 3901-8-08 | Medicare supplement.
...nt-of-service option), plans offered by provider-sponsored organizations, and preferred provider organization plans; (b) Medical savings account plans coupled with a contribution into a "Medicare Advantage" medical savings account; and (c) "Medicare Advantage" private fee-for-service plans. (13) "Medicare supplement policy" means a group or individual policy of sickness and accident insurance o... |
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Rule 3901-8-08 | Medicare supplement.
...nt-of-service option), plans offered by provider-sponsored organizations, and preferred provider organization plans; (b) Medical savings account plans coupled with a contribution into a "Medicare Advantage" medical savings account; and (c) "Medicare Advantage" private fee-for-service plans. (13) "Medicare supplement policy" means a group or individual policy of sickness and accident insurance o... |
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Rule 3901-8-11 | Unfair health claim practices.
...amples include, but are not limited to, provider selection or referral, preadmission certification, length of stay determination and second surgical opinions. (3) "Day" means calendar day. However, when the last day of a time limit stated in this rule falls on a Saturday, Sunday or state or federal holiday, the time limit is extended to the next immediate following day that is not a Saturday, Sun... |