Ohio Revised Code Search

...No administrator shall do any of the following: (A) Use plan sponsor funds for any purpose or purposes not specifically set forth in written form by the administrator; (B) Fail to disclose in written solicitation material and on an on-going basis, at least once annually, to the plan sponsor all of the following: (1) All fixed plan costs, identifying what each fixed cost includes; (2) Levels of the specific excess...

...(A) Administrators shall maintain detailed books and records that reflect all administered transactions specifically in regard to premiums or contributions received and deposited and claims and authorized expenses paid. (B) The detailed preparation, journalizing, and posting of such books and records shall be made in accordance with the terms and conditions of the service agreement between the administrator and the ...

...Sections 3959.01 to 3959.16 of the Revised Code do not apply to an employer's self-insurance plan to the extent that federal law supersedes, preempts, prohibits, or otherwise precludes the application of any provisions of those sections to such plan.

...On receipt of a notice pursuant to section 3123.43 of the Revised Code, the superintendent of insurance shall comply with sections 3123.41 to 3123.50 of the Revised Code and any applicable rules adopted under section 3123.63 of the Revised Code with respect to a license issued pursuant to this chapter.

...(A) As used in this section: (1) "Cost-sharing" means the cost to an individual insured under a health benefit plan according to any coverage limit, copayment, coinsurance, deductible, or other out-of-pocket expense requirements imposed by the plan. (2) "Health benefit plan" and "health plan issuer" have the same meanings as in section 3922.01 of the Revised Code. (3) "Pharmacy audit" has the same meaning as in...

...No health plan issuer, pharmacy benefit manager, or any other administrator shall prohibit a pharmacy from mailing or delivering drugs to patients as an ancillary service.

...A person who violates section 3959.05 of the Revised Code is guilty of a misdemeanor of the fourth degree.

...provider's participation in health care contracts. "Provider" does not mean either of the following: (1) A nursing home; (2) A provider organization or physician-hospital organization that leases the provider organization's or physician-hospital organization's network to a third party or contracts directly with employers or health and welfare funds. (T) "Specialty health care services" has the same meaning as...

... section with whom a contracting entity contracts for the purpose of selling, renting, or giving the contracting entity's rights to the services of participating providers that is updated at least every six months and is accessible to all participating providers, or maintain a toll-free telephone number accessible to all participating providers by means of which participating providers may access the same listing of ...

... or causes of action in favor of either party. (3) No contracting entity that includes any information in the summary disclosure form with the reasonable belief that the information is truthful or accurate shall be subject to a civil action for damages or to binding arbitration based on the summary disclosure form. Division (B)(3) of this section does not impair or affect any power of the department of insurance to...

...no resolution of the objection, either party may terminate the health care contract upon written notice of termination provided to the other party not later than sixty days prior to the effective date of the material amendment. (4) If the participating provider does not object to the material amendment in the manner described in division (A)(3) of this section, the material amendment shall be effective as spec...

... connection with policies, health care contracts, and agreements providing basic health care services, specialty health care services, or supplemental health care services. (C) No contracting entity shall require a provider to provide any information in addition to the information required by the applicable standard credentialing form described in division (A) of this section in connection with policies...

...(A) If a provider, upon the oral or written request of a contracting entity to submit a credentialing form, submits a credentialing form that is not complete, the contracting entity that receives the form shall notify the provider of the deficiency electronically, by facsimile, or by certified mail, return receipt requested, not later than twenty-one days after the contracting entity receives the form. (B) ...

...(A) All remittance notices sent by a payer, whether written or electronic, shall include both of the following: (1) The name of the payer issuing the payment to the participating provider; (2) The name of the contracting entity through which the payment rate and any discount are claimed, if the contracting entity is different from the payer. (B) Division (A) of this section takes effect March 31, 2009.

...The superintendent of insurance shall adopt any rules necessary for the implementation of this chapter.

...(A) A series of violations of this chapter by any person regulated by the department of insurance under Title XVII or Title XXXIX of the Revised Code that, taken together, constitute a pattern or practice of violating this chapter may be defined as an unfair and deceptive insurance practice under sections 3901.19 to 3901.26 of the Revised Code. (B) The superintendent of insurance may conduct a market conduct ...

...This chapter does not apply with respect to any of the following: (A) A contract or provider agreement between a provider and the state or federal government, a state agency, or federal agency for health care services provided through a program for medicaid or medicare; (B) A contract for payments made to providers for rendering health care services to claimants pursuant to claims made under Chapter 4121...

...(A) No contracting entity shall do any of the following: (1) Offer to a provider a health care contract that includes a most favored nation clause; (2) Enter into a health care contract with a provider that includes a most favored nation clause; (3) Amend or renew an existing health care contract previously entered into with a provider so that the contract as amended or renewed adds or continues to include a...

...(A) The board of building standards, established by section 3781.07 of the Revised Code, shall: (1) Formulate rules governing the design, construction, and installation of power, refrigerating, hydraulic, heating, and liquefied petroleum gas, oxygen, and other gaseous piping systems. Such rules shall prescribe uniform minimum standards necessary for the protection of the public health and safety and shall include ru...

...and obey orders, and prescribe hours of labor reasonably adequate to render such employment and places of employment safe, and shall do every other thing reasonably necessary to protect the life, health, safety, and welfare of such employees and frequenters.

...No employer shall require, permit, or suffer any employee to go or be in any employment or place of employment which is not safe, and no such employer shall fail to furnish, provide, and use safety devices and safeguards, or fail to obey and follow orders or to adopt and use methods and processes reasonably adequate to render such employment and place of employment safe. No employer shall fail to do every other thing...

...No employee shall remove, displace, damage, destroy, or carry off any safety device or safeguard furnished or provided for use in any employment or place of employment, or interfere in any way with the use thereof by any other person. No employee shall interfere with the use of any method or process adopted for the protection of any employee in such employment or place of employment, or frequenter of such place of em...

...A substantial compliance with the applicable sections of sections 4101.01 to 4101.16, inclusive, and 4121.01 to 4121.29, inclusive, of the Revised Code, is sufficient to give effect to orders, and such orders shall not be declared inoperative, illegal, or void for any omission of a technical nature in respect thereto.

...No employer, employee, or other person shall violate this chapter or Chapter 4121. of the Revised Code, do any act prohibited by such chapters, fail to perform any duty lawfully enjoined, within the time prescribed by the bureau of workers' compensation, for which violation no penalty has been specifically provided, or fail to obey any lawful order given or made by the bureau, or any judgment or decree made by ...

...Every day during which any person, or corporation, or any officer, agent, or employee thereof fails to observe and comply with any order of the bureau of workers' compensation, or to perform any duty enjoined by this chapter and Chapter 4121. of the Revised Code, constitutes a separate violation of the order or chapters.