Ohio Revised Code Search

...ator shall do all of the following: (1) Maintain reasonable clearance between any underground facility and the cutting edge or point of powered equipment; (2) Protect and preserve the markings of tolerance zones of underground utility facilities until those markings are no longer required for proper and safe excavations; (3) When approaching and excavating within the tolerance zone of underground utility fac...

...n, "place of public assembly" means: (1) Enclosed theatres, except the lobby; opera houses; auditoriums; classrooms; elevators; rooms in which persons are confined as a matter of health care, including but not limited to a hospital room and a room in a residential care facility serving as the residence of a person living in such residential care facility; (2) All buildings and other enclosed structures owned by t...

...t or any other person under sections 3901.072 to 3901.078 of the Revised Code are recognized by this state as being proprietary and to contain trade secrets. (B) The documents, materials, or other information described in division (A) of this section shall be confidential by law and privileged and shall not be admissible into evidence in any private civil action or subject to section 149.43 of the Revised Code, su...

...(A) As used in this section: (1) "Captive insurer" has the same meaning as in section 3905.36 of the Revised Code. (2) "Insurer" includes, but is not limited to, any person that is an affiliate of or affiliated with the insurer, as defined in section 3901.32 of the Revised Code, and any person that is a subsidiary of the insurer as defined in section 3901.32 of the Revised Code. (3) "Laws of this state relat...

... or any other person under sections 3901.371 to 3901.378 of the Revised Code, are recognized by this state as being proprietary and to contain trade secrets. (B) The documents described in division (A) of this section shall be confidential by law and privileged, and shall not be admissible into evidence in any private civil action or subject to section 149.43 of the Revised Code, subpoena, or discovery. (C)(1...

...(A) Except as provided in sections 3901.382, 3901.383, 3901.384, and 3901.386 of the Revised Code, a third-party payer shall process a claim for payment for health care services rendered by a provider to a beneficiary in accordance with this section. (B)(1) Unless division (B)(2) or (3) of this section applies, when a third-party payer receives from a provider or beneficiary a claim on the standard claim form presc...

...of violating division (A) of section 3901.3811 of the Revised Code, the superintendent may impose on the third-party payer any of the administrative remedies specified in division (B) of this section. In making a finding under this division, the superintendent shall apply the error tolerance standards for claims processing contained in the market conduct examiners handbook issued by the national association of insura...

...surance act as defined in section 3999.31 of the Revised Code. (B) All documents, reports, and evidence in the possession of the superintendent or the superintendent's designee that pertain to an insurance fraud investigation are confidential law enforcement investigatory records under section 149.43 of the Revised Code. Notwithstanding such section, the superintendent shall not prohibit public inspection of such r...

...on or factors described in division (C)(1) of section 3901.45 of the Revised Code that are used to ascertain the applicant's sexual orientation. (B)(1) An insurer that requests an applicant to take an HIV test shall obtain the applicant's written consent for the test and shall inform the applicant of the purpose of the test. The consent form shall include information about the tests to be performed, the confidentia...

...t a public record as defined in section 149.43 of the Revised Code. The original work papers and any copies of them are not subject to subpoena and shall not be made public by the superintendent or any other person. (B) The work papers of the superintendent or of the person appointed by the superintendent, resulting from the conduct of an examination made pursuant to section 3901.07 of the Revised Code or from the ...

...onate to its own book of business. (1) A domestic ceding insurer shall notify the superintendent within thirty days after reinsurance recoverables from any single assuming insurer, or group of affiliated assuming insurers, exceed fifty per cent of the domestic ceding insurer's last reported surplus to policyholders, or after it has determined that reinsurance recoverables from any single assuming insurer, or...

...ll include the following information: (1) The date of the transaction; (2) The manner of acquisition or disposition; (3) A description of the assets involved; (4) The nature and amount of the consideration given or received; (5) The purpose of, or reason for, the transaction; (6) The manner by which the amount of consideration was determined; (7) The gain or loss recognized or realized as a result of the trans...

...(A)(1)(a) When coverage of a prescription drug for the treatment of any medical condition is restricted for use by a health plan issuer or utilization review organization through the use of a step therapy protocol, the health plan issuer or utilization review organization shall provide the prescribing health care provider access to a clear, easily accessible, and convenient process to request a step therapy exemption...

... first of the following that applies: (1) A plan that does not coordinate with other plans is always the primary plan. (2) The benefits of the plan that covers a person as an employee, member, insured, or subscriber, other than a dependent, is the primary plan. The plan that covers the person as a dependent is the secondary plan. (3) When more than one plan covers the same child as a dependent of different parents...

...(A) As used in this section: (1) "Cost sharing" means the cost to a covered individual 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," "health care services," and "health plan issuer" have the same meanings as in section 3922.01 of the Revised Code. (3) "Health care prof...

...(A) As used in this section: (1) "Pay in full" means paying for a health service in its entirety without cost-sharing on the part of a third-party payer. "Pay in full" includes payment made under a deductible requirement. (2) "Third-party payer" and "provider" have the same meanings as in section 3901.38 of the Revised Code. (B)(1) Subject to division (C) of this section, a provision in a contract entered into ...

...thereof under sections 3903.09 and 3903.10 of the Revised Code, all records of the insurer, other documents, and all department of insurance files and court records and papers, so far as they pertain to or are a part of the record of the proceedings, shall be and remain confidential and privileged except as is necessary to enforce compliance with those sections, unless and until the court of common pleas, after heari...

...(A)(1) The superintendent shall annually value, or cause to be valued, the reserve liabilities, referred to as reserves, for all outstanding life insurance policies and annuity and pure endowment contracts of every life insurance company doing business in this state issued prior to the operative date of the valuation manual. In calculating reserves, the superintendent may use group methods and approximate av...

... company, the following documents: (1) An actuarial opinion that certifies to the reasonableness of the insurance company's reserves and that shall be entitled a "statement of actuarial opinion"; (2) A summary that shall be in support of the statement of actuarial opinion and that shall be entitled an "actuarial opinion summary." An insurance company licensed but not domiciled in this state need not includ...

...(A) For purposes of sections 3903.81 to 3903.93 of the Revised Code, an "authorized control level event" is any of the following events: (1) The filing of an RBC report by an insurer that indicates that the insurer's total adjusted capital is greater than or equal to its mandatory control level RBC but less than its authorized control level RBC; (2) The notification by the superintendent of insurance to an insurer ...

...ed in this section or in section 3905.041 of the Revised Code, a resident individual applying for an insurance agent license for any of the lines of authority described in division (B) of this section shall take and pass a written examination prior to application for licensure. The examination shall test the knowledge of the individual with respect to the lines of authority for which application will be made, the dut...

...As used in sections 3905.064 to 3905.0611 of the Revised Code: (A) "Aggregator site" means a web site that provides access to information regarding insurance products from more than one insurer, including product and insurer information, for use in comparison shopping. (B) "Blanket travel insurance" means a policy of travel insurance issued to any eligible group providing coverage for specific classes of person...

...emiums paid by any of the following: (1) An individual primary policyholder who is a resident of this state; (2) A primary certificate holder who is a resident of this state who elects coverage under a group travel insurance policy; (3)(a) A blanket travel insurance policyholder, when the policy covers eligible blanket group members, that is a resident of, or has its principal place of business in, this state,...

...ntendent finds all of the following: (1) The applicant is currently licensed as a resident and is in good standing in the applicant's home state. (2) The applicant is licensed in the applicant's home state for the lines of authority requested in this state. (3) The applicant has submitted or has had transmitted to the superintendent the application for licensure that the applicant submitted to the applicant's h...

...(A)(1) No agent shall sell, solicit, or negotiate insurance through an exchange, or enroll or offer to enroll a person in a health benefit plan offered through an exchange, on or after October 1, 2013, without first completing a training program either required by an exchange or approved by the superintendent of insurance in accordance with division (B) of this section. (2) If an exchange does not require the...