Ohio Revised Code Search

...(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...

...of the following conditions are met: (1) The fee is disclosed to the consumer in a manner that separately identifies the fee and the premium. (2) The fee is not calculated as a percentage of the premium. (3) The fee is not refunded, forgiven, waived, offset, or reduced by any commission earned or received for any policy or coverage sold. (4) The amount of the fee, and the consumer's obligation to pay the fee, ar...

...(A) As used in this section: (1) "Reinsurance intermediary-broker" means a person, other than an officer or employee of the ceding insurer, that solicits, negotiates, or places reinsurance cessions or retrocessions on behalf of a ceding insurer without the authority or power to bind reinsurance on behalf of such insurer. (2)(a) "Reinsurance intermediary-manager" means a person that has authority to bind or that m...

...rance company may, subject to section 3911.011 of the Revised Code, issue policies, annuities, or other contracts, whether on an individual or group basis, providing benefits or other contractual payments payable in fixed or variable dollar amounts, or both, and allocate to one or more separate accounts any amounts which are to be applied to provide such benefits and contractual payments. The income, if any, and any ...

...ion or entity described in division (B)(1) of this section, or any creditor the person causes to be appointed and provided for in the policy. (B)(1) Any religious, charitable, scientific, literary, educational, or other institution or entity that is described in section 170, 501(c)(3), 2055, or 2522 of the "Internal Revenue Code of 1986," 100 Stat. 2085, 26 U.S.C.A. 170, 501, 2055, 2522, as amended, may be the owner...

...any of the following representations: (1) "Guaranteed," "fully secured," "100 percent secured," "fully insured," "secure," "safe," "backed by rated insurance companies," "backed by federal law," "backed by state law," or "state guaranty funds," or similar representations; (2) "No risk," "minimal risk," "low risk," "no speculation," "no fluctuation," or similar representations; (3) "Qualified or approved for indivi...

...ect age. (C) A provision as follows: (1) Other insurance in this insurer. If an accident or sickness or accident and sickness policy or policies previously issued by the insurer to the insured be in force concurrently herewith, making the aggregate indemnity for _______________ in excess of _________ dollars, the excess insurance shall be void and all premiums paid for such excess shall be returned to the insured o...

...(A) As used in this section: (1) "Biologically based mental illness" means schizophrenia, schizoaffective disorder, major depressive disorder, bipolar disorder, paranoia and other psychotic disorders, obsessive-compulsive disorder, and panic disorder, as these terms are defined in the most recent edition of the diagnostic and statistical manual of mental disorders published by the American psychiatric associa...

...(A) As used in this section: (1) "Emergency medical condition" means a medical condition that manifests itself by such acute symptoms of sufficient severity, including severe pain, that a prudent layperson with average knowledge of health and medicine could reasonably expect the absence of immediate medical attention to result in any of the following: (a) Placing the health of the individual or, with respect to a...

...(A)(1) If a court in a civil action enters a final judgment that awards damages to a plaintiff for injury, death, or loss to the person or property of the plaintiff or another person for whom the plaintiff is a legal representative and if, at the time that the cause of action accrued against the judgment debtor, the judgment debtor was insured against liability for that injury, death, or loss, the plaintiff or the pl...

...rule adopted in accordance with Chapter 119. of the Revised Code, shall require each authorized insurer, surplus lines insurer, risk retention group, self-insurer, captive insurer, the medical liability underwriting association if created under section 3929.63 of the Revised Code, and any other entity that provides medical malpractice insurance to risks located in this state, to report information to the department o...

...or rails, or any similar vehicle. (B)(1) For purposes of any uninsured motorist coverage included in a policy of insurance, an "uninsured motorist" is the owner or operator of a motor vehicle if any of the following conditions applies: (a) There exists no bodily injury liability bond or insurance policy covering the owner's or operator's liability to the insured. (b) The liability insurer denies coverage to the...

...cribed in division (A) of section 3929.01 of the Revised Code, such company or attorney may apply to the superintendent for the appropriate license or certificate of authority, as provided in section 3925.11, 3927.01, 3931.10, or 3941.06 of the Revised Code, which application shall state which of the kinds of insurance it proposes to transact, and the superintendent shall act thereon in the manner prescribed by that ...

..." has the same meaning as in section 4501.01 of the Revised Code. (C) "Digital network" means any online-enabled application, software, web site, or system offered or utilized by a transportation network company that enables the prearrangement of rides with transportation network company drivers. (D) "Personal vehicle" means a vehicle to which all of the following apply: (1) The vehicle is used by a transportation...

...licy, including all of the following: (1) Liability coverage for bodily injury and property damage; (2) Uninsured and underinsured motorist coverage described in section 3937.18 of the Revised Code; (3) Uninsured and underinsured motor vehicle property damage coverage described in section 3937.181 of the Revised Code; (4) Medical payments coverage; (5) Comprehensive physical damage coverage; (6) Collision physi...