Ohio Revised Code Search

...e made in premiums, dividends, or other benefits under the policy. (C) The rate of interest charged on a policy loan made under division (B)(2) of this section shall not exceed the higher of the following: (1) The published monthly average for the calendar month ending two months before the date on which the rate is determined; (2) The rate used to compute the cash surrender values under the policy during the appl...

...ative form of government, and providing benefits in accordance with this chapter, is hereby declared to be a fraternal benefit society.

...(A) A fraternal benefit society may create, maintain, and operate charitable, benevolent, or educational institutions for the benefit of its members and their families and dependents and for the benefit of children insured by the society. For such purpose it may own, hold, or lease personal property or real property located within or without this state, with necessary buildings. The property shall be reported in ever...

...surers issuing policies containing like benefits based upon such tables.

...hospital, surgical, and medical expense benefits or hospital confinement indemnity benefits, and that is delivered or issued for delivery in this state on or after January 1, 1981, shall provide covered family members the right to continue such coverage upon the death of the named insured and upon the divorce, the annulment or dissolution of marriage, or the legal separation of the spouse from the named insured. Such...

...this state that excludes or reduces the benefits payable to or on behalf of an insured because benefits are also payable or have been paid under a supplemental sickness and accident policy to which all of the following apply: (1) The policy covers a specified disease or a limited plan of coverage. (2) The policy is specifically designed, advertised, represented, and sold as a supplement to other basic sickness and ...

...tion of coverage shall provide the same benefits as those provided to any similarly situated eligible person who is covered under the same group policy and an employee who has not been called or ordered to active duty. (2) An employer shall notify each employee of the right of continuation of coverage at the time of employment. At the time the reservist is called or ordered to active duty, the employer shall notify ...

...condition for which the insured sought benefits. (3) After a policy or certificate has been in force for at least two years, an insurer may rescind a long-term care insurance policy or certificate or deny an otherwise valid long-term care insurance claim if the insurer can demonstrate that the insured knowingly and intentionally misrepresented relevant facts relating to the insured's health in the insured's ap...

...ent insurance; or insurance under which benefits are payable with or without regard to fault and which is statutorily required to be contained in any liability insurance policy or equivalent self-insurance. (b) Coverage provided under the medicaid program. (c) Coverage provided under an employer's self-insurance plan or by any of its administrators, as defined in section 3959.01 of the Revised Code, to the extent t...

...ent insurance policies providing dental benefits, and that bases payment for those benefits on a usual and customary fee charged by dentists, and each administrator of a self-insured dental plan that bases payment for dental benefits on a usual and customary fee charged by dentists, shall disclose all of the following in accordance with division (B) of this section: (1) The frequency of the determination of the usua...

...(A) If a person is covered by a health benefit plan issued by a sickness and accident insurer, health insuring corporation, or multiple employer welfare arrangement and the person is required to pay for health care costs out-of-pocket or with funds from a savings account, the amount the person is required to pay to a health care provider or pharmacy shall not exceed the amount the sickness and accident insurer, healt...

...(A) As used in this section, "health benefit plan" has the same meaning as in section 3924.01 of the Revised Code. (B) Notwithstanding section 3901.71 of the Revised Code, no health benefit plan or public employee benefit plan shall contain a provision that limits or excludes an insured's coverage under the plan for a loss or expense the insured sustains that is the result of the insured's use of alcohol ...

... substantially all medical and surgical benefits under the policy. (B) Benefits provided under this section shall cover, at minimum, all of the following: (1) For speech and language therapy or occupational therapy for an insured under the age of fourteen that is performed by a licensed therapist, twenty visits per year for each service; (2) For clinical therapeutic intervention for an insured under the age of ...

...-existing condition exclusion; (4) The benefits and premiums available under all health benefit plans for which the employer is qualified. (B) The information described in division (A) of this section shall be provided in a manner determined to be understandable by the average small employer, and in a manner sufficient to reasonably inform a small employer regarding the employer's rights and obligations under the h...

... or other obligation for the receipt of benefits that is required by the insurer or other third-party payer providing health coverage to the account holder. The administrator shall keep a record of the amounts disbursed from the account for documented eligible medical expenses and of the dates on which the expenses were incurred. This record shall be made available to any sickness and accident insurer or other third-...

...ans any person eligible for health care benefits under a health benefit plan, including an eligible recipient of medicaid, and includes all of the following terms: (1) "Enrollee" and "subscriber" as defined by section 1751.01 of the Revised Code; (2) "Member" as defined by section 1739.01 of the Revised Code; (3) "Insured" and "plan member" pursuant to Chapter 3923. of the Revised Code; (4) "Beneficiary" as d...

...ion care materials that are not covered benefits under your plan and instead charges his or her normal fee for those services and materials. This vision care provider will provide you with an estimated cost for each non-covered service or material upon your request." (4) Nothing in division (E) of this section shall do any of the following: (a) Restrict or limit a contracting entity's determination of specific am...

...(A) As used in sections 3964.19 to 3964.194 of the Revised Code: (1) "Counterparty" means a special purpose financial captive insurance company's parent or an affiliated entity that is an insurer domiciled in this state that cedes life insurance risks to the special purpose financial captive insurance company pursuant to a special purpose financial captive insurance company contract. (2) "Insolvency" or "insolven...

...-related purposes, including receipt of benefits under fringe benefit programs, as other persons not so affected but similar in their ability or inability to work, and nothing in division (B) of section 4111.17 of the Revised Code shall be interpreted to permit otherwise. This division shall not be construed to require an employer to pay for health insurance benefits for abortion, except where the life of the mother ...

..., if the terms of the agreement contain benefits which are less than those contained in that section or the agreement contains no such terms and the public authority is the state or any agency, authority, commission, or board of the state or if the public authority is another entity listed in division (B) of section 4117.01 of the Revised Code that elects to provide leave of absence and compensation as provided in se...

... is entitled to all rights, status, and benefits accruing to the position during the person's time of service in the position in the unclassified service. (3) Reorganize the work of the bureau, its sections, departments, and offices to the extent necessary to achieve the most efficient performance of its functions and to that end may establish, change, or abolish positions and assign and reassign duties and respon...

...ng of a claim for workers' compensation benefits; (2) Provide claimants and employers with information regarding problems which arise out of the functions of the bureau, commission hearing officers, and the commission and the procedures employed in the processing of claims; (3) Answer inquiries or investigate complaints of an employer as they relate to reserves established and premiums charged in connection with ...

...this division is entitled to all of the benefits and protections of this chapter. Upon receipt of payment, the bureau shall issue a receipt to the employer certifying that payment has been made, which receipt is prima-facie evidence of payment. Workers' compensation coverage under this chapter continues uninterrupted upon timely receipt of payment under this division. Every public employer, except public employers...

...ry or death, claims for compensation or benefits for the specific part or parts of the body injured shall be forever barred unless, within one year after the injury or death: (1) Written or facsimile notice of the specific part or parts of the body claimed to have been injured has been made to the industrial commission or the bureau of workers' compensation; (2) The employer, with knowledge of a claimed compensab...

...igible to receive compensation, medical benefits, or death benefits under this chapter or Chapter 4121., 4127., or 4131. of the Revised Code. (B) "Statutory subrogee" means the administrator of workers' compensation, a self-insuring employer, or an employer that contracts for the direct payment of medical services pursuant to division (P) of section 4121.44 of the Revised Code. (C) "Third party" means an individual...