Ohio Revised Code Search
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Section 3902.52 | Out-of-network care arbitration.
...revious arbitration between the parties conducted under this section that the arbitrator considers relevant in rendering a decision. (D) After considering the evidence submitted by the parties pursuant to division (B) of this section and the criteria described in division (C) of this section, the arbitrator shall issue a decision that awards the final offer of either party that best reflects a fair reimbursement ra... |
Section 3903.06 | Duty of persons exercising control to cooperate with superintendent.
...nterfere with the superintendent in the conduct of any delinquency proceeding or any investigation preliminary or incidental thereto or violate an order of the superintendent issued under sections 3903.01 to 3903.59 of the Revised Code. (D) If the superintendent finds, after proceedings in accordance with Chapter 119. of the Revised Code, that any person has violated division (B) or (C) of this section, the superint... |
Section 3903.12 | Grounds for rehabilitation order.
...tions 3903.01 to 3903.59 of the Revised Code, the insurer has failed to promptly make available for examination any of its own property, books, accounts, documents, or other records, or those of any subsidiary or related company within the control of the insurer, or those of any person having executive authority in the insurer so far as they pertain to the insurer. (G) Without first obtaining the written consent of ... |
Section 3903.722 | Submission of data prior to operative date of valuation manual.
...ord under section 149.43 of the Revised Code, shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action. (8) Neither the superintendent nor any person who received documents, materials, or other information while acting under the authority of the superintendent shall be permitted or required to testify in any private civil action concerning any... |
Section 3903.88 | Confidential information.
...B)(2) of section 3903.84 of the Revised Code, and a corrective order issued pursuant to division (B)(3) of section 3903.84 of the Revised Code. (B) The plans, reports, information, and orders described in division (A) of this section are confidential and privileged and not subject to subpoena. (C) Notwithstanding divisions (A) and (B) of this section, the superintendent may do any of the following: (1) Use the p... |
Section 3905.15 | Hearing to determine administrative action modification.
...ffered by any person as a result of the conduct that gave rise to the administrative action; (4) The person has not been convicted of any felony or of any misdemeanor described in division (B)(7) of section 3905.14 of the Revised Code unless the conviction was the subject of a previous administrative action by the superintendent; (5) The circumstances surrounding the previous violation are such that it is unlikel... |
Section 3905.33 | Unauthorized insurers; applicability and construction of federal provisions; due diligence.
...placement law, the superintendent shall conduct a fiscal analysis of the impact of entering into a multistate agreement or compact for determining eligibility for placement of unauthorized insurance and for payment, reporting, collection, and allocation of the tax on unauthorized insurance. If the fiscal analysis indicates that entering into a multistate agreement or compact is advantageous to this state, the superin... |
Section 3905.471 | Insurance navigator certification.
...der section 36B of the Internal Revenue Code of 1986, 26 U.S.C. 36B, and cost-sharing reductions under section 1402 of the Affordable Care Act; (3) Facilitate enrollment in qualified health plans, without suggesting that an individual select a particular plan; (4) Provide referrals to appropriate state agencies for any enrollee with a grievance, complaint, or question regarding their health plan, coverage, or a... |
Section 3905.65 | Remedies for noncompliance.
...perintendent may, pursuant to a hearing conducted in accordance with Chapter 119. of the Revised Code, order the controlling producer to cease placing business with the controlled insurer. (2) If, pursuant to the hearing held under division (A)(1) of this section, the superintendent finds that, due to the material noncompliance, the controlled insurer or any policyholder of the insurer has suffered any loss or damag... |
Section 3905.75 | Acts of agent deemed acts of insurer - examinations.
... shall pay the expenses incurred in the conduct of the examination in accordance with section 3901.07 of the Revised Code. |
Section 3905.77 | Penalties for violations.
...rdance with Chapter 119. of the Revised Code, finds a violation of section 3905.76 of the Revised Code, the superintendent may order any of the following: (1) For each separate violation committed by an insurer, managing general agent, or other person, a civil penalty in an amount of not more than one thousand dollars; (2) For a violation committed by a managing general agent or the producer of the managing general... |
Section 3906.04 | Rights of insurer.
... environments. These analyses shall be conducted at least annually and make specific reference to the economic conditions considered. |
Section 3907.02 | Articles of incorporation.
...ny, and the manner in which it is to be conducted. The number of directors or trustees shall be not less than five nor more than twenty-one. The number of directors or trustees may be fixed or changed at a meeting of the stockholders or members called for the purpose of electing directors or trustees at which a quorum is present, by affirmative vote of the holders of a majority of the shares, or a majority of the me... |
Section 3913.03 | Rights and privileges of dissenting stockholder.
..., and the corporation shall continue to conduct its business as a domestic stock life insurance corporation as though no plan of mutualization had ever been adopted. |
Section 3913.12 | Consideration to policyholders in effecting conversion.
... policy on, the date of the examination conducted pursuant to division (C) of section 3913.11 of the Revised Code bear to the total premiums received and dividends paid or credited by the company during the same period and the reserves on all policies, appropriate weight being given to premiums, dividends, and reserves as the company with the approval of the superintendent of insurance deems appropriate in the circum... |
Section 3916.03 | Application for license - issuance, renewal - new or revised information.
...ay materially influence the applicant's conduct meets the standards set forth in this chapter. (F) Except as otherwise provided in this division, a license as a viatical settlement provider or viatical settlement broker expires on the last day of March next after its issuance or continuance. A license as a viatical settlement provider or viatical settlement broker may, in the discretion of the superintendent and th... |
Section 3916.18 | Prohibiting fraudulent acts.
...ursuant to Chapter 119. of the Revised Code. If the person waives or does not request a hearing pursuant to Chapter 119. of the Revised Code, or a hearing is held and the person is found to have participated in one or more stranger-originated life insurance transactions, the superintendent shall publish the order on the department's web site, and shall notify each insurance company licensed in this state that ... |
Section 3919.11 | Bylaws.
... time, place, and manner of calling and conducting their meetings; (B) The number of members constituting a quorum; (C) The time of the annual election for trustees and the mode and manner of giving notice thereof; (D) The duties and compensation of officers; (E) The manner of election or appointment and the tenure of office of all officers. The tenure of the trustees shall not be for more than three years, one ... |
Section 3921.22 | No individual right to assets.
...: (1) Adopt special procedures for the conduct of the business and affairs of a separate account; (2) For persons having beneficial interests in the account, provide special voting and other rights, including special rights and procedures relating to investment policy, investment advisory services, selection of certified public accountants, and selection of a committee to manage the business and affairs of the... |
Section 3922.11 | Review by superintendent of insurance.
...xcept that the superintendent shall not conduct a review under this section unless the covered person has exhausted the health plan issuer's internal appeal process, pursuant to sections 3922.03 and 3922.04 of the Revised Code. The health plan issuer and covered person shall provide the superintendent with any information required by the superintendent that is in their possession and is germane to the review. (D) U... |
Section 3922.13 | Accreditation of independent review organizations.
...ndent review organizations approved to conduct external reviews. (F) The superintendent shall maintain and periodically update a list of accredited independent review organizations. |
Section 3923.021 | Approval or disapproval of premium rates.
...ry to assist in the preparation for and conduct of any public hearing under this section. The expense for retaining such experts and the expenses of the department of insurance incurred in connection with such public hearing shall be assessed against the insurer in an amount not to exceed one one-hundredth of one per cent of the sum of premiums earned plus net realized investment gain or loss of such insurer as refle... |
Section 3923.041 | Policies with prior authorization requirement provisions.
...ective or utilization review procedures conducted prior to providing a health care service, device, or drug. (9) "Urgent care services" means a medical care or other service for a condition where application of the timeframe for making routine or non-life threatening care determinations is either of the following: (a) Could seriously jeopardize the life, health, or safety of the patient or others due to the patient... |
Section 3923.338 | Orders of superintendent.
... insurance, pursuant to an adjudication conducted in accordance with Chapter 119. of the Revised Code, may issue an order requiring issuers violating any provision of section 3923.33 or sections 3923.331 to 3923.339 of the Revised Code or rules adopted pursuant to those sections to do either or both of the following: (A) Cease marketing any medicare supplement policy or certificate in this state that is related dire... |
Section 3923.63 | Coverage of inpatient care and follow-up care for mother and her newborn.
...nly if the health care professional who conducts the visit is knowledgeable and experienced in maternity and newborn care. When a decision is made in accordance with division (B) of this section to discharge a mother or newborn prior to the expiration of the applicable number of hours of inpatient care required to be covered, the coverage of follow-up care shall apply to all follow-up care that is provided within se... |