Ohio Revised Code Search

...policy. (B) No insurer shall recover from the insured benefits that were paid under a long-term care insurance policy or certificate prior to the rescission of the policy or certificate pursuant to this section. (C) In the event of the death of the insured, the remaining death benefits under a life insurance policy that accelerates benefits for long-term care are governed by section 3923.04 of the Revised Cod...

... than to a continuing care retirement community or other similar entity, the insurer shall make the offer required by division (A) of this section to each proposed certificate holder. (C) The superintendent of insurance may adopt rules specifying the type of nonforfeiture benefits insurers may offer as part of long-term care insurance policies and certificates, the standards for nonforfeiture benefits, and the...

...long-term care insurance without first completing an initial eight-hour partnership program training course as described in division (B) of this section. (2)(a) Any agent that sells, solicits, or negotiates any long-term care insurance shall complete at least four hours of continuing education in every license renewal period beginning with the first license renewal period following the agent's completion of the pa...

...nsurance policy or certificate if the compensation to the agent or third-party administrator is not based on the number of policies or certificates issued. (B) As used in this section, "field issue" means to issue a policy or certificate pursuant to the underwriting authority granted to an agent or third-party administrator by an insurer using the insurer's underwriting guidelines.

...The form of all long-term care insurance policies and applications shall be filed and approved in accordance with section 3923.02 of the Revised Code.

...Premium rates for any individual policy of long-term care insurance shall be filed in accordance with section 3923.021 of the Revised Code.

...The superintendent of insurance shall, pursuant to Chapter 119. of the Revised Code, adopt rules to carry out the purposes of sections 3923.41 to 3923.48 of the Revised Code including rules related to the state long-term care partnership program.

...Any violation of sections 3923.44 to 3923.46 of the Revised Code is an unfair and deceptive insurance practice under sections 3901.19 to 3901.23 of the Revised Code.

...The department of insurance shall establish an outreach program to educate consumers about the following: (A) The need for long-term care insurance; (B) Mechanisms for financing long-term care; (C) The availability of long-term care insurance; (D) The resource protection provided by the Ohio long-term care insurance program under section 5164.86 of the Revised Code; (E) That a consumer who purchased a long-te...

... of the following requirements: (A) Comply with sections 3923.41 to 3923.48 of the Revised Code and the rules adopted under section 3923.47 of the Revised Code; (B) Provide benefits for home and community-based services in addition to nursing home care; (C) Include case management services in its coverage of home and community-based services; (D) Provide five per cent inflation protection compounded annual...

...oundation that is certified as exempt from taxation under section 501(c)(3) of the "Internal Revenue Code of 1986," 100 Stat. 2085, 26 U.S.C.A. 1, as amended, and that has the sole purpose of issuing certificates of coverage under these contracts to persons under the age of nineteen who are members of families that have incomes that are no greater than three hundred per cent of the official poverty line. (C) Contra...

...reast cancer at an early stage in asymptomatic women and includes the x-ray examination of the breast using equipment that is dedicated specifically for mammography, including, but not limited to, the x-ray tube, filter, compression device, screens, film, and cassettes, and that has an average radiation exposure delivery of less than one rad mid-breast. "Screening mammography" includes digital breast tomosynthesis. "...

...the presence of breast cancer in adult women, screening mammography; (2) To detect the presence of breast cancer in adult women meeting any of the conditions described in division (B)(2) of this section, supplemental breast cancer screening; (3) To detect the presence of cervical cancer, cytologic screening. (B)(1) The benefits provided under division (A)(1) of this section shall cover expenses for one screenin...

...reast cancer at an early stage in asymptomatic women and includes the x-ray examination of the breast using equipment that is dedicated specifically for mammography including, but not limited to, the x-ray tube, filter, compression device, screens, film, and cassettes, and that has an average radiation exposure delivery of less than one rad mid-breast. "Screening mammography" includes two views for each breast. The ...

...ew performed in accordance with the recommendations of the American academy of pediatrics and includes a history, complete physical examination, developmental assessment, anticipatory guidance, appropriate immunizations, and laboratory tests. (3) "Physician" means a person authorized under Chapter 4731. of the Revised Code to practice medicine and surgery or osteopathic medicine and surgery. (B) Notwithstandi...

...or child health supervision services from the moment of birth until age nine. (B) A plan that provides the benefits described in division (A) of this section may limit the benefits to cover only the expenses of child health supervision services that are performed by one physician or by a health care professional under the supervision of one physician during the course of any one visit. (C) Copayments and ded...

...ndividuals or of individuals who may become eligible for such coverage. (2) If an insurer elects to discontinue offering all health insurance coverage in the individual market in this state, health insurance coverage may be discontinued by the insurer only if both of the following apply: (a) The insurer provides notice to the department of insurance and to each individual of the discontinuation at least one hundr...

...vised Code: (A) Any such policy shall comply with the requirements of division (A) of section 3924.03 and section 3924.033 of the Revised Code. (B)(1) Except as provided in section 2712(b) to (e) of the "Health Insurance Portability and Accountability Act of 1996," if an insurer offers coverage in the small or large group market in connection with a group policy, the insurer shall renew or continue in force such co...

...more of the standard medical reference compendia adopted by the United States department of health and human services under 42 U.S.C. 1395x(t)(2), as amended, or in medical literature that meets the criteria specified in division (B) of this section. (B) Medical literature may be accepted for purposes of division (A) of this section only if all of the following apply: (1) Two articles from major peer-reviewed ...

...e, or vision care; coverage under a one-time-limited-duration policy that is less than twelve months; coverage issued as a supplement to liability insurance; insurance arising out of workers' compensation or similar law; automobile medical payment 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...

...er issued by a prescriber for drugs or combinations or mixtures of drugs to be used by a particular individual. (B) Notwithstanding section 3901.71 of the Revised Code, each policy of sickness and accident insurance that provides prescription drug coverage and each public employee benefit plan that provides prescription drug coverage shall provide for medication synchronization for an insured if all of the following...

...more of the standard medical reference compendia specified in division (B)(1) of this section or in medical literature that meets the criteria specified in division (B)(2) of this section. (B)(1) The compendia accepted for purposes of division (A) of this section are the following: (a) The "AMA drug evaluations," a publication of the American medical association; (b) The "AHFS (American hospital formulary service)...

...t 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 usual and customary fee; (2) A general description of the methodology used...

...inpatient setting for a fixed period of time following delivery; (3) Require a child to be delivered in a hospital or other inpatient setting; (4) Authorize a certified nurse-midwife to practice beyond the authority to practice nurse-midwifery in accordance with Chapter 4723. of the Revised Code; (5) Establish minimum standards of medical diagnosis, care or treatment for inpatient or follow-up care for a mother or...

...inpatient setting for a fixed period of time following delivery; (3) Require a child to be delivered in a hospital or other inpatient setting; (4) Authorize a certified nurse-midwife to practice beyond the authority to practice nurse-midwifery in accordance with Chapter 4723. of the Revised Code; (5) Establish minimum standards of medical diagnosis, care, or treatment for inpatient or follow-up care for a mother o...