Ohio Revised Code Search

...is protection, the Ohio life and health insurance guaranty association, an association of member insurers, is created to pay benefits and to continue coverages, as limited in this chapter. Members of the association are subject to assessment to provide funds to carry out the purpose of this chapter.

..., including all of the following: (i) Claims based on marketing materials; (ii) Claims based on side letters, riders, or other documents that were issued by the member insurer without meeting applicable policy or contract form filing or approval requirements; (iii) Misrepresentations of or regarding policy or contract benefits; (iv) Extra-contractual claims; (v) A claim for penalties or consequential or inc...

...This chapter shall be liberally construed to effect its purpose as set forth in section 3956.03 of the Revised Code.

...to be known as the Ohio life and health insurance guaranty association. All member insurers shall be and remain members of the association as a condition of their license or authority to transact the business of insurance or health insuring corporation business in this state. The association shall perform its functions under the plan of operation established and approved under section 3956.10 of the Revised Code and ...

... to be filed with the superintendent of insurance under this chapter, and any other documents required to be released under this chapter unless otherwise prohibited from release by law.

...f directors of the Ohio life and health insurance guaranty association shall consist of not less than nine nor more than eleven member insurers serving terms as established in the plan of operation. A majority of the members of the board shall be representatives of member insurers domiciled in this state. Three of the members of the board shall be representatives of the three member insurers that write the largest pr...

...tracts of the insolvent insurer, for claims incurred within the following time limits: (a) With respect to group policies or contracts, not later than the earlier of the next renewal date under such policies or contracts or forty-five days, but in no event less than thirty days, after the date on which the association becomes obligated with respect to such policies and contracts; (b) With respect to individu...

...surer that has contributed funds to pay claims of an impaired or insolvent insurer, pursuant to an agreement entered into with the superintendent and approved by the Franklin county court of common pleas during the five years preceding November 20, 1989, or at any time following November 20, 1989, shall receive a credit against any assessments levied pursuant to this section, whether the assessments are class A asses...

...(A)(1) The Ohio life and health insurance guaranty association shall submit to the superintendent of insurance a plan of operation and any amendments to the plan necessary or suitable to ensure the fair, reasonable, and equitable administration of the association. The plan of operation and any amendments shall become effective upon the written approval of the superintendent, or unless the superintendent has not disap...

...(A) The superintendent of insurance shall: (1) Upon request of the board of directors of the Ohio life and health insurance guaranty association, provide the association with a statement of the premiums in this and any other appropriate states for each member insurer; (2) When an impairment is declared and the amount of the impairment is determined, serve a demand upon the impaired insurer to make good the impair...

...mpairments: (A) The superintendent of insurance shall do all of the following: (1) Notify the commissioners of insurance of all the other states, territories of the United States, and the District of Columbia when the superintendent takes any of the following actions against a member insurer: (a) Revocation of license; (b) Suspension of license; (c) Makes any formal order that such member insurer restrict i...

...be made until the total amount of valid claims of the association with interest on that amount at a rate not less than the rate allowed under 96 Stat. 2478, 28 U.S.C.A. 1961 for funds expended in carrying out its powers and duties under section 3956.08 of the Revised Code with respect to such member insurer have been fully recovered by the association. (F)(1) If an order for rehabilitation or liquidation of a membe...

...The Ohio life and health insurance guaranty association is subject to examination and regulation by the superintendent of insurance. The board of directors shall submit to the superintendent each year, not later than four months after the end of the association's fiscal year, a financial report in a form approved by the superintendent and a report of its activities during the preceding fiscal year.

...The Ohio life and health guaranty association is exempt from payment of all fees and all taxes levied by this state or any of its political subdivisions.

... of the board, or the superintendent of insurance or the superintendent's representatives, for any action or omission by them pursuant to the purposes and provisions of this chapter or in the performance of their powers and duties under this chapter. Immunity under this section extends to the participation in any organization of one or more other state associations of similar purposes as provided in division (N)(7) o...

...All proceedings in which the insolvent insurer is a party in any court in this state shall be stayed sixty days from the date an order of rehabilitation or liquidation is final to permit proper legal action by the association on any matters germane to its powers or duties. As to judgment under any decision, order, verdict, or finding based on default, the Ohio life and health guaranty association may apply to have th...

...e existence of the Ohio life and health insurance guaranty association for the purposes of sales, solicitation, or inducement to purchase any form of insurance or other coverage covered by this chapter. (2) As used in division (A)(1) of this section, "person" includes but is not limited to any member insurer or any agent or affiliate of any member insurer. (3) Division (A)(1) of this section does not apply to the...

...(A) The provisions of this chapter in effect prior to the effective date of this section shall apply to all matters relating to any impaired insurer or insolvent insurer for which the association first became obligated under section 3956.08 of the Revised Code prior to the effective date. (B) The provisions of this chapter in effect on and after the effective date of this section shall apply to all matters relating...

...usiness. (4) The Ohio life and health insurance guaranty association may require a member insurer to report any offset to the association. (B) A member insurer that is exempt from taxes described in division (A) of this section may recoup its assessments by a surcharge on its premiums in a sum reasonably calculated to recoup the assessments over a reasonable period of time, as approved by the superintendent. Amou...

...alth, prescription drugs, or disability insurance or self-insurance programs. "Administrator" includes a pharmacy benefit manager. "Administrator" does not include any of the following: (1) An insurance agent or solicitor licensed in this state whose activities are limited exclusively to the sale of insurance and who does not provide any administrative services; (2) Any person who administers or operates the wo...

...ll be licensed by the superintendent of insurance in accordance with rules adopted by the superintendent. (B) An administrator who has been licensed or certified by the state of the administrator's domicile under a statute or rule similar to sections 3959.01 to 3959.16 of the Revised Code shall, upon application, be licensed without testing, provided the state of domicile recognizes and grants licenses to administra...

...No person shall solicit a plan or sponsor of a plan to act as an administrator for, or provide administrative services to, a plan or sponsor of a plan that is either domiciled in this state or has its principal headquarters or principal administrative office in this state unless the person is duly licensed under sections 3959.01 to 3959.16 of the Revised Code.

...r shall file with the superintendent of insurance an application for a license on a form prescribed by the superintendent. (B) All applications for a license shall be accompanied by a nonrefundable filing fee of two hundred dollars per application made payable to the department of insurance. (C) All fees collected under this section and under section 3959.10 of the Revised Code shall be paid into the state treasury...

...The superintendent of insurance shall act on all applications submitted for a license within thirty days after receipt.

...If the superintendent of insurance denies the application for license, the superintendent shall promptly notify the applicant of the denial and the reasons for the denial within thirty days of the date the application is denied by the superintendent. The notice shall advise the applicant of the applicant's right to request a hearing within thirty days from the date of the mailing of the notice.