Ohio Revised Code Search
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Section 3959.09 | Issuing license and certificate of authority.
...nted a license by the superintendent of insurance and an appropriate certificate of authority to operate as an administrator will be issued to the applicant. The license shall be issued, effective on the date the application is approved by the superintendent or board, or both, for a term expiring on the following June 30. The license may be renewed annually for a period of one year commencing July 1. |
Section 3959.10 | License renewal.
...(A) The superintendent of insurance shall, at least sixty days before the expiration of the administrators license granted by the superintendent, provide a renewal notice on a form approved by the superintendent. (B) The renewal application shall require the payment of a renewal fee of three hundred dollars and the payment shall be made prior to the expiration date of the license. Failure to make the renewal payment... |
Section 3959.11 | Written agreement to act as administrator between the administrator and the plan sponsor.
...hall at all times maintain any required insurance coverage or bond as provided for and mandated by the "Employee Retirement and Income Security Act of 1974," 88 Stat. 829, 29 U.S.C. 1001, as amended. |
Section 3959.111 | Access to information regarding maximum allowable cost pricing.
...vised Code. (D) The superintendent of insurance shall adopt rules as necessary to implement the requirements of this section. |
Section 3959.12 | Suspension, revocation or nonrenewal of license.
...or not renewed by the superintendent of insurance after notice to the licensee and hearing in accordance with Chapter 119. of the Revised Code. The superintendent may suspend, revoke, or refuse to renew a license if upon investigation and proof the superintendent finds that the licensee has done any of the following: (1) Knowingly violated any provision of sections 3959.01 to 3959.16 or 3959.20 of the Revised Code... |
Section 3959.13 | Report of felony conviction.
...the conviction to the superintendent of insurance within thirty days of the entry date of the judgment of conviction. Within that thirty-day period, the person shall also provide the superintendent with a copy of the judgment, the commitment order or the order imposing a community control sanction, and any other relevant documents. As used in this section, "community control sanction" has the same meaning as in se... |
Section 3959.14 | Administrator prohibitions.
...des; (2) Levels of the specific excess insurance stop-loss deductible; (3) The aggregate excess insurance stop-loss attachment point factors, including any minimum attachment point factors; (4) The names of all insurance carriers providing protection for the plan sponsor's plans, and any ownership relationship of five per cent or more between the administrator and such insurance carriers. (C) Fail to remit insura... |
Section 3959.15 | Books and records.
... administrator by the superintendent of insurance that the administrator has violated any provision of sections 3959.01 to 3959.16 of the Revised Code, the administrator shall have sixty days within which to correct the violation specified in the notice, in compliance with such sections. |
Section 3959.16 | Preemption of federal law.
...Code do not apply to an employer's self-insurance plan to the extent that federal law supersedes, preempts, prohibits, or otherwise precludes the application of any provisions of those sections to such plan. |
Section 3959.17 | Effect of child support default on license.
...the Revised Code, the superintendent of insurance shall comply with sections 3123.41 to 3123.50 of the Revised Code and any applicable rules adopted under section 3123.63 of the Revised Code with respect to a license issued pursuant to this chapter. |
Section 3959.20 | Prohibited acts regarding cost-sharing, pharmacy claims for reimbursement, fees.
...ing to any coverage limit, copayment, coinsurance, deductible, or other out-of-pocket expense requirements imposed by the plan. (2) "Health benefit plan" and "health plan issuer" have the same meanings as in section 3922.01 of the Revised Code. (3) "Pharmacy audit" has the same meaning as in section 3901.81 of the Revised Code. (4) "Pharmacy benefit manager" and "administrator" have the same meanings as in sect... |
Section 3959.22 | Mailing or delivering drugs.
...No health plan issuer, pharmacy benefit manager, or any other administrator shall prohibit a pharmacy from mailing or delivering drugs to patients as an ancillary service. |
Section 3959.99 | Penalty.
...A person who violates section 3959.05 of the Revised Code is guilty of a misdemeanor of the fourth degree. |
Section 3960.01 | Risk retention definitions.
...in the normal course of business. (D) "Insurance" means primary insurance, excess insurance, reinsurance, surplus lines insurance, and any other arrangement for shifting and distributing risk that is determined to be insurance under the laws of this state. (E)(1) "Liability," except as provided in division (E)(2) of this section, means legal liability for damages, including but not limited to costs of defense, lega... |
Section 3960.02 | Requirements for transacting business.
...sand dollars, and the superintendent of insurance issues a certificate of authority to transact the business of liability insurance as a risk retention group. Section 3960.03 of the Revised Code applies to the risk retention group only to the extent that that section does not conflict with or limit the operation of any law or rule of this state applicable to liability insurance companies. (2) The superintendent has ... |
Section 3960.03 | Requirements for foreign risk retention groups.
...(A) No risk retention group shall offer insurance in this state unless it has submitted to the superintendent of insurance, in a form satisfactory to the superintendent, all of the following: (1) A statement identifying the state or states in which it is chartered and licensed as a liability insurance company, the date of chartering, its principal place of business, and any other information, including but not... |
Section 3960.04 | Notices on application forms and policies.
...(A)(1) Every application form for insurance from a risk retention group and every policy or certificate of insurance issued by a risk retention group shall contain in ten-point type on the front page and the declaration page, the following notice: "Notice This policy is issued by your risk retention group. Your risk retention group may not be subject to all of the insurance laws and regulations of your state. Sta... |
Section 3960.05 | No coverage by Ohio insurance guaranty association or similar mechanism.
...m any such association or mechanism for claims arising under the insurance policies issued by the risk retention group. (B) When the laws of this state or any of its political subdivisions require any person to obtain liability insurance as a condition of licensure, approval, permission, or other authorization, the insurance may be obtained from a risk retention group as defined in division (J) of section 3960.01 of... |
Section 3960.06 | Applicability of laws to purchasing group.
...rer or insurers, in regard to liability insurance for the purchasing group, are exempt from any law that does any of the following: (1) Prohibits the establishment of a purchasing group; (2) Makes it unlawful for an insurer to provide or offer to provide insurance on a basis providing, to a purchasing group or its members, advantages based on their loss and expense experience not afforded to other persons with resp... |
Section 3960.07 | Requirements of purchasing group for transacting business.
...ssued a notice to the superintendent of insurance that does all of the following: (a) Identifies the state in which the purchasing group is domiciled and all other states in which the group intends to do business; (b) Specifies the lines and classifications of liability insurance that the purchasing group intends to purchase and specifies the method by which and the person or persons, if any, through whom insuran... |
Section 3960.08 | Restricting purchases of insurance.
...(A) No purchasing group shall purchase insurance from a risk retention group that is not chartered, or from an insurer that is not admitted to do business, in the state in which the purchasing group is located, unless the purchase is effected through an agent or broker licensed in this state to sell surplus lines. (B)(1) A purchasing group that obtains liability insurance from an insurer not admitted in this state ... |
Section 3960.09 | Premium taxes or taxes on premiums paid for coverage of risks.
...aid for similar coverage from a similar insurance source by other insureds; (B) Paid first by the insurance source; if not by the source, then by the agent or broker for the purchasing group; if not by the agent or broker, then by the purchasing group; and if not by the purchasing group, then by each of its members. |
Section 3960.10 | Authority and powers of superintendent of insurance.
...(A) The superintendent of insurance may exercise any powers to enforce the insurance laws of this state applicable to risk retention groups and purchasing groups, except those that are specifically preempted by the federal "Product Liability Risk Retention Act of 1981," 95 Stat. 949, 15 U.S.C.A. 3901, as amended by the federal "Risk Retention Amendments of 1986," 100 Stat. 3170, 15 U.S.C.A. 3901, as amended. (B) The... |
Section 3960.11 | Soliciting, negotiating, or procuring liability insurance restricted to licensed agents and brokers.
...ng, negotiating, or procuring liability insurance in this state from a risk retention group unless the person is licensed as an insurance agent or broker in accordance with Chapter 3905. of the Revised Code. (B) No person shall act or aid in any manner in soliciting, negotiating, or procuring liability insurance in this state for a purchasing group from an authorized insurer or a risk retention group chartered in a ... |
Section 3960.12 | Adoption of rules for enforcement.
...The superintendent of insurance may adopt any rules necessary or desirable for the enforcement of sections 3960.01 to 3960.13 of the Revised Code. |