Ohio Revised Code Search

... 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...

... this section, the Ohio life and health insurance guaranty association may do either of the following with respect to an impaired member insurer: (a) Guarantee, assume, reissue, or reinsure, or cause to be guaranteed, assumed, reissued, or reinsured, any or all of the policies or contracts of the impaired insurer; (b) Provide the moneys, pledges, notes, guarantees, or other means that are proper to effectuate d...

... and duties of the Ohio life and health insurance guaranty association, the board of directors shall assess the member insurers, separately for each subaccount or account, at such time and for such amounts as the board finds necessary. Assessments shall be due not less than thirty days after prior written notice to the member insurers and shall accrue interest at ten per cent per year on and after the due date. (B)...

...(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...

...t 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 impairment within a reasonable time. Notice to the impaired insure...

...t to the board of directors of the Ohio life and health insurance guaranty association when the superintendent has taken any of the actions set forth in division (A)(1) of this section or has received a report from any other insurance commissioner indicating that any such action has been taken in another state. The report to the board of directors shall contain all significant details of the action taken or the repor...

...lished for all policies or contracts of insurance or health benefit plans written by the impaired or insolvent insurer. (D)(1) As a creditor of the impaired or insolvent insurer as established in division (C) of this section and consistent with section 3903.34 of the Revised Code, the association and other similar associations shall be entitled to receive a disbursement of assets out of the marshaled assets, from t...

...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...

..., or finding based on default, the Ohio life and health guaranty association may apply to have the judgment set aside by the same court that made the judgment and may defend against the suit on the merits.

...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...

...ear," "plan," "plan sponsor," and "self-insurance program" have the same meanings as in section 3959.01 of the Revised Code. (E) "Health benefit plan" and "health plan issuer" have the same meanings as in section 3922.01 of the Revised Code. (F) "Insurance" has the same meaning as in section 3905.01 of the Revised Code. (G) "Insurer" has the same meaning as in section 3901.32 of the Revised Code. (H) "License...

...The superintendent of insurance shall establish by rule, adopted in accordance with Chapter 119. of the Revised Code, and administer a process for licensing pharmacy benefit managers in this state. The superintendent may adopt any other rules the superintendent deems necessary for the administration, implementation, and enforcement of this chapter. When adopting rules pursuant to this section, the superintendent shal...

...(A) On and after July 1, 2027, no person shall solicit a plan or plan sponsor that is domiciled in this state or has its principal headquarters or principal administrative office in this state to act as a pharmacy benefit manager for the plan or plan sponsor unless licensed under this chapter. (B) No person shall provide pharmacy benefit management services pursuant to an agreement subject to this chapter unless li...

... application with the superintendent of insurance in the form and manner prescribed by the superintendent. The application shall include all the information the superintendent considers necessary to process the application, including evidence satisfactory to the superintendent that the applicant meets the requirements specified in division (C) of this section. (B) All applications for a pharmacy benefit manager lic...

...The superintendent of insurance shall approve or deny an application for a license under this chapter within a reasonable time after receipt.

...der this chapter, the superintendent of insurance shall notify the applicant of the denial and the reasons for the denial. The superintendent shall include a statement in the notice advising that the applicant is entitled to a hearing, in accordance with Chapter 119. of the Revised Code, if the applicant requests such a hearing within thirty days after receipt of the notice.

...iated filing fee, the superintendent of insurance shall grant the applicant a license to operate as a pharmacy benefit manager in this state. The initial license is effective on the date the application is approved by the superintendent and expires annually on the thirtieth day of June. If the initial license application is approved in May or June, the license expires on the thirtieth day of June the following year. ...

...(A) The superintendent of insurance shall provide a renewal notice to each licensee not later than the first day of May each year. (B) A licensee may renew its pharmacy benefit manager license by applying to the superintendent, in the form and manner prescribed by the superintendent, and paying a renewal fee of three thousand dollars before the date the license expires. A licensee shall not apply for a license rene...

...ate privacy laws, including the "Health Insurance Portability and Accountability Act of 1996," 42 U.S.C. 1320d, et seq. and the regulations adopted under that act. (D) A pharmacy benefit manager shall account, annually or more frequently, to the plan sponsor for any pricing discounts, rebates of any kind, inflationary payments, credits, claw backs, fees, grants, charge backs, drug product reimbursements, or other b...

...the Revised Code, the superintendent of insurance may take any of the actions enumerated in division (C) of this section if the superintendent finds that a licensee has done any of the following: (1) Violated any provision of this chapter, any rule adopted by the superintendent, or any consent agreement or order of the superintendent; (2) Provided incorrect, misleading, incomplete, or materially false information...