Ohio Revised Code Search

...Whoever purposely violates division (D) of section 3753.03 of the Revised Code shall be fined not more than twenty thousand dollars and imprisoned for not more than one year, or both. Each day of violation is a separate offense.

...he carrier for the same or similar coverage under a plan or arrangement covering any small employer with similar case characteristics. (C) "Carrier" means any sickness and accident insurance company or health insuring corporation authorized to issue health benefit plans in this state or a MEWA. A sickness and accident insurance company that owns or operates a health insuring corporation, either as a separate corpor...

...ividual is reimbursed, whether through wage adjustments or otherwise, by a small employer for any portion of the premium. (2) The health benefit plan is treated by the employer or any of the covered individuals as part of a plan or program for purposes of section 106 or 162 of the "Internal Revenue Code of 1986," 100 Stat. 2085, 26 U.S.C.A. 1, as amended. (B) Notwithstanding division (A) of this section, division...

...visions shall not exclude or limit coverage for a period beyond twelve months, or eighteen months in the case of a late enrollee, following the individual's enrollment date and may only relate to a physical or mental condition, regardless of the cause of the condition, for which medical advice, diagnosis, care, or treatment was recommended or received within the six months immediately preceding the enrollment date. ...

... employers that may apply for such coverage to those with eligible employees who live, work, or reside in the service area of the network plan; (2) Within the service area of the network plan, deny the coverage to small employers if the carrier has demonstrated both of the following to the superintendent of insurance: (a) The carrier will not have the capacity to deliver services adequately to the members of any ad...

...necessary to underwrite additional coverage. (2) The carrier is applying division (A) of this section uniformly to all employers in the small employer market in this state consistent with the applicable laws and rules of this state and without regard to the claims experience of those employers and their employees and dependents or to any health status-related factor relating to such employees and dependents. (B) A ...

...e plan relating to renewability of coverage; (3) The provisions of the plan relating to any pre-existing condition exclusion; (4) The benefits and premiums available under all health benefit plans for which the employer is qualified. (B) The information described in division (A) of this section shall be provided in a manner determined to be understandable by the average small employer, and in a manner sufficient t...

...ing period for the same or similar coverage under a health benefit plan covering any small employer with similar case characteristics shall not vary from the applicable midpoint rate by more than forty per cent of the midpoint rate, as to all health benefit plans issued on or after the effective date of this section. (2) A carrier may apply a low claims discount not to exceed five per cent of the midpoint rate to sm...

...(A) Compliance with the underwriting and rating requirements contained in sections 3924.01 to 3924.06 of the Revised Code shall be demonstrated through actuarial certification. Carriers offering health benefit plans to small employers shall file annually with the superintendent of insurance an actuarial certification stating that the underwriting and rating methods of the carrier do all of the following: (1) Compl...

...(A) As used in this section: (1) "Beneficiary," "hospital," and "third-party payer" have the same meanings as in section 3901.38 of the Revised Code. (2) "Overcharged" means charged more than the usual and customary charge, rate, or fee that is charged by the provider or hospital for a particular item or service. (3) "Provider" has the same meaning as in section 3902.11 of the Revised Code. (B) If a beneficiary ...

...n individual. (B) No employer shall engage in any act or practice that, due solely to the actual or expected health condition of one or more individuals, excludes or causes the exclusion of any individual from coverage under an existing employer-provided policy, contract, or plan of health benefits for which the individual would otherwise be eligible. (C) If an employer violates division (B) of this section, the pr...

... carrier offering health insurance coverage in connection with a group health benefit plan, shall require any individual, as a condition of enrollment or continued enrollment under the plan, to pay a premium or contribution that is greater than the premium or contribution for a similarly situated individual enrolled in the plan on the basis of any health status-related factor in relation to the individual or to an in...

...g an individual's eligibility for coverage or when making payments to or on behalf of an enrollee, subscriber, policyholder, or certificate holder.

...from the requirements applicable to an agent or assignee of any other individual so covered.

...(A) As used in sections 3924.46 to 3924.49 of the Revised Code, "health insurer" has the same meaning as in section 3924.41 of the Revised Code. (B) No health insurer shall deny enrollment of a child under the health plan of the child's parent on the basis that any of the following applies: (1) The child was born out of wedlock. (2) The child is not claimed as a dependent on the federal tax return of the parent. ...

...If a child has health care coverage through a health insurer of a noncustodial parent, the health insurer shall do all of the following: (A) Provide such information to the custodial parent of the child as may be necessary for the child to obtain benefits through the coverage; (B) Permit the custodial parent, or a provider with the approval of the custodial parent, to submit claims for covered services without the ...

...ative order to provide health care coverage for the child, and if the parent is eligible for family health care coverage provided by a health insurer, the health insurer shall do both of the following: (1) If the child is otherwise eligible for the coverage, permit the parent to enroll the child under the family coverage without regard to any enrollment period restrictions; (2) If the parent is enrolled under the c...

...order to provide health insurance coverage for the child, which coverage is available through an employer doing business in this state, the employer shall do all of the following: (1) If the child is otherwise eligible for the family coverage, permit the parent to enroll the child under the coverage without regard to any enrollment period restrictions; (2) If the parent is enrolled under the coverage but fails to ...

...ild, an individual who has not attained age eighteen as of the date of the adoption or placement for adoption. (2) "Health insurer" has the same meaning as in section 3924.41 of the Revised Code. (3) "Placement for adoption" means the assumption and retention by a person of a legal obligation for total or partial support of a child in anticipation of the adoption of the child. The child's placement with a person te...

...ts contract shall limit or exclude coverage for the reason that the beneficiary is under confinement or is otherwise under the custody of a law enforcement officer, and a governmental entity is wholly or primarily responsible for rendering or arranging for the rendering of health care services for the beneficiary. (C) A benefits contract may limit or exclude coverage for health care services rendered to such a benef...

...e sickness and accident insurance, coverage under a health care plan of a health insuring corporation organized under Chapter 1751. of the Revised Code, long-term care insurance as defined in section 3923.41 of the Revised Code, medicare supplemental coverage as defined in section 3923.33 of the Revised Code, or payments made pursuant to cost sharing agreements under comprehensive sickness and accident plans. An "eli...

...olicy, plan, or contract of health coverage that is funded by the person's employer, and who receives additional monetary compensation by virtue of refusing that coverage, may not open a medical savings account unless the medical savings account also is sponsored by the person's employer.

...The owners of interest in a medical savings account are the account holder and the account holder's spouse and dependents. No medical savings account shall be subject to garnishment or attachment.

...ministrator. The administrator shall manage the account in a fiduciary capacity for the benefit of the account holder. (B) Medical savings accounts shall be administered by one of the following: (1) A federally or state-chartered bank, savings and loan association, savings bank, or credit union; (2) A trust company authorized to act as a fiduciary; (3) An insurer authorized under Title XXXIX of the Revised Code t...

...Each employer that opens a medical savings account for an employee shall inform the employee, in writing at the time the account is opened, of the federal and state tax status of deposits made to the account.