Ohio Revised Code Search

...) Coverage provided under an employer's self-insurance plan or by any of its administrators, as defined in section 3959.01 of the Revised Code, to the extent that federal law supersedes, preempts, prohibits, or otherwise precludes the application of this section to the plan and its administrators. (B) A standardized identification card or an electronic technology issued or required to be used as provided in div...

...h of the following: (a) Incapable of self-sustaining employment by reason of physical disability or intellectual disability; (b) Primarily dependent upon the subscriber for support and maintenance. (B) Proof of incapacity and dependence for purposes of division (A)(2) of this section shall be furnished to the health insuring corporation within thirty-one days of the child's attainment of the limiting age. Up...

...iability insurance policy or equivalent self-insurance; a medicare supplement policy of insurance as defined by the superintendent of insurance by rule; coverage under a plan through medicare or the federal employees benefit program; or any coverage issued under Chapter 55 of Title 10 of the United States Code and any coverage issued as a supplement to that coverage.

... or policies of insurance, a program of self-insurance or joint self-insurance, a joint self-insurance pool, or any other independent or joint method or arrangement insuring the clerk against liability arising from the duties of his office. The coverage may be provided separately or as part of liability coverage provided to other officers or employees of a municipal corporation or county. (C) The liability coverage ...

...in twelve months after the death of the insured or the person covered by the benefit plan, or if satisfactory evidence is furnished to the insurance company or the trustee of or other person holding funds of the benefit plan within that twelve-month period showing that there is or will be no trustee to receive the proceeds, payment shall be made by the insurance company or the trustee of or other person holding funds...

...iability insurance policy or equivalent self-insurance; a medicare supplement policy of insurance, as defined by the superintendent of insurance by rule, coverage under a plan through medicare, medicaid, or the federal employees benefit program; any coverage issued under Chapter 55 of Title 10 of the United States Code and any coverage issued as a supplement to that coverage. (3) "Health plan issuer" means an entit...

...ess in this state. "Insurer" includes a self-insuring employer and the United States centers for medicare and medicaid services. (3) "Medical claim" has the same meaning as in section 2305.113 of the Revised Code. (4) "Reimbursement determination" means an insurer's determination of whether the insurer will reimburse a health care provider for health care services and the amount of that reimbursement. (5) "Reim...

... insurance, establishes and maintains a self-insurance program, or enters into an agreement for the joint administration of a self-insurance program, the political subdivision may, pursuant to a written agreement and to the extent that it considers necessary, join with other political subdivisions in establishing and maintaining a joint self-insurance pool to provide for the payment of judgments, settlement of claims...

...hicles with auxiliary equipment, or all self-propelling equipment or trailers owned or operated by the county. Whenever the board deems it necessary to procure such insurance, it shall adopt a resolution setting forth the necessity therefor, together with a statement of the estimated premium cost, and upon adoption of the resolution the board may purchase such insurance. The premium for such insurance or any other in...

...l services or items to individuals on a self-insurance basis; (c) A health insuring corporation as defined in section 1751.01 of the Revised Code; (d) A group health plan as defined in 29 U.S.C. 1167; (e) Any organization, business, or association described in 42 U.S.C. 1396a(a)(25); or (f) A managed care organization. (2) "Information" means all of the following: (a) An individual's name, address, date of b...

...of coverage. The board may provide for self-insurance of risk or level of risk as set forth in the contract with the companies, corporations, or agencies, and may provide through the self-insurance method specific coverage as authorized by the rules of the board. (B) The board may make a monthly payment to each recipient of service retirement, or a disability or survivor benefit under the STRS defined benefit plan ...

... medical payments, comprehensive, and uninsured motorists insurance. Before procuring such insurance each board of education shall adopt a resolution setting forth the amount of insurance to be purchased, the necessity of the insurance, together with a statement of its estimated premium cost. Insurance procured pursuant to this section shall be from one or more recognized insurance companies authorized to do busine...

...in establishing and maintaining a joint self-insurance pool to do both of the following: (1) Provide for payment of claims expenses that arise, or are claimed to have arisen, from an act or omission of the state university or college or any of its employees or other persons authorized by the board while doing either of the following: (a) Acting in the scope of their employment or official responsibilities; (b) ...

...ised Code, the medicaid program, or any self-insurance plan. (H) "Government unit" means the state and any county, municipal corporation, township, or other political subdivision of the state, or any department, division, board, or other agency of the state or a political subdivision. (I) "Health maintenance organization" means a public or private organization organized under the law of any state that is qualifie...

...ompany, health insuring corporation, or self-insurance plan authorized to do business in this state shall include or provide in its policies or subscriber agreements for benefit payments or reimbursement for services in any hospital which is not licensed under Chapter 3722. of the Revised Code. No hospital located in this state shall charge any insurance company, health insuring corporation, federal, state, or local ...

...dual who seeks to become a member of an insured group after having declined a previous offer of coverage under the group policy; (b) An individual who seeks life insurance coverage under a group policy in excess of the maximum coverage available under the policy without evidence of insurability; (c) A certificate of life or sickness and accident insurance covering no more than twenty-five individuals under a grou...

...r pharmacy services to individuals on a self-insurance basis; (4) A group health plan, as defined in 29 U.S.C. 1167; (5) A service benefit plan, as referenced in 42 U.S.C. 1396a(a)(25); (6) A medicaid managed care organization that has entered into a contract with the department of medicaid pursuant to section 5167.10 of the Revised Code; (7) Any other person or government entity that is, by law, contract, or agr...

...he interview; (4) Refuses to identify self upon request. (U) "Privileged information" means any individually identifiable information that relates to a claim for life, health, or disability insurance benefits or a civil or criminal proceeding involving an individual, and that is collected in connection with, or in reasonable anticipation of, a claim for life, health, or disability insurance benefits or civil or c...

...icile and operated in a manner so as to self-insure risks of their owners and insureds. (4) Professional or medical liability insurance procured by a hospital organized under Chapter 3701. of the Revised Code; (5) Insurance with an initial policy period of more than three years and that is procured to cover known events related to environmental remediation that occurred prior to the effective date of that insu...

...or stipulation by which a person binds self, or the person's heirs, executors, administrators, or assigns, to accept any sum less than the full value or amount of the policy in case of a claim accruing thereon by reason of the death of the person insured. Any stipulation or condition described in division (D) of this section so made or inserted is void. If a life insurance company denies an applicant life insuranc...

...ability insurance policy or equivalent self-insurance; a medicare supplement policy of insurance, as defined by the superintendent of insurance by rule, coverage under a plan through medicare, medicaid, or the federal employees benefit program; any coverage issued under Chapter 55 of Title 10 of the United States Code and any coverage issued as a supplement to that coverage. (M) "Health care professional" mean...

...sident of this state from employment or self-employment and has since been continuously unemployed or is employed only so that the person does not have, or have a right to purchase, group health coverage. An individual who is, or who becomes, covered by medicare is not a qualified unemployed person. A person eligible for coverage under this section, who is also eligible for continuation of coverage under section 1751...

...s any private or public employer group self-insurance plan that provides payment for health care benefits for other than specific diseases or accidents only, which benefits are not provided by contract with a sickness and accident insurer or health insuring corporation. (B) Notwithstanding section 3901.71 of the Revised Code, and subject to division (F) of this section, each plan of health coverage shall provi...

...includes any private or public employer self-insurance plan that satisfies all of the following: (a) The plan is established or modified in this state on or after April 17, 1991. (b) The plan provides, or provides payment for, health benefits for employees resident in this state other than through an insurer or health insuring corporation. (c) The plan is in effect and covers an eligible person at the time a reser...

...rmation: (a) The plan's name; (b) The insured's name, group number, and identification number; (c) A telephone number to inquire about pharmacy-related issues; (d) The issuer's international identification number, labeled as "ANSI BIN" or "RxBIN"; (e) The processor's control number, labeled as "RxPCN"; (f) The insured's pharmacy benefits group number if different from the insured's medical group number, labeled...