Ohio Revised Code Search

...y action, suit, or proceeding, in which service is made in the manner provided in division (B) or (C) of section 3901.17 of the Revised Code the court or, if the proceeding is before the superintendent of insurance, the superintendent may order such postponement as may be necessary to afford the unauthorized insurer reasonable opportunity to comply with the provisions of division (A) of this section and to defend suc...

...ir and deceptive act or practice in the business of insurance under sections 3901.19 to 3901.26 of the Revised Code. (2) Any person subject to this section shall, upon reasonable notice, make available to the superintendent of insurance all books and records relating to insurance transactions.

...an unfair and deceptive practice in the business of insurance under section 3901.21 of the Revised Code.

...d by the third-party payer on the fifth business day after the day the claim was mailed, unless it can be proven otherwise. (2) If the provider or a person acting on behalf of the provider submits a claim directly to a third-party payer electronically, there exists a rebuttable presumption that the claim was received by the third-party payer twenty-four hours after the claim was submitted, unless it can be proven o...

...yment of any amount due for health care services rendered by a provider to a beneficiary; (B) Refuse to process or pay within the time periods specified in section 3901.381 of the Revised Code a claim submitted by a provider on the grounds the beneficiary has not been discharged from the hospital or the treatment has not been completed, if the submitted claim covers services actually rendered and charges actually in...

...r 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 government agency, or person for any services rendered unless the hospital is licensed under Chapter 3722. of the Revised Code. "Hospital" as used in this section means...

...or governmental entity providing health services coverage for individuals on a self-insurance basis. (3) "Group policy" means, with respect to life insurance, a policy covering more than twenty-five individuals and issued pursuant to section 3917.01 of the Revised Code, and with respect to sickness and accident insurance, a policy covering more than twenty-five individuals and issued pursuant to section 3923.11, 39...

...d shall provide this data within thirty business days of receipt of the request. (b) A health plan issuer shall not be required to release claims information as required in division (B)(1)(a) of this section more than once per calendar year per group policyholder. (2) The data released shall include all of the following with regard to the policy in question for the policy period immediately preceding or the curre...

...an unfair and deceptive practice in the business of insurance under sections 3901.19 to 3901.26 of the Revised Code.

... (1) It is current not later than one business day after any change is made. (2) It is provided in real time. (3) It is provided in the same format that the request is made by the covered person, the covered person's health care provider, or the third-party representative. (D) The format in which a health plan issuer, including a pharmacy benefit manager, replies to a request made under division (B) of this s...

...cted providers for covered health care services provided to medicaid recipients, then next to pay other claimants with any remaining funds, consistent with the priorities set forth in sections 3903.421 and 3903.42 of the Revised Code. (F) The rehabilitator shall have the power under sections 3903.26 and 3903.27 of the Revised Code to avoid fraudulent transfers. (G) As used in this section: (1) "Contracted pr...

...ir and deceptive act or practice in the business of insurance under sections 3901.19 to 3901.26 of the Revised Code. (F) This section does not apply with respect to any expense fee charged by a surety bail bond agent to cover the costs incurred by the surety bail bond agent in executing the bail bond.

...s a written designation of an agent for service of process with the superintendent. (2) The applicant has filed with the superintendent the applicant's written irrevocable consent that any action against the applicant may be commenced against the applicant by service of process on the superintendent. (I) A viatical settlement provider or viatical settlement broker shall provide to the superintendent new or revise...

...the following: (1) Any licensee or its business practices or methods of operation; (2) The merits, desirability, or advisability of any viatical settlement contract; (3) Any viatical settlement contract; (4) Any policy or life insurance company. (O) If the advertiser emphasizes the speed with which the viatication will occur, the advertising must disclose the average time frame, from completed application to th...

...(B)(1) The department of administrative services shall only offer employees paid by warrant of the director of budget and management voluntary supplemental benefit plans that are selected through a state-administered request for proposals process. If an employee authorizes the director of administrative services, in writing, to deduct the premium or a portion of the premium agreed to be paid by the employee to ...

...n arises, and summons may be issued and service had as provided by law for the issuance and service of such writs in the court of common pleas.

...d health care services. (L) Within one business day after the receipt of any such information submitted by the covered person in accordance with division (K)(1) of this section, the independent review organization shall forward the information to the health plan issuer. Upon receipt of any such forwarded information in accordance with division (K)(1) of this section, a health plan issuer may reconsider its adv...

...ephone callers during other than normal business hours; (3) Agree to maintain and provide to the superintendent, upon request and in accordance with any associated rules, policies, or procedures adopted by the superintendent of insurance, the information prescribed in section 3922.17 of the Revised Code. (B) An independent review organization may not own or control, be a subsidiary of or in any way be owned or co...

...l be treated as a domestic corporation. Service of process against the association made upon a managing agent, any member thereof, or any agent authorized by appointment to receive service of process, shall have the same force and effect as if the service had been made upon all members of the association. (H) Under any policy issued as provided in this section, the policyholder, or such person as the policyholder sh...

...l be treated as a domestic corporation. Service of process against such association made upon a managing agent, any member thereof, or any agent authorized by appointment to receive service of process, shall have the same force and effect as if such service had been made upon all members of the association. (H) Under any policy issued as provided in this section, the policyholder, or such person as the policyholder ...

...ir and deceptive act or practice in the business of insurance under sections 3901.19 to 3901.26 of the Revised Code.

...r which the insurer is authorized to do business; provided, however, that such coverage is terminated uniformly without regard to any health status-related factor of covered individuals. (e) If the coverage is made available in the individual market only through one or more bona fide associations, the membership of the individual in the association, on the basis of which the coverage is provided, ceases; provided, ...

...ir and deceptive act or practice in the business of insurance under sections 3901.19 to 3901.26 of the Revised Code. (D) This section does not do any of the following: (1) Require a policy to cover inpatient or follow-up care that is not received in accordance with the policy's terms pertaining to the health care professionals and facilities from which an individual is authorized to receive health care services; (...

...ir and deceptive act or practice in the business of insurance under sections 3901.19 to 3901.26 of the Revised Code. (D) This section does not do any of the following: (1) Require a plan to cover inpatient or follow-up care that is not received in accordance with the plan's terms pertaining to the health care professionals and facilities from which an individual is authorized to receive health care services; (2) R...

...to such books and records during normal business hours. (3) The fiscal agent shall maintain a bank account under the name of the "Ohio commercial market assistance plan." All checks drawn upon the account of the plan shall bear the signatures of the fiscal agent and another person duly authorized by the executive committee. (4) If a surplus of funds exists at any time the plan is suspended, the then existing surplu...