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The Legislative Service Commission staff updates the Revised Code on an ongoing basis, as it completes its act review of enacted legislation. Updates may be slower during some times of the year, depending on the volume of enacted legislation.

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Section 3956.18 | Advertising prohibitions - summary document.

...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...

Section 3956.19 | Applicability of prior law and current law.

...(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...

Section 3956.20 | Offset of assessments against premium or franchise tax liability.

...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...

Section 3959.01 | Third-party administrator definitions.

...alth, prescription drugs, or disability insurance or self-insurance programs. "Administrator" includes a pharmacy benefit manager. "Administrator" does not include any of the following: (1) An insurance agent or solicitor licensed in this state whose activities are limited exclusively to the sale of insurance and who does not provide any administrative services; (2) Any person who administers or operates the wo...

Section 3959.04 | Administrators tested and licensed by superintendent.

...ll be licensed by the superintendent of insurance in accordance with rules adopted by the superintendent. (B) An administrator who has been licensed or certified by the state of the administrator's domicile under a statute or rule similar to sections 3959.01 to 3959.16 of the Revised Code shall, upon application, be licensed without testing, provided the state of domicile recognizes and grants licenses to administra...

Section 3959.05 | License requirement.

...No person shall solicit a plan or sponsor of a plan to act as an administrator for, or provide administrative services to, a plan or sponsor of a plan that is either domiciled in this state or has its principal headquarters or principal administrative office in this state unless the person is duly licensed under sections 3959.01 to 3959.16 of the Revised Code.

Section 3959.06 | Application for license - filing fee.

...r shall file with the superintendent of insurance an application for a license on a form prescribed by the superintendent. (B) All applications for a license shall be accompanied by a nonrefundable filing fee of two hundred dollars per application made payable to the department of insurance. (C) All fees collected under this section and under section 3959.10 of the Revised Code shall be paid into the state treasury...

Section 3959.07 | Action on application by superintendent.

...The superintendent of insurance shall act on all applications submitted for a license within thirty days after receipt.

Section 3959.08 | Denying application for license.

...If the superintendent of insurance denies the application for license, the superintendent shall promptly notify the applicant of the denial and the reasons for the denial within thirty days of the date the application is denied by the superintendent. The notice shall advise the applicant of the applicant's right to request a hearing within thirty days from the date of the mailing of the notice.

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...