Ohio Revised Code Search

...the applicant needs an intermediate level of care. The department of medicaid or an agency under contract pursuant to division (C) of this section shall conduct the assessment. The assessment may be performed concurrently with a long-term care consultation provided under section 173.42 of the Revised Code. (B) An applicant or applicant's representative has the right to appeal an assessment's findings. Section...

...n services for those individuals; (C) Help keep the individuals safe and secure.

... individual enrolled in the medicaid-funded component of the assisted living program may choose a single occupancy room or multiple occupancy room in the residential care facility in which the individual resides. The choice of a multiple occupancy room is subject to approval pursuant to a process the director of aging shall establish in rules adopted under section 173.54 of the Revised Code.

...ls who have applied and been determined eligible for department of aging-administered medicaid waiver components and the PACE program, the department shall establish a unified waiting list for the components and program. Only individuals eligible for a department of aging-administered medicaid waiver component or the PACE program may be placed on the unified waiting list. An individual who may be enrolled in a depart...

... an appeal hearing to be conducted by telephone and permit the department to record hearings conducted by telephone. Chapter 119. of the Revised Code applies to a hearing under section 173.523 or 173.545 of the Revised Code only to the extent provided in rules the department adopts under this section. (B) An appeal shall be commenced by submission of a written request for a hearing to the director of aging wi...

... (2) "Person-centered care" means a relationship-based approach to care that honors and respects the opinions of individuals receiving care and those working closely with them. (B) The department of aging shall implement a nursing home quality initiative to improve the provision of person-centered care in nursing homes. The office of the state long-term care ombudsman program shall assist the department with th...

...red per cent of the federal poverty guidelines, as revised annually by the United States department of health and human services in accordance with section 673(2) of the "Omnibus Budget Reconciliation Act of 1981," 95 Stat. 511, 42 U.S.C. 9902, as amended; (3) Individuals who are persons with disabilities, as defined in section 173.06 of the Revised Code. (B) The director may disclose to the person under contr...

...er to do all of the following: (1) Develop best practices and standards for preventing elder fraud and financial exploitation ; (2) Provide education on elder fraud and financial exploitation; (3) Ensure that victims of elder fraud and exploitation have access to available services and resources. (B) The director of aging, the director of commerce, and the director of job and family services shall create a re...

... (C) of section 173.24 of the Revised Code is subject to a fine not to exceed one thousand dollars for each violation. (B) Whoever violates division (C) of section 173.23 of the Revised Code is guilty of registering a false complaint, a misdemeanor of the first degree. (C) Whoever violates division (G)(1) or (2) of section 173.19 of the Revised Code is subject to a fine not to exceed five hundred dollars for each v...

...uted by members of a multiple employer welfare arrangement that establishes an arrangement, provides for its operation, and through which each member agrees to assume and discharge all liability under sections 1739.01 to 1739.22 of the Revised Code relating to or arising out of the operation of the arrangement in proportion to the ratio of the total number of covered employees employed by the member at the time the l...

...perate a group self-insurance program under a multiple employer welfare arrangement that is chartered and created in this state under sections 1739.01 to 1739.22 of the Revised Code: (1) A chamber of commerce; (2) A trade association; (3) An industry association; (4) A professional association; (5) A voluntary employee beneficiary association that is exempt from taxation by the internal revenue service under sec...

...rtificate of authority by the superintendent of insurance. Employers or other organizers that propose to create an arrangement or arrangements and provide benefits through a group self-insurance program or group self-insurance programs shall apply to the superintendent for a certificate of authority. If a group listed under division (A) of section 1739.02 of the Revised Code establishes, maintains, or operates more ...

...etermine whether the multiple employer welfare arrangement will be able to comply with sections 1739.01 to 1739.22 of the Revised Code and any rules adopted pursuant to those sections. If the superintendent finds that the arrangement is capable of complying with such sections, he shall issue a certificate of authority authorizing the arrangement to operate in this state. (B) The superintendent shall approve or disap...

...ons 1739.01 to 1739.22 of the Revised Code and that operates a group self-insurance program may be established only if any of the following applies: (1) The arrangement has and maintains a minimum enrollment of three hundred employees of two or more employers. (2) The arrangement has and maintains a minimum enrollment of three hundred self-employed individuals. (3) The arrangement has and maintains a minimum...

...e program, nor shall any endorsement, rider, or application that becomes or is designated to become a part of any certificate be used until all of the following have been filed by the arrangement with the superintendent of insurance: (1) The form of the certificate, endorsement, rider, or application; (2) The premium or rates, including the calculations, formulas, and supporting statistics used to establish the pre...

... or requires the use of a standardized identification card or an electronic technology for submission and routing of prescription drug claims; (b) A person or entity that a multiple employer welfare arrangement contracts with to issue a standardized identification card or an electronic technology described in division (A)(1)(a) of this section. (2) Notwithstanding division (A)(1) of this section, this section does ...

...tice to the arrangement. Except as provided in division (A)(2) of this section, the voluntary termination shall be approved by the board of the arrangement upon a finding that the member is in good standing, that both the member and the arrangement have met all the requirements of sections 1739.01 to 1739.22 of the Revised Code and any rules adopted by the superintendent of insurance pursuant to such sections, and th...

...ons 1739.01 to 1739.22 of the Revised Code shall be operated by a board of trustees chosen by a majority of the participating members of the arrangement in accordance with sections 1739.01 to 1739.22 of the Revised Code and with the articles and bylaws of the arrangement. (B) The board, in addition to other powers contained in its articles, shall do all of the following: (1) Invest and reinvest funds held by it in ...

... shall make and file with the superintendent of insurance an annual report of its affairs and operations during the last preceding calendar year. The report shall be made pursuant to the forms, instructions, and manuals prescribed by the national association of insurance commissioners for the preparation of statutory financial statements and other financial information for domestic insurance companies other than life...

...ry, the affairs of a multiple employer welfare arrangement and its members. The arrangement shall pay to the superintendent the expenses incurred by the department of insurance in making an examination authorized under this section. To the extent that expenses are the result of the use of the personnel of the examination department of the department of insurance, the superintendent shall remit expenses paid to the...

...ancial capacity of a multiple employer welfare arrangement operating a group self-insurance program to pay employee welfare benefit obligations promptly and to otherwise meet its obligations under sections 1739.01 to 1739.22 of the Revised Code, the superintendent of insurance may take into consideration all of the following: (A) Maintenance of minimum reserves that are necessary in the exercise of sound and prudent...

...ogram shall be filed with the superintendent of insurance. (B) As a condition to the issuance and maintenance of a certificate of authority, a multiple employer welfare arrangement operating a group self-insurance program shall purchase individual stop-loss insurance from insurers authorized to transact business in this state with a deductible retention of no more than five per cent of the arrangement's annual aggre...

...her amounts of surplus as the superintendent of insurance may establish by rule for the protection of the members and their employees. (B) Except as otherwise provided for in sections 1739.01 to 1739.21 of the Revised Code, the assets of a multiple employer welfare arrangement operating a group self-insurance program shall be invested only in securities or other investments permitted by the laws of this state for th...

...er costs incurred by the arrangement as determined by the board of the arrangement or by a third-party administrator and approved by the board of the arrangement. This amount may be adjusted by the board according to the claims experience of each participating member in accordance with criteria set forth in the articles or bylaws of the arrangement. (B) Each member shall pay a premium for each year at the beginning ...

... shall file annually with the superintendent of insurance an actuarial certification including a statement that the underwriting and rating methods of the carrier do all of the following: (1) Comply with accepted actuarial practices; (2) Are uniformly applied to arrangement members, employees of members, and the dependents of members or employees; (3) Comply with the provisions of section 1739.06 of the Revised Co...