Ohio Revised Code Search

... an average of at least thirty hours of service per week during a calendar month, or at least one hundred thirty hours of service during the calendar month. (2) "Group policyholder" means a policyholder for a health insurance policy covering fifty or more full-time employees. "Group policyholder" includes an authorized representative of a group policyholder. (3) "Health plan issuer" has the same meaning as in se...

...viders for reimbursement of health care services and supplies, taking into consideration the special needs of, and differences between, third-party payers. The standard claim form shall be prescribed in rules the superintendent shall adopt in accordance with Chapter 119. of the Revised Code. The superintendent may prescribe a separate claim form for each third-party payer. If a national standard claim form is estab...

...p therapy, quantity limits, and site-of-service restrictions. (C) A health plan issuer, including a pharmacy benefit manager, providing the data required under division (B) of this section shall ensure that the data meets all of the following: (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 m...

...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...

...either by certified mail or by personal service at least forty days prior to the date set for hearing. If the domiciliary liquidator, within thirty days after the giving of such notice, gives notice in writing to the ancillary receiver and to the claimant, either by certified mail or by personal service, of the domiciliary liquidator's intention to contest the claim, the domiciliary liquidator shall be entitled to ap...

... amounts received for travel assistance services or cancellation fee waivers. (C) Neither of the following are insurance: (1) A cancellation fee waiver; (2) Travel assistance services. (D) Surplus lines brokers selling travel insurance shall pay taxes on premiums related to travel insurance in accordance with sections 3905.30 to 3905.38 of the Revised Code and not in accordance with the requirements of this ...

...icensed insurance agent entering active service in the United States armed forces; (4) Any other person if the superintendent determines that the public interest will best be served by the issuance of the license. (B) A temporary license issued under division (A) of this section shall remain in force for a period not to exceed one hundred eighty days. However, a temporary license may not continue in force under any...

...t card payments, electronic processing service, and manual processing service. Fees collected under this section shall be credited to the department of insurance operating fund created under section 3901.021 of the Revised Code. (B) To assist the superintendent in carrying out the superintendent's duties under this chapter, the superintendent may contract with any nongovernmental entity, including the NAIC and...

...posing fees. The statutory fee for each service requested shall be charged against the proper account immediately upon the rendition of the service. Not later than the tenth day of each calendar month the superintendent shall render an itemized statement to each company or agent whose account has been charged during the month next preceding, showing the amount of all fees charged during that month and demandi...

...a vehicle protection device, system, or service that is installed on or applied to a vehicle and that is designed to deter the theft of a vehicle or facilitate the recovery of the vehicle after it has been stolen. "Vehicle protection product" includes, but is not limited to, alarm systems, window etch products, body part marking products, steering locks, pedal and ignition locks, fuel and ignition kill switches, and ...

...oose; (4) Provide any information or services related to health benefit plans or other products not offered in the exchange. Division (C)(4) of this section shall not be interpreted as prohibiting an insurance navigator from providing information on eligibility for medicaid; (5) Engage in any unfair method of competition or any fraudulent, deceptive, or dishonest act or practice. (D) An individual shall not ...

...on, an agent may charge a fee for agent services in connection with a policy issued on a no-commission basis, if the agent provides the consumer with prior disclosure of the fee and of the services to be provided. (D) In the event of a dispute between an agent and a consumer regarding any disclosure required by this section, the agent has the burden of proving that the disclosure was made. (E)(1) No person shall ...

... or any paid employment or contract for service of any kind, or anything of value; nor shall such company or person give or offer to give, or enter into any separate agreement promising to secure, as an inducement or consideration for insurance, the loan of any money, either directly or indirectly, or any contract for services; nor shall such company or person require as a condition of or in connection with the grant...

...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...

...at an escrow agent shall provide escrow services to the parties pursuant to a written agreement, signed by the viatical settlement provider, the viatical settlement broker, and the viator. At the close of escrow, the escrow agent will distribute the proceeds of the sale to the viator, minus any compensation to be paid to any other persons who provided services and to whom the viator has agreed to compensate out...

... the viator via United States postal service or other nationally recognized delivery service. (B) Failure to transfer the proceeds to the viator within the period of time disclosed pursuant to division (A)(1)(f) of section 3916.06 of the Revised Code renders the viatical settlement contract voidable by the viator for lack of consideration until the time consideration is tendered to and accepted by the viato...

...oney or purchasers or lessees of goods, services, or property for which payment is arranged through a credit transaction; (b) The debtors of one or more subsidiary corporations; (c) The debtors of one or more affiliated corporations, proprietorships, or partnerships if the business of the policyholder and of the affiliated corporations, proprietorships, or partnerships is under common control. (2) The premium for ...

...(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 ...

... of money or vendor or lessor of goods, services, property, rights, or privileges, for which payment is arranged through a credit transaction or any successor to the right, title, or interest of any such lender, vendor, or lessor, and an affiliated, associate, or subsidiary of any of them or any director, officer, or employee of any of them or any other person in any way associated with any of them. (E) "Debtor" mea...

..., disability, death, age, or length of service, to the extent reasonably necessary for the support of the person who is the beneficiary of the plan or party to the contract and any dependents of the person, is not liable to attachment or other process, or to be taken, appropriated, or applied by any legal or equitable process or by operation of law, either before or after payment of the benefits, to pay ...

...cal insurance on an expense incurred or service basis, other than for specified diseases or accidental injuries only. (c) The policy is in effect and covers an eligible person at the time a reservist is called or ordered to active duty. (3) "Reservist" means a member of a reserve component of the armed forces of the United States. "Reservist" includes a member of the Ohio national guard. (B) Every group policy sha...

... associated with receipt of the covered service; (3) By making any other arrangement that provides the benefits described in division (B) of this section. (D) The benefits provided under division (B)(1) of this section shall cover expenses in accordance with all of the following: (1) If a woman is at least thirty-five years of age but under forty years of age, one screening mammography; (2) If a woman is at least...

...w coverage, exclusive of any applicable service waiting period under the policy. (C)(1) Except as otherwise provided in division (C) of this section, an insurer that provides an individual sickness and accident insurance policy to an individual shall renew or continue in force such coverage at the option of the individual. (2) An insurer may nonrenew or discontinue coverage of an individual in the individual mark...

...al parent, to submit claims for covered services without the approval of the noncustodial parent; (C) Make payment on claims submitted in accordance with division (B) of this section directly to the custodial parent, the provider, or the department of job and family services.

...edical expense" means any expense for a service rendered by a licensed health care provider or a Christian Science practitioner, or for an article, device, or drug prescribed by a licensed health care provider or provided by a Christian Science practitioner, when intended for use in the mitigation, treatment, or prevention of disease; any amount paid for transportation to the location at which such a service is rende...