Ohio Revised Code Search

... (A) The superintendent of insurance may examine or investigate the business and affairs of a discount medical plan organization as the superintendent deems appropriate to protect the interests of the residents of this state. (B) When examining or investigating a discount medical plan organization pursuant to division (A) of this section, the superintendent may do both of the following: (1) Order a discount medical...

... (A) No person shall fail to comply with sections 3961.01 to 3961.09 of the Revised Code. If the superintendent of insurance determines that any person has violated sections 3961.01 to 3961.07 of the Revised Code, the superintendent may take one or more of the following actions: (1) Assess a civil penalty in an amount not to exceed twenty-five thousand dollars per violation if the person knew or should have known o...

... The superintendent of insurance may adopt rules in accordance with Chapter 119. of the Revised Code for purposes of implementing sections 3961.01 to 3961.08 of the Revised Code.

... As used in this chapter: (A) "Affiliate" means any person or entity that has ownership or control of a contracting entity, is owned or controlled by a contracting entity, or is under common ownership or control with a contracting entity. (B) "Basic health care services" has the same meaning as in division (A) of section 1751.01 of the Revised Code, except that it does not include any services listed in that divi...

... (A)(1) No contracting entity shall sell, rent, or give a third party the contracting entity's rights to a participating provider's services pursuant to the contracting entity's health care contract with the participating provider unless one of the following applies: (a) The third party accessing the participating provider's services under the health care contract is an employer or other entity providing coverage f...

... (A) Each health care contract shall include all of the following information: (1)(a) Information sufficient for the participating provider to determine the compensation or payment terms for health care services, including all of the following, subject to division (A)(1)(b) of this section: (i) The manner of payment, such as fee-for-service, capitation, or risk; (ii) The fee schedule of procedure codes reasonab...

...(A)(1) If an amendment to a health care contract is not a material amendment, the contracting entity shall provide the participating provider notice of the amendment at least fifteen days prior to the effective date of the amendment. The contracting entity shall provide all other notices to the participating provider pursuant to the health care contract. (2) A material amendment to a health care contract shall...

...(A) The department of insurance shall prescribe the credentialing application form used by the council for affordable quality healthcare (CAQH) in electronic or paper format for physicians. The department of insurance also shall prepare the standard credentialing form for all other providers and shall make the standard credentialing form as simple, straightforward, and easy to use as possible, having due reg...

...(A) If a provider, upon the oral or written request of a contracting entity to submit a credentialing form, submits a credentialing form that is not complete, the contracting entity that receives the form shall notify the provider of the deficiency electronically, by facsimile, or by certified mail, return receipt requested, not later than twenty-one days after the contracting entity receives the form. (B) ...

...(A) All remittance notices sent by a payer, whether written or electronic, shall include both of the following: (1) The name of the payer issuing the payment to the participating provider; (2) The name of the contracting entity through which the payment rate and any discount are claimed, if the contracting entity is different from the payer. (B) Division (A) of this section takes effect March 31, 2009.

...The superintendent of insurance shall adopt any rules necessary for the implementation of this chapter.

...(A) A series of violations of this chapter by any person regulated by the department of insurance under Title XVII or Title XXXIX of the Revised Code that, taken together, constitute a pattern or practice of violating this chapter may be defined as an unfair and deceptive insurance practice under sections 3901.19 to 3901.26 of the Revised Code. (B) The superintendent of insurance may conduct a market conduct ...

... This chapter does not apply with respect to any of the following: (A) A contract or provider agreement between a provider and the state or federal government, a state agency, or federal agency for health care services provided through a program for medicaid or medicare; (B) A contract for payments made to providers for rendering health care services to claimants pursuant to claims made under Chapter 412...

...(A) No contracting entity shall do any of the following: (1) Offer to a provider a health care contract that includes a most favored nation clause; (2) Enter into a health care contract with a provider that includes a most favored nation clause; (3) Amend or renew an existing health care contract previously entered into with a provider so that the contract as amended or renewed adds or continues to include a...

...As used in this chapter: (A) "Affiliated company" means any company in the same corporate system as a parent, or a member organization by virtue of common ownership, control, operation, or management. (B) "Captive insurance company" means any insurer that insures only the risks of its parent or affiliated companies of its parent. "Captive insurance company" includes any protected cell captive insurance compan...

... (A) A captive insurance company may apply for authority to insure only the following lines of insurance: (1) Commercial multiple peril; (2) Ocean marine; (3) Inland marine; (4) Medical malpractice; (5) Workers' compensation, to the extent permitted by law, but only for the purpose of indemnification of a self-insuring employer pursuant to division (B)(1) of section 4123.82 of the Revised Code; (6) Commerc...

... (A) A captive insurance company shall be organized under Chapter 1701., 1702., 1705., or 1706. of the Revised Code. (B) A captive insurance company shall not operate in this state unless all of the following are met: (1) The captive insurance company obtains from the superintendent a license to do the business of captive insurance in this state. (2) The captive insurance company's board of directors holds a...

... No captive insurance company shall adopt a name that is the same, deceptively similar, or likely to be confused with, or mistaken for, any other existing business name registered in this state. The name under which a captive insurance company engages in business must contain the word "captive."

...(A) No captive insurance company shall be issued a license unless it possesses and maintains minimum unimpaired, paid-in total capital and surplus as follows: (1) Not less than two hundred fifty thousand dollars; (2) In the case of a protected cell captive insurance company, not less than five hundred thousand dollars. (B) The superintendent may prescribe additional capital and surplus based upon the type, vo...

... (A) No captive insurance company shall pay any extraordinary dividend or make any other extraordinary distribution to its shareholders or members other than in accordance with this section. The declaration of an extraordinary dividend or distribution shall be conditional and shall confer no rights upon shareholders or members until thirty days after the superintendent has received notice of the declaration the...

... (A) A captive insurance company shall not be required to make any annual report except as required by this section. (B)(1) The chief financial officer and at least one additional executive officer of a captive insurance company, or a majority of the directors of a captive insurance company annually, on the first day of January, or within sixty days thereafter prepare under oath and deposit in the office of ...

... (A) Captive insurance companies shall be examined, evaluated, and monitored pursuant to section 3901.07 of the Revised Code. (B) All examination reports, preliminary examination reports or results, working papers, recorded information, documents and copies thereof produced by, obtained by, or disclosed to the superintendent or any other person in the course of an examination made under this section are conf...

... The superintendent may suspend or revoke the license of a captive insurance company, in accordance with Chapter 119. of the Revised Code, for any of the following reasons: (A) Insolvency or impairment of capital or surplus; (B) Failure to meet the requirements of section 3964.05 of the Revised Code; (C) Refusal or failure to submit an annual report, as required by section 3964.07 of the Revised Code, or any ...

... (A) The board of directors of a captive insurance company shall determine appropriate investments for the company. With respect to all of the insurance company's investments, the board of directors shall exercise the judgment and care, under the circumstances then prevailing, that a person of reasonable prudence, discretion, and intelligence might exercise in the management of a like enterprise, that person no...

...No captive insurance company shall be required to join a rating organization.

...No captive insurance company shall be permitted to join or contribute financially to any plan, pool, association, or guaranty or insolvency fund in this state, nor shall any captive insurance company, or any insured or affiliate thereof, receive any benefit from any such plan, pool, association, or guaranty or insolvency fund for claims arising out of the operations of the captive insurance company.

... (A)(1) Not later than the second day of March of each year, a captive insurance company shall pay to the superintendent of insurance a fee computed in accordance with both of the following: (a) 0.35 per cent on its net direct premiums; (b) 0.15 per cent on revenue from assumed reinsurance premiums. (2) The annual minimum aggregate fee to be paid by a captive insurance company calculated under this division ...

...(A) Except as provided in this chapter, captive insurance companies shall be governed by this chapter and are exempt from all other provisions of the insurance laws of this state. No insurance law of this state shall apply to captive insurance companies unless captive insurance companies are expressly designated as being subject to the law or, with respect to a line of authority granted to a captive insurance c...

... (A) The superintendent may charge captive insurance companies for any of the following expenses incurred in carrying out this chapter: (1) The entire compensation for each day, or portion thereof, worked by all personnel, including those who are not employees of the department of insurance, in any of the following capacities: (a) The conduct of an examination, calculated at the rates provided in the financial ...

... (A) As used in sections 3964.17 to 3964.1710 of the Revised Code: (1) "Protected cell" means an incorporated cell that is organized pursuant to Chapter 1701., 1702., 1705., or 1706. of the Revised Code and that has a separate legal identity from the protected cell captive insurance company of which it is a part. (2) "Protected cell captive insurance company" means a captive insurance company that meets all of th...

... (A) A protected cell captive insurance company may create and issue shares in one or more classes for one or more protected cells. (1) The proceeds of the issue of shares for a specific protected cell shall be included in the assets of that protected cell. (2) The proceeds of the issue of shares that are not for a specific protected cell shall be included in the protected cell captive insurance company's g...

... (A) No sale, exchange, or other transfer of assets may be made by a protected cell captive insurance company between or among any of its protected cells without the written consent of the participants of the protected cell and the superintendent. (B)(1) No sale, exchange, transfer of assets, or distribution may be made from a protected cell to any person without the superintendent's prior written approval. ...

... (A) The owners of a protected cell captive insurance company, shall not, by virtue of being owners of the protected cell captive insurance company, be the owners or participants of any protected cell of the protected cell captive insurance company. (B) The participants of a protected cell shall not, by virtue of being such participants, be the owners of the protected cell captive insurance company or partic...

... (A) If a protected cell captive insurance company enters into a transaction with respect to a particular protected cell, or incurs a liability arising from an activity or asset of a particular protected cell, a claim by any person in connection with the transaction or liability extends only to the cell assets of the protected cell. (B) If a protected cell captive insurance company enters into a transaction ...

... If a protected cell captive insurance company is liable for any penalty, under this chapter or otherwise, due to an act or the failure to act of a protected cell or an officer or director of a protected cell, then both of the following apply: (A) The penalty shall only be met by the protected cell captive insurance company from the cell assets of the protected cell responsible. (B) The penalty shall not be ...

... The directors of a protected cell captive insurance company shall establish and maintain, or cause to be established and maintained, procedures to do all of the following: (A) Segregate cell assets and liabilities separate and separately identifiable from general assets and liabilities; (B) Segregate cell assets and liabilities of each protected cell separate and separately identifiable from cell assets and ...

... (A) If a protected cell captive insurance company enters into an agreement with respect to a protected cell of the protected cell captive insurance company, the directors shall ensure that both of the following are met: (1) The other party to the transaction knows, or ought reasonably to know, that the protected cell captive insurance company is acting with respect to a particular protected cell. (2) The mi...

... (A) A captive insurance company may amend its organizational document to become a protected cell captive insurance company. (B) The amendment of the organizational document of a captive insurance company to become a protected cell captive insurance company shall require approval by both of the following: (1) Holders of two-thirds of the outstanding shares or ownership interests of the captive insurance comp...

... (A) A protected cell of a protected cell captive insurance company may be transferred to another protected cell captive insurance company. (B) The protected cell captive insurance companies between which a protected cell is being transferred shall enter into a written agreement that sets forth the terms of the transfer. (C) A transfer of a protected cell shall be approved by the superintendent when all of t...

... (A) Any insurance company organized under Chapter 3925. of the Revised Code, and any captive insurance company that is not a protected cell captive insurance company, may become a protected cell of a protected cell captive insurance company, with the approval of the superintendent. (B)(1) A protected cell of a protected cell captive insurance company may apply to the superintendent to be incorporated as an i...

... (A) If a protected cell captive insurance company with one or more protected cells is being liquidated, the protected cell captive insurance company may be considered to have no assets and no liabilities only if the protected cell captive insurance company continues to have no protected cells. (B) In the course of liquidating a protected cell captive insurance company, each protected cell shall be dealt with...

... (A) As used in sections 3964.19 to 3964.194 of the Revised Code: (1) "Counterparty" means a special purpose financial captive insurance company's parent or an affiliated entity that is an insurer domiciled in this state that cedes life insurance risks to the special purpose financial captive insurance company pursuant to a special purpose financial captive insurance company contract. (2) "Insolvency" or "insolve...

... (A) Notwithstanding the provisions of sections 3903.01 to 3903.59 of the Revised Code, the superintendent may apply to the court of common pleas of Franklin county for an order authorizing the superintendent to rehabilitate or liquidate a special purpose financial captive insurance company domiciled in this state on one or both of the following grounds: (1) There has been embezzlement, wrongful sequestration...

... (A) Except as otherwise provided in this section, documents and information submitted by a company pursuant to sections 3964.19 to 3964.194 of the Revised Code are not subject to section 149.43 of the Revised Code, and are confidential, and may not be disclosed by the superintendent or any employee of the department of insurance without the written consent of the company. (B) Such documents and information ...

... (A) Notwithstanding any other section of the Revised Code, a counterparty may take credit for reinsurance ceded to a special purpose financial captive insurance company that is a subsidiary or affiliate of the counterparty, if assets valued using the basis of accounting applicable to the special purpose financial captive insurance company under division (E) of section 3964.03 of the Revised Code at least equal...

... A captive insurance company organized under the laws of another state or jurisdiction may become a domestic captive insurance company pursuant to section 3913.40 of the Revised Code after complying with all the requirements of this chapter relative to the organization and formation of a domestic captive insurance company.

... The superintendent may adopt rules in accordance with Chapter 119. of the Revised Code as are reasonably necessary for the implementation and operation of this chapter.

... As used in this chapter: (A) "Assuming insurer" has the same meaning as in section 3901.61 of the Revised Code. (B) "Authorized individual" means an individual authorized by the licensee to access nonpublic information held by the licensee and its information systems. (C) "Ceding insurer" has the same meaning as in section 3901.61 of the Revised Code. (D) "Consumer" means an individual who is a resident of ...

... (A) Each licensee shall develop, implement, and maintain a comprehensive written information security program based on the licensee's risk assessment. The program shall be commensurate with the size and complexity of the licensee, the nature and scope of the licensee's activities including its use of third-party service providers, and the sensitivity of the nonpublic information used by the licensee or in the licen...

... (A) If a licensee learns that a cybersecurity event has or may have occurred, the licensee or an outside vendor or service provider designated to act on behalf of the licensee shall conduct a prompt investigation. (B) During the investigation, the licensee or an outside vendor or service provider designated to act on behalf of the licensee shall, at a minimum, do as much of the following as possible: (1) Determ...