Ohio Rev. Code § 3901.62 — Ohio Revised Code / Title 39 / Chapter 3901 / § 3901.62
§ 3901.62. Credit for reinsurance ceded as asset or reduction of liability; accreditation as reinsurer
Status: in_force

March 24, 2021 Senate Bill 284 - 133rd General Assembly (A) Except as provided in sections 3901.63 and 3901.64 of the Revised Code, a domestic ceding insurer that is authorized to do any insurance business in this state may take credit for any reinsurance ceded as either an asset or a reduction of liability only if one of the following applies: (1) The reinsurance is ceded to an assuming insurer that is authorized to do any insurance or reinsurance business in this state. (2) The reinsurance is ceded to an assuming insurer that is accredited by the superintendent of insurance as a reinsurer in this state in accordance with division (B) of this section. (3) The reinsurance is ceded to an assuming insurer that is not authorized to do any insurance or reinsurance business in this state, provided the reinsurance is ceded to a reinsurance pool or other risk-sharing entity in which participation is required by law, rule, or regulation of the jurisdiction in which the pool or entity is located. (4) The reinsurance is ceded to an assuming insurer that maintains a trust fund in a qualified United States financial institution, as defined in section 3901.63 of the Revised Code, for the payment of the valid claims of its United States policyholders and ceding insurers, and their assigns and successors in interest in accordance with division (C) of this section. (5) The reinsurance is ceded to an assuming insurer that has been certified by the superintendent as a reinsurer in this state and that secures its obligations in accordance with division (D) of this section. (6) The reinsurance is ceded to an assuming insurer that meets all of the conditions set forth in division (E) of this section. (B)(1) In order to be eligible for accreditation under division (A)(2) of this section, the assuming insurer shall do all of the following: (a) File with the superintendent evidence of its submission to this state's jurisdiction; (b) Submit to this state's authority to examine its books and records; (c) Maintain a license to transact insurance or reinsurance in at least one state or, in the case of a United States branch of a foreign or alien assuming insurer, be entered through and licensed to transact insurance or reinsurance in at least one state; (d) File annually with the superintendent a copy of its annual statement filed with the insurance department of its state of domicile, and a copy of its most recent audited financial statement; (e) Demonstrate to the satisfaction of the superintendent that it has adequate financial capacity to meet its reinsurance obligations and is otherwise qualified to assume reinsurance from domestic insurers. (2) An assuming insurer is considered to meet the requirement of division (B)(1)(e) of this section as of the time of its application to the superintendent for accreditation if it maintains a surplus with regard to policyholders in an amount not less than twenty million dollars, and the superintendent has not denied its accreditation within ninety days after submission of its application. (C)(1) A trust maintained by an assuming insurer under division (A)(4) of this section shall meet the following requirements: (a) In the case of a single assuming insurer, the trust shall consist of a trusteed account representing the assuming insurer's liabilities attributable to business underwritten in the United States. A trusteed surplus of not less than twenty million dollars shall be maintained by the assuming insurer, except that at any time after the assuming insurer has permanently discontinued underwriting new business secured by the trust for at least three full years, the superintendent with principal regulatory oversight of the trust may authorize a reduction in the required trusteed surplus, but only after a finding, based on an assessment of the risk, that the new required surplus level is adequate for the protection of ceding insurers within the United States, policyholders, and claimants in light of reasonably foreseeable adverse loss development. The risk assessment may involve an actuarial review, including an independent analysis of reserves and cash flows, and shall consider all material risk factors, including when applicable the lines of business involved, the stability of the incurred loss estimates, and the effect of the surplus requirements on the assuming insurer's liquidity or solvency. The minimum required trusteed surplus shall not be reduced to an amount less than thirty per cent of the assuming insurer's liabilities attributable to reinsurance ceded by ceding insurers within the United States covered by the trust. (b) In the case of a group of assuming insurers, including incorporated and individual unincorporated underwriters, the trust shall consist of a trusteed account representing the group's liabilities attributable to business written in the United States. A trusteed surplus shall be maintained by the group, of which surplus one hundred million dollars shall be held jointly for the benefit of the United States ceding insurers of any member of the group. The following requirements apply to the group of assuming insurers: (i) The incorporated members of the group shall not engage in any business other than underwriting as a member of the group, and shall be subject to the same level of solvency regulation and control by the group's domiciliary regulator as are the unincorporated members. (ii) The group shall make available to the superintendent of insurance an annual certification of the solvency of each underwriter in the group. The certification shall be provided by the group's domiciliary regulator and its independent public accountants. (c) In the case of a group of incorporated insurers under common administration with aggregate policyholders' surplus of ten billion dollars that has continuously transacted an insurance business outside the United States for at least three years immediately prior to assuming reinsurance, the trust shall be in an amount equal to the group's several liabilities attributable to business ceded by United States ceding insurers to any member of the group pursuant to reinsurance contracts issued in the name of the group. A joint trusteed surplus shall be maintained by the group, of which surplus one hundred million dollars shall be held jointly for the benefit of United States ceding insurers of any member of the group as additional security for any such liabilities. The following requirements apply to the group of incorporated insurers: (i) The group shall comply with all filing requirements contained in this section. (ii) The books and records of the group shall be subject to examination by the superintendent in the same manner as the books and records of insurers are subject to examination by the superintendent in accordance with section 3901.07 of the Revised Code. The group shall bear the expenses of these examinations in the manner provided by that section. (iii) Each member of the group shall make available to the superintendent an annual certification of the member's solvency by the member's domiciliary regulator and an independent public accountant. (2) A trust maintained by an assuming insurer under division (A)(4) of this section shall remain in effect for as long as the assuming insurer has outstanding obligations due under the reinsurance agreements subject to the trust. The trust shall be in a form approved by the superintendent and shall include the following: (a) The trust instrument shall provide that contested claims are valid and enforceable upon the final order of any court of competent jurisdiction in the United States. (b) The trust shall vest legal title to its assets in the trustees of the trust for its United States policyholders and ceding insurers, and their assigns and successors in interest. (c) The trust, and the assuming insurer maintaining the trust, shall allow the superintendent to conduct examinations in the same manner as the superintendent conducts examinations of insurers under section 3901.07 of the Revised Code. (3) No later than the last day of February of each year, the trustees of a trust maintained by an assuming insurer under division (A)(4) of this section shall provide the superintendent with a written report setting forth the balance of the trust and listing the trust's investments as of the preceding thirty-first day of December. The trustees shall certify the date of the termination of the trust, if termination of the trust is planned, or shall certify that the trust does not expire prior to the following thirty-first day of December. (4) To enable the superintendent to determine the sufficiency of a trust maintained by an assuming insurer under division (A)(4) of this section, the assuming insurer shall annually report information on the trust to the superintendent that is substantially the same as that information licensed insurers are required to report under sections 3907.19 , 3909.06 , and 3929.30 of the Revised Code on forms adopted under section 3901.77 of the Revised Code. (D)(1) In order to be eligible for certification under division (A)(5) of this section, the assuming insurer shall do all of the following: (a) Be domiciled and licensed to transact insurance or reinsurance in a qualified jurisdiction as determined by the superintendent pursuant to division (D)(3) of this section; (b) Maintain minimum capital and surplus, or its equivalent, in an amount to be determined by the superintendent in rule or regulation; (c) Maintain financial strength ratings from two or more rating agencies that meet criteria the superintendent sets forth in rule or regulation; (d) Agree to submit to the jurisdiction of this state, appoint the superintendent as its agent for service of process in this state, and agree to provide security for one hundred per cent of the assuming insurer's liabilities attributable to reinsurance ceded by ceding insurers in the United States if it resists enforcement of a final judgment from the United States; (e) Agree to meet applicable information filing requirements as determined by the superintendent with respect to an initial application for certification and on an ongoing basis; (f) Satisfy any other requirements for certification considered relevant by the superintendent. (2) An association, including incorporated and individual unincorporated underwriters, may be a certified reinsurer. In order to be eligible for certification, an association, in addition to satisfying the requirements of division (D)(1) of this section, shall also meet the following requirements: (a) The association shall satisfy its minimum capital and surplus requirements through the capital and surplus equivalents (net of liabilities), or the net liabilities, of the association and its members which shall include a joint central fund that may be applied to any unsatisfied obligation of the association or any of its members, in an amount determined by the superintendent in order to provide adequate protection. (b) The incorporated members of the association shall not be engaged in any business other than underwriting as a member of the association, and shall be subject to the same level of regulation and solvency control by the association's domiciliary regulator as the unincorporated members. (c) The association shall provide the superintendent an annual certification by the association's domiciliary regulator of the solvency of each underwriter member within ninety days after its financial statements are due to be filed with the association's domiciliary regulator. If a certification is unavailable, the association shall provide the superintendent with financial statements prepared by independent public accountants of each underwriter member of the association. (3) The superintendent shall create and publish a list of qualified jurisdictions under which an assuming insurer licensed and domiciled in such jurisdiction is eligible to be considered by the superintendent for certification as a certified reinsurer. (a) The superintendent shall consider the list of qualified jurisdictions published through the national association of insurance commissioner's committee process in determining qualified jurisdictions. If the superintendent approves a jurisdiction as qualified that does not appear on the list, the superintendent shall provide justification in accordance with criteria to be developed by the superintendent under rule or regulation. (b) Jurisdictions within the United States that meet the requirement for accreditation under the national association of insurance commissioner's financial standards and accreditation program shall be recognized as qualified. (c) To determine if a domiciliary jurisdiction not located within the United States is eligible to be recognized as a qualified jurisdiction, the superintendent shall evaluate the appropriateness and effectiveness of the reinsurance supervisory system of the jurisdiction, both initially and on an ongoing basis, and consider the rights, benefits, and the extent of reciprocal recognition afforded by the jurisdiction to reinsurers licensed and domiciled in the United States. (d) A qualified jurisdiction shall agree to share information and cooperate with the superintendent with respect to all certified reinsurers domiciled within that jurisdiction. (e) A jurisdiction shall not be recognized as a qualified jurisdiction if the superintendent has determined that the jurisdiction does not adequately and promptly enforce final judgments and arbitration awards from the United States. (f) If a certified reinsurer's domiciliary jurisdiction ceases to be a qualified jurisdiction, the superintendent may revoke the reinsurer's certification or suspend the reinsurer's certification indefinitely. (g) The superintendent may consider additional factors as the superintendent considers appropriate. (4) The superintendent shall assign a rating to each certified reinsurer giving due consideration to the financial strength ratings assigned by rating agencies pursuant to division (D)(1)(c) of this section. The superintendent shall publish a list of all certified reinsurers and their ratings. (5) A certified reinsurer shall secure obligations assumed from a ceding insurer within the United States at a level consistent with its rating as specified by the superintendent in rule or regulation. (a) Except as otherwise provided in division (D)(5) of this section, a certified reinsurer shall maintain security in a form acceptable to the superintendent and consistent with section 3901.63 of the Revised Code, or in a multibeneficiary trust on behalf of the ceding insurer in accordance with division (A)(4) of this section, in order for a domestic ceding insurer to qualify for full financial statement credit for reinsurance ceded to a certified reinsurer. (b) If a certified reinsurer chooses to secure its obligations incurred as a certified reinsurer in the form of a multibeneficiary trust for the benefit of the ceding insurer, the certified reinsurer shall maintain separate trust accounts for its obligations incurred under reinsurance agreements issued or renewed as a certified reinsurer with reduced security as permitted by this division or comparable laws of other jurisdictions within the United States, and for its obligations subject to division (A)(4) of this section. (c) Upon termination of any such trust account described in division (A)(4) of this section, a certified reinsurer shall be bound by the language of the trust and agreement with the superintendent that has principal regulatory oversight of each trust account to fund any deficiency of any other trust account out of the remaining surplus of such trust as a condition to certification under division (D)(1) of this section. (d) The minimum trusteed surplus requirements provided in division (C) of this section are not applicable with respect to a multibeneficiary trust maintained by a certified reinsurer for the purpose of securing obligations incurred under division (A)(5) of this section, except that such trust shall maintain a minimum trusteed surplus of ten million dollars. (e) With respect to obligations incurred by a certified reinsurer under division (A)(5) of this section, if the security is insufficient, the superintendent shall reduce the allowable credit by an amount proportionate to the deficiency, and the superintendent may impose further reductions in allowable credit upon finding that there is a material risk that the certified reinsurer's obligations will not be paid in full when due. (f) Except as otherwise provided in division (D)(5) of this section, a reinsurer whose certification has been terminated for any reason shall be treated under this section as a certified reinsurer required to secure one hundred per cent of its obligations. The superintendent may continue to assign a higher rating to the reinsurer if the reinsurer is in inactive status or the reinsurer's certification has been suspended. As used in division (D)(5)(f) of this section, "terminated" means revocation, suspension, voluntary surrender, or inactive status. (6) If an applicant for certification has been certified as a reinsurer in a national association of insurance commissioners accredited jurisdiction, the superintendent may defer to that jurisdiction's certification and rating assignment, and the assuming insurer shall be considered to be a certified reinsurer in this state. (7) A certified reinsurer that ceases to assume new business in this state may request to maintain its certification in inactive status in order to continue to qualify for a reduction in security for its in-force business. An inactive certified reinsurer shall continue to comply with all applicable requirements of division (A)(5) of this section, and the superintendent shall assign a rating that takes into account, if relevant, the reasons why the reinsurer is not assuming new business. (E)(1)(a) The assuming insurer shall have its head office, or be domiciled in, as applicable, and be licensed in a reciprocal jurisdiction. (b)(i) The assuming insurer shall have and maintain, on an ongoing basis, minimum capital and surplus, or its equivalent, calculated according to the methodology of its domiciliary jurisdiction, in an amount to be set forth in rule adopted by the superintendent. (ii) If the assuming insurer is an association, including incorporated and individual unincorporated underwriters, it shall have and maintain, on an ongoing basis, minimum capital and surplus equivalents, net of liabilities, calculated according to the methodology applicable in its domiciliary jurisdiction, and a central fund containing a balance in amounts determined by the superintendent in rule or regulation. (c)(i) The assuming insurer shall have and maintain, on an ongoing basis, a minimum solvency or capital ratio, as applicable, that will be set forth in rule adopted by the superintendent. (ii) If the assuming insurer is an association, including incorporated and individual unincorporated underwriters, it shall have and maintain, on an ongoing basis, a minimum solvency or capital ratio in the reciprocal jurisdiction where the assuming insurer has its head office or is domiciled, as applicable, and is also licensed. (d) The assuming insurer shall agree and provide adequate assurance to the superintendent, in a form specified in rule adopted by the superintendent, as follows: (i) The assuming insurer shall provide prompt written notice and explanation to the superintendent if it falls below the minimum requirements set forth in division (E)(1)(b) or (c) of this section, or if any regulatory action is taken against it for serious noncompliance with applicable law. (ii) The assuming insurer shall consent in writing to the jurisdiction of the courts of this state and to the appointment of the superintendent as agent for service of process. The superintendent may require that consent for service of process be provided to the superintendent and included in each reinsurance agreement. Nothing in this provision shall be construed as limiting, or in any way altering, the capacity of parties to a reinsurance agreement to agree to alternative dispute resolution mechanisms, except to the extent such agreements are unenforceable under applicable insolvency or delinquency laws. (iii) The assuming insurer shall consent in writing to pay all final judgments, wherever enforcement is sought, obtained by a ceding insurer or its legal successor, that have been declared enforceable in the jurisdiction where the judgment was obtained. (iv) Each reinsurance agreement shall include a provision requiring the assuming insurer to provide security in an amount equal to one hundred per cent of the assuming insurer's liabilities attributable to reinsurance ceded pursuant to that agreement if the assuming insurer resists enforcement of a final judgment that is enforceable under the law of the jurisdiction in which it was obtained or a properly enforceable arbitration award, whether obtained by the ceding insurer or by its legal successor on behalf of its resolution estate. (v) The assuming insurer shall confirm that it is not presently participating in any solvent scheme of arrangement that involves this state's ceding insurers, and agree to notify the ceding insurer and the superintendent and to provide security in an amount equal to one hundred per cent of the assuming insurer's liabilities to the ceding insurer, should the assuming insurer enter into such a solvent scheme of arrangement. Such security shall be in a form consistent with the provisions of division (A)(5) of this section and section 3901.63 of the Revised Code and as specified by the superintendent in rule or regulation. (e) The assuming insurer or its legal successor shall provide, if requested by the superintendent, on behalf of itself and any legal predecessors, certain documentation to the superintendent, as specified in rule adopted by the superintendent. (f) The assuming insurer shall maintain a practice of prompt payment of claims under reinsurance agreements, pursuant to criteria set forth in rule adopted by the superintendent. (g) The assuming insurer's supervisory authority shall confirm to the superintendent on an annual basis, as of the preceding thirty-first day of December, or on the annual date that the assuming insurer is statutorily required to report to the reciprocal jurisdiction, that the assuming insurer complies with the requirements set forth in divisions (E)(1)(b) and (c) of this section. (h) Nothing in division (E) of this section precludes an assuming insurer from providing the superintendent with information on a voluntary basis. (2) The superintendent shall timely create and publish a list of reciprocal jurisdictions. (a) The superintendent's list shall include any reciprocal jurisdiction as defined under divisions (E)(8)(b)(i) and (ii) of this section, and shall consider any other reciprocal jurisdiction included on the list compiled by the national association of insurance commissioners. The superintendent may approve a jurisdiction that does not appear on the national association of insurance commissioners' list of reciprocal jurisdictions in accordance with criteria established rules or regulations issued by the superintendent. (b)(i) The superintendent may remove a jurisdiction from the list of reciprocal jurisdictions upon a determination that the jurisdiction no longer meets the requirements of a reciprocal jurisdiction, in accordance with a process set forth in rules or regulations issued by the superintendent, except that the superintendent shall not remove from the list a reciprocal jurisdiction as defined under division (E)(8)(b)(i) or (ii) of this section. (ii) Upon removal of a reciprocal jurisdiction from this list credit for reinsurance ceded to an assuming insurer that has its home office or is domiciled in that jurisdiction shall be allowed, if otherwise allowed pursuant to sections 3901.61 to 3901.65 of the Revised Code. (3)(a) The superintendent shall timely create and publish a list of assuming insurers that have satisfied the conditions set forth in division (E)(1) of this section and to which cessions shall be granted credit in accordance with this section. (b) The superintendent may add an assuming insurer to such list if a jurisdiction accredited by the national association of insurance commissioners has added such assuming insurer to a list of such assuming insurers or if, upon initial eligibility, the assuming insurer submits the information to the superintendent as required under division (E)(1)(d) of this section and complies with any additional requirements that the superintendent may impose by rule or regulation, except to the extent that they conflict with an applicable covered agreement. (4)(a) If the superintendent determines that an assuming insurer no longer meets one or more of the requirements prescribed in division (E)(1) of this section, the superintendent may revoke or suspend the eligibility of the assuming insurer for recognition under this section in accordance with rules adopted by the superintendent. (b) While an assuming insurer's eligibility is suspended, no reinsurance agreement issued, amended, or renewed after the effective date of the suspension qualifies for credit except to the extent that the assuming insurer's obligations under the contract are secured in accordance with section 3901.63 of the Revised Code. (c) If an assuming insurer's eligibility is revoked, no credit for reinsurance may be granted after the effective date of the revocation with respect to any reinsurance agreements entered into by the assuming insurer, including reinsurance agreements entered into prior to the date of revocation, except to the extent that the assuming insurer's obligations under the contract are secured in a form acceptable to the superintendent and consistent with the provisions of section 3901.63 of the Revised Code. (5) If subject to a legal process of rehabilitation, liquidation, or conservation, as applicable, the ceding insurer, or its representative, may seek and, if determined appropriate by the court in which the proceedings are pending, may obtain an order requiring that the assuming insurer post security for all outstanding ceded liabilities. (6) Nothing in division (E) of this section shall limit, or in any way alter, the capacity of parties to a reinsurance agreement to agree on requirements for security or other terms in that reinsurance agreement, except as expressly prohibited by sections 3901.61 to 3901.65 of the Revised Code or other applicable law, rule, or regulation. (7)(a) Credit may be taken under division (E) of this section only for reinsurance agreements entered into, amended, or renewed on or after the effective date of this amendment, and only with respect to losses incurred and reserves reported on or after the later of the following: (i) The date on which the assuming insurer has met all eligibility requirements pursuant to division (E)(1) of this section; (ii) The effective date of the new reinsurance agreement, amendment, or renewal. (b) Division (E)(7)(a) of this section does not alter or impair a ceding insurer's right to take credit for reinsurance, to the extent that credit is not available under division (E) of this section, as long as the reinsurance qualifies for credit under any other applicable provision of sections 3901.61 to 3901.65 of the Revised Code. (c) Nothing in division (E)(7) of this section shall be construed as authorizing an assuming insurer to withdraw or reduce the security provided under any reinsurance agreement, except as permitted by the terms of the agreement. (d) Nothing in division (E)(7) of this section shall limit, or in any way alter, the capacity of parties to any reinsurance agreement to renegotiate the agreement. (8) As used in division (E) of this section: (a) "Covered agreement" means an agreement entered into pursuant to the Dodd-Frank Wall Street Reform and Consumer Protection Act, 31 U.S.C. 313 and 314, that is currently in effect or in a period of provisional application and addresses the elimination, under specified conditions, of collateral requirements as a condition for entering into any reinsurance agreement with a ceding insurer domiciled in this state or for allowing the ceding insurer to recognize credit for reinsurance. (b) "Reciprocal jurisdiction" means a jurisdiction that meets one of the following: (i) A non-United States jurisdiciction that is subject to an in-force covered agreement with the United States, each within its legal authority, or, in the case of a covered agreement between the United States and the European Union, is a member state of the European Union; (ii) A United States jurisdiction that meets the requirements for accreditation under the national association of insurance commissioners' financial standards and accreditation program; (iii) A qualified jurisdiction, as determined by the superintendent pursuant to division (D)(3) of this section, that is not otherwise described in division (E)(8)(b)(i) or (ii) of this section, and that meets certain additional requirements, consistent with the terms and conditions of in-force covered agreements, as specified in rule adopted by the superintendent. (F) An assuming insurer shall file a written instrument appointing an attorney as its agent in this state upon whom all service of process may be served. Service of process upon this agent shall bring the assuming insurer within the jurisdiction of the courts of this state as if served upon an agent pursuant to section 3927.03 of the Revised Code. (G) Nothing in this section shall prohibit the parties to a reinsurance agreement from agreeing to provisions in the agreement establishing security requirements that exceed the minimum security requirements established for certified reinsurers under this section. (H)(1) In order to facilitate the prompt payment of claims, the superintendent may permit a certified reinsurer to defer the posting of security for catastrophe recoverables for a period of up to one year from the date of the first instance of a liability reserve entry by the ceding insurer as a result of a loss from a catastrophic occurrence. (2) Upon notice by the ceding insurer to the superintendent that the certified reinsurer has failed to pay claims owed under a reinsurance agreement in a timely manner, the superintendent shall notify the certified reinsurer that it is no longer permitted to defer the posting of security for catastrophe recoverables. (3) Reinsurance recoverables for only the following lines of business, as reported on the national association of insurance commissioners' annual financial statement related specifically to the catastrophic occurrence, shall be included in the deferral: (a) Fire; (b) Allied lines; (c) Farmowner's multiple peril; (d) Homeowners multiple peril; (e) Commercial multiple peril; (f) Inland marine; (g) Earthquake; (h) Auto physical damage. (4) The superintendent may adopt rules in accordance with Chapter 119. of the Revised Code to establish the process for a certified reinsurer to seek a deferral of posting of security for catastrophe recoverables.
Ohio Rev. Code § 3902.71 — Ohio Revised Code / Title 39 / Chapter 3902 / § 3902.71
§ 3902.71. Health plan issuer contracts with 340B program participants
Status: in_force

April 12, 2021 Senate Bill 263 - 133rd General Assembly (A) On and after the effective date of this section , a contract entered into between a health plan issuer, including a third-party administrator, and a 340B covered entity shall not contain any of the following provisions: (1) A reimbursement rate for a prescription drug that is less than the national average drug acquisition cost rate for that drug as determined by the United States centers for medicare and medicaid services, measured at the time the drug is administered or dispensed, or, if no such rate is available at that time, a reimbursement rate that is less than the wholesale acquisition cost of the drug, as defined in 42 U.S.C. 1395w-3a(c)(6)(B); (2) A dispensing fee reimbursement amount that is less than the reimbursement amount provided to a terminal distributor of dangerous drugs under section 5164.753 of the Revised Code; (3) A fee that is not imposed on a health care provider that is not a 340B covered entity; (4) A fee amount that exceeds the fee amount for a health care provider that is not a 340B covered entity. (B) No health plan issuer or third-party administrator making payments pursuant to a health benefit plan shall discriminate against a 340B covered entity in a manner that prevents or interferes with an enrollee's choice to receive a prescription drug from a 340B covered entity or its contracted pharmacies. (C) Any provision of a contract entered into between a health plan issuer and a 340B covered entity that is contrary to division (A) of this section is unenforceable and shall be replaced with the dispensing fee or reimbursement rate that applies for health care providers that are not 340B covered entities.
Ohio Rev. Code § 3905.472 — Ohio Revised Code / Title 39 / Chapter 3905 / § 3905.472
§ 3905.472. Qualified health benefit plans
Status: in_force

July 30, 2013 House Bill 3 - 130th General Assembly An exchange shall permit an insurer to offer any health benefit plan that the insurer seeks to offer through the exchange, so long as the health benefit plan in question is a qualified health plan under the Affordable Care Act, as approved by the superintendent of insurance. Nothing in this section shall be construed to allow the superintendent of insurance to impose any additional state certification requirements in order to be a qualified health plan.
Ohio Rev. Code § 3938.01 — Ohio Revised Code / Title 39 / Chapter 3938 / § 3938.01
§ 3938.01. Definitions
Status: in_force

March 23, 2016 House Bill 259 - 131st General Assembly (A) This chapter may be cited as the "Certificates of Insurance Act." (B) As used in this chapter: (1) "Certificate of insurance" means a document or instrument, regardless of how titled or described, that is prepared or issued by an insurer or insurance agent licensed under Chapter 3905. of the Revised Code to verify the existence of property or casualty insurance coverage. "Certificate of insurance" includes a document issued to a person as verification of the existence of coverage under a master policy. "Certificate of insurance" does not include a policy of insurance, insurance binder, policy endorsement, or automobile identification card, or any document used to provide proof of financial responsibility for purposes of Chapter 4509. of the Revised Code. (2) "Certificate holder" means any person, other than a policyholder, that requests, obtains, or possesses a certificate of insurance. (3) "Person" has the same meaning as in section 1.59 of the Revised Code and includes a limited liability company, the state, and all political subdivisions, authorities, agencies, boards, and commissions of the state.
Ohio Rev. Code § 3901.82 — Ohio Revised Code / Title 39 / Chapter 3901 / § 3901.82
§ 3901.82. Restatement of the Law, Liability Insurance
Status: in_force

October 29, 2018 Senate Bill 239 - 132nd General Assembly The "Restatement of the Law, Liability Insurance" that was approved at the 2018 annual meeting of the American law institute does not constitute the public policy of this state and is not an appropriate subject of notice.
Ohio Rev. Code § 3999.02 — Ohio Revised Code / Title 39 / Chapter 3999 / § 3999.02
§ 3999.02. False statement by medical examiner of insurance company
Status: in_force

October 1, 1953 House Bill 1 - 100th General Assembly No medical examiner for a life insurance company or for an applicant for insurance therein shall knowingly make a false statement or report to such company or to an officer thereof concerning the health or physical condition of an applicant for insurance, or other matter or thing affecting the granting of such insurance.
Ohio Rev. Code § 3964.19 — Ohio Revised Code / Title 39 / Chapter 3964 / § 3964.19
§ 3964.19. Contracts of assumption of risk or indemnification; permissible commercial activities
Status: in_force

January 1, 2021 House Bill 339 - 133rd General Assembly (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 "insolvent" means that the special purpose financial captive insurance company is unable to pay its obligations when they are due, unless those obligations are the subject of a bona fide dispute. (3) "Insurance securitization" means a package of related risk transfer instruments, capital market offerings, and facilitating administrative agreements, for which a special purpose financial captive insurance company obtains proceeds, either directly or indirectly, through the issuance of securities, where the investment risk to the holders of the securities is contingent upon the obligations of the special purpose financial captive insurance company to the counterparty under the special purpose financial captive insurance company contract, in accordance with the transaction terms, and pursuant to this section. This includes situations where the securitization proceeds are held in trust to secure the obligations of the special purpose financial captive insurance company under one or more special purpose financial captive insurance company contracts. (4) "Organizational document" means the special purpose financial captive insurance company's articles of incorporation, bylaws, code of regulations, operating agreement, or other foundational documents that establish the special purpose financial captive insurance company as a legal entity. (5) "Securities" means debt obligations, equity investments, surplus certificates, surplus notes, funding agreements, derivatives, and other legal forms of financial instruments. (6) "Special purpose financial captive insurance company contract" means a contract between a special purpose financial captive insurance company and a counterparty pursuant to which the special purpose financial captive insurance company agrees to provide insurance or reinsurance protection to the counterparty for risks associated with the counterparty's insurance or reinsurance business, and includes a contract entered into under division (F) of this section. (7) "Special purpose financial captive insurance company securities" means the securities issued by a special purpose financial captive insurance company. (B) The requirements of this section shall not apply to a specific special purpose financial captive insurance company if the superintendent finds a specific requirement is inappropriate due to the nature of the risks to be insured by the special purpose financial captive insurance company and if the special purpose financial captive insurance company meets the criteria established by rules and regulations adopted and promulgated by the superintendent. (C)(1) A special purpose financial captive insurance company may not issue a contract for assumption of risk or indemnification of loss other than a special purpose financial captive insurance company contract. However, the special purpose financial captive insurance company may cede a risk assumed through a special purpose financial captive insurance company contract to a third-party reinsurer through the purchase of reinsurance or retrocession protection if approved by the superintendent. (2) A special purpose financial captive insurance company may enter into contracts and conduct other commercial activities related or incidental to and necessary to fulfill the purposes of special purpose financial captive insurance company contracts, insurance securitization, and this section. Those activities may include: (a) Entering into special purpose financial captive insurance company contracts; (b) Issuing securities of the special purpose financial captive insurance company in accordance with applicable securities law; (c) Complying with the terms of special purpose financial captive insurance company contracts or securities; (d) Entering into trust, swap, tax, administration, reimbursement, or fiscal agent transactions; (e) Complying with trust indenture, reinsurance, retrocession, and other agreements necessary or incidental to effectuate an insurance securitization in compliance with this section and in the plan of operation considered by the superintendent under division (F)(5) of section 3964.03 of the Revised Code. (D)(1) A special purpose financial captive insurance company may issue securities, subject to and in accordance with applicable law, its plan of operation considered by the superintendent under division (E) of section 3964.03 of the Revised Code, and its organizational documents. (2) A special purpose financial captive insurance company, in connection with the issuance of securities, may enter into and perform all of its obligations under any required contracts to facilitate the issuance of these securities. (3) The obligation to repay principal or interest, or both, on the securities issued by the special purpose financial captive insurance company shall reflect the risk associated with the obligations of the special purpose financial captive insurance company to the counterparty under the special purpose financial captive insurance company contract. (E)(1)(a) A special purpose financial captive insurance company may enter into the following types of transactions for the purposes described in division (E)(1)(b) of this section: (i) Asset management agreements, including swap agreements; (ii) Guaranteed investment contracts; (iii) Other transactions with the objective of reducing timing differences in the funding of upfront, or ongoing, transaction expenses, or managing asset, credit, prepayment, or interest rate risk of the investments of the special purpose financial captive insurance company. (b) The purpose of the transactions described in division (E)(1)(a) of this section shall be any of the following: (i) To ensure that the investments are sufficient to assure payment or repayment of the securities, and related interest or principal payments, issued pursuant to a special purpose financial captive insurance company insurance securitization transaction; (ii) To ensure that the investments are sufficient to assure payment or repayment of the obligations required under a special purpose financial captive insurance company contract; (iii) Any other purpose approved by the superintendent. (2) An asset management agreement shall not be entered into under this section by a special purpose financial captive insurance company unless it has been approved by the superintendent. (F)(1) If a special purpose financial captive insurance company has entered into a special purpose financial captive insurance company contract with a counterparty and the special purpose financial captive insurance company has conducted an insurance securitization that is made up, in part or in whole, of the risks of that contract, then the special purpose financial captive insurance company may enter into a second contract with the counterparty under which the counterparty is held liable for those losses or other obligations that were securitized. (2) Such obligations may be funded and secured with assets held in trust for the benefit of the counterparty pursuant to agreements contemplated by this section and invested in a manner that meet the criteria in sections 3907.14 and 3907.141 of the Revised Code. (G)(1) A special purpose financial captive insurance company may enter into agreements with affiliated companies and third parties and conduct business necessary to fulfill its obligations and administrative duties incidental to an insurance securitization and a special purpose financial captive insurance company contract entered into under division (F) of this section. (2) The agreements may include management and administrative services agreements and other allocation and cost sharing agreements, or swap and asset management agreements, or both, or agreements for other contemplated types of transactions provided in this section. (H) A special purpose financial captive insurance company contract entered into under division (F) of this section shall contain all of the following: (1) A requirement that the special purpose financial captive insurance company do either of the following: (a) Enter into a trust agreement specifying what recoverables or reserves, or both, the agreement is to cover and to establish a trust account for the benefit of the counterparty and the security holders; (b) Establish such other methods of security acceptable to the superintendent. (2) A stipulation that assets deposited in the trust account shall be valued in accordance with their current fair-market value and shall consist only of investments permitted by sections 3907.14 and 3907.141 of the Revised Code; (3) A requirement that, if a trust arrangement is used, the special purpose financial captive insurance company, before depositing assets with the trustee, execute assignments, execute endorsements in blank, or take such actions as are necessary to transfer legal title to the trustee of all assets requiring assignment, in order that the counterparty, or the trustee upon the direction of the counterparty, may negotiate whenever necessary the assets without consent or signature from the special purpose financial captive insurance company or another entity; (4) A stipulation that, if a trust arrangement is used, the special purpose financial captive insurance company and the counterparty agree that the assets in the trust account established pursuant to the contract: (a) May be withdrawn by the counterparty, or the trustee on its behalf, at any time, but only in accordance with the terms of the contract; (b) Shall be utilized and applied by the counterparty, without diminution because of insolvency on the part of the counterparty or the special purpose financial captive insurance company, only for the purposes set forth in the credit for reinsurance laws and rules of this state. As used in this division, "counterparty" includes any successor of the counterparty by operation of law, including, subject to the provisions of this section, but without further limitation, any liquidator, rehabilitator, or receiver of the counterparty. (I) A special purpose financial captive insurance company contract entered into under division (F) of this section may contain provisions that give the special purpose financial captive insurance company the right to seek approval from the counterparty to withdraw from the trust all or part of the assets, or income from them, contained in the trust and to transfer the assets to the special purpose financial captive insurance company if such provisions comply with the credit for reinsurance laws and rules of this state. (J)(1) A special purpose financial captive insurance company contract entered into under division (F) of this section, meeting the requirements of this section, shall be granted credit for reinsurance treatment or otherwise qualify as an asset or a reduction from liability for reinsurance ceded by a domestic insurer to a special purpose financial captive insurance company as an assuming insurer for the benefit of the counterparty if both of the following apply: (a) The assets are held or invested in one or more of the forms allowed in sections 3907.14 and 3907.141 of the Revised Code. (b) The agreement is in compliance with section 3901.64 of the Revised Code. (2) The contract shall be granted credit or otherwise qualify as an asset or reduction from liability only to the extent of the value of the assets held in trust for, or letters of credit, that meet the requirements set forth in division (C) of section 3964.05 of the Revised Code, or as approved by the superintendent, for the benefit of the counterparty under the special purpose financial captive insurance company contract. (K) A special purpose financial captive insurance company may make investments that meet the qualifications set forth in sections 3907.14 and 3907.141 of the Revised Code, however these investments shall not be subject to any limitations contained in such sections as to invested amounts. The superintendent may prohibit or limit any investment that threatens the solvency or liquidity of a special purpose financial captive insurance company or that is not made in accordance with the approved plan of operation.
Ohio Rev. Code § 3959.08 — Ohio Revised Code / Title 39 / Chapter 3959 / § 3959.08
§ 3959.08. Denying application for license
Status: in_force

December 2, 1996 House Bill 670 - 121st General Assembly 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.
Ohio Rev. Code § 3901.075 — Ohio Revised Code / Title 39 / Chapter 3901 / § 3901.075
§ 3901.075. Documents deemed proprietary
Status: in_force

April 6, 2017 Senate Bill 273 - 131st General Assembly (A) Documents, materials, or other information, including the corporate governance annual disclosure, in the possession or control of the department of insurance that are obtained by, created by, or disclosed to the superintendent or any other person under sections 3901.072 to 3901.078 of the Revised Code are recognized by this state as being proprietary and to contain trade secrets. (B) The documents, materials, or other information described in division (A) of this section shall be confidential by law and privileged and shall not be admissible into evidence in any private civil action or subject to section 149.43 of the Revised Code, subpoena, or discovery. (C)(1) Notwithstanding division (B) of this section, the superintendent may use the documents, materials, or other information described in division (A) of this section in furtherance of any regulatory or legal action brought as part of the superintendent's official duties. (2) The superintendent shall not otherwise make the documents, materials, or other information public without the prior written consent of the insurer. (3) Nothing in division (B) or (C) of this section shall be construed to require the written consent of the insurer before the superintendent shares or receives confidential documents, materials, or other CGAD-related information pursuant to division (E) of this section to assist in the performance of the superintendent's regulatory duties. (D) Neither the superintendent nor any person who receives documents, materials, or other CGAD -related information, through examination or otherwise, while acting under the authority of the superintendent or with whom such documents, materials, or other information are shared pursuant to sections 3901. 072 to 3901.078 of the Revised Code shall be permitted or required to testify in any private civil action concerning any confidential documents, materials, or information described in division (A) of this section. (E)(1) In order to assist in the performance of the superintendent's regulatory duties, the superintendent may do either of the following: (a) Upon request, share documents, materials, or other CGAD -related information, including confidential and privileged documents, materials, or information subject to division (A) of this section, and proprietary and trade secret documents, with other state, federal, and international financial regulatory agencies, members of any supervisory college as described in section 3901.351 of the Revised Code, the NAIC, or any third- party consultant pursuant to section 3901.076 of the Revised Code; (b) Receive documents, materials, or other CGAD -related information, including confidential and privileged documents, materials, or information subject to division (A) of this section, and proprietary and trade secret documents, from regulatory officials or other foreign or domestic jurisdictions, including members of any supervisory college as described in section 3901.351 of the Revised Code, and from the NAIC. (2) The recipient of any information pursuant to division (E)(1)(a) of this section shall agree in writing to maintain the confidentiality and privileged status of the documents, materials, or other information and verify in writing their legal authority to maintain confidentiality. If the superintendent receives any information pursuant to division (E) (1)(b) of this section, the superintendent shall maintain as confidential or privileged any documents, materials, or information received with notice or the understanding that it is confidential or privileged under the laws of the jurisdiction that is the source of the document, material, or information. (F) The sharing of information, materials, and documents by the superintendent pursuant to sections 3901.072 to 3901.078 of the Revised Code shall not constitute a delegation of regulatory or rule-making authority, and the superintendent is solely responsible for the administration, execution, and enforcement of sections 3901.072 to 3901.078 of the Revised Code. (G) No waiver of any applicable privilege or claim of confidentiality in the document, proprietary and trade-secret materials, or other CGAD -related information shall occur as a result of disclosure of such CGAD -related information, materials, or documents to the superintendent as a result of sharing authorized in sections 3901.072 to 3901.078 of the Revised Code.
Ohio Rev. Code § 3951.06 — Ohio Revised Code / Title 39 / Chapter 3951 / § 3951.06
§ 3951.06. Fee - renewal of certificate - supplemental certificate
Status: in_force

January 1, 2021 House Bill 339 - 133rd General Assembly (A) A fee of one hundred dollars shall be paid to the superintendent by the applicant for a public insurance adjuster's certificate of authority before the initial application is granted. If the applicant is a firm, association, partnership, or corporation, the fee shall be paid for each person specified in the application. (B) A firm, association, partnership, or corporation to which a certificate of authority has been issued by the superintendent may at any time make an application to the superintendent for the issuance of a supplemental certificate of authority authorizing additional officers or directors of the corporation or members of the firm, association, or partnership to act as a public insurance adjuster, and the superintendent may thereupon issue to such firm, association, partnership, or corporation a supplemental certificate accordingly upon the payment of a fee of fifty dollars for each member or officer or director thereby authorized to act as a public insurance adjuster. (C) Every public insurance adjuster's certificate of authority shall expire on the thirty-first day of December of the calendar year in which it was issued, and shall be renewed according to the standard renewal procedure of sections 4745.01 to 4745.03 of the Revised Code. Every public insurance adjuster's certificate of authority with a payment of a fifty-dollar fee can be renewed for the ensuing year without examination, but if an application for the renewal of such certificate has been filed with the superintendent before January first of any year the certificate of authority sought to be renewed shall continue in full force and effect until the issuance by the superintendent of the new certificate applied for or until five days after the superintendent has refused to issue a new certificate and has served notice of such refusal on the applicant therefor. Service of such notice shall be made by registered or certified mail directed to the applicant at the place of business specified in the application. (D) No certificate of authority shall be issued or renewed unless, the applicant is a resident of the state, a lending institution, a bona fide employee of a lending institution who is authorized to act as a public insurance adjuster in another state on behalf of the lending institution, or a nonresident that is licensed as a public insurance adjuster and is in good standing in the applicant's home state, and there is on file with the superintendent a bond, executed by such applicant and by approved sureties, in the penal sum of one thousand dollars for each person designated in the application, conditioned for the faithful performance by such applicant and by all persons designated in such application, of their duties as public insurance adjusters. Such bond shall be approved as to form by the attorney general and as to sufficiency by the superintendent. Such bond shall be made payable to the state and shall specifically authorize recovery for and on behalf of an injured party of the sum provided therein in case the adjuster has been guilty of fraudulent or dishonest practices in connection with the transaction of business as an adjuster.
Ohio Rev. Code § 3904.13 — Ohio Revised Code / Title 39 / Chapter 3904 / § 3904.13
§ 3904.13. Disclosure of personal or privileged information
Status: in_force

July 1, 2021 Senate Bill 9 - 133rd General Assembly No insurance institution, agent, or insurance support organization shall disclose any personal or privileged information about an individual collected or received in connection with an insurance transaction, unless the disclosure is made pursuant to any of the following: (A) With the written authorization of the individual, provided: (1) If such authorization is submitted by another insurance institution, agent, or insurance support organization, the authorization meets the requirements of section 3904.06 of the Revised Code; (2) If such authorization is submitted by a person other than an insurance institution, agent, or insurance support organization, the authorization is dated, signed by the individual, and obtained one year or less prior to the date a disclosure is sought under this division. (B) To a person other than an insurance institution, agent, or insurance support organization, provided such disclosure is reasonably necessary for the following reasons: (1) To enable such person to perform a business, professional, or insurance function for the disclosing insurance institution, agent, or insurance support organization, and such person agrees not to disclose the information further without the individual's written authorization unless the further disclosure either: (a) Would otherwise be permitted by this section if made by an insurance institution, agent, or insurance support organization; (b) Is reasonably necessary for such person to perform the person's function for the disclosing insurance institution, agent, or insurance support organization. (2) To enable such person to provide information to the disclosing insurance institution, agent, or insurance support organization for the purpose of either: (a) Determining an individual's eligibility for an insurance benefit or payment; (b) Detecting or preventing criminal activity, fraud, material misrepresentation, or material nondisclosure in connection with an insurance transaction. (C) To an insurance institution, agent, insurance support organization, or self-insurer, provided the information disclosed is limited to that which is reasonably necessary either: (1) To detect or prevent criminal activity, fraud, material misrepresentation, or material nondisclosure in connection with insurance transactions; (2) For either the disclosing or receiving insurance institution, agent, or insurance support organization to perform its function in connection with an insurance transaction involving the individual. (D) To a medical care institution or medical professional for the purpose of verifying insurance coverage or benefits, informing an individual of a medical problem of which the individual may not be aware, or conducting an operations or services audit to verify the individuals treated by the medical professional or at the medical care institution. However, only such information may be disclosed as is reasonably necessary to accomplish any of the purposes set forth in this division. (E) To an insurance regulatory authority; (F) To a law enforcement or other governmental authority to protect the interests of the insurance institution, agent, or insurance support organization in preventing or prosecuting the perpetration of fraud upon it; or if the insurance institution, agent or insurance support organization reasonably believes that illegal activities have been conducted by the individual; (G) As otherwise permitted or required by law; (H) In response to a facially valid administrative or judicial order, including a search warrant or subpoena; (I) Made for the purpose of conducting actuarial or research studies, provided the following conditions are met: (1) No individual may be identified in any actuarial or research report; (2) Materials allowing the individual to be identified are returned or destroyed as soon as they are no longer needed; (3) The actuarial or research organization agrees not to disclose the information unless the disclosure would otherwise be permitted by this section if made by an insurance institution, agent, or insurance support organization. (J) To a party or representative of a party to a proposed or consummated sale, transfer, merger, or consolidation of all or part of the business of the insurance institution, agent, or insurance support organization, provided the following conditions are met: (1) Prior to the consummation of the sale, transfer, merger, or consolidation, only such information is disclosed as is reasonably necessary to enable the recipient to make business decisions about the purchase, transfer, merger, or consolidation; (2) The recipient agrees not to disclose the information, unless the disclosure would otherwise be permitted by this section if made by an insurance institution, agent, or insurance support organization. (K) To a person whose only use of such information will be in connection with the marketing of a product or service, provided the following conditions are met: (1) No medical record information, privileged information, or personal information relating to an individual's character, personal habits, mode of living, or general reputation is disclosed, and no classification derived from such information is disclosed; (2) The individual has been given an opportunity to indicate that the individual does not want personal information disclosed for marketing purposes and has given no indication that the individual does not want the information disclosed; (3) The person receiving such information agrees not to use it except in connection with the marketing of a product or service. (L) To an affiliate whose only use of the information will be in connection with an audit of the insurance institution or agent or the marketing of an insurance product or service, provided the affiliate agrees not to disclose the information for any other purpose or to unaffiliated persons; (M) By a consumer reporting agency, provided the disclosure is to a person other than an insurance institution or agent; (N) To a group policyholder for the purpose of reporting claims experience or conducting an audit of the insurance institution's or agent's operations or services, provided the information disclosed is reasonably necessary for the group policyholder to conduct the review or audit; (O) To a group policyholder as provided in section 3901.89 of the Revised Code; (P) To a professional peer review organization for the purpose of reviewing the service or conduct of a medical care institution or medical professional; (Q) To a governmental authority for the purpose of determining the individual's eligibility for health benefits for which the governmental authority may be liable; (R) To a certificate holder or policyholder for the purpose of providing information regarding the status of an insurance transaction; (S) To a lienholder, mortgagee, assignee, lessor, or other person shown on the records of an insurance institution or agent as having a legal or beneficial interest in a policy of insurance, provided the following conditions are met: (1) No medical record information is disclosed unless the disclosure would otherwise be permitted by this section; (2) The information disclosed is limited to that which is reasonably necessary to permit such person to protect its interests in such policy.
Ohio Rev. Code § 3901.87 — Ohio Revised Code / Title 39 / Chapter 3901 / § 3901.87
§ 3901.87. No coverage for nontherapeutic abortion
Status: in_force

January 1, 2021 House Bill 339 - 133rd General Assembly (A) No qualified health plan shall provide coverage for a nontherapeutic abortion. (B) As used in this section: (1) "Nontherapeutic abortion" has the same meaning as in section 9.04 of the Revised Code. (2) "Qualified health plan" means any qualified health plan as defined in section 1301 of the "Patient Protection and Affordable Care Act," 42 U.S.C. 18021, offered in this state through an exchange created under that act.
Ohio Rev. Code § 3939.07 — Ohio Revised Code / Title 39 / Chapter 3939 / § 3939.07
§ 3939.07. Information filed with superintendent of insurance
Status: in_force

October 12, 2006 House Bill 442 - 126th General Assembly Before granting insurance, an association organized under section 3939.01 of the Revised Code shall file with the superintendent of insurance a copy of its articles of incorporation, certified by the secretary of state, a copy of its constitution adopted under section 3939.06 of the Revised Code, and forms of certificates of membership or insurance. If the superintendent finds that the association was properly organized and has complied with the law, the superintendent shall issue to it a certificate reciting that compliance. The certificate shall be the authority of the association to commence business and grant insurance.
Ohio Rev. Code § 3911.20 — Ohio Revised Code / Title 39 / Chapter 3911 / § 3911.20
§ 3911.20. Prohibition against rebates and special favors - bonuses and industrial insurance excepted
Status: in_force

August 11, 1959 Senate Bill 64 - 103rd General Assembly No life insurance company doing business in this state, whether on the group insurance or any other plan, shall make or permit any distinction or discrimination in favor of individuals between insured persons of the same class and equal expectation of life in the amount or payment of premiums, or in rates charged for policies of insurance, or in the dividends or other benefits payable thereon, or in any other of the terms and conditions of the contracts it makes. No such company, or any agent thereof, shall make any contract of insurance or agreement as to such contract, other than as plainly expressed in the policy issued thereon. No life insurance company doing business in this state, or any officer, agent, employee, or representative thereof, nor any other person, shall pay, allow, or give, or offer to pay, allow, or give, directly or indirectly, as an inducement to insurance, nor shall any person, partnership or corporation knowingly receive as such inducement to insurance, any rebate of premium payable on the policy or any special favor or advantage in the dividends or other benefits to accrue thereon, or any special advantage in the date of a policy or date of the issue thereof, or any valuable consideration or inducement. Nor shall such company or person give, receive, sell, or purchase, or offer to give, receive, sell, or purchase, as inducements to insurance or in connection therewith, any stocks, bonds, or other obligations or securities of any insurance company or other corporation, association, partnership, or individual, or any dividends or profits to accrue thereon, 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 granting of a loan, that the applicant or borrower or any other person, either directly or indirectly, acquire a policy of life or accident and health insurance from any particular company, agent, or person. No person shall receive or accept from any company, agent, subagent, or any other person any such rebate of premium payable on the policy, or any special favor or advantage in the dividend or other benefits to accrue thereon, or any valuable consideration or inducement not specified in the policy of insurance. No person shall be excused from testifying or from producing any books, papers, contracts, agreements, or documents at the trial of any other person charged with violation of this section, upon the ground that such testimony or evidence may tend to incriminate, but no person shall be prosecuted or subjected to any penalty or forfeiture on account of any transaction, matter, or thing concerning which he so testifies or produces evidence, and no testimony so given or produced shall be received against him upon any criminal investigation or proceeding involving rebates or violation of insurance laws. This section does not prohibit any company issuing nonparticipating life insurance from paying bonuses to policyholders or otherwise abating their premiums out of surplus accumulated from nonparticipating insurance; nor does it prohibit any company which transacts industrial insurance on the weekly payment plan from returning to policyholders, who have made premium payments for a period of at least one year directly to the company at its home or district offices, a percentage of the premium which the company would have paid for the weekly collection of such payments. In so far as it is adaptable to the conduct of such business, this section is also applicable to the sale and purchase of annuities by and from life insurance companies.
Ohio Rev. Code § 3933.02 — Ohio Revised Code / Title 39 / Chapter 3933 / § 3933.02
§ 3933.02. Testimony required - immunity
Status: in_force

October 1, 1953 House Bill 1 - 100th General Assembly No person shall be excused from attending, testifying, or producing any books, papers, or other documents before any court or magistrate having jurisdiction, upon any investigation, proceeding, or trial for a violation of any of sections 3933.01 to 3933.03 , inclusive, of the Revised Code, upon the ground that the testimony of evidence, documentary or otherwise, required of him may tend to incriminate or degrade him. No person shall be prosecuted or subject to any penalty or forfeiture on account of any transaction, matter, or thing concerning which he may so testify or produce evidence, documentary or otherwise, except for perjury committed in so testifying.
Ohio Rev. Code § 3905.332 — Ohio Revised Code / Title 39 / Chapter 3905 / § 3905.332
§ 3905.332. Designation as domestic surplus lines insurer
Status: in_force

March 20, 2019 Senate Bill 273 - 132nd General Assembly (A) Notwithstanding any other provision of the Revised Code, a domestic insurer may be designated a domestic surplus lines insurer pursuant to this section. (B) A domestic insurer shall not be designated a domestic surplus lines insurer unless all of the following are met: (1) The domestic insurer possesses minimum capital and surplus of at least fifteen million dollars. (2) The domestic insurer is seeking to become a domestic surplus lines insurer pursuant to a resolution adopted by its board of directors. (3) The superintendent of insurance has authorized the designation of the insurer as a domestic surplus lines insurer in writing. (C) A domestic surplus lines insurer shall be considered an unauthorized insurer for the purposes of writing surplus lines insurance coverage pursuant to the requirements of this chapter. (D)(1) A domestic surplus lines insurer shall only write surplus lines insurance in this state in accordance with the requirements of this chapter. (2) A domestic surplus lines insurer may write surplus lines insurance in any other jurisdiction in which the insurer is eligible to write surplus lines insurance, provided that the domestic surplus lines insurer complies with any requirements of that jurisdiction. (E) A domestic surplus lines insurer shall not engage in the business of insurance in this state on an admitted basis. (F) Surplus lines insurance written by a domestic surplus lines insurer is subject to the tax on premiums as required in section 3905.36 of the Revised Code and is exempt from the tax on premiums required in section 5725.18 of the Revised Code. (G) A domestic surplus lines insurer shall be considered a nonadmitted insurer as defined in 15 U.S.C. 8206 with respect to surplus lines insurance issued in this state. (H) Surplus lines insurance policies issued in this state by a domestic surplus lines insurer are not subject to the provisions of Chapter 3955. of the Revised Code nor are they subject to the protection of either Ohio insurance guaranty association account established pursuant to section 3955.06 of the Revised Code. (I) Surplus lines insurance policies issued in this state by a domestic surplus lines insurer are not subject to and are exempt, in the same manner and to the same extent as surplus lines insurance policies issued by an insurer domiciled in another state, from all statutory requirements relating to all of the following: (1) Insurance rating and rating plans; (2) Policy forms; (3) Policy cancellation and renewal. (J) Unless otherwise specified in this section or specifically exempted under this chapter, a domestic surplus lines insurer shall be subject to all financial, reserve, and solvency requirements under this title that are imposed on domestic admitted insurers, as applicable.
Ohio Rev. Code § 3902.31 — Ohio Revised Code / Title 39 / Chapter 3902 / § 3902.31
§ 3902.31. Void contracts
Status: in_force

October 17, 2019 House Bill 166 - 133rd General Assembly (A) As used in this section: (1) "Pay in full" means paying for a health service in its entirety without cost-sharing on the part of a third-party payer. "Pay in full" includes payment made under a deductible requirement. (2) "Third-party payer" and "provider" have the same meanings as in section 3901.38 of the Revised Code. (B)(1) Subject to division (C) of this section, a provision in a contract entered into between a third-party payer and a provider is void and against public policy if it does either of the following: (a) Establishes a minimum amount that the provider is required to charge an individual for a health service when that individual pays in full for the service; (b) Prohibits a provider from advertising the provider's rates for a service. (2) Division (B)(1)(b) of this section shall not be construed as prohibiting a provision in a contract between a provider and a third-party payer that prohibits a provider from disclosing or advertising contractually agreed upon reimbursement rates for providers. (C)(1) This section shall apply to all new contracts between a third-party payer and a provider entered into on or after the effective date of this section. (2) For existing contracts, this section shall apply on the earlier of either of the following: (a) Three years after the effective date of this section; (b) The expiration date of the contract or renewal of the contract.
Ohio Rev. Code § 3921.11 — Ohio Revised Code / Title 39 / Chapter 3921 / § 3921.11
§ 3921.11. Amendment of laws
Status: in_force

January 1, 1997 House Bill 468 - 121st General Assembly (A) A domestic fraternal benefit society may amend its laws in accordance with the provisions of its laws by action of its supreme governing body at any regular or special meeting of that body or, if its laws so provide, by referendum. A referendum may be held in accordance with the provisions of its laws by the vote of the voting members of the society, by the vote of delegates or representatives of voting members, or by the vote of local lodges. A society may provide for voting by mail. No amendment submitted for adoption by referendum shall be adopted unless, within six months after the date of submission, a majority of the members voting have signified their consent to the amendment by one of the methods specified in this section. (B) No amendment to the laws of any domestic society shall take effect unless approved by the superintendent of insurance, who shall approve the amendment if the superintendent finds that it has been duly adopted and is not inconsistent with any requirement of the laws of this state or with the character, objects, and purposes of the society. Unless the superintendent disapproves an amendment within sixty days after its filing, the amendment shall be considered to be approved. The approval or disapproval of the superintendent shall be in writing and shall be mailed to the secretary or corresponding officer of the society at its principal office. If the superintendent disapproves the amendment, the reasons for the disapproval shall be stated in the written notice. (C) Within ninety days after an amendment is approved by the superintendent, the amendment or a synopsis of the amendment shall be furnished to all members of the society either by mail or by publication in full in the official publication of the society. The affidavit of any officer of the society or of anyone authorized by it to mail an amendment or synopsis, stating facts that show that the amendment or synopsis has been duly addressed and mailed, is prima facie evidence that the amendment or synopsis has been furnished the addressee. (D) Every foreign or alien society authorized to do business in this state shall file with the superintendent a duly certified copy of all amendments of, or additions to, its laws within ninety days after their enactment. (E) Printed copies of the laws as amended, certified by the secretary or corresponding officer of the society, are prima facie evidence of their legal adoption.
Ohio Rev. Code § 3970.03 — Ohio Revised Code / Title 39 / Chapter 3970 / § 3970.03
§ 3970.03. Limitations and exclusions
Status: in_force

January 22, 2025 Senate Bill 175 - 135th General Assembly (A) If a pet insurance policy includes any of the terms defined in section 3970.01 of the Revised Code, those terms shall have the same meaning prescribed by that section, and the policy shall restate the definition of each such term. The pet insurer shall also make the definition available through a clear and conspicuous link on the main page of the pet insurer's or pet insurer's program administrator's publicly accessible web site. (B) This chapter does not prohibit or limit the types of exclusions a pet insurer may use or apply to a pet insurance policy. This chapter does not require a pet insurer to use or apply to a pet insurance policy any of the limitations or exclusions defined in section 3970.01 of the Revised Code. Last updated January 23, 2025 at 2:49 PM
Ohio Rev. Code § 3955.08 — Ohio Revised Code / Title 39 / Chapter 3955 / § 3955.08
§ 3955.08. Association powers and duties
Status: in_force

June 29, 1994 House Bill 89 - 120th General Assembly (A) The Ohio insurance guaranty association shall: (1) Be obligated to the extent of the covered claims existing prior to the determination that an insolvent insurer exists and arising within thirty days after such determination, or before the policy expiration date if less than thirty days after the determination, or before the insured replaces the policy or on request effects cancellation, if he does so within thirty days after the determination. In no event shall the association be obligated to a policyholder or claimant in an amount in excess of the face amount of the policy from which the claim arises. Claims of assessable members or subscribers of an insolvent insurer shall not be paid until all assessable subscribers or members have been assessed in accordance with section 3903.31 of the Revised Code and such assessments have been paid. Notwithstanding any other provision of the Revised Code, the association shall not be liable to pay any claim filed with the association after the earlier of the final date set by a court for filing claims in the liquidation proceedings of the insolvent insurer or eighteeen months after the order of liquidation. (2) Be deemed the insurer to the extent of its obligation on the covered claims and to such extent shall have all rights, duties, and obligations of the insolvent insurer as if the insurer had not become insolvent; (3) Allocate claims paid and expenses incurred among the accounts separately, and assess member insurers separately for each account amounts necessary to pay the obligations of the association under division (A)(1) of this section subsequent to an insolvency, the expenses of handling covered claims subsequent to insolvency, and other expenses authorized by sections 3955.01 to 3955.19 of the Revised Code. The assessments of each member insurer shall be in the proportion that the net direct written premiums of the member insurer for the preceding calendar year on the kinds of insurance in the account bears to the net direct written premiums of all member insurers for the preceding calendar year on such kinds of insurance. Each member insurer shall be notified of the assessment not later than thirty days before it is due. Each member insurer may be assessed in any year on any account any amount not greater than one and one-half per cent of its net direct written premiums for the preceding calendar year on the kinds of insurance in that account. After an initial assessment has been made for an insolvency, any subsequent assessments for that insolvency may be calculated in the same manner as the initial assessment and may use the same calendar year's net direct written premiums as were used in determining the original assessment. If the maximum assessment, together with the other assets of the association in any account, does not provide in any one year in any account an amount sufficient to make all necessary payments from that account, the funds available shall be prorated and the unpaid portion shall be paid as soon as funds become available, or claims shall be paid in any other manner the association may consider reasonable, including the payment of claims as they are received from claimants or the payment of claims in groups or categories. The association may exempt or defer, in whole or in part, the assessment of any member insurer, if it would cause the insurer's financial statement to reflect amounts of capital or surplus less than the minimum amounts required for a certificate of authority by any jurisdiction in which such insurer is authorized to transact insurance. The association may waive an assessment of any insurer if such assessment does not exceed ten dollars. If the balance of funds in any account, established pursuant to this section and section 3955.06 of the Revised Code, is in excess of amounts needed to pay all obligations chargeable to that account, the board of directors may authorize the transfer of such excess funds to any other account established pursuant to such sections in lieu of making an additional assessment for such other account or to reduce the total amount of an additional assessment for such other account. (4) Investigate claims brought against the association and adjust, compromise, settle, or pay covered claims to the extent of the association's obligation and deny all other claims; (5) Notify such persons as the superintendent directs under section 3955.10 of the Revised Code; (6) Handle claims through its employees or through one or more insurers or other persons designated as servicing facilities. Designation of a servicing facility is subject to the approval of the superintendent, but may be declined by a member insurer. (7) Reimburse each servicing facility for obligations of the association paid by the facility and for expenses incurred by the facility while handling claims on behalf of the association, and pay all other expenses of the association authorized by sections 3955.01 to 3955.19 of the Revised Code. (B) The association may: (1) Appear in, defend, and appeal any action on a claim brought against the association; (2) Employ or retain such persons as are necessary to handle claims and perform other duties of the association; (3) Borrow funds necessary to effect the purposes of sections 3955.01 to 3955.19 of the Revised Code, in accord with the plan of operation; (4) Sue or be sued; (5) Negotiate and become a party to such contracts as are necessary to carry out the purposes of sections 3955.01 to 3955.20 of the Revised Code; (6) Perform such other acts as are necessary or proper to effectuate the purposes of sections 3955.01 to 3955.19 of the Revised Code; (7) Refund to the member insurers in proportion to the contribution of each member insurer to that account that amount by which the assets of the account exceed the liabilities, if, at the end of any calendar year, the board of directors finds that the assets of the association in any account exceed the liabilities of that account as estimated by the board of directors for the coming year, provided that the association shall not be required to make a refund to any member insurer where the amount does not exceed ten dollars; (8) Act, with the approval of the superintendent, as a servicing facility for other insurance guaranty associations.
Ohio Rev. Code § 3915.08 — Ohio Revised Code / Title 39 / Chapter 3915 / § 3915.08
§ 3915.08. Loan, reserve, and cash surrender value
Status: in_force

November 5, 1959 Senate Bill 428 - 103rd General Assembly Except in the case of policies to which the second paragraph of this section applies, the loan value referred to in division (G) of section 3915.05 of the Revised Code shall be the reserve at the end of the current policy year on the policy and on any dividend additions thereto, less a sum of not more than two and one-half per cent of the amount insured by the policy and of any dividend additions thereto. The policy shall specify the mortality table and rate of interest adopted for computing such reserve and may further provide that such loan may be deferred for not more than six months after the application therefor is made. In the case of policies issued pursuant to section 3915.07 of the Revised Code on or after the operative date for such policies as authorized by division (H) of said section, the loan value referred to in division (G) of section 3915.05 of the Revised Code shall be the cash surrender value at the end of the current policy year as required by section 3915.07 of the Revised Code. The company shall reserve the right to defer such loan, except when made to pay premiums, for six months after application therefor is made.
Ohio Rev. Code § 3923.20 — Ohio Revised Code / Title 39 / Chapter 3923 / § 3923.20
§ 3923.20. Exemptions for certain insurance policies
Status: in_force

August 30, 1955 Senate Bill 294 - 101st General Assembly Sections 3923.01 to 3923.22 , inclusive, of the Revised Code, do not apply to or affect: (A)(1) Any policy of liability insurance, with or without supplementary expense coverage therein; (2) Any policy of motor vehicle liability insurance with supplementary coverage protecting the insured against loss where said insured has secured a judgment against a party for bodily injury or death as a result of a motor vehicle accident and where said judgment remains unsatisfied. (3) Any policy of motor vehicle liability insurance with supplementary coverage which insures against the hazards which arise out of a motor vehicle accident as defined in section 4509.01 (J) of the Revised Code. (B) Any life insurance, endowment, or annuity policy or contract, or any contract supplemental thereto, which contains only such provisions relating to sickness and accident insurance as: (1) Provide additional benefits in case of death or dismemberment by accident; (2) Operate to safeguard such policy or contract against lapse, or to give a special surrender value or special benefit or annuity in the event that the insured or annuitant becomes totally and permanently disabled, as defined by the policy, contract, or supplemental contract. Sections 3923.03 to 3923.07 , inclusive, of the Revised Code, do not apply to those forms of sickness and accident policies enumerated in sections 3923.12 and 3923.13 of the Revised Code, provided that no such policy shall contain any provision relative to notice or proof of loss, or the time for paying benefits, or the time within which suit may be brought upon the policy, which in the opinion of the superintendent of insurance is less favorable to the insured than would be permitted by the standard provisions set forth in section 3923.04 of the Revised Code.
Ohio Rev. Code § 3903.56 — Ohio Revised Code / Title 39 / Chapter 3903 / § 3903.56
§ 3903.56. Ohio residents claiming against foreign insurers
Status: in_force

January 1, 2021 House Bill 339 - 133rd General Assembly (A) In a liquidation proceeding in a reciprocal state against an insurer domiciled in that state, claimants against the insurer who reside within this state may file claims either with the ancillary receiver, if any, in this state, or with the domiciliary liquidator. Claims must be filed on or before the last dates fixed for the filing of claims in the domiciliary liquidation proceeding. (B) Claims belonging to claimants residing in this state may be proved either in the domiciliary state under the law of that state, or in ancillary proceedings, if any, in this state. If a claimant elects to prove the claimant's claim in this state, the claimant shall file the claim with the liquidator in the manner provided in sections 3903.35 and 3903.36 of the Revised Code. The ancillary receiver shall make a recommendation to the court as under section 3903.43 of the Revised Code. The ancillary receiver shall also arrange a date for hearing if necessary under section 3903.39 of the Revised Code and shall give notice to the liquidator in the domiciliary state, 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 appear or to be represented in any proceeding in this state involving the adjudication of the claim. (C) The final allowance of the claim by the courts of this state shall be accepted as conclusive as to amount and as to priority against special deposits or other security located in this state.
Ohio Rev. Code § 3970.04 — Ohio Revised Code / Title 39 / Chapter 3970 / § 3970.04
§ 3970.04. Disclosures
Status: in_force

January 22, 2025 Senate Bill 175 - 135th General Assembly (A) A pet insurance policy shall include all of the following: (1) Disclosure of whether the pet insurance policy excludes coverage due to any of the following: (a) A preexisting condition; (b) A hereditary disorder; (c) A congenital anomaly or disorder; (d) A chronic condition. (2) Disclosure of whether the pet insurance policy excludes coverage for any reason other than those listed in division (A)(1) of this section and, if so, the following statement: "Other exclusions may apply. Please refer to the exclusions section for more information." (3) Disclosure of whether the pet insurance policy or rider limits coverage through a waiting period, affiliation period, deductible, coinsurance, or an annual or lifetime policy limit; (4) Disclosure of whether the pet insurer reduces coverage or increases premiums based on the insured's claim history, the age of the covered pet, or a change in the geographic location of the insured; (5) Disclosure of whether the underwriting company differs from the brand name used to market and sell the pet insurance policy or rider. (B)(1) Pet insurance may be canceled by the purchaser within thirty days after the purchaser first receives the associated policy, rider, or certificate. The pet insurer shall issue a full refund to the purchaser within thirty days after receiving timely notice of cancellation under this division, so long as no claim has been made under the pet insurance. The purchaser may provide notice of cancellation to the pet insurer or through the insurance agent from which the pet insurance was purchased. (2) Pet insurance policies shall include a notice prominently printed on the first page, or attached to the first page, that provides specific instructions for canceling the insurance under division (B)(1) of this section. The notice shall include the following statement, or a substantially similar statement: "You have thirty (30) days from the day you receive this pet insurance policy, rider, or certificate to review it and, if you decide not to keep it, cancel the pet insurance. You do not have to tell the company why you are canceling the insurance. If you decide not to keep the insurance, you may cancel it by giving notice to the company at its administrative office or to the insurance agent from which you bought the insurance. If you cancel the insurance within that time, and have not filed a claim, the company is required by law to grant a full refund within 30 days after it receives your notice of cancellation. The refund will be sent directly to the person who paid for the insurance. The pet insurance policy, rider, or certificate will be void as if it had never been issued." (C) A pet insurer shall clearly disclose a summary description of the basis or formula on which the pet insurer determines claim payments under the policy. This information shall also be posted through a clear and conspicuous link on the main page of the pet insurer's or pet insurer's program administrator's publicly accessible web site. (D) A pet insurer that uses a benefit schedule to determine claim payment under a pet insurance policy shall do both of the following: (1) Clearly disclose the applicable benefit schedule in the policy. (2) Disclose all benefit schedules used by the pet insurer under its pet insurance policies through a clear and conspicuous link on the main page of the pet insurer's or pet insurer's program administrator's publicly accessible web site. (E) A pet insurer that determines claim payments under a pet insurance policy based on usual and customary fees, or any other reimbursement limitation based on prevailing veterinary service provider charges, shall do both of the following: (1) Include a usual and customary fee limitation provision in the policy or rider that clearly describes the pet insurer's basis for determining usual and customary fees and how that basis is applied in calculating claim payments; (2) Disclose the pet insurer's basis for determining usual and customary fees through a clear and conspicuous link on the main page of the pet insurer's or pet insurer's program administrator's publicly accessible web site. (F) If any medical examination by a licensed veterinarian is required to effectuate coverage, the pet insurer shall clearly and conspicuously disclose the required aspects of the examination prior to purchase of a pet insurance policy and, if applicable, disclose that examination documentation may result in a preexisting condition exclusion. (G) A pet insurer shall clearly and conspicuously disclose to the purchaser any requirements relating to waiting periods. (H) A pet insurer shall include a summary of all pet insurance provisions required by divisions (A) to (G) of this section in a separate document titled "Insurer Disclosure of Important Policy Provisions," and do both of the following: (1) Post the document through a clear and conspicuous link on the main page of the pet insurer's or pet insurer's program administrator's publicly accessible web site; (2) Upon delivery of any new pet insurance policy, provide the purchaser with a copy of the document in at least twelve point font. (I) At the time a pet insurance policy is issued or delivered to a policyholder, the pet insurer shall include a written disclosure with both of the following: (1) The address and customer service telephone number of the pet insurer or the agent; (2) If the policy is issued or delivered by an agent, a statement advising the policyholder to contact the agent for assistance. (J) The disclosures required by this section are in addition to any other disclosures required by law. Last updated January 23, 2025 at 2:50 PM
Ohio Rev. Code § 3923.32 — Ohio Revised Code / Title 39 / Chapter 3923 / § 3923.32
§ 3923.32. Right of family member to continue coverage after subscriber's death or upon change in marital relation to subscriber
Status: in_force

October 6, 1980 House Bill 45 - 113th General Assembly (A) Every individual family sickness and accident insurance policy that provides hospital, surgical, and medical expense benefits or hospital confinement indemnity benefits, and that is delivered or issued for delivery in this state on or after January 1, 1981, shall provide covered family members the right to continue such coverage upon the death of the named insured and upon the divorce, the annulment or dissolution of marriage, or the legal separation of the spouse from the named insured. Such right shall not exist with respect to any covered family member who is eligible for medicare or any other similar federal or state health insurance program, or in the event the coverage terminates for nonpayment of premium, nonrenewal of the policy, or the expiration of the term for which the policy is issued. (B) In the case of the divorce, annulment, or dissolution of marriage, or legal separation of the spouse from the named insured, the insurer shall satisfy the right to the continuation of coverage under this section by issuing either a converted or separate policy with the person who exercises the conversion right designated as the named insured. In the case of the death of the named insured, the insurer may satisfy the right to the continuation of coverage under this section by continuing the original policy with the person who exercises the right of continuation designated as the named insured or by issuing either a converted or separate policy with the person who exercises the conversion right designated as the named insured. Where continuation of coverage or conversion is made in the name of the spouse of the named insured, such coverage may, at the option of the spouse, include covered dependent children for whom the spouse has responsibility for care and support. (C) Coverage continued through the issuance of a converted or separate policy shall consist of a form of coverage then being offered by the insurer as a conversion policy in the jurisdiction where the person exercising the conversion right resides that most nearly approximates the coverage of the policy from which conversion is exercised. Continued and converted coverages shall contain renewal provisions that are not less favorable to the insured than those contained in the policy from which the conversion is made, except that the person who exercises the right of conversion is not entitled to have included a right to renew the coverage after the attainment of the age of eligibility for medicare or any other similar federal or state health insurance program. (D) The eligible covered family member exercising the continuation or conversion right must notify the insurer and make payment of the applicable premium within thirty-one days following the date such coverage otherwise terminates as specified in the policy or contract from which continuation or conversion is being exercised. (E) Coverage shall be provided through continuation or conversion without additional evidence of insurability, and shall not impose any preexisting condition limitations or other contractual time limitations other than those remaining unexpired under the policy or contract from which continuation or conversion is exercised. (F) Benefits otherwise payable under a converted or separate policy may be reduced: (1) So they are not, during the first policy year of the converted or separate policy, in excess of those that would have been payable had the coverage under the policy from which conversion is exercised not terminated; and (2) By the amount of benefits, if any, payable as to the same loss under the policy from which conversion is exercised. (G) Any probationary or waiting period set forth in the converted or separate policy is deemed to commence on the effective date of the applicant's coverage under the original policy.
Ohio Rev. Code § 3901.08 — Ohio Revised Code / Title 39 / Chapter 3901 / § 3901.08
§ 3901.08. Information from banks
Status: in_force

September 28, 1990 House Bill 629 - 118th General Assembly The superintendent of insurance may make written requisitions upon the officers or directors of any national bank, state bank, or state bank and trust company of this state, and upon any clearing corporation, direct participant, or member bank, as defined in section 3901.51 of the Revised Code, domiciled or doing business in this state, for information as he requires relating to the financial transactions of any of these institutions or entities with any insurance company, fraternal beneficiary association, or assessment association, authorized to do business in this state.
Ohio Rev. Code § 3903.89 — Ohio Revised Code / Title 39 / Chapter 3903 / § 3903.89
§ 3903.89. Effectiveness of notice
Status: in_force

March 3, 1996 House Bill 374 - 121st General Assembly Unless otherwise provided, all notices sent to an insurer by the superintendent of insurance that may result in regulatory action under sections 3903.81 to 3903.93 of the Revised Code shall be effective upon dispatch if transmitted by registered or certified mail. Any other notice transmitted shall be effective upon the insurer's receipt of the notice.
Ohio Rev. Code § 3915.24 — Ohio Revised Code / Title 39 / Chapter 3915 / § 3915.24
§ 3915.24. Rules
Status: in_force

October 23, 1991 House Bill 16 - 119th General Assembly Within six months after the effective date of this section, the superintendent of insurance shall adopt rules in accordance with Chapter 119. of the Revised Code to carry out the purposes of sections 3915.21 to 3915.24 of the Revised Code. The rules shall include criteria for the payment of accelerated benefits, disclosure requirements, and actuarial standards. Disclaimer Contact About
Ohio Rev. Code § 3929.01 — Ohio Revised Code / Title 39 / Chapter 3929 / § 3929.01
§ 3929.01. Powers of companies - deposits required of foreign companies
Status: in_force

August 8, 1991 Senate Bill 137 - 119th General Assembly (A) A domestic, foreign, or alien mutual or stock insurance company, other than a life insurance company, organized or admitted under Title XXXIX of the Revised Code or created by a special act or acts of the general assembly, or an attorney licensed under section 3931.10 of the Revised Code to make reciprocal or interinsurance contracts under sections 3931.01 to 3931.12 of the Revised Code, may directly, or by ceding or assuming reinsurance, transact any of the following kinds of insurance: (1) Fire; (2) Allied lines; (3) Farmowners multiple peril; (4) Homeowners multiple peril; (5) Commercial multiple peril; (6) Ocean marine; (7) Inland marine; (8) Financial guaranty; (9) Medical malpractice; (10) Earthquake; (11) Group accident and health; (12) Credit A & H (group and individual); (13)(a) Collectively renewable A & H; (b) Noncancellable A & H; (c) Guaranteed renewable A & H; (d) Nonrenewable for stated reasons only; (e) Other accident only; (f) All other A & H. (14) To the extent permitted by law, workers' compensation; (15) Other liability; (16)(a) To the extent permitted by law, private passenger auto no-fault (personal injury protection); (b) Other private passenger auto liability; (c) To the extent permitted by law, commercial auto no-fault (personal injury protection); (d) Other commercial auto liability. (17)(a) Private passenger auto physical damage; (b) Commercial auto physical damage. (18) Aircraft (all perils); (19) Fidelity; (20) Surety; (21) Glass; (22) Burglary and theft; (23) Boiler and machinery; (24) Credit; (25) Reinsurance only; (26) Any other insurance against loss or damage by any hazard upon any risk, other than life insurance, that is not prohibited by the Revised Code or at common law from being the subject of insurance. (B) A company of another state, territory, district, or country admitted to transact the fidelity or surety insurance business, in addition to any other deposit required by this state, shall deposit with the superintendent of insurance, for the benefit and security of all of its policyholders, fifty thousand dollars in bonds of the United States or of this state, or of a county, township, or municipal corporation in this state, which shall not be received by the superintendent at a rate above their par value. The securities deposited may be exchanged from time to time for other securities. So long as the company continues solvent and complies with the laws of this state, it may collect the interest on the deposits. (C) Nothing in this section shall be construed to enlarge upon or extend the powers possessed by an insurer authorized to transact business in this state as a title insurance company.
Ohio Rev. Code § 3959.06 — Ohio Revised Code / Title 39 / Chapter 3959 / § 3959.06
§ 3959.06. Application for license - filing fee
Status: in_force

December 2, 1996 House Bill 670 - 121st General Assembly (A) An administrator 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 to the credit of the department of insurance operating fund created under section 3901.021 of the Revised Code.
Ohio Rev. Code § 3927.02 — Ohio Revised Code / Title 39 / Chapter 3927 / § 3927.02
§ 3927.02. Actual capital and minimum surplus of foreign companies
Status: in_force

July 26, 1982 Senate Bill 249 - 114th General Assembly No company, association, or partnership organized under the laws of another state shall take risks or transact business of insurance in this state, directly or indirectly, unless it possesses the amount of actual capital and the minimum surplus required by similar companies formed under Chapters 3925., 3927., 3929., and 3931. of the Revised Code, nor unless the capital stock of the company is paid up and invested as required by the laws of the state where it was organized, and, if a livestock insurance company, until it has deposited in such state or in this state, for the benefit of its policyholders, securities approved by the insurance department of such state in an amount equal to one fourth of its entire capital stock. If the company is a mutual fire insurance company, it must have actual cash assets of the amount and description required of similar companies of this state, after organization, invested as required by the law of the state where the company was organized. Such company must also have either premium notes or contingent liability of the amount required of similar fire insurance companies of this state, which contingent liability may be either in writing or expressed in the policies issued by the company.
Ohio Rev. Code § 3902.52 — Ohio Revised Code / Title 39 / Chapter 3902 / § 3902.52
§ 3902.52. Out-of-network care arbitration
Status: in_force

April 12, 2021 House Bill 388 - 133rd General Assembly (A)(1) If a negotiation undertaken pursuant to division (B)(2) of section 3902.51 of the Revised Code has not successfully concluded within thirty days, or if both parties agree that they are at an impasse, the provider, facility, emergency facility, or ambulance may send a request for arbitration to the superintendent of insurance and shall notify the health plan issuer of its request. To be eligible for arbitration, both of the following must apply: (a) The service in question was provided not more than one year prior to the request. (b) The billed amount exceeds seven hundred fifty dollars, except as provided in division (A)(2)(b) of this section. (2)(a) In seeking arbitration, a provider, facility, emergency facility, or ambulance may bundle up to fifteen claims with respect to the same health benefit plan that involve the same or similar services provided under similar circumstances. Any bundled claims shall be for services using the same coding set and providers of the same license type. (b) A claim that is bundled with other claims may be seven hundred fifty dollars or less so long as the sum of the bundled claims is greater than seven hundred fifty dollars. (B) If arbitration is requested under division (A) of this section, each party shall submit its final offer to the arbitrator. The parties also may submit, and the arbitrator may consider, evidence that relates to the factors described in division (C) of this section if the evidence is in a form that can be verified and authenticated. (C) An arbitrator shall consider all of the following factors in rendering a decision: (1) The in-network rates that other health benefit plans reimburse, and have reimbursed, that particular provider, facility, emergency facility, or ambulance for the service in question, including the factors that went into those rates such as guaranteed patient volume or availability of providers in the provider's, facility's, emergency facility's, or ambulance's geographic area; (2) The in-network rates that the health benefit plan reimburses, or has reimbursed, other providers, facilities, emergency facilities, or ambulances for the service in question in that particular geographic area, including the factors that went into those rates such as guaranteed patient volume or availability of providers in that particular geographic area; (3) If the health plan issuer and the provider, facility, emergency facility, or ambulance have had a contractual relationship in the previous six years, any in-network reimbursement rates previously agreed upon between the issuer and the provider, facility, emergency facility, or ambulance; (4) The results of, or any documents submitted in the course of, a previous arbitration between the parties conducted under this section that the arbitrator considers relevant in rendering a decision. (D) After considering the evidence submitted by the parties pursuant to division (B) of this section and the criteria described in division (C) of this section, the arbitrator shall issue a decision that awards the final offer of either party that best reflects a fair reimbursement rate based upon the factors considered under division (C) of this section. (E) The nonprevailing party shall pay seventy per cent of the arbitrator's fees, and the prevailing party shall pay thirty per cent. (F) A final arbitration decision shall be binding except as to other remedies available at law. (G) Documents and other evidence submitted to an arbitrator under this section are confidential, not public records for the purposes of section 149.43 of the Revised Code, and shall not be released except as authorized pursuant to this division. If release of the evidence is required pursuant to a court order, the arbitrator shall release the evidence pursuant to the court order but shall redact from the evidence released information that constitutes intellectual property, trade secrets, or information requiring redaction pursuant to a rule adopted by the superintendent of insurance. (H) As used in this section, "provider" includes a practice of providers to the extent permitted by rules adopted by the superintendent of insurance under division (D) of section 3902.54 of the Revised Code including but not limited to rules adopted regarding the maximum number of providers in a practice.
Ohio Rev. Code § 3935.17 — Ohio Revised Code / Title 39 / Chapter 3935 / § 3935.17
§ 3935.17. Applicability of sections
Status: in_force

October 1, 1953 House Bill 1 - 100th General Assembly Section 3927.05 of the Revised Code is not repealed or affected by sections 3935.01 to 3935.17 , inclusive, of the Revised Code, but compliance with sections 3935.01 to 3935.17 , inclusive, of the Revised Code, shall not be deemed to be a violation of section 3927.05 of the Revised Code.
Ohio Rev. Code § 3911.24 — Ohio Revised Code / Title 39 / Chapter 3911 / § 3911.24
§ 3911.24. Revocation of license for misrepresentation
Status: in_force

January 1, 2021 House Bill 339 - 133rd General Assembly Upon the conviction of any person, firm, association, or life insurance company for violating section 3911.23 of the Revised Code, the superintendent of insurance shall revoke the license of such person, firm, association, or life insurance company for not less than one year. The superintendent, when the superintendent has good reason to believe that any company or association writing life insurance in this state, on any plan, is knowingly permitting any of its agents or representatives to violate section 3911.23 of the Revised Code, shall give such company or association notice of a hearing in accordance with Chapter 119. of the Revised Code, upon the charge of knowingly permitting said section to be violated, and, if the superintendent finds said company or association guilty of the offense, the superintendent shall revoke its license.
Ohio Rev. Code § 3905.181 — Ohio Revised Code / Title 39 / Chapter 3905 / § 3905.181
§ 3905.181. Accepting consideration without license
Status: in_force

September 1, 2002 Senate Bill 129 - 124th General Assembly A person shall not accept a commission, service fee, brokerage fee, or other type of consideration for selling, soliciting, or negotiating insurance in this state if that person is required to be licensed under this chapter and is not so licensed.
Ohio Rev. Code § 3925.101 — Ohio Revised Code / Title 39 / Chapter 3925 / § 3925.101
§ 3925.101. Regulation of foreign branches of domestic companies
Status: in_force

September 23, 2008 House Bill 562 - 127th General Assembly With the approval of the superintendent of insurance, sections 3925.06 to 3925.09 and 3925.20 of the Revised Code shall not apply to a domestic insurance company that qualifies as a foreign country branch of a United States company that writes policies exclusively in countries other than the United States if those other countries have laws pertaining to insurance company investments and the foreign country branch is required to comply with those laws.
Ohio Rev. Code § 3955.19 — Ohio Revised Code / Title 39 / Chapter 3955 / § 3955.19
§ 3955.19. Staying pending proceedings involving insolvent insurers
Status: in_force

June 29, 1994 House Bill 89 - 120th General Assembly To permit a proper defense by the Ohio insurance guaranty association of all pending causes of action, all proceedings in which an insolvent insurer is a party or is obligated to defend a party in any court in this state shall be stayed for six months, and such additional time thereafter as may be determined by the court in which the proceedings are pending or with jurisdiction over the proceedings, from the date the insolvency is determined or an ancillary proceeding is instituted in this state, whichever is later. As to any covered claims arising from any judgment, order, decision, verdict, or finding based on a default or stipulation of the insolvent insurer or its insured, the association, either on its own behalf or on behalf of the insured, may apply to the court to have its judgment, order, decision, verdict, or finding vacated. The court shall grant the application, and the association shall be permitted to defend the claim on the merits. Disclaimer Contact About
Ohio Rev. Code § 3916.10 — Ohio Revised Code / Title 39 / Chapter 3916 / § 3916.10
§ 3916.10. Limiting contact with insured after settlement has occurred
Status: in_force

September 11, 2008 House Bill 404 - 127th General Assembly After a viatical settlement has occurred, contact with the insured for the purpose of determining the health status of the insured shall be made only by the viatical settlement provider, or the authorized representative of the viatical settlement provider. The viatical settlement provider, or authorized representative shall not contact the insured for the purpose of determining the insured's health status more than once every three months if the insured has a life expectancy of more than one year, or more than once per month if the insured has a life expectancy of one year or less. The viatical settlement provider shall explain the procedure for making these contacts at the time the viatical settlement contract is entered into. The limitations set forth in this section do not apply to contacts made with an insured under a viaticated policy for purposes other than to determine the insured's health status. Viatical settlement providers are responsible for the actions of their authorized representatives, for the purposes of this section except viatical settlement providers are not responsible for the actions of subsequent purchasers of a policy.
Ohio Rev. Code § 3929.481 — Ohio Revised Code / Title 39 / Chapter 3929 / § 3929.481
§ 3929.481. Issuing fair plan policies
Status: in_force

October 24, 2024 Senate Bill 175 - 135th General Assembly The Ohio fair plan underwriting association is authorized to issue fair plan policies of insurance in its own name and to perform acts relative thereto in accordance with the plan of operation. The association is exempt from all license fees, and income, franchise, premium, and privilege taxes levied or assessed by this state or any political subdivision of this state, except that premium receipts from policies issued directly by the association are subject to the tax imposed by section 3737.71 of the Revised Code, computed upon the basis of a statement to be filed annually on or before the first day of March by the association with the superintendent of insurance in the form prescribed by the superintendent. Last updated August 16, 2024 at 8:46 AM
Ohio Rev. Code § 3930.16 — Ohio Revised Code / Title 39 / Chapter 3930 / § 3930.16
§ 3930.16. Program for decreasing overall utilization of association as source of insurance
Status: in_force

January 5, 1988 House Bill 1 - 117th General Assembly The board of governors of the Ohio commercial insurance joint underwriting association shall adopt a written program for decreasing the overall utilization of the association as a source of insurance. The program shall set forth actions that the board shall take to decrease such utilization, including actions intended to reduce the classes of insurance offered by the association, to reduce the number of policies issued, the number of persons insured, and the total amount of insurance written by the association, provided this section does not authorize the board to take action intended to decrease utilization of the association as a source of insurance if such action would substantially conflict with the purposes set forth in section 3930.03 of the Revised Code or the plan of operation of the association.
Ohio Rev. Code § 3935.04 — Ohio Revised Code / Title 39 / Chapter 3935 / § 3935.04
§ 3935.04. Filing of rates and schedules with superintendent - procedure
Status: in_force

October 24, 2024 Senate Bill 175 - 135th General Assembly As used in sections 3935.01 to 3935.17 of the Revised Code, "filing" or "filings" means the whole or any part thereof. (A)(1) Every insurer shall file with the superintendent of insurance, except as to inland marine risks which by general custom of the business are not written according to manual rates or rating plans, every form of a policy, endorsement, rider, manual, minimum class rate, rating schedule, or rating plan, and every other rating rule, and every modification of any of them, which it proposes to use. Every such filing shall state the proposed effective date thereof, and shall indicate the character and extent of the coverage contemplated. When a filing is not accompanied by the information upon which the insurer supports the filing, and the superintendent does not have sufficient information to determine whether the filing meets the requirements of sections 3935.01 to 3935.17 of the Revised Code, the superintendent shall require the insurer to furnish the information upon which it supports the filing, and in such event the waiting period shall commence as of the date the information is furnished. The information furnished in support of a filing may include the experience or judgment of the insurer or rating bureau making the filing, its interpretation of any statistical data it relies upon, the experience of other insurers or rating bureaus, or any other relevant factors. A filing and any supporting information shall be open to public inspection after the filing becomes effective. Trade secrets contained in any filing or in any supporting information shall not be open to public inspection, are not a public record under section 149.43 of the Revised Code, and the release of such trade secrets is prohibited. Specific inland marine rates on risks specially rated, made by a rating bureau, shall be filed with the superintendent. (2) As used in division (A)(1) of this section, "trade secret" has the same meaning as in section 1333.61 of the Revised Code. (B) An insurer may satisfy its obligation to make such filings by becoming a member of, or a subscriber to, a licensed rating bureau which makes such filings, and by authorizing the superintendent to accept such filings on its behalf, but sections 3935.01 to 3935.17 of the Revised Code do not require any insurer to become a member of, or a subscriber to, any rating bureau. (C) The superintendent shall review filings as soon as reasonably possible after they have been made in order to determine whether they meet the requirements of sections 3935.01 to 3935.17 of the Revised Code. (D) Subject to the exception specified in division (E) of this section, each filing shall be on file for a waiting period of thirty days before it becomes effective. Upon written application by such insurer or rating bureau, the superintendent may authorize a filing which the superintendent has reviewed to become effective before the expiration of the waiting period. A filing complies with sections 3935.01 to 3935.17 of the Revised Code unless it is disapproved by the superintendent within the waiting period. (E) Specific inland marine rates on risks specially rated by a rating bureau become effective when filed and comply with sections 3935.01 to 3935.17 of the Revised Code until the superintendent reviews the filing and so long thereafter as the filing remains in effect. (F) Notwithstanding Chapter 119. of the Revised Code, the superintendent may, by written order, without notice or hearing, suspend or modify the requirements of a filing as to any kind of insurance, subdivision or combination thereof, or classes of risks, the rates for which cannot practicably be filed before they are used. Such orders shall be made known to insurers and rating bureaus affected thereby. The superintendent may make such examinations as the superintendent deems advisable to ascertain whether any rates affected by such order meet the standards set forth in division (B) of section 3935.03 of the Revised Code. (G) Upon the written application of the insured, stating the insured's reasons therefor, a rate in excess of that provided by a filing otherwise applicable may be used on any specific risk. (H) A commercial insurance policy form or endorsement that is unique in character and designed for a particular risk is exempt from filing, except that the superintendent may, by regulation or order, prescribe specific restrictions relating to the exemption. (I) An insurer shall retain any insurance policy form, endorsement, or rate that is exempt from filing under division (F), (G), or (H) of this section and all supporting documentation, for not less than three years after the effective date of the exempt policy form, endorsement, or rate. Upon request of the superintendent during that period, the insurer shall make such policy form, endorsement, or rate, and the supporting documentation available for inspection by the superintendent. (J) No insurer shall make or issue a contract or policy except in accordance with the filings which are in effect for the insurer as provided in sections 3935.01 to 3935.17 of the Revised Code or in accordance with division (F), (G), or (H) of this section. This division does not apply to contracts or policies for inland marine risks as to which filings are not required. Last updated August 16, 2024 at 8:47 AM
Ohio Rev. Code § 3905.211 — Ohio Revised Code / Title 39 / Chapter 3905 / § 3905.211
§ 3905.211. Immunity
Status: in_force

September 1, 2002 Senate Bill 129 - 124th General Assembly (A) In the absence of actual malice, an insurer, the authorized representative of an insurer, an insurance agent, the superintendent of insurance, or any organization of which the superintendent is a member, which organization compiles the information provided pursuant to section 3905.21 of the Revised Code and makes it available to other insurance commissioners or to regulatory or law enforcement agencies, is immune from any civil liability that otherwise might be incurred or imposed as a result of either of the following: (1) Any statement required by section 3905.21 of the Revised Code or any information relating to any such statement, which information may be requested in writing by the superintendent; (2) Any statement of an insurer that has terminated an insurance agent to an insurer or agent, or any statement of an insurance agent to an insurer or agent, which statement is limited solely to whether a termination for any of the reasons set forth in division (B) of section 3905.14 of the Revised Code was reported to the superintendent, provided the propriety of any such termination is certified in writing by an officer or authorized representative of the insurer or agent terminating the relationship. (B) In any action brought against a person that may have immunity under division (A) of this section for making any statement required by section 3905.21 of the Revised Code or providing any information relating to any such statement, which information may have been requested in writing by the superintendent, the party bringing the action shall plead specifically in any allegation that division (A) of this section does not apply because the person making the statement or providing the information did so with malice. (C) Nothing in this section shall abrogate or modify any statutory or common law privilege or immunity that otherwise applies.
Ohio Rev. Code § 3901.052 — Ohio Revised Code / Title 39 / Chapter 3901 / § 3901.052
§ 3901.052. Application for innovative waiver
Status: in_force

September 29, 2015 House Bill 64 - 131st General Assembly The superintendent of insurance shall apply to the United States secretary of health and human services and the United States secretary of the treasury for an innovative waiver regarding health insurance coverage in this state as authorized by section 1332 of the "Patient Protection and Affordable Care Act," 42 U.S.C. 18052. The superintendent shall include in the application a request for waivers of the employer and individual mandates in sections 4980H and 5000A of the "Internal Revenue Code of 1986," 26 U.S.C. 4980H and 5000A. The application shall provide for the establishment of a system that provides access to affordable health insurance coverage for the residents of this state.
Ohio Rev. Code § 3941.47 — Ohio Revised Code / Title 39 / Chapter 3941 / § 3941.47
§ 3941.47. Discontinuing contract with hospital
Status: in_force

October 1, 1987 Senate Bill 124 - 117th General Assembly (A) As used in this section, "median price" means the median price charged to the mutual insurance company during the twelve months preceding the notice of intention to discontinue the contract by all other hospitals providing a similar service or services in the same county and the contiguous counties. (B) Any mutual insurance company which merged or consolidated with a hospital service association may not discontinue before January 1, 1990, the contractual relationship which was in effect between the hospital service association and any hospital, pursuant to Chapter 1739. of the Revised Code, unless the hospital fails to participate in cost management programs provided by the mutual insurance company to its insureds, or the hospital is not operated in a cost effective manner, or the hospital offers services to insureds of the mutual insurance company which, in the exercise of its business judgment, the mutual insurance company believes are priced more expensively than is in the best interests of its policyholders. In determining whether a hospital's prices are more expensive than is in the best interests of its policyholders, the mutual insurance company may conclusively base its decision on the following criterion: whether the price the hospital charges the mutual insurance company for a service or services provided to insureds of the mutual insurance company is greater than the median price. The mutual insurance company shall, at least ninety days prior to the proposed effective date set forth in a notice of intent to discontinue a contract with a hospital, notify in writing the hospital and the superintendent of insurance of the intention to discontinue the contract. The notice of intention to discontinue a contract shall include the median price. In determining whether to discontinue the contract of a hospital, the mutual insurance company shall, in the exercise of its business judgment, determine the hospital's price on a case-mix adjusted basis, including, where appropriate, giving reasonable and uniform credit for a portion of a hospital's reasonable charity care and medical education expense. In applying the conclusive price criterion, the mutual insurance company shall not discontinue any hospital's contract prior to January 1, 1990, if that hospital's price is at or below the median price, or the hospital agrees within ninety days from the date of receipt of a notice of intention to discontinue the contract, to provide services to policyholders of the mutual insurance company at a price, adjusted for case mix, including where appropriate, giving reasonable and uniform credit for a portion of a hospital's reasonable charity care and medical education expenses, not greater than the median price. A discontinuance pursuant to this section shall not be effective until the next annual renewal date of the contract between the mutual insurance company and the hospital or on the thirty-first day of December if the contract has no expiration date. If a hospital receives a notice of intention to discontinue as provided in this section, it may appeal the decision to the superintendent of insurance within thirty days from the date it receives notice of the discontinuance. The superintendent shall, within thirty days after receipt of notice of appeal, hold a hearing upon proper notice. The superintendent shall, within twenty days after the hearing, issue an order approving or disapproving the discontinuance. All final orders and decisions of the superintendent are subject to judicial review as provided in Chapter 119. of the Revised Code.
Ohio Rev. Code § 3923.331 — Ohio Revised Code / Title 39 / Chapter 3923 / § 3923.331
§ 3923.331. Statutes applicable to medicare supplement policies
Status: in_force

March 3, 1996 House Bill 374 - 121st General Assembly (A) Except as otherwise provided in the Revised Code, section 3923.33 and sections 3923.331 to 3923.339 of the Revised Code shall apply to: (1) All medicare supplement policies delivered or issued for delivery in this state on or after the effective date of this amendment; and (2) All certificates issued under group medicare supplement policies, which certificates are delivered or issued for delivery in this state on or after the effective date of this amendment. (B) Section 3923.33 and sections 3923.331 to 3923.339 of the Revised Code shall not apply to a policy of one or more employers or labor organizations, or of the trustees of a fund established by one or more employers or labor organizations, or a combination thereof, for employees or former employees, or a combination thereof, or for members or former members, or a combination thereof, of the labor organizations. (C) Except as otherwise provided in division (D) of section 3923.334 of the Revised Code, section 3923.33 and sections 3923.331 to 3923.339 of the Revised Code are not intended to prohibit or apply to insurance policies or health care benefit plans, including group conversion policies, provided to medicare eligible persons, which policies are not marketed or held to be medicare supplement policies or benefit plans.
Ohio Rev. Code § 3911.23 — Ohio Revised Code / Title 39 / Chapter 3911 / § 3911.23
§ 3911.23. Misrepresentation prohibited
Status: in_force

October 1, 1953 House Bill 1 - 100th General Assembly No life insurance company doing business in this state, and no officer, director, representative, or other agent thereof, or any other person, firm, partnership, association, or corporation, shall knowingly make, issue, or circulate, or cause or knowingly permit to be made, issued, or circulated, any estimate, illustration, circular, or statement of any sort which misrepresents the terms of any policy issued or to be issued by it or any other company, or the benefits or advantages promised thereby, or makes any misleading estimate of the dividends or shares of surplus to be received thereon; nor shall such organization or person use any name or title of any policy or class of policies which misrepresents the true nature thereof. No such life insurance company or officer, director, or agent thereof, or any other person, firm, partnership, association, corporation, or representative shall make any misrepresentation or incomplete comparison, oral or written, to any person insured in any company for the purpose of inducing or tending to induce a policyholder in any company to lapse, forfeit, change, or surrender his life insurance whether it is of a temporary or a permanent plan.
Ohio Rev. Code § 3901.28 — Ohio Revised Code / Title 39 / Chapter 3901 / § 3901.28
§ 3901.28. Provisions effective if no emergency bylaws
Status: in_force

November 11, 1965 House Bill 561 - 106th General Assembly In the event that the board of directors of a domestic insurance company has not adopted emergency bylaws, the following provisions shall become effective upon the occurrence of an emergency as described in section 3901.27 of the Revised Code. (A) Three directors shall constitute a quorum for the transaction of business at all meetings of the board. (B) Any vacancy in the board may be filled by a majority of the remaining directors, though less than a quorum, or by a sole remaining director. (C) If there are no surviving directors, but at least three vice-presidents of the company survive, the three vice-presidents with the longest term of service shall be the directors and shall possess all of the powers of the previous board of directors and such powers as are granted herein or by subsequently enacted legislation. By majority vote, said emergency board of directors may elect other directors. If there are not at least three surviving vice-presidents, the superintendent of insurance or duly designated person exercising the powers of the superintendent shall appoint three persons as directors who shall possess all of the powers of the previous board of directors and such powers as are granted herein or by subsequently enacted legislation, and these directors may, by majority vote, elect other directors.
Ohio Rev. Code § 3924.032 — Ohio Revised Code / Title 39 / Chapter 3924 / § 3924.032
§ 3924.032. Refusing to issue plans in small employer market
Status: in_force

June 30, 1997 House Bill 374 - 122nd General Assembly (A) A carrier may refuse to issue health benefit plans in the small employer market if the carrier has demonstrated both of the following to the superintendent of insurance: (1) The carrier does not have the financial reserves necessary to underwrite additional coverage. (2) The carrier is applying division (A) of this section uniformly to all employers in the small employer market in this state consistent with the applicable laws and rules of this state and without regard to the claims experience of those employers and their employees and dependents or to any health status-related factor relating to such employees and dependents. (B) A carrier that, pursuant to division (A) of this section, refuses to issue health benefit plans in the small employer market, shall not offer health benefit plans in the small employer market in this state for at least one hundred eighty days after the date the coverage is denied or until the carrier has demonstrated to the superintendent that the carrier has sufficient financial reserves to underwrite additional coverage, whichever is later. (C) The superintendent may provide for the application of this section on a service-area-specific basis.
Ohio Rev. Code § 3964.191 — Ohio Revised Code / Title 39 / Chapter 3964 / § 3964.191
§ 3964.191. Grounds for rehabilitation or liquidation
Status: in_force

September 17, 2014 House Bill 117 - 130th General Assembly (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, dissipation, or diversion of the assets of the special purpose financial captive insurance company intended to be used to pay amounts owed to the counterparty or the holders of special purpose financial captive insurance company securities. (2) The special purpose financial captive insurance company is insolvent and the holders of a majority in outstanding principal amount of each class of special purpose financial captive insurance company securities request or consent to conservation, rehabilitation, or liquidation pursuant to the provisions of this section. (B) A court may not grant the relief provided by division (A) of this section unless, after notice and a hearing, the superintendent establishes that relief must be granted. (C) Notwithstanding any other applicable law or rule, upon any order of rehabilitation or liquidation of a special purpose financial captive insurance company, the receiver shall manage the assets and liabilities of the special purpose financial captive insurance company pursuant to the provisions of section 3964.193 of the Revised Code. (D) With respect to amounts recoverable under a special purpose financial captive insurance company contract, the amount recoverable by the receiver shall not be reduced or diminished as a result of the entry of an order of conservation, rehabilitation, or liquidation with respect to the counterparty, notwithstanding any provision in the contracts or other documentation governing a special purpose financial captive insurance company insurance securitization. (E) An application or petition, or a temporary restraining order or injunction issued pursuant to sections 3903.01 to 3903.59 of the Revised Code, with respect to a counterparty, does not prohibit the transaction of business by a special purpose financial captive insurance company, including any payment by a special purpose financial captive insurance company made pursuant to a special purpose financial captive insurance company security, or any action or proceeding against a special purpose financial captive insurance company or its assets. (F) Notwithstanding the provisions of any applicable law or rule, the commencement of a summary proceeding or other interim proceeding commenced before a formal delinquency proceeding with respect to a special purpose financial captive insurance company, and any order issued by the court, does not prohibit the payment by a special purpose financial captive insurance company made pursuant to a special purpose financial captive insurance company security or special purpose financial insurance company contract, and also does not prohibit the special purpose financial captive insurance company from taking any action required to make such payments. (G) Notwithstanding the provisions of any other applicable law or rule, both of the following shall apply: (1) A receiver of a counterparty may not void a nonfraudulent transfer by a counterparty to a special purpose financial captive insurance company of money or other property made pursuant to a special purpose financial captive insurance company contract. (2) A receiver of a special purpose financial captive insurance company may not void a nonfraudulent transfer by the special purpose financial captive insurance company of money or other property made to a counterparty pursuant to a special purpose financial captive insurance company contract or made to or for the benefit of any holder of a special purpose financial captive insurance company security on account of the special purpose financial captive insurance company security. (H) With the exception of the fulfillment of the obligations under a special purpose financial captive insurance company contract, and notwithstanding the provisions of any other applicable law or rule, the assets of a special purpose financial captive insurance company, including assets held in trust, shall not be consolidated with or included in the estate of a counterparty in any delinquency proceeding against the counterparty, pursuant to the provisions of this section, for any purpose, including distribution to creditors of the counterparty.
Ohio Rev. Code § 3905.53 — Ohio Revised Code / Title 39 / Chapter 3905 / § 3905.53
§ 3905.53. Effect of child support default on license
Status: in_force

March 22, 2001 Senate Bill 180 - 123rd General Assembly On receipt of a notice pursuant to section 3123.43 of 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.
Ohio Rev. Code § 3937.07 — Ohio Revised Code / Title 39 / Chapter 3937 / § 3937.07
§ 3937.07. Advisory organizations
Status: in_force

October 1, 1953 House Bill 1 - 100th General Assembly Any member of or subscriber to a rating organization may appeal to the superintendent of insurance from the action or decision of such rating organization in approving or rejecting any proposed change in or addition to the filings of such rating organization and the superintendent shall, after a hearing held upon not less than ten days' written notice to the appellant and to such rating organization, issue an order approving the action or decision of such rating organization or directing it to give further consideration to such proposal. If such appeal is from the action or decision of the rating organization in rejecting a proposed addition to its filings, the superintendent may, in the event he finds that such action or decision was unreasonable, issue an order directing the rating organization to make an addition to its filings, on behalf of its members and subscribers, in a manner consistent with his findings, within a reasonable time after the issuance of such order. If such appeal is based upon the failure of the rating organization to make a filing on behalf of such member or subscriber which is based on a system of expense provisions which differs, in accordance with the right granted in division (B) of section 3937.02 of the Revised Code, from the system of expense provisions included in a filing made by the rating organization, the superintendent shall, if he grants the appeal, order the rating organization to make the requested filing for use by the appellant. In deciding such appeal the superintendent shall apply the standards set forth in division (B) of section 3937.02 of the Revised Code.
Ohio Rev. Code § 3903.99 — Ohio Revised Code / Title 39 / Chapter 3903 / § 3903.99
§ 3903.99. Penalty
Status: in_force

March 7, 1983 House Bill 830 - 114th General Assembly Whoever violates division (B) or (C) of section 3903.06 of the Revised Code shall be fined not more than ten thousand dollars or imprisoned for not more than one year, or both. Disclaimer Contact About
Ohio Rev. Code § 3906.04 — Ohio Revised Code / Title 39 / Chapter 3906 / § 3906.04
§ 3906.04. Rights of insurer
Status: in_force

September 4, 2014 Senate Bill 140 - 130th General Assembly (A) Subject to this chapter, an insurer making investments under this chapter may loan or invest its funds, and may buy, sell, hold title to, possess, occupy, pledge, convey, manage, protect, insure, and deal with its investments, property, and other assets to the same extent as any other person or corporation under the laws of this state and of the United States. (B) With respect to all of the insurer's investments, the board of directors of an insurer making investments under this chapter shall exercise the judgment and care, under the circumstances then prevailing, that persons of reasonable prudence, discretion, and intelligence would exercise in the management of a like enterprise, not in regard to speculating but in regard to the permanent disposition of their funds, considering the probable income as well as the probable safety of their capital. Investments shall be of sufficient value, liquidity, and diversity to assure the insurer's ability to meet its outstanding obligations based on reasonable assumptions as to new business production for current lines of business. As part of its exercise of judgment and care, the board of directors shall take into account the prudence evaluation criteria of division (C) of section 3906.05 of the Revised Code. The exercise of judgment and care by the board of directors under this section shall also be governed by sections 1701.59 and 1702.30 of the Revised Code, as applicable. (C) An insurer making investments under this chapter shall establish and implement internal controls and procedures to assure compliance with investment policies and procedures to assure that all of the following are met: (1) The insurer's investment staff and any consultants used are reputable and capable. (2) A periodic evaluation and monitoring process occurs for assessing the effectiveness of investment policy and strategies. (3) Management's performance is assessed in meeting the stated objectives within the investment policy through periodic presentations to the board of directors. (4) Appropriate analyses are undertaken on the degree to which asset cash flows are adequate to meet liability cash flows under different economic environments. These analyses shall be conducted at least annually and make specific reference to the economic conditions considered.
Ohio Rev. Code § 3911.02 — Ohio Revised Code / Title 39 / Chapter 3911 / § 3911.02
§ 3911.02. Annual statements to superintendent of insurance
Status: in_force

October 1, 1953 House Bill 1 - 100th General Assembly Every life insurance company doing business in this state, and issuing policies on both the participating and nonparticipating plans, shall file with the superintendent of insurance separate annual statements of profits and losses with reference to each of such kinds of insurance.
Ohio Rev. Code § 3901.3812 — Ohio Revised Code / Title 39 / Chapter 3901 / § 3901.3812
§ 3901.3812. Administrative remedies
Status: in_force

July 17, 2009 House Bill 1 - 128th General Assembly (A) If, after completion of an examination involving information collected from a six-month period, the superintendent finds that a third-party payer has committed a series of violations that, taken together, constitutes a consistent pattern or practice of violating division (A) of section 3901.3811 of the Revised Code, the superintendent may impose on the third-party payer any of the administrative remedies specified in division (B) of this section. In making a finding under this division, the superintendent shall apply the error tolerance standards for claims processing contained in the market conduct examiners handbook issued by the national association of insurance commissioners in effect at the time the claims were processed. Before imposing an administrative remedy, the superintendent shall provide written notice to the third-party payer informing the third-party payer of the reasons for the superintendent's finding, the administrative remedy the superintendent proposes to impose, and the opportunity to submit a written request for an administrative hearing regarding the finding and proposed remedy. If the third-party payer requests a hearing, the superintendent shall conduct the hearing in accordance with Chapter 119. of the Revised Code not later than fifteen days after receipt of the request. (B)(1) In imposing administrative remedies under division (A) of this section for violations of section 3901.381 of the Revised Code, the superintendent may do any of the following: (a) Levy a monetary penalty in an amount determined in accordance with division (B)(3) of this section; (b) Order the payment of interest directly to the provider in accordance with section 3901.389 of the Revised Code; (c) Order the third-party payer to cease and desist from engaging in the violations; (d) If a monetary penalty is not levied under division (B)(1)(a) of this section, impose any of the administrative remedies provided for in section 3901.22 of the Revised Code, other than those specified in divisions (D)(4) and (5) and (G) of that section. (2) In imposing administrative remedies under division (A) of this section for violations of sections 3901.384 to 3901.3810 of the Revised Code, the superintendent may do any of the following: (a) Levy a monetary penalty in an amount determined in accordance with division (B)(3) of this section; (b) Order the payment of interest directly to the provider in accordance with section 3901.38 of the Revised Code; (c) Order the third-party payer to cease and desist from engaging in the violations; (d) If a monetary penalty is not levied under division (B)(2)(a) of this section, impose any of the administrative remedies provided for in section 3901.22 of the Revised Code, other than those specified in divisions (D)(4) and (5) and (G) of that section. For violations of sections 3901.384 to 3901.3810 of the Revised Code that did not comply with section 3901.381 of the Revised Code, the superintendent may also use section 3901.22 of the Revised Code except divisions (D)(4) and (5) of that section. (3) A finding by the superintendent that a third-party payer has committed a series of violations that, taken together, constitutes a consistent pattern or practice of violating division (A) of section 3901.3811 of the Revised Code, shall constitute a single offense for purposes of levying a fine under division (B)(1)(a) and (B)(2)(a) of this section. For a first offense, the superintendent may levy a fine of not more than one hundred thousand dollars. For a second offense that occurs on or earlier than four years from the first offense, the superintendent may levy a fine of not more than one hundred fifty thousand dollars. For a third or additional offense that occurs on or earlier than seven years after a first offense, the superintendent may levy a fine of not more than three hundred thousand dollars. In determining the amount of a fine to be levied within the specified limits, the superintendent shall consider the following factors: (a) The extent and frequency of the violations; (b) Whether the violations were due to circumstances beyond the third-party payer's control; (c) Any remedial actions taken by the third-party payer to prevent future violations; (d) The actual or potential harm to others resulting from the violations; (e) If the third-party payer knowingly and willingly committed the violations; (f) The third-party payer's financial condition; (g) Any other factors the superintendent considers appropriate. (C) The remedies imposed by the superintendent under this section are in addition to, and not in lieu of, such other remedies as providers and beneficiaries may otherwise have by law. (D) Any fine collected under this section shall be paid into the state treasury as follows: (1) Twenty-five per cent of the total to the credit of the department of insurance operating fund created by section 3901.021 of the Revised Code; (2) Sixty-five per cent of the total to the credit of the general revenue fund; (3) Ten per cent of the total to the credit of claims processing education account, which is hereby created within the department of insurance operating fund created by section 3901.021 of the Revised Code. All money credited to the claims processing education account shall be used by the department of insurance to make technical assistance available to third-party payers, providers, and beneficiaries for effective implementation of the provisions of sections 3901.38 and 3901.381 to 3901.3814 of the Revised Code.
Ohio Rev. Code § 3901.05 — Ohio Revised Code / Title 39 / Chapter 3901 / § 3901.05
§ 3901.05. Deputy superintendent - duties
Status: in_force

September 9, 1957 House Bill 312 - 102nd General Assembly In the event of a vacancy in the office of the superintendent of insurance, or in the absence or disability of that officer, or when so directed by the superintendent, the deputy superintendent of insurance shall perform all the duties of the superintendent. In the absence of the superintendent and the deputy superintendent, and when so directed by the superintendent, either assistant superintendent shall perform all the duties of the superintendent. The deputy superintendent, or either assistant superintendent, may serve upon any board or commission of which the superintendent is a member.
Ohio Rev. Code § 3925.20 — Ohio Revised Code / Title 39 / Chapter 3925 / § 3925.20
§ 3925.20. Authorized real estate holdings
Status: in_force

May 13, 1980 House Bill 729 - 113th General Assembly No insurance company organized under Chapter 3925. of the Revised Code, shall purchase, hold, or convey real estate, except for the folowing purposes and in the following manner: (A) Real estate requisite for its convenient accommodation in the transaction of its business; (B) Real estate mortgaged to it in good faith, by way of security for loans previously contracted, or for money due; (C) Real estate conveyed to it in satisfaction of debts previously contracted in its legitimate business, or for money due; (D) Real estate purchased at sales upon judgment or mortgages obtained or made for such debts; (E) Real estate, or any interest in real estate, acquired or held by purchase, lease, or otherwise, as an investment for production of income or to be improved or developed for the production of income. An insurer shall not have at any one time more than ten per cent of its assets invested in real estate under this section. An insurer shall not have at any one time more than two per cent of its assets invested in any one real estate investment except with the prior approval of the superintendent of insurance. No investment in real estate to be used primarily for recreational, agricultural, or mining purposes shall be made under authority of this section.
Ohio Rev. Code § 3999.12 — Ohio Revised Code / Title 39 / Chapter 3999 / § 3999.12
§ 3999.12. Disbursements by domestic life insurance companies
Status: in_force

October 1, 1953 House Bill 1 - 100th General Assembly No domestic life insurance company making a disbursement of one hundred dollars or more shall fail to have it evidenced by a voucher signed by or on behalf of the person, firm, or corporation receiving the money and correctly describing the consideration thereof; if such expenditure is for both services and disbursements, such company shall not fail to set forth in such voucher, the service rendered and an itemized statement of the disbursement made; if such expenditure was in connection with a matter pending before a legislative or public body or a department or officer of any state or government, in addition to the foregoing information, such corporation shall not fail to describe correctly in such voucher the nature of the matter and of the interest of such company therein. If such voucher cannot be obtained, such expenditures must be evidenced by an affidavit describing the character and object of the expenditure and stating the reasons for not obtaining such voucher.
Ohio Rev. Code § 3905.93 — Ohio Revised Code / Title 39 / Chapter 3905 / § 3905.93
§ 3905.93. Bail bond - charges and fees
Status: in_force

October 9, 2001 House Bill 730 - 123rd General Assembly A surety bail bond agent shall not execute a bail bond without doing both of the following: (A) Charging the premium rate filed with and approved by the superintendent of insurance; (B) Disclosing the expense fee that will be charged to cover the costs incurred by the agent in executing the bond.
Ohio Rev. Code § 3923.444 — Ohio Revised Code / Title 39 / Chapter 3923 / § 3923.444
§ 3923.444. Compensation of agents selling long-term care policies
Status: in_force

September 10, 2007 House Bill 100 - 127th General Assembly (A) No agent or third-party administrator shall field issue a long-term care insurance policy or certificate if the compensation to the agent or third-party administrator is not based on the number of policies or certificates issued. (B) As used in this section, "field issue" means to issue a policy or certificate pursuant to the underwriting authority granted to an agent or third-party administrator by an insurer using the insurer's underwriting guidelines.
Ohio Rev. Code § 3937.03 — Ohio Revised Code / Title 39 / Chapter 3937 / § 3937.03
§ 3937.03. Classifications - rules - rates - rating plan
Status: in_force

October 24, 2024 Senate Bill 175 - 135th General Assembly (A)(1) Every insurer shall file with the superintendent of insurance every form of a policy, endorsement, rider, manual of classifications, rules, and rates, every rating plan, and every modification of any of them which it proposes to use. Every such filing shall state any proposed effective date and indicate the character and extent of the coverage contemplated. When a filing is not accompanied by the information upon which the insurer supports such filing, and the superintendent does not have sufficient information to determine whether such filing complies with sections 3937.01 to 3937.17 of the Revised Code, the superintendent may require such insurer to furnish the information upon which it supports such filing. Any filing may be supported by the experience or judgment of the insurer or rating organization making the filing, the experience of other insurers or rating organizations, or any other factors which the insurer or rating organization considers relevant. A filing and any supporting information shall be open to public inspection after the filing becomes effective. Trade secrets contained in any filing or in any supporting information shall not be open to public inspection, are not a public record under section 149.43 of the Revised Code, and the release of such trade secrets is prohibited. (2) As used in division (A)(1) of this section, "trade secret" has the same meaning as in section 1333.61 of the Revised Code. (B) An insurer may satisfy its obligation to make such filings by becoming a member of, or a subscriber to, a licensed rating organization which makes such filings, and by authorizing the superintendent to accept such filings on its behalf. Sections 3937.01 to 3937.17 of the Revised Code do not require an insurer to become a member of or a subscriber to any rating organization. (C)(1) For purposes of this division: (a) "Commercial insurance" means any commercial casualty or commercial liability insurance except sickness and accident, fidelity and surety, and automobile insurance as defined in section 3937.30 of the Revised Code. (b) "Personal lines coverage" means any policy of insurance issued to a natural person for personal or family protection, including, but not limited to, personal automobile, homeowner's, tenant's, and personal umbrella liability coverages. (2) Except as provided in division (C)(3) of this section, each filing shall become effective immediately upon its filing and is deemed to comply with such sections, unless disapproved by the superintendent as provided in this section or section 3937.04 of the Revised Code. (3) Whenever the superintendent declares by rule pursuant to Chapter 119. of the Revised Code that a degree of competition that will assure that rates are not excessive does not exist in the market for a line of commercial insurance, or that the market is conducted in a manner that may result in inadequate rates or be destructive of competition or detrimental to solvency of insurers, the superintendent shall provide that every filing that would result in an increase or decrease of rates for any coverages for that line of commercial insurance shall be subject to this division. Such filing shall be on file for a waiting period of thirty days before it becomes effective, which period may be extended by the superintendent for one additional period not to exceed fifteen days, if the superintendent gives written notice within such initial waiting period to the insurer or rating bureau that the superintendent needs such additional time for the consideration of such filing. A filing is deemed to comply with sections 3937.04 to 3937.17 of the Revised Code unless disapproved by the superintendent within the waiting period or its extension. Upon written application by such insurer or rating bureau, the superintendent may authorize a filing that the superintendent has reviewed to become effective before the expiration of the initial waiting period or its extension. If, during the initial waiting period or extension, the superintendent finds the filing to which sections 3937.04 to 3937.17 of the Revised Code apply does not comply with the sections, the superintendent shall disapprove the filing by sending written notice to the person who made the filing, specifying therein the reasons the filing fails to comply with the sections. Upon notice of disapproval, the person who made such a filing may request a hearing pursuant to section 3937.15 of the Revised Code. (4) In determining whether circumstances exist in a market for a line of commercial insurance as required in division (C)(3) of this section, the superintendent shall consider all relevant structural factors in determining the conditions of the market, including: the number of insurers actively engaged in providing coverage; market shares; changes in market shares; and ease of entry. (5) This division does not apply to any filings required under Chapter 3937. of the Revised Code for personal lines coverage. (6) Any rule adopted by the superintendent under this division shall expire one year after its issuance unless rescinded earlier or extended by rule adopted by the superintendent. (D) A special filing may be made with respect to a surety or guaranty bond required by law, by court or executive order, or by order, rule, or regulation of a public body not covered by a previous filing. (E) Special filings may be made at any time with respect to any individual or special risks whose size, classification, degree of exposure to loss, previous loss experience, or other relevant factors call for the exercise of sound underwriting judgment in the promulgation of rates appropriate to such individual or special risks. The superintendent may make such examination as the superintendent considers advisable to ascertain whether such rates meet the standards set forth in division (D) of section 3937.02 of the Revised Code. (F) The superintendent may, by written order, suspend or modify the requirement of filing as to any kind of insurance, subdivision, or combination thereof, or as to classes of risks, the rates for which cannot practicably be filed before they are used. Such orders shall be made known to insurers and rating organizations affected thereby. The superintendent may make such examination as the superintendent considers advisable to ascertain whether any rates affected by such order meet the standards set forth in division (D) of section 3937.02 of the Revised Code. (G) Upon the written application of the insured, stating the insured's reasons therefor, a rate in excess of that provided by a filing otherwise applicable may be used on any specific risk. (H) A commercial insurance policy form or endorsement that is unique in character and designed for a particular risk is exempt from filing, except that the superintendent may, by regulation or order, prescribe specific restrictions relating to this exemption. (I) An insurer shall retain any insurance policy form, endorsement, or rate that is exempt from filing under division (E), (F), (G), or (H) of this section and all supporting documentation for not less than three years after the effective date of the exempt policy form, endorsement, or rate. Upon request of the superintendent during that period, the insurer shall make such policy form, endorsement, or rate, and the supporting documentation available for inspection by the superintendent. (J) No insurer shall make or issue a contract or policy except in accordance with filings which are in effect for said insurer as provided in sections 3937.01 to 3937.17 of the Revised Code or in accordance with division (E), (F), (G), or (H) of this section. Last updated August 16, 2024 at 8:48 AM
Ohio Rev. Code § 3913.23 — Ohio Revised Code / Title 39 / Chapter 3913 / § 3913.23
§ 3913.23. Appeal of policyholder adversely affected
Status: in_force

September 29, 2023 Senate Bill 21, House Bill 33 - 135th General Assembly Any policyholder adversely affected by an order of the superintendent of insurance pursuant to division (F) of section 3913.21 of the Revised Code, may appeal to the court of common pleas pursuant to section 119.12 of the Revised Code. Last updated August 7, 2023 at 2:41 PM
Ohio Rev. Code § 3905.78 — Ohio Revised Code / Title 39 / Chapter 3905 / § 3905.78
§ 3905.78. Rights not limited or restricted
Status: in_force

August 8, 1991 Senate Bill 137 - 119th General Assembly Nothing in sections 3905.71 to 3905.79 of the Revised Code is intended, in any manner, to limit or restrict the rights of policyholders and claimants of any insurer on whose behalf a managing general agent is acting, or of auditors, accountants, examiners, or other persons that conduct examinations of insurers.
Ohio Rev. Code § 3916.14 — Ohio Revised Code / Title 39 / Chapter 3916 / § 3916.14
§ 3916.14. Examination by superintendent
Status: in_force

September 11, 2008 House Bill 404 - 127th General Assembly (A)(1) The superintendent of insurance may conduct an examination under this chapter of a licensee as often as the superintendent in the superintendent's sole discretion considers appropriate. The superintendent shall consider all of the following to determine the nature, scope, and frequency of examinations: (a) Consumer complaints; (b) The results of financial statement analyses and ratios; (c) Any changes in ownership, officers, or directors; (d) Any report of independent certified public accountants; (e) Any other criteria the superintendent determines to be appropriate. (2) For the purposes of completing an examination of a licensee under this chapter, the superintendent may examine or investigate any person, or the business of any person, insofar as the examination or investigation, in the sole discretion of the superintendent, is necessary or material to the examination of the licensee. (3) In lieu of an examination under this chapter of any foreign or alien licensee licensed under this chapter, the superintendent, at the superintendent's discretion, may accept an examination report on the licensee as prepared by the official of the licensee's state of domicile or port-of-entry state who is comparable to the superintendent. As far as is practical, the superintendent shall cooperate with that official for any examination of a foreign or alien licensee. (B) The licensee or applicant shall pay to the superintendent all costs, assessments, forfeitures, or fines incurred in conducting an examination under this section. The superintendent shall deposit the money into the state treasury to the credit of the department of insurance operating fund created by section 3901.021 of the Revised Code.
Ohio Rev. Code § 3923.44 — Ohio Revised Code / Title 39 / Chapter 3923 / § 3923.44
§ 3923.44. Standards for full and fair disclosure for sale of long-term care insurance policies
Status: in_force

September 10, 2007 House Bill 100 - 127th General Assembly (A) The superintendent of insurance, pursuant to Chapter 119. of the Revised Code, may adopt rules that include standards for full and fair disclosure setting forth the manner, content, and required disclosures for the sale of long-term care insurance policies, terms of renewability, initial and subsequent conditions of eligibility, nonduplication of coverage provisions, coverage of dependents, preexisting conditions, termination of coverage, continuation or conversion, probationary periods, limitations, exceptions, reductions, elimination periods, requirements for replacement, recurrent conditions, and definitions of terms. Such rules may include provisions related to the state long-term care partnership program, including, but not limited to, requirements related to offers to exchange partnership program policies for previously issued policies and for consumer disclosures related to the state long-term care partnership program. (B) No long-term care insurance policy shall: (1) Be canceled, nonrenewed, or otherwise terminated on the grounds of the age or the deterioration of the mental or physical health of the insured individual or certificate holder; (2) Contain a provision establishing a new waiting period if existing coverage is converted to or replaced by a new or other form within the same company, except with respect to an increase in benefits voluntarily selected by the insured individual or group policyholder; (3) Provide coverage for skilled nursing care only or provide significantly more coverage for skilled care in a facility than coverage for lower levels of care; (4) Use a definition of "preexisting condition" that is more restrictive than the following: "Preexisting condition" means a condition for which medical advice or treatment was recommended by, or received from, a provider of health care services, within six months preceding the effective date of coverage of an insured person. (5) Exclude coverage for a loss or confinement that is the result of a preexisting condition unless the loss or confinement begins within six months following the effective date of coverage of an insured person. (C) The superintendent may extend the limitation periods set forth in divisions (B)(4) and (5) of this section as to specific age group categories in specific policy forms upon findings that the extension is in the best interest of the public. (D) "Preexisting condition" does not prohibit an insurer from using an application form designed to elicit the complete health history of an applicant, and, on the basis of the answers on that application, from underwriting in accordance with that insurer's established underwriting standards. Unless otherwise provided in the policy or certificate, a preexisting condition, regardless of whether it is disclosed on the application, need not be covered until the waiting period described in division (B)(5) of this section expires. No long-term care insurance policy or certificate may exclude or use waivers or riders of any kind to exclude, limit, or reduce coverage or benefits for specifically named or described preexisting diseases or physical conditions beyond the waiting period described in division (B)(5) of this section. (E)(1) No long-term care insurance policy shall do any of the following: (a) Condition eligibility for any institutional benefits on a requirement of prior hospitalization; (b) Condition eligibility for benefits provided in an institutional care setting on the receipt of a higher level of institutional care; (c) Condition eligibility for any institutional benefits, other than waiver of premium or post-confinement, post-acute care, or recuperative benefits, on a requirement of prior institutionalization. (2) Every long-term care insurance policy that conditions eligibility for noninstitutional benefits on the prior receipt of institutional care is subject to both of the following: (a) The policy shall not require a prior institutional stay of more than thirty days. (b) The policy shall provide that eligibility for noninstitutional benefits shall be established by the alternative of a period of hospitalization of not more than three days. (3) No long-term care insurance policy, except for the policy described in division (E)(2) of this section, shall condition eligibility for noninstitutional benefits on the requirement of prior hospitalization. (4) No long-term care insurance policy that provides benefits only following institutionalization shall condition the benefits upon admission to a facility for the same or related conditions within a period of less than thirty days after discharge from the institution. (F) A long-term care insurance policy that provides post-confinement, post-acute care, or recuperative benefits shall state any limitations or conditions on eligibility for benefits, including any required period of prior institutionalization as permitted in division (E)(1)(c) of this section, in a separate paragraph of the policy or certificate and shall label that paragraph "Limitations or Conditions on Eligibility for Benefits." (G) The superintendent, pursuant to Chapter 119. of the Revised Code, may adopt rules establishing loss ratio standards for long-term care insurance policies provided that a specific reference to long-term care insurance policies is contained in the rule. (H)(1) A person insured under a long-term care insurance policy may return the policy or certificate in accordance with the procedures and requirements provided for individual policyholders under section 3923.31 of the Revised Code, except that the person has thirty days from the date of delivery to return the policy or certificate and have the premium refunded. (2) A notice of the policyholder's or certificate holder's rights under division (H)(1) of this section and section 3923.31 of the Revised Code shall be printed prominently on the first page of the policy or certificate or attached to the policy or certificate. (I) Except as provided in division (M) of this section, an outline of coverage and a notice that consumer information is available from the department of insurance under section 3923.49 of the Revised Code shall be delivered to a prospective applicant for long-term care insurance at the time of the initial solicitation through means that prominently direct the attention of the prospective applicant to the outline of coverage, the purpose of the outline of coverage, and the notice. In the case of agent solicitations, the agent shall deliver the outline of coverage and notice prior to the presentation of an application or enrollment form. In the case of direct response solicitations, the insurer shall deliver the outline of coverage and notice in conjunction with any application or enrollment form. The superintendent shall prescribe by rule the content and format of the outline of coverage and notice, including the style, overall appearance, size, color and prominence of type, and the arrangement of text and captions. The outline of coverage shall include all of the following: (1) A description of the principal benefits and coverage provided in the policy; (2) A statement of the principal exclusions, reductions, and limitations contained in the policy; (3) A statement of the terms under which the individual policy or certificate or the group policy or certificate may be renewed and the terms under which cancellation is permitted, including any reservation in the policy of a right to change premiums. Continuation or conversion provisions of group long-term care insurance shall be specifically described. (4) A description of the terms under which the policy or certificate may be returned and the premium refunded; (5) A brief description of the relationship of the cost of care and benefits; (6) A statement that the outline of coverage is a summary of the policy issued or applied for, and that the policy or group master policy should be consulted to determine governing contractual provisions; (7) A statement that discloses to the policyholder or certificate holder whether the policy is intended to be a federally tax-qualified long-term care insurance contract. (J) A certificate issued pursuant to a group long-term care insurance policy that is delivered, issued for delivery, or used in or outside this state shall include all of the following: (1) A description of the principal benefits and coverage provided in the policy; (2) A statement of the principal exclusions, reductions, and limitations contained in the policy; (3) A statement that the group master policy determines governing contractual provisions. (K) If an individual life insurance policy provides long-term care benefits within the policy or by rider, a policy summary shall be delivered to an applicant for the policy at the time of policy delivery. In the case of direct response solicitations, the insurer shall deliver the policy summary to the applicant upon the applicant's request. If no such request is made, the insurer shall deliver the policy summary no later than at the time of policy delivery. In addition to any other information required by this section, the policy summary shall include all of the following: (1) A statement that explains how the terms of the policy that provide benefits for long-term care insurance affect the other terms of the policy, including how the payment of these benefits would reduce the death benefits payable by the policy; (2) A description of the amount of benefits for long-term care insurance that is available under the policy, the length of time these benefits could be paid by the policy, and any guaranteed lifetime benefits provided by the policy, for each insured under the policy; (3) A statement of the exclusions, reductions, and limitations on benefits for long-term care insurance that are contained in the policy; (4) A statement of the effects of exercising other rights under the policy; (5) A statement of the guarantees, if any, with respect to the policy costs of providing benefits for long-term care insurance; (6) A statement of all current and projected maximum lifetime benefits; (7) A statement of whether long-term care inflation protection is available under the policy. (L) During the time when a long-term care benefit, funded through a life insurance vehicle by the acceleration of the death benefit, is in benefit payment status, the insurer shall provide a monthly report to the policyholder. The report shall include all of the following: (1) A description of all benefits for long-term care insurance that were paid by the policy during that month; (2) An explanation of any changes in the policy, including death benefits or cash values due to the payout of long-term care benefits; (3) A statement of the amount of benefits for long-term care insurance that is still available under the policy. (M) In case of a policy issued to a group defined in division (D)(1) of section 3923.41 of the Revised Code, an outline of coverage shall not be required to be delivered, provided that the information described in division (I) of this section is contained in other materials relating to enrollment and, upon request, these other materials are made available to the superintendent. (N)(1) Policies that are intended to qualify under the state long-term care partnership program shall comply with all state and federal requirements applicable to policies issued in connection with the state long-term care partnership program. (2)(a) For policies intended to qualify under the state long-term care partnership program, the agent or insurer shall deliver to the applicant a long-term care partnership policy disclosure form along with the outline of coverage specified in division (I) of this section. (b) In the case of a policy issued to a group where an outline of coverage is not delivered, the long-term care partnership policy disclosure form is delivered with enrollment forms. (c) In the case of a life insurance policy that offers long-term care insurance within the policy or as a rider, the disclosure form is provided with the policy summary. (O) No insurer shall issue a policy intended to qualify as a state partnership program policy that fails to satisfy the following inflation protection requirements: (1) For a person who is less than sixty-one years of age as of the date of purchase of the policy, the policy provides annual inflation protection of at least three per cent compounded annually per year or a rate, compounded annually, that is equal to the annual consumer price index. (2) For a person who is at least sixty-one years of age but less than seventy-six years of age as of the date of purchase of the policy, the policy provides annual inflation protection of at least three per cent simple or a rate equal to the annual consumer price index. (3) For a person who is at least seventy-six years of age as of the date of purchase of the policy, the policy may provide inflation protection. (P) As used in this section, "consumer price index" means consumer price index for all urban consumers, U.S. city average, all items, as determined by the bureau of labor statistics of the United States department of labor. (Q) For purposes of division (O) of this section, the superintendent may approve an alternative index to be used in place of the consumer price index. (R) The superintendent shall prescribe by rule pursuant to Chapter 119. of the Revised Code the content and format of the state long-term care partnership program policy disclosure form required by division (N)(2) of this section. (S) No policy may be advertised, marketed, or offered as long-term care insurance unless it complies with sections 3923.41 to 3923.48 of the Revised Code. (T) The superintendent may adopt rules in accordance with Chapter 119. of the Revised Code to establish minimum standards for marketing practices, agent compensation, agent testing, and reporting practices for long-term care insurance.
Ohio Rev. Code § 3999.37 — Ohio Revised Code / Title 39 / Chapter 3999 / § 3999.37
§ 3999.37. Prohibiting fraudulent acts concerning impairment or insolvency of insurer
Status: in_force

August 8, 1991 Senate Bill 137 - 119th General Assembly No person shall do any of the following: (A) Conceal any property belonging to an insurer; (B) Transfer or conceal his own property or property belonging to an insurer in contemplation of a proceeding under Chapter 3903. of the Revised Code; (C) Conceal, destroy, multilate, alter, or make a false entry in any document that affects or relates to the property of an insurer; (D) Withhold any document that affects or relates to the property of an insurer from a receiver, trustee, or other officer of a court entitled to its possession; (E) Give, obtain, or receive anything of value for acting or forbearing to act in any judicial proceeding, if the act results in or contributes to the impairment or insolvency of any insurer.
Ohio Rev. Code § 3923.46 — Ohio Revised Code / Title 39 / Chapter 3923 / § 3923.46
§ 3923.46. Rates for individual policy
Status: in_force

September 14, 1988 House Bill 611 - 117th General Assembly Premium rates for any individual policy of long-term care insurance shall be filed in accordance with section 3923.021 of the Revised Code.
Ohio Rev. Code § 3939.08 — Ohio Revised Code / Title 39 / Chapter 3939 / § 3939.08
§ 3939.08. Renewal of certificate
Status: in_force

October 1, 1953 House Bill 1 - 100th General Assembly Upon the filing of its annual statement by an association organized under section 3939.01 of the Revised Code, the superintendent of insurance, annually, shall issue to such association a renewal of the certificate issued under section 3939.07 of the Revised Code, if he finds that such association has complied with the law. For each such certificate and renewal every association shall pay five dollars to the superintendent for the use of the state.
Ohio Rev. Code § 3931.02 — Ohio Revised Code / Title 39 / Chapter 3931 / § 3931.02
§ 3931.02. Schedule of fees
Status: in_force

October 1, 1953 House Bill 1 - 100th General Assembly Every attorney under section 3931.01 of the Revised Code shall pay to the superintendent of insurance for the use of the state the following fees: (A) For filing declaration, twenty-five dollars; (B) For filing each financial statement required by sections 3931.01 to 3931.13 , inclusive, 3931.12 of the Revised Code, twenty dollars; (C) For filing each certificate of license, and certified copy thereof, two dollars; (D) For each copy of a paper filed in the superintendent's office, twenty cents per folio; (E) For affixing the seal of office and certifying any paper, one dollar.
Ohio Rev. Code § 3905.071 — Ohio Revised Code / Title 39 / Chapter 3905 / § 3905.071
§ 3905.071. Nonresident to file change of address
Status: in_force

May 26, 2010 House Bill 300 - 128th General Assembly (A)(1) If a nonresident person licensed as a nonresident insurance agent under section 3905.07 of the Revised Code changes the person's address within the person's state of residence, the person shall, within thirty days after making that change, file a change of address with the superintendent of insurance or the superintendent's designee. (2) If a nonresident person licensed as a nonresident insurance agent under section 3905.07 of the Revised Code changes the person's home state, the person shall, within thirty days after making that change, file a change of address with the superintendent and provide the superintendent with certification from the new home state. (B) If a nonresident insurance agent complies with division (A) of this section and the agent is in good standing with the superintendent, no fee or license application shall be required. A change in the residency status of an agent's license under this section does not change the license renewal date established by the initial license under section 3905.07 of the Revised Code.
Ohio Rev. Code § 3924.51 — Ohio Revised Code / Title 39 / Chapter 3924 / § 3924.51
§ 3924.51. Plan benefits for adopted children
Status: in_force

June 30, 1997 House Bill 374 - 122nd General Assembly (A) As used in this section: (1) "Child" means, in connection with any adoption or placement for adoption of the child, an individual who has not attained age eighteen as of the date of the adoption or placement for adoption. (2) "Health insurer" has the same meaning as in section 3924.41 of the Revised Code. (3) "Placement for adoption" means the assumption and retention by a person of a legal obligation for total or partial support of a child in anticipation of the adoption of the child. The child's placement with a person terminates upon the termination of that legal obligation. (B) If an individual or group health plan of a health insurer makes coverage available for dependent children of participants or beneficiaries, the plan shall provide benefits to dependent children placed with participants or beneficiaries for adoption under the same terms and conditions as apply to the natural, dependent children of the participants and beneficiaries, irrespective of whether the adoption has become final. (C) A health plan described in division (B) of this section shall not restrict coverage under the plan of any dependent child adopted by a participant or beneficiary, or placed with a participant or beneficiary for adoption, solely on the basis of a pre-existing condition of the child at the time that the child would otherwise become eligible for coverage under the plan, if the adoption or placement for adoption occurs while the participant or beneficiary is eligible for coverage under the plan.
Ohio Rev. Code § 3903.55 — Ohio Revised Code / Title 39 / Chapter 3903 / § 3903.55
§ 3903.55. Foreign claimants
Status: in_force

March 7, 1983 House Bill 830 - 114th General Assembly (A) In a liquidation proceeding begun in this state against an insurer domiciled in this state, claimants residing in foreign countries or in states not reciprocal states must file claims in this state, and claimants residing in reciprocal states may file claims either with the ancillary receivers, if any, in their respective states, or with the domiciliary liquidator. Claims must be filed on or before the last date fixed for the filing of claims in the domiciliary liquidation proceeding. (B) Claims belonging to claimants residing in reciprocal states may be proved either in the liquidation proceeding in this state as provided in sections 3903.01 to 3903.59 of the Revised Code, or in ancillary proceedings, if any, in the reciprocal states. If notice of the claims and opportunity to appear and be heard is afforded the domiciliary liquidator of this state as provided in division (B) of section 3903.56 of the Revised Code with respect to ancillary proceedings, the final allowance of claims by the courts in ancillary proceedings in reciprocal states shall be conclusive as to amount and as to priority against special deposits or other security located in such ancillary states, but shall not be conclusive with respect to priorities against assets under section 3903.42 of the Revised Code.
Ohio Rev. Code § 3905.081 — Ohio Revised Code / Title 39 / Chapter 3905 / § 3905.081
§ 3905.081. Waiving licensing requirement for nonresident persons in violation of federal reciprocity requirements
Status: in_force

September 1, 2002 Senate Bill 129 - 124th General Assembly Notwithstanding any other provision of this chapter, the superintendent of insurance may waive any licensing requirement for nonresident persons that the superintendent determines is in violation of the reciprocity requirements set forth in section 321 of the "Financial Services Modernization Act of 1999," 113 Stat. 1338, 15 U.S.C.A. 6751.
Ohio Rev. Code § 3922.05 — Ohio Revised Code / Title 39 / Chapter 3922 / § 3922.05
§ 3922.05. Opportunities for external review by independent review organization
Status: in_force

September 6, 2012 House Bill 341 - 129th General Assembly (A) A health plan issuer shall afford the opportunity for an external review by an independent review organization for an adverse benefit determination if the determination involved a medical judgment or if the decision was based on any medical information, pursuant to the following sections: (1) Section 3922.08 of the Revised Code for a standard review; (2) Section 3922.09 of the Revised Code for an expedited review; (3) Section 3922.10 of the Revised Code for reviews involving experimental procedures. (B) A health plan issuer shall afford the opportunity for an external review by the superintendent of insurance for an adverse benefit determination by the health plan issuer based on a contractual issue that did not involve a medical judgment or any medical information, pursuant to section 3922.11 of the Revised Code. (C) For an adverse benefit determination in which emergency medical services have been determined to be not medically necessary or appropriate after an external review pursuant to division (A) of this section, the health plan issuer shall afford the covered person the opportunity for an external review by the superintendent of insurance, based on the prudent layperson standard, pursuant to section 3922.11 of the Revised Code. (D) Upon receipt of a request for an external review from a covered person, the health plan issuer shall review it for completeness as prescribed under any associated rules, policies, or procedures adopted by the superintendent. (1) If the request is complete, the health plan issuer shall initiate an external review in accordance with any associated rules, policies, or procedures adopted by the superintendent of insurance and shall notify the covered person in writing, in a form specified by the superintendent of insurance, that the request is complete. This notification shall include both of the following: (a) The name and contact information for the assigned independent review organization or the superintendent of insurance, as applicable, for the purpose of submitting additional information; (b) Except for when an expedited request is made under section 3922.09 or 3922.10 of the Revised Code, a statement that the covered person may, within ten business days after the date of receipt of the notice, submit, in writing, additional information for either the independent review organization or the superintendent of insurance to consider when conducting the external review. (2) If the request for an external review is not complete, the health plan issuer shall, in accordance with any associated rules, policies, or procedures adopted by the superintendent of insurance, inform the covered person in writing, including what information is needed to make the request complete. (E)(1) If the health plan issuer denies a request for an external review on the basis that the adverse benefit determination is not eligible for an external review, the health plan issuer shall notify the covered person in writing of both of the following: (a) The reason for the denial; (b) That the denial may be appealed to the superintendent. (2) If the health plan issuer denies a request for external review on the basis that the adverse benefit determination is not eligible for an external review, the covered person may appeal the denial to the superintendent of insurance. (3) Regardless of a determination made by a health plan issuer, the superintendent of insurance may determine that a request is eligible for external review. The superintendent's determination shall be made in accordance with the terms of the covered person's benefit plan and shall be subject to all applicable provisions of this chapter. (F)(1) If an external review of an adverse benefit determination is granted, the superintendent, according to any rules, policies, or procedures adopted by the superintendent shall assign an independent review organization from the list of organizations maintained by the superintendent under section 3922.13 of the Revised Code to conduct the external review and shall notify the health plan issuer of the name of the assigned independent review organization. (2) The assignment of an approved independent review organization shall be done on a random basis from those independent review organizations qualified to conduct the review in question based on the nature of the health care service that is the subject of the adverse benefit determination. (3) The superintendent of insurance shall not choose an independent review organization with a conflict of interest, as prescribed under section 3922.14 of the Revised Code. (G) In its review of an adverse benefit determination under section 3922.08 , 3922.09 , or 3922.10 of the Revised Code, an assigned independent review organization is not bound by any decisions or conclusions reached by the health plan issuer during its utilization review process or internal appeals process. The organization is not required to, but may, accept and consider additional information submitted after the end of the ten-business-day period described in division (D)(1)(b) of this section. (H)(1) An independent review organization assigned to review an adverse benefit determination shall provide written notice of its decision to either uphold or reverse the determination within thirty days of receipt by the health plan issuer of a request for a standard review or a standard review involving an experimental or investigational treatment, or within seventy-two hours of receipt by the health plan issuer of an expedited request. (2) The written notice shall be sent to all of the following: (a) The covered person; (b) The health plan issuer; (c) The superintendent of insurance. (3) The written notification shall include all of the following: (a) A general description of the reason for the request for external review; (b) The date the independent review organization was assigned by the superintendent of insurance to conduct the external review; (c) The dates over which the external review was conducted; (d) The date on which the independent review organization's decision was made; (e) The rationale for its decision; (f) References to the evidence or documentation, including any evidence-based standards used, that were considered in reaching its decision. (I) Upon receipt of a notice by an independent review organization to reverse the adverse benefit determination, a health plan issuer shall immediately provide coverage for the health care service or services in question.