reglab/housing_qa huggingface dataset:
Ohio Rev Code § 3921.28 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3921 | Fraternal Benefit Societies|Section 3921.28 | Examination of Domestic and Foreign Societies.

Effective: January 1, 2013|Latest Legislation:  House Bill 341 - 129th General Assembly|(A)(1) Each domestic fraternal benefit society and each applicant for a certificate of incorporation as a domestic fraternal benefit society shall be subject to examination by the superintendent of insurance in accordance with section 3901.07 of the Revised Code. Section 3901.07 of the Revised Code shall govern every aspect of the examination, including the circumstances under and frequency with which it is conducted, and the authority of the superintendent and any examiner or other person appointed by the superintendent. (2)(a) A domestic fraternal benefit society shall be liable for the payment of any additional expense of an examination resulting from unreasonable delays by the society in fulfilling a request for documents or information by the examiner conducting the examination. A delay is deemed unreasonable if the examiner has made two separate unfulfilled requests for the same documents or information. A request for records or information from an examiner shall allow the fraternal benefit society a minimum of ten business days to fulfill the request.(b) In the event of an unreasonable delay, the examiner shall notify the superintendent, who shall set a hearing, under Chapter 119. of the Revised Code, to determine if there has been an unreasonable delay because of the fraternal benefit society's response to a request for documents or information and to calculate the additional expense incurred by the superintendent as a result of the unreasonable delay.(3) A summary of the examination of the superintendent and any recommendations or statements of the superintendent that accompany the report, shall be read at the first meeting of the board of directors or corresponding body of the society following the receipt thereof, and if directed so to do by the superintendent, shall also be read at the first meeting of the supreme legislative or governing body of the society following the receipt thereof. A copy of the report, recommendations, and statements of the superintendent shall be furnished by the society to each member of the board of directors or other governing body.(B) Each foreign or alien fraternal benefit society transacting or applying for admission to transact business in this state shall be subject to examination by the superintendent in accordance with section 3901.07 of the Revised Code. Section 3901.07 of the Revised Code shall govern every aspect of the examination, including the circumstances under and frequency with which it is conducted, the authority of the superintendent and any examiner or other person appointed by the superintendent, the liability for the assessment of expenses incurred in conducting the examination, and the remittance of the assessment to the superintendent's examination fund.
Ohio Rev Code § 3921.29 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3921 | Fraternal Benefit Societies|Section 3921.29 | Foreign or Alien Benefit Society License.

Effective: January 1, 2013|Latest Legislation:  House Bill 341 - 129th General Assembly|No foreign or alien fraternal benefit society shall transact business in this state without a license issued by the superintendent of insurance. Any such society may be licensed to transact business in this state upon filing all of the following with the superintendent: (A) A duly certified copy of its articles of incorporation;(B) A copy of its bylaws certified by its secretary or corresponding officer;(C) A written appointment of an agent as prescribed in section 3921.35 of the Revised Code;(D) A statement of its business made under oath of its president and secretary or corresponding officers in a form prescribed by the superintendent and duly verified by an examination made by the supervising insurance official of its state of domicile or of any other state, district, territory, province, or country, which examination is satisfactory to the superintendent;(E) Certification from the proper official of its state, district, territory, province, or country of domicile that the society is legally incorporated and licensed to transact business in that state, district, territory, province, or country;(F) Copies of its certificate forms;(G) A description of its investments that shows that its assets are invested in accordance with this chapter;(H) Any other information the superintendent considers necessary.
Ohio Rev Code § 3921.30 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3921 | Fraternal Benefit Societies|Section 3921.30 | Notice of Deficiency.

Effective: January 1, 2013|Latest Legislation:  House Bill 341 - 129th General Assembly|If the superintendent of insurance finds, upon investigation, that a domestic fraternal benefit society has exceeded its powers, has failed to comply with any provision of this chapter, is not fulfilling its contracts in good faith, has a membership of less than four hundred after an existence of one year or more, or is conducting business fraudulently or in a manner hazardous to its members, creditors, the public, or the business, the superintendent shall issue a written notice to the society that sets forth the deficiency and the reasons for the superintendent's dissatisfaction, and that requires the society to correct the deficiency within thirty days after receipt of the notice. If the society fails to correct the deficiency within that thirty-day period, the superintendent shall commence an action against the society under sections 3903.01 to 3903.59 of the Revised Code.
Ohio Rev Code § 3921.31 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3921 | Fraternal Benefit Societies|Section 3921.31 | Notice and Correction of Deficiency of Society.

Effective: January 1, 2013|Latest Legislation:  House Bill 341 - 129th General Assembly|If the superintendent of insurance finds, upon investigation, that a foreign or alien fraternal benefit society transacting or applying to transact business in this state has exceeded its powers, has failed to comply with any provision of this chapter, is not fulfilling its contracts in good faith, or is conducting its business fraudulently or in a manner hazardous to its members or creditors or the public, the superintendent shall issue a written notice to the society that sets forth the deficiency and the reasons for the superintendent's dissatisfaction, and that requires the society to correct the deficiency within thirty days after receipt of the notice. If the society fails to correct the deficiency within that thirty-day period, the superintendent shall commence an action against the society under section 3903.71 of the Revised Code.
Ohio Rev Code § 3921.33 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3921 | Fraternal Benefit Societies|Section 3921.33 | Licensing of Agents - Exceptions.

Effective: January 1, 2013|Latest Legislation:  House Bill 341 - 129th General Assembly|(A) Agents of fraternal benefit societies shall be licensed in the manner provided for agents of insurance companies in Chapter 3905. of the Revised Code, and shall be required to complete continuing education as set forth in section 3905.481 of the Revised Code starting with the twenty-four-month period commencing on the first day of January of 1999. However, no written or other examination shall be required of any person whose application for the original issuance of a license to represent a fraternal benefit society as its agent was filed with the superintendent of insurance prior to January 1, 1997. (B) The following persons shall not be required to be licensed in accordance with division (A) of this section:(1) Any regularly salaried officer, employee, or member of a licensed society who devotes substantially all of the person's services to activities other than the solicitation of fraternal insurance contracts from the public, and who receives for the solicitation of any such contracts no commission or other compensation directly dependent upon the amount of business obtained.The officers, employees, and members described in division (B)(1) of this section also are not subject to examination by the superintendent under Chapter 3905. of the Revised Code.(2) Any agent or representative of a society who devotes, or intends to devote, less than fifty per cent of the person's time to the solicitation and procurement of insurance contracts for the society. For purposes of division (B)(2) of this section, any person who, in the preceding calendar year, has received a commission or other compensation for soliciting and procuring any of the following contracts on behalf of an individual society is presumed to have devoted, or to have intended to devote, fifty per cent of the person's time to the solicitation and procurement of insurance contracts:(a) Life insurance contracts that, in the aggregate, exceeded two hundred thousand dollars of coverage for all lives insured for the preceding calendar year;(b) A permanent life insurance contract offering more than ten thousand dollars of coverage on an individual life;(c) A term life insurance contract offering more than fifty thousand dollars of coverage on an individual life;(d) Any insurance contracts other than life that the society may write and that insure the individual lives of more than twenty-five individuals;(e) Any contract issued on a variable basis, as authorized by division (C) of section 3921.22 of the Revised Code.(C) Notwithstanding division (B) of this section, any person selling an annuity contract under the authority of division (A)(3) of section 3921.16 of the Revised Code shall be licensed pursuant to Chapter 3905. of the Revised Code.
Ohio Rev Code § 3921.331 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3921 | Fraternal Benefit Societies|Section 3921.331 | Effect of Child Support Default on License.

Effective: March 22, 2001|Latest Legislation:  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 § 3921.34 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3921 | Fraternal Benefit Societies|Section 3921.34 | Application of Deceptive Act or Practice Prohibitions.

Effective: January 1, 1997|Latest Legislation:  House Bill 468 - 121st General Assembly|Sections 3901.19 to 3901.26 of the Revised Code, and any other provision of Title XXXIX of the Revised Code that prohibits life or sickness and accident insurers from engaging in any unfair and deceptive act or practice in the business of insurance, continue on and after January 1, 1997, to apply to every fraternal benefit society authorized to do business in this state. However, nothing in any of those sections or provisions shall be construed as applying to or otherwise affecting either the right of any society to determine its eligibility requirements for membership or the offering of benefits exclusively to members or persons eligible for membership in the society by a subsidiary corporation or affiliated organization of the society.
Ohio Rev Code § 3921.36 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3921 | Fraternal Benefit Societies|Section 3921.36 | False or Misleading Statements.

Effective: January 1, 1997|Latest Legislation:  House Bill 468 - 121st General Assembly|(A) No person shall cause or permit to be made, issued, or circulated in any form any of the following:(1) Any misrepresentation or false or misleading statement concerning the terms, benefits, or advantages of any fraternal insurance contract now issued or to be issued in this state, or the financial condition of any fraternal benefit society;(2) Any false or misleading estimate or statement concerning the dividends or shares of surplus paid or to be paid by any society on any insurance contract;(3) Any incomplete comparison of an insurance contract of one society with an insurance contract of another society or insurer for the purpose of inducing the lapse, forfeiture, or surrender of any insurance contract. A comparison of insurance contracts is incomplete if either of the following applies:(a) The comparison does not compare in detail the gross rates, the gross rates less any dividend or other reduction allowed at the date of the comparison, any increase in cash values, and all the benefits provided by each contract for the possible duration of the contract as determined by the life expectancy of the insured;(b) The comparison omits from consideration any benefit or value provided in the contract, any differences as to amount or period of rates, or any differences in limitations or conditions or other provisions that directly or indirectly affect the benefits.In any determination of the incompleteness or misleading character of any comparison or statement, it is presumed that the insured has no knowledge of any of the contents of the contract involved.(B) No person shall solicit membership for, or in any manner assist in procuring membership in, any society not licensed to do business in this state.(C) No person shall purposely violate, or neglect or refuse to comply with, any provision of this chapter for which a penalty is not otherwise prescribed.
Ohio Rev Code § 3921.37 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3921 | Fraternal Benefit Societies|Section 3921.37 | Exceptions to Chapter.

Effective: January 1, 1997|Latest Legislation:  House Bill 468 - 121st General Assembly|(A) Nothing in this chapter shall be construed as applying to or otherwise affecting any of the following:(1) Grand or subordinate lodges of societies, orders, or associations doing business in this state that provide benefits exclusively through local or subordinate lodges;(2) Orders, societies, or associations that admit to membership only persons engaged in one or more crafts or hazardous occupations, in the same or similar lines of business, insuring only their own members, their families and descendants of members, and the ladies' societies or ladies' auxiliaries to such orders, societies, or associations;(3) Domestic societies that limit their membership to employees of a particular city or town, designated firm, business house, or corporation that provide for a death benefit of not more than four hundred dollars or disability benefits of not more than three hundred fifty dollars to any person in any one year, or both;(4) Domestic societies or associations of a purely religious, charitable, or benevolent description, that provide for a death benefit of not more than four hundred dollars or for disability benefits of not more than three hundred fifty dollars to any one person in any one year, or both.(B) No society that, pursuant to division (A) of this section, is exempt from the requirements of this chapter, except any society described in division (A)(2) of this section, shall give or allow, or promise to give or allow, to any person any compensation for procuring new members.(C) Every society that provides for benefits in case of death or disability resulting solely from accident, and that does not obligate itself to pay natural death or sick benefits, shall have all of the privileges and be subject to all the applicable provisions of this chapter, except for the provisions and rules relating to medical examination, valuations of benefit certificates, and incontestability.(D) The superintendent of insurance may require from any society or association, by examination or otherwise, such information as will enable the superintendent to determine whether the society or association is exempt from the requirements of this chapter.(E) Societies that, pursuant to division (A) of this section, are exempt from the requirements of this chapter shall also be exempt from all other provisions of the insurance laws of this state.
Ohio Rev Code § 3921.38 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3921 | Fraternal Benefit Societies|Section 3921.38 | Review of Superintendent's Decisions and Findings.

Effective: January 1, 1997|Latest Legislation:  House Bill 468 - 121st General Assembly|All decisions and findings of the superintendent of insurance made under the provisions of this chapter are subject to review by the proper proceedings in any court of competent jurisdiction in this state.
Ohio Rev Code § 3921.99 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3921 | Fraternal Benefit Societies|Section 3921.99 | Penalty.

Effective: January 1, 1997|Latest Legislation:  House Bill 468 - 121st General Assembly|(A) Whoever violates division (A) of section 3921.36 of the Revised Code or knowingly receives any compensation or commission by or in consequence of such violation, is guilty of a misdemeanor of the first degree, and shall in addition be liable for a civil penalty in the amount of three times the sum received by the violator as compensation or commission, which penalty may be sued for and recovered by any person or society aggrieved for the person's or society's own use and benefit in accordance with the provisions of civil practice.(B) Whoever violates division (B) of section 3921.36 of the Revised Code shall be fined not less than fifty nor more than two hundred dollars.(C) Whoever violates division (C) of section 3921.36 of the Revised Code shall be fined not more than two hundred dollars.
Ohio Rev Code § 3922.02 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3922 | External Review|Section 3922.02 | Request for Review of Adverse Benefit Determination.

Effective: September 6, 2012|Latest Legislation:  House Bill 341 - 129th General Assembly|(A) A covered person may make a request for an external review of an adverse benefit determination. (B) All requests for external review shall be made in writing, including by electronic means, by the covered person to the health plan issuer within one hundred eighty days of the date of the final adverse benefit determination. However, in the case of an expedited external review under section 3922.09 of the Revised Code, the review may be requested orally.(C) An adverse benefit determination shall be eligible for internal appeal or external review, regardless of the cost of the requested health care service related to the adverse benefit determination.
Ohio Rev Code § 3922.03 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3922 | External Review|Section 3922.03 | Internal Appeal Processes; Review of Final Determination.

Effective: September 6, 2012|Latest Legislation:  House Bill 341 - 129th General Assembly|(A) All health plan issuers shall implement an internal appeal process under which a covered person may appeal an adverse benefit determination. This process must be in compliance with the "Patient Protection and Affordable Care Act of 2010," Pub. L. 111-148, 124 Stat. 119, as amended, and the associated regulations, as well as any other applicable state laws or rules or federal regulations. (B) Review of a final adverse benefit determination shall be through an external review under section 3922.08, 3922.09, or 3922.10 of the Revised Code.(C) All health plan issuers shall provide notice to covered persons, pursuant to and in accordance with federal regulations, of all internal appeal processes, external review processes, the availability of any applicable office of health insurance assistance, ombudsman program, or other similar program in this state to assist consumers.
Ohio Rev Code § 3922.06 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3922 | External Review|Section 3922.06 | Reconsideration by Issuer.

Effective: September 6, 2012|Latest Legislation:  House Bill 341 - 129th General Assembly|Except for when an expedited request is made under section 3922.09 or 3922.10 of the Revised Code, an independent review organization shall forward upon receipt a copy of any information received from a covered person pursuant to division (D)(1) of section 3922.05 of the Revised Code, as well as any other information received from the covered person, to the health plan issuer. Upon receipt of that information or the information described in division (K) of section 3922.10 of the Revised Code, a health plan issuer may reconsider its adverse benefit determination and provide coverage for the health service in question.Reconsideration of an adverse benefit determination by a health plan issuer based upon receipt of information under this section shall not delay or terminate an external review.If a health plan issuer reverses an adverse benefit determination under this section, the health plan issuer shall notify, in writing and within one business day of making such a decision, the covered person, the assigned independent review organization, and the superintendent of insurance.Upon receipt of such a notification, the assigned independent review organization shall terminate the associated external review.
Ohio Rev Code § 3922.07 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3922 | External Review|Section 3922.07 | Information Considered for Review.

Effective: December 26, 2011|Latest Legislation:  House Bill 218 - 129th General Assembly|In addition to the information provided under division (D)(1)(b) of section 3922.05, division (B) of section 3922.08, division (C) of section 3922.09, and division (D) of section 3922.10 of the Revised Code, an assigned independent review organization, to the extent that such documents are available and appropriate, shall consider all of the following when conducting its review: (A) The covered person's medical records;(B) The attending health care professional's recommendation;(C) Consulting reports from appropriate health care professionals and other documents submitted by the health plan issuer, covered person, or covered person's treating provider;(D) The terms of coverage under the covered person's health benefit plan to ensure that the independent review organization's decision is not contrary to the terms of the plan;(E) The most appropriate practice guidelines, including evidence-based standards, and practice guidelines developed by the federal government, and national or professional medical societies, boards, and associations;(F) Any applicable clinical review criteria developed and used by the health plan issuer or its designated utilization review organization;(G) The opinion of the independent review organization's clinical reviewer or reviewers after considering the other sources described in this section.
Ohio Rev Code § 3922.08 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3922 | External Review|Section 3922.08 | Provisions Applicable to Standard Reviews; Timing;.

Effective: December 26, 2011|Latest Legislation:  House Bill 218 - 129th General Assembly|(A) The provisions of this section apply only to standard reviews, which are not expedited and do not involve an experimental or investigational treatment. (B) Within five days after the receipt of a request for an external review that is complete and valid, the health plan issuer shall provide to the assigned independent review organization all documents and information considered in making the adverse benefit determination.(C) An external review shall not be delayed due to failure on the part of the health plan issuer to provide the information required under division (B) of this section.(D)(1) An independent review organization may reverse an adverse benefit determination if the information required under division (B) of this section is not provided in the allotted time. The independent review organization may also grant a request from the health plan issuer for more time to provide the required information.(2) If an adverse benefit determination is reversed under division (D)(1) of this section, the independent review organization shall notify, within one business day of making the decision, the covered person, the health plan issuer, and the superintendent of insurance.