reglab/housing_qa huggingface dataset:
Ohio Rev Code § 3959.17 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3959 | Third-Party Administrators|Section 3959.17 | 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 § 3959.20 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3959 | Third-Party Administrators|Section 3959.20 | Prohibited Acts Regarding Cost-Sharing, Pharmacy Claims for Reimbursement, Fees.

Effective: October 17, 2019|Latest Legislation:  House Bill 166 - 133rd General Assembly|(A) As used in this section: (1) "Cost-sharing" means the cost to an individual insured under a health benefit plan according to any coverage limit, copayment, coinsurance, deductible, or other out-of-pocket expense requirements imposed by the plan. (2) "Health benefit plan" and "health plan issuer" have the same meanings as in section 3922.01 of the Revised Code. (3) "Pharmacy audit" has the same meaning as in section 3901.81 of the Revised Code. (4) "Pharmacy benefit manager" and "administrator" have the same meanings as in section 3959.01 of the Revised Code. (B) No health plan issuer, pharmacy benefit manager, or any other administrator shall require cost-sharing in an amount, or direct a pharmacy to collect cost-sharing in an amount, greater than the lesser of either of the following from an individual purchasing a prescription drug: (1) The amount an individual would pay for the drug if the drug were to be purchased without coverage under a health benefit plan; (2) The net reimbursement paid to the pharmacy for the prescription drug by the health plan issuer, pharmacy benefit manager, or administrator. (C)(1) No health plan issuer, pharmacy benefit manager, or administrator shall retroactively adjust a pharmacy claim for reimbursement for a prescription drug unless the adjustment is the result of either of the following: (a) A pharmacy audit conducted in accordance with sections 3901.811 to 3901.814 of the Revised Code; (b) A technical billing error. (2) No health plan issuer, pharmacy benefit manager, or administrator shall charge a fee related to a claim unless the amount of the fee can be determined at the time of claim adjudication. (D) The department of insurance shall create a web form that consumers can use to submit complaints relating to violations of this section.
Ohio Rev Code § 3959.99 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3959 | Third-Party Administrators|Section 3959.99 | Penalty.

Effective: May 18, 1988|Latest Legislation:  House Bill 284 - 117th General Assembly|A person who violates section 3959.05 of the Revised Code is guilty of a misdemeanor of the fourth degree.
Ohio Rev Code § 3960.02 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3960 | Risk Retention|Section 3960.02 | Requirements for Transacting Business.

Effective: October 26, 1989|Latest Legislation:  House Bill 105 - 118th General Assembly|(A) No risk retention group organized under the laws of this state shall transact business in this state unless both of the following apply:(1) It has capital and surplus in an amount of not less than two million five hundred thousand dollars, and the superintendent of insurance issues a certificate of authority to transact the business of liability insurance as a risk retention group. Section 3960.03 of the Revised Code applies to the risk retention group only to the extent that that section does not conflict with or limit the operation of any law or rule of this state applicable to liability insurance companies.(2) The superintendent has approved a plan of operation or a feasibility study submitted to the superintendent by the risk retention group applicable to the lines of liability insurance to be offered by the risk retention group. The risk retention group shall submit an appropriate revision, in the event of any subsequent material change in any item of the plan of operation or feasibility study, within ten days of the change. The group shall not offer any additional kinds of liability insurance, in this state or in any other state, until a revision of the plan or study is approved by the commissioner of insurance of each state.(B) The superintendent, upon the filing of an application by a risk retention group for a certificate of authority to transact the business of liability insurance in this state, shall provide summary information to the national association of insurance commissioners including the name of the risk retention group, the identity of its initial members, the identity of the individuals who organized it or who will provide administrative services or otherwise influence or control its activities, the amount and nature of its initial capitalization, the coverages to be afforded by it, and the states in which it intends to operate. As part of its application, the risk retention group also shall provide such information in summary form.(C) The laws of this state apply to risk retention groups doing business in the state, except as preempted by the federal "Risk Retention Amendments of 1986," 100 Stat. 3170, 15 U.S.C.A. 3901, as amended, or other federal laws, and except to the extent modified in sections 3960.01 to 3960.13 of the Revised Code.(D) Each risk retention group domiciled in this state is liable for the payment of franchise taxes or taxes on premiums of direct business for risks resident or located within this state. A risk retention group domiciled in this state also is subject to any taxes, applicable fines, and penalties as are any domiciled insurers.
Ohio Rev Code § 3960.04 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3960 | Risk Retention|Section 3960.04 | Notices on Application Forms and Policies.

Effective: October 27, 1989|Latest Legislation:  House Bill 105 - 118th General Assembly|(A)(1) Every application form for insurance from a risk retention group and every policy or certificate of insurance issued by a risk retention group shall contain in ten-point type on the front page and the declaration page, the following notice: "Notice This policy is issued by your risk retention group. Your risk retention group may not be subject to all of the insurance laws and regulations of your state. State insurance insolvency guaranty funds are not available for your risk retention group." (2) No risk retention group shall fail to comply with the notice requirement of division (A)(1) of this section. (B) No risk retention group shall do any of the following: (1) Solicit or sell insurance to a person who is not eligible for membership in it; (2) Solicit or sell insurance or operate as a risk retention group if it is in a hazardous financial condition or is financially impaired. (C) No risk retention group shall do business in this state if an insurance company is directly or indirectly a member or owner of the risk retention group, except if all of the members of the risk retention group are insurance companies. (D) The terms of any insurance policy issued by any risk retention group shall not provide, or be construed to provide, coverage prohibited generally by statute of this state or declared unlawful by the highest court of the state whose law applies to the policy. (E) Sections 3901.19 to 3901.26 of the Revised Code apply to risk retention groups and to their agents and representatives.
Ohio Rev Code § 3960.05 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3960 | Risk Retention|Section 3960.05 | No Coverage by Ohio Insurance Guaranty Association or Similar Mechanism.

Effective: October 26, 1989|Latest Legislation:  House Bill 105 - 118th General Assembly|(A) Sections 3955.01 to 3955.19 of the Revised Code do not apply to risk retention groups. No risk retention group shall be required or permitted to join or contribute financially to the Ohio insurance guaranty association or similar mechanism in this state. No risk retention group, or its insureds or claimants against its insureds, shall receive any benefit from any such association or mechanism for claims arising under the insurance policies issued by the risk retention group.(B) When the laws of this state or any of its political subdivisions require any person to obtain liability insurance as a condition of licensure, approval, permission, or other authorization, the insurance may be obtained from a risk retention group as defined in division (J) of section 3960.01 of the Revised Code, if the public agency administering those laws has made a determination that the protection of the Ohio insurance guaranty association provided by Chapter 3955. of the Revised Code is not necessary and that insurance provided by a risk retention group is acceptable to the public agency under the standards of the law that it administers.(C) When a purchasing group obtains insurance covering its members' risks from an insurer not authorized in this state or a risk retention group, the risks are not covered by any insurance guaranty association or similar mechanism in this state.(D) When a purchasing group obtains insurance covering its members' risks from an authorized insurer, only risks resident or located in this state shall be covered by the state guaranty association subject to Chapter 3955. of the Revised Code.
Ohio Rev Code § 3960.06 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3960 | Risk Retention|Section 3960.06 | Applicability of Laws to Purchasing Group.

Effective: June 27, 2005|Latest Legislation:  Senate Bill 124 - 126th General Assembly|(A) A purchasing group and its insurer or insurers are subject to all applicable laws of this state, except that a purchasing group and its insurer or insurers, in regard to liability insurance for the purchasing group, are exempt from any law that does any of the following:(1) Prohibits the establishment of a purchasing group;(2) Makes it unlawful for an insurer to provide or offer to provide insurance on a basis providing, to a purchasing group or its members, advantages based on their loss and expense experience not afforded to other persons with respect to rates, policy forms, coverages, or other matters;(3) Prohibits a purchasing group or its members from purchasing insurance on a group basis described in division (A)(2) of this section;(4) Prohibits a purchasing group from obtaining insurance on a group basis because the group has not been in existence for a minimum period of time or because any member has not belonged to the group for a minimum period of time;(5) Requires that a purchasing group have a minimum number of members, common ownership or affiliation, or a certain legal form;(6) Requires that a certain percentage of a purchasing group obtain insurance on a group basis;(7) Otherwise discriminates against a purchasing group or any of its members;(8) Requires that any insurance policy issued to a purchasing group or any of its members be countersigned by an insurance agent or broker residing in this state.(B) The superintendent of insurance may require or exempt a risk retention group from participation in any joint underwriting association established under section 3930.03 or in the plan established under section 4509.70 of the Revised Code. Any risk retention group that is required to participate under this division shall submit sufficient information to the superintendent to enable the superintendent to apportion on a nondiscriminatory basis the risk retention group's proportionate share of losses and expenses.
Ohio Rev Code § 3960.07 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3960 | Risk Retention|Section 3960.07 | Requirements of Purchasing Group for Transacting Business.

Effective: January 1, 2021|Latest Legislation:  House Bill 339 - 133rd General Assembly|(A) No purchasing group shall conduct business in this state unless it has done both of the following: (1) Issued a notice to the superintendent of insurance that does all of the following: (a) Identifies the state in which the purchasing group is domiciled and all other states in which the group intends to do business; (b) Specifies the lines and classifications of liability insurance that the purchasing group intends to purchase and specifies the method by which and the person or persons, if any, through whom insurance will be offered to its members whose risks are resident or located in this state; (c) Identifies the name and domicile of the insurance company from which the purchasing group intends to purchase its insurance; (d) Identifies the principal place of business of the purchasing group; (e) Provides any other information that the superintendent may require to verify that the purchasing group is qualified under division (I) of section 3960.01 of the Revised Code. A purchasing group, within ten days, shall notify the superintendent of any changes in any of the items set forth in division (A)(1) this section. (2) Registered with the superintendent, paid a filing fee as determined by the superintendent, and consented to the exercise of jurisdiction over it by the superintendent and the courts of this state. The fee shall be paid into the state treasury to the credit of the department of insurance operating fund pursuant to section 3901.021 of the Revised Code. Division (A)(2) of this section does not apply to a purchasing group to which all of the following apply: (a) It was domiciled in any state before April 1, 1986, and on and after October 27, 1986; (b) It purchased insurance from an insurance carrier licensed in any state before and after October 27, 1986; (c) It was a purchasing group meeting the requirements of the federal "Product Liability Risk Retention Act of 1981," 95 Stat. 949, 15 U.S.C.A. 3901, before October 27, 1986; (d) It does not purchase insurance that was not authorized for purposes of an exemption under that act, as in effect before October 27, 1986. (B) Each purchasing group that is required to give notice pursuant to division (A)(1) of this section also shall furnish any information that may be required by the superintendent to do both of the following: (1) Determine where the purchasing group is located; (2) Determine appropriate tax treatment. (C) Sections 3937.01 to 3937.17 of the Revised Code apply to admitted insurers that provide insurance to purchasing groups.
Ohio Rev Code § 3960.08 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3960 | Risk Retention|Section 3960.08 | Restricting Purchases of Insurance.

Effective: October 26, 1989|Latest Legislation:  House Bill 105 - 118th General Assembly|(A) No purchasing group shall purchase insurance from a risk retention group that is not chartered, or from an insurer that is not admitted to do business, in the state in which the purchasing group is located, unless the purchase is effected through an agent or broker licensed in this state to sell surplus lines. (B)(1) A purchasing group that obtains liability insurance from an insurer not admitted in this state or a risk retention group shall inform, as provided in division (B)(2) of this section, each of the members of such group that have a risk resident or located in this state that the risk is not protected by an insurance insolvency guaranty association or mechanism in this state, and that the risk retention group or insurer may not be subject to all insurance laws and regulations of this state. (2)(a) Every application form for insurance from a purchasing group and every policy or certificate of insurance issued by a purchasing group shall contain in ten-point type on the front page the following notice: "Notice Your risk is not protected by the state insurance insolvency fund, and the insurer or the risk retention group from which your purchasing group obtained its insurance may not be subject to all of the insurance laws and rules of this state." (b) No purchasing group shall fail to comply with the notice requirements of division (B)(2)(a) of this section. (C) No purchasing group shall purchase insurance providing for a deductible or self-insured retention applicable to the group as a whole. Coverage may provide for a deductible or self-insured retention applicable to individual members.
Ohio Rev Code § 3960.09 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3960 | Risk Retention|Section 3960.09 | Premium Taxes or Taxes on Premiums Paid for Coverage of Risks.

Effective: October 26, 1989|Latest Legislation:  House Bill 105 - 118th General Assembly|Premium taxes or taxes on premiums paid for coverage of risks resident or located in this state by a purchasing group or any members of the purchasing group shall be imposed and paid in accordance with the following:(A) Imposed at the same rate and subject to the same interest, fines, and penalties as those applicable to premium taxes and taxes on premiums paid for similar coverage from a similar insurance source by other insureds;(B) Paid first by the insurance source; if not by the source, then by the agent or broker for the purchasing group; if not by the agent or broker, then by the purchasing group; and if not by the purchasing group, then by each of its members.
Ohio Rev Code § 3960.10 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3960 | Risk Retention|Section 3960.10 | Authority and Powers of Superintendent of Insurance.

Effective: October 26, 1989|Latest Legislation:  House Bill 105 - 118th General Assembly|(A) The superintendent of insurance may exercise any powers to enforce the insurance laws of this state applicable to risk retention groups and purchasing groups, except those that are specifically preempted by the federal "Product Liability Risk Retention Act of 1981," 95 Stat. 949, 15 U.S.C.A. 3901, as amended by the federal "Risk Retention Amendments of 1986," 100 Stat. 3170, 15 U.S.C.A. 3901, as amended.(B) The authority of the superintendent under division (A) of this section includes, but is not limited to, the superintendent's administrative authority under the laws of this state to investigate, issue subpoenas, conduct depositions and hearings, issue orders, and impose penalties. Actions by the superintendent seeking an injunction are subject to the restrictions in the federal "Risk Retention Amendments of 1986," 100 Stat. 3170, 15 U.S.C.A. 3901, as amended.
Ohio Rev Code § 3960.11 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3960 | Risk Retention|Section 3960.11 | Soliciting, Negotiating, or Procuring Liability Insurance Restricted to Licensed Agents and Brokers.

Effective: March 20, 2019|Latest Legislation:  Senate Bill 273 - 132nd General Assembly|(A) No person shall act or aid in any manner in soliciting, negotiating, or procuring liability insurance in this state from a risk retention group unless the person is licensed as an insurance agent or broker in accordance with Chapter 3905. of the Revised Code.(B) No person shall act or aid in any manner in soliciting, negotiating, or procuring liability insurance in this state for a purchasing group from an authorized insurer or a risk retention group chartered in a state unless the person is licensed as an insurance agent or broker in accordance with Chapter 3905. of the Revised Code.(C) No person shall act or aid in any manner in soliciting, negotiating, or procuring liability insurance coverage in this state for any member of a purchasing group under a purchasing group's policy unless the person is licensed as an insurance agent or broker in accordance with Chapter 3905. of the Revised Code.(D) No person shall act or aid in any manner in soliciting, negotiating, or procuring liability insurance from an insurer not authorized to do business in this state, or from a domestic insurer designated as a domestic surplus lines insurer pursuant to section 3905.332 of the Revised Code, on behalf of a purchasing group located in this state unless the person is licensed as a surplus line broker in accordance with section 3905.30 of the Revised Code.
Ohio Rev Code § 3960.12 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3960 | Risk Retention|Section 3960.12 | Adoption of Rules for Enforcement.

Effective: October 26, 1989|Latest Legislation:  House Bill 105 - 118th General Assembly|The superintendent of insurance may adopt any rules necessary or desirable for the enforcement of sections 3960.01 to 3960.13 of the Revised Code.
Ohio Rev Code § 3960.13 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3960 | Risk Retention|Section 3960.13 | Enforcement Powers of Superintendent of Insurance.

Effective: October 26, 1989|Latest Legislation:  House Bill 105 - 118th General Assembly|The superintendent of insurance, after notice and an opportunity for hearing under Chapter 119. of the Revised Code, may do all of the following:(A) Suspend, revoke, or refuse to renew the certificate of authority of a risk retention group that violates any provision of sections 3960.01 to 3960.13 of the Revised Code for which a specific sanction is not imposed by the law applicable to liability insurance companies admitted to do business in this state;(B) Impose a civil penalty not to exceed three thousand five hundred dollars for each violation of the type described in division (A) of this section, but not to exceed an aggregate penalty of thirty-five thousand dollars in any six-month period upon the group or any member of the group that participates in the violation;(C) Obtain injunctive relief to restrain or prevent a violation or threatened violation of the type described in division (A) of this section.
Ohio Rev Code § 3961.02 (2021)
2021 Ohio Revised Code|Title 39 | Insurance|Chapter 3961 | Discount Medical Plans|Section 3961.02 | Provider Agreement Required for Discounted Medical Services.

Effective: March 23, 2007|Latest Legislation:  Senate Bill 5 - 126th General Assembly|(A) A discount medical plan organization shall not offer to members, or advertise to prospective members, discounted medical services unless the services are offered pursuant to a provider agreement. A discount medical plan organization may enter into a provider agreement directly with a provider, indirectly through a provider network to which a provider belongs, or through another discount medical plan organization that contracts with providers directly or through a provider network.(B) A provider agreement between a discount medical plan organization and a provider shall contain all of the following:(1) A list of medical services and products offered at a discount;(2) The discounted rates for medical services or a fee schedule that reflects the provider's discounted rates;(3) A statement that the provider will not charge members more than the discounted rates described in division (B)(2) of this section.(C) A provider agreement between a discount medical plan organization and a provider network shall require the provider network to do all of the following:(1) Maintain an up-to-date list of the provider network's contracted providers and supply that list to the discount medical plan organization on a monthly basis;(2) Have a written agreement with each provider who offers discounted medical services that contains both of the following:(a) The items listed in division (B) of this section;(b) A grant of authority that allows the provider network to contract with discount medical plan organizations on behalf of the provider.(D) A provider agreement between a discount medical plan organization and another discount medical plan organization shall require that the other discount medical plan organization have provider agreements in place that comply with division (A) of this section and division (B) or (C) of this section, as applicable.(E) A discount medical plan organization shall keep for the duration of the agreement a copy of each provider agreement into which the organization has entered.