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Ohio Statutes, Title 39

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Ohio/Statutes

← All Ohio coverage

Title 39, Insurance

44 chapters · 1,388 sections in this title.

All chapters in Title 391,388 Ch 3901, Superintendent Of Insurance151 Ch 3905, Insurance Producers Licensing Act123 Ch 3923, Sickness And Accident Insurance109 Ch 3903, Reserve Valuation; Rehabilitation An…92 Ch 3929, Domestic And Foreign Insurance Compa…77 Ch 3941, Operation Of Mutual Insurance Companies51 Ch 3937, Casualty Insurance; Motor Vehicle In…50 Ch 3921, Fraternal Benefit Societies43 Ch 3919, Mutual Protective Insurance Upon Persons40 Ch 3925, Domestic Insurance Companies Other T…36 Ch 3953, Title Insurance36 Ch 3924, Small Employer Health Benefit Plans;…33 Ch 3964, Captive Insurance Companies33 Ch 3902, Insurance Policies And Contracts32

1,388 sections·Filtered byTitle 39✕

Ohio Rev. Code Ann. § 3901.99 Penalty
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(A) Whoever violates section 3901.09 of the Revised Code shall be fined not less than twenty-five nor more than five hundred dollars. (B) Whoever violates any law relating to the superintendent of insurance, or any law of this state relating to insurance as defined in division (A…
Ohio Rev. Code Ann. § 3902.01 Purpose of sections
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(A) The purpose of sections 3902.01 to 3902.08 of the Revised Code is to establish minimum standards for language used in policies and certificates of life insurance and annuities, credit life insurance and credit disability insurance, and sickness and accident insurance, and sub…
Ohio Rev. Code Ann. § 3902.02 Insurance policy and contract definitions
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As used in sections 3902.01 to 3902.08 of the Revised Code: (A) "Policy" or "policy form" means any policy, contract, plan or agreement of life insurance and annuities, credit life insurance and credit disability insurance, and sickness and accident insurance, and subscriber poli…
Ohio Rev. Code Ann. § 3902.03 Policies to which sections apply - exceptions - non-English language policies

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(A) Sections 3902.01 to 3902.08 of the Revised Code apply to all policies delivered or issued for delivery in this state by any company on or after the date such forms must be approved under sections 3902.01 to 3902.08 of the Revised Code. Sections 3902.01 to 3902.08 of the Revis…

Ohio Rev. Code Ann. § 3902.04 Requirements for policy forms

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(A) No policy forms, except as stated in section 3902.03 of the Revised Code, shall be delivered or issued for delivery in this state on or after the dates such forms must be approved under sections 3902.01 to 3902.08 of the Revised Code, unless: (1) The text achieves a minimum s…

Ohio Rev. Code Ann. § 3902.05 Construction

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Nothing in sections 3902.01 to 3902.08 of the Revised Code shall be construed to negate any law of this state permitting the issuance of any policy form after it has been on file for the time period specified.

Ohio Rev. Code Ann. § 3902.06 Superintendent may authorize lower test score

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The superintendent of insurance may authorize a lower score than the Flesch reading ease score required in division (A)(1) of section 3902.04 of the Revised Code whenever, in his discretion, he finds that a lower score meets any of the following conditions: (A) The lower score wi…

Ohio Rev. Code Ann. § 3902.07 Approval of policy form notwithstanding provisions of other laws

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A policy form meeting the requirements of section 3902.04 of the Revised Code shall be approved notwithstanding the provisions of any other laws that specify the content of policies, if the policy form provides the policyholders and claimants protection not less favorable than th…

Ohio Rev. Code Ann. § 3902.08 Policy forms compliance date

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(A) Except as provided in section 3902.03 of the Revised Code, sections 3902.01 to 3902.08 of the Revised Code apply to all policy forms filed on or after January 9, 1983. No policy form shall be delivered or issued for delivery in this state on or after January 9, 1985 unless ap…

Ohio Rev. Code Ann. § 3902.11 Coordination of benefits definitions

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As used in sections 3902.11 to 3902.14 of the Revised Code: (A) "Beneficiary" and "third-party payer" have the same meanings as in section 3901.38 of the Revised Code. (B) "Plan of health coverage" means any of the following if the policy, contract, or agreement contains a coordi…

Ohio Rev. Code Ann. § 3902.12 Primary or secondary health coverage

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When a plan of health coverage is primary, its benefits are paid without regard to the benefits of another plan. When a plan of health coverage is secondary, its benefits are determined by taking into consideration the payments made or to be made by another plan. When there are m…

Ohio Rev. Code Ann. § 3902.13 Order of benefits for health coverage plan

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(A) A plan of health coverage determines its order of benefits using the first of the following that applies: (1) A plan that does not coordinate with other plans is always the primary plan. (2) The benefits of the plan that covers a person as an employee, member, insured, or sub…

Ohio Rev. Code Ann. § 3902.14 Rules

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The superintendent of insurance may, pursuant to Chapter 119. of the Revised Code, adopt rules to carry out the purposes of sections 3902.11 to 3902.14 of the Revised Code.

Ohio Rev. Code Ann. § 3902.21 Standard claim form definitions

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As used in sections 3902.22 and 3902.23 of the Revised Code, "third-party payer" has the same meaning as in section 3901.38 of the Revised Code.

Ohio Rev. Code Ann. § 3902.22 Superintendent to develop standard claim form

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The superintendent of insurance shall develop a standard claim form to be used by all third-party payers and providers for reimbursement of health care services and supplies, taking into consideration the special needs of, and differences between, third-party payers. The standard…

Ohio Rev. Code Ann. § 3902.23 Use of form mandatory

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Beginning one hundred eighty days after rules adopted under section 3902.22 of the Revised Code take effect, no third-party payer shall fail to use the standard claim form prescribed in those rules.

Ohio Rev. Code Ann. § 3902.30 Coverage for telehealth services

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(A) As used in this section: (1) "Cost sharing" means the cost to a covered individual 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," "hea…

Ohio Rev. Code Ann. § 3902.31 Void contracts

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(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 meani…

Ohio Rev. Code Ann. § 3902.36 Compliance with federal mental health and addiction parity laws

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(A) As used in this section: (1) "Health benefit plan" and "health plan issuer" have the same meanings as in section 3922.01 of the Revised Code. (2) "Mental Health Parity and Addiction Equity Act" means the federal "Paul Wellstone and Pete Domenici Mental Health Parity and Addic…

Ohio Rev. Code Ann. § 3902.50 Definitions for R.C. 3902.50 to 3902.72

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As used in sections 3902.50 to 3902.72 of the Revised Code: (A) "Ambulance" has the same meaning as in section 4765.01 of the Revised Code. (B) "Clinical laboratory services" has the same meaning as in section 4731.65 of the Revised Code. (C) "Cost sharing" means the cost to a co…

Ohio Rev. Code Ann. § 3902.51 Out-of-network care reimbursement requirement, negotiations

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(A)(1)(a) A health plan issuer shall reimburse an out-of-network provider for unanticipated out-of-network care when both of the following apply: (i) The services are provided to a covered person at an in-network facility. (ii) The services would be covered if provided by an in-n…

Ohio Rev. Code Ann. § 3902.52 Out-of-network care arbitration

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(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 reque…

Ohio Rev. Code Ann. § 3902.53 Out-of-network care rules, prompt pay requirements, violations

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(A)(1) Except as provided in division (A)(2) of this section, sections 3901.38 to 3901.3814 of the Revised Code shall not apply with respect to a claim during a period of negotiation under section 3902.51 of the Revised Code or a period of arbitration under section 3902.52 of the…

Ohio Rev. Code Ann. § 3902.54 Out-of-network care arbitrator requirements

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(A)(1) The superintendent of insurance shall contract with a single arbitration entity to perform all arbitrations described in section 3902.52 of the Revised Code. The superintendent shall ensure that the arbitration entity, any arbitrators the arbitration entity designates to c…

Ohio Rev. Code Ann. § 3902.60 Advanced cancer fail first drug coverage definitions

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As used in sections 3902.60 and 3902.61 of the Revised Code: (A) "Associated conditions" means the symptoms or side effects of stage four advanced metastatic cancer, or the treatment thereof, which would, in the judgment of the health care practitioner in question, jeopardize the…

Ohio Rev. Code Ann. § 3902.61 Advanced cancer fail first drug coverage prohibitions

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(A) Notwithstanding section 3901.71 and sections 3901.831 to 3901.833 of the Revised Code, a health benefit plan issued, delivered, or renewed in this state on or after the effective date of this section that directly or indirectly covers the treatment of stage four advanced meta…

Ohio Rev. Code Ann. § 3902.62 Coverage for drugs refilled without a prescription

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(A) As used in this section, "licensed health professional authorized to prescribe drugs" has the same meaning as in section 4729.01 of the Revised Code. (B) Notwithstanding section 3901.71 of the Revised Code, if a health plan issuer covers a prescription drug under a health ben…

Ohio Rev. Code Ann. § 3902.63 Coverage for occupational therapy, physical therapy, and chiropractic service

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(A) On and after the effective date of this section, and notwithstanding section 3901.71 of the Revised Code, the cost-sharing requirement, on a per day basis, imposed by a health benefit plan for services rendered by an occupational therapist or physical therapist licensed under…

Ohio Rev. Code Ann. § 3902.631 Reimbursement for certified registered nurse anesthetist services

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(A) A health benefit plan issued, amended, or renewed on or after the effective date of this section that provides coverage for a health service that a certified registered nurse anesthetist is authorized to perform pursuant to section 4723.43 of the Revised Code shall not differ…

Ohio Rev. Code Ann. § 3902.64 Coverage for hearing aids and related services

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(A) As used in this section: (1) "Hearing aid" means any wearable instrument or device designed or offered for the purpose of aiding or compensating for impaired human hearing, including all attachments, accessories, and parts thereof, except batteries and cords, that is dispense…

Ohio Rev. Code Ann. § 3902.70 Health plan issuer contracts with 340B program participants definitions

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As used in this section and section 3902.71 of the Revised Code: (A) "340B covered entity" means an entity described in section 340B(a)(4) of the "Public Health Service Act," 42 U.S.C. 256b(a)(4) and includes any pharmacy under contract with the entity to dispense drugs on behalf…

Ohio Rev. Code Ann. § 3902.71 Health plan issuer contracts with 340B program participants

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(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…

Ohio Rev. Code Ann. § 3902.72 Health plan issuer disclosure of drug data

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(A) As used in this section, "health care provider" has the same meaning as in section 3701.74 of the Revised Code. (B) A health plan issuer, including a pharmacy benefit manager, shall, upon request of a covered person, the covered person's health care provider, or the third-par…

Ohio Rev. Code Ann. § 3903.01 Reserve valuation - rehabilitation and liquidation definitions

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As used in sections 3903.01 to 3903.59 of the Revised Code: (A) "Admitted assets" means investment in assets which will be admitted by the superintendent of insurance pursuant to the law of this state. (B) "Affiliate" has the same meaning as "affiliate of" or "affiliated with," a…

Ohio Rev. Code Ann. § 3903.02 Citing of act - purpose of act

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(A) Sections 3903.01 to 3903.59 of the Revised Code may be cited as "the insurers supervision, rehabilitation, and liquidation act." (B) Sections 3903.01 to 3903.59 of the Revised Code do not limit the powers granted the superintendent of insurance under any other section of the …

Ohio Rev. Code Ann. § 3903.03 Application of sections

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The proceedings authorized by sections 3903.01 to 3903.59 of the Revised Code may be applied to any one or more of the following: (A) All insurers who are doing, or have done, an insurance business in this state, and against whom claims arising from that business may exist now or…

Ohio Rev. Code Ann. § 3903.04 Jurisdiction

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(A) No delinquency proceeding shall be commenced under this chapter by anyone other than the superintendent of insurance of this state. No court has jurisdiction to entertain, hear, or determine any delinquency proceeding commenced by any other person. (B) No court of this state …

Ohio Rev. Code Ann. § 3903.05 Temporary restraining orders - injunctions

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(A) Upon complaint or motion of any receiver, conservator, rehabilitator, or liquidator appointed in a proceeding under sections 3903.01 to 3903.59 of the Revised Code, any court of general jurisdiction may issue a temporary restraining order, a preliminary injunction, a permanen…

Ohio Rev. Code Ann. § 3903.06 Duty of persons exercising control to cooperate with superintendent

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(A) Any officer, manager, director, trustee, owner, employee, or agent of any insurer, or any other persons with authority over or in charge of any segment of the insurer's affairs, shall cooperate with the superintendent of insurance in any proceeding under sections 3903.01 to 3…

Ohio Rev. Code Ann. § 3903.07 Responsibilities of superintendent and deputies

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(A) In any proceeding under sections 3903.01 to 3903.59 of the Revised Code, the superintendent of insurance and his deputies are responsible on their official bonds for the faithful performance of their duties. If the court considers it desirable for the protection of the assets…

Ohio Rev. Code Ann. § 3903.08 Effect on pending proceedings

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Every proceeding to rehabilitate or liquidate an insurer commenced under the laws in effect before the effective date of sections 3903.01 to 3903.59 of the Revised Code shall be continued as it would have been continued had these sections not been enacted.

Ohio Rev. Code Ann. § 3903.09 Correction orders issued by superintendent

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(A) Whenever the superintendent of insurance has reasonable cause to believe, and determines, after a hearing held under division (E) of this section, that any domestic insurer has committed or engaged in, or is about to commit or engage in, any act, practice, or transaction that…

Ohio Rev. Code Ann. § 3903.10 Complaint - court may issue ex parte seizure or other order

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(A) The superintendent of insurance may file in the court of common pleas a complaint alleging, with respect to a domestic insurer all of the following: (1) That there exist any grounds that would justify a court order for a formal delinquency proceeding against an insurer under …

Ohio Rev. Code Ann. § 3903.11 Confidentiality of information - exceptions

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(A) In all proceedings and judicial reviews thereof under sections 3903.09 and 3903.10 of the Revised Code, all records of the insurer, other documents, and all department of insurance files and court records and papers, so far as they pertain to or are a part of the record of th…

Ohio Rev. Code Ann. § 3903.12 Grounds for rehabilitation order

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The superintendent of insurance may file a complaint in the court of common pleas for an order authorizing him to rehabilitate a domestic insurer or an alien insurer domiciled in this state on any one or more of the following grounds: (A) The insurer is in such condition that the…

Ohio Rev. Code Ann. § 3903.13 Rehabilitation orders

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(A) An order to rehabilitate the business of a domestic insurer, or an alien insurer domiciled in this state, shall appoint the superintendent of insurance and his successors in office the rehabilitator, and shall direct the rehabilitator forthwith to take possession of the asset…

Ohio Rev. Code Ann. § 3903.14 Employment of special deputies

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(A) The superintendent of insurance as rehabilitator may appoint one or more special deputies, who shall have all the powers and responsibilities of the rehabilitator granted under this section, and the superintendent may employ such clerks and assistants as considered necessary.…

Ohio Rev. Code Ann. § 3903.15 Stay of actions - statute of limitations - standing

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(A) Any court in this state, before which any action or proceeding in which the insurer is a party or is obligated to defend a party is pending when a rehabilitation order against the insurer is entered, shall stay the action or proceeding for ninety days and such additional time…

Ohio Rev. Code Ann. § 3903.16 Motion for order of liquidation - order terminating rehabilitation of insurer

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(A) Whenever the superintendent of insurance believes rehabilitation of an insurer would substantially increase the risk of loss to creditors, policyholders, or the public, or would be futile, the superintendent may file a motion in the court of common pleas for an order of liqui…

Ohio Rev. Code Ann. § 3903.17 Basis for liquidation order

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The superintendent of insurance may file a complaint in the court of common pleas for an order directing him to liquidate a domestic insurer or an alien insurer domiciled in this state on the basis of any one or more of the following: (A) Upon any ground for an order of rehabilit…