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Ohio Statutes, Title 39

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Ohio/Statutes

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Title 39, Title 39. Insurance

43 chapters · 1,367 sections in this title.

All chapters in Title 391,367 Ch 3901, Chapter 3901 | Superintendent Of Ins…150 Ch 3905, Chapter 3905 | Insurance Producers L…123 Ch 3923, Chapter 3923 | Sickness And Accident…109 Ch 3903, Chapter 3903 | Reserve Valuation; Re…92 Ch 3929, Chapter 3929 | Domestic And Foreign …77 Ch 3941, Chapter 3941 | Operation Of Mutual I…51 Ch 3937, Chapter 3937 | Casualty Insurance; M…50 Ch 3921, Chapter 3921 | Fraternal Benefit Soc…43 Ch 3919, Chapter 3919 | Mutual Protective Ins…40 Ch 3925, Chapter 3925 | Domestic Insurance Co…36 Ch 3953, Chapter 3953 | Title Insurance36 Ch 3924, Chapter 3924 | Small Employer Health…33 Ch 3964, Chapter 3964 | Captive Insurance Com…33 Ch 3902, Chapter 3902 | Insurance Policies An…32

1,367 sections·Filtered byTitle 39✕

Ohio Rev. Code Ann. § 3923.28 Outpatient coverage for mental or emotional disorders
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(A) Every policy of group sickness and accident insurance providing hospital, surgical, or medical expense coverage for other than specific diseases or accidents only, and delivered, issued for delivery, or renewed in this state on or after January 1, 1979, and that provides cove…
Ohio Rev. Code Ann. § 3923.281 Sickness and accident policies - biologically based mental illness
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(A) As used in this section:(1) "Biologically based mental illness" means schizophrenia, schizoaffective disorder, major depressive disorder, bipolar disorder, paranoia and other psychotic disorders, obsessive-compulsive disorder, and panic disorder, as these terms are defined in…
Ohio Rev. Code Ann. § 3923.282 Health coverage plans - biologically based mental illness
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(A) As used in this section: (1) "Biologically based mental illness" means schizophrenia, schizoaffective disorder, major depressive disorder, bipolar disorder, paranoia and other psychotic disorders, obsessive-compulsive disorder, and panic disorder, as these terms are defined i…
Ohio Rev. Code Ann. § 3923.29 Outpatient, inpatient, and intermediate primary care benefits for alcoholism

Showing 751–800 of 1,367

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(A)(1) Every policy of group sickness and accident insurance providing hospital, surgical, or medical expense coverage for other than specific diseases or accidents only, and delivered, issued for delivery, or renewed in this state on or after January 1, 1979, shall provide for e…

Ohio Rev. Code Ann. § 3923.30 Requiring provision of coverage of treatment of mental or nervous disorders and alcoholism

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Every person, the state and any of its instrumentalities, any county, township, school district, or other political subdivisions and any of its instrumentalities, and any municipal corporation and any of its instrumentalities, which provides payment for health care benefits for a…

Ohio Rev. Code Ann. § 3923.301 Requiring provision of coverage for services of certified nurse-midwife performing service in collaboration with licensed physician

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Every person, the state and any of its instrumentalities, any county, township, school district, or other political subdivision and any of its instrumentalities, and any municipal corporation and any of its instrumentalities that provides payment for health care benefits for any …

Ohio Rev. Code Ann. § 3923.31 Right to rescind individual policy of sickness and accident insurance

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(A)(1) A policyholder has the right to rescind an individual policy of sickness and accident insurance delivered or issued for delivery in this state at least until midnight of the tenth day after the date on which the policyholder receives the policy, by returning the policy to …

Ohio Rev. Code Ann. § 3923.32 Right of family member to continue coverage after subscriber's death or upon change in marital relation to subscriber

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(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 cove…

Ohio Rev. Code Ann. § 3923.33 Medicare supplement policy definitions

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As used in section 3923.33 and sections 3923.331 to 3923.339 of the Revised Code:(A) "Applicant" means:(1) In the case of an individual medicare supplement policy, the person who seeks to contract for insurance benefits; and(2) In the case of a group medicare supplement policy, t…

Ohio Rev. Code Ann. § 3923.331 Statutes applicable to medicare supplement policies

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(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) …

Ohio Rev. Code Ann. § 3923.332 Standards for policy provisions of medicare supplement policies and certificates

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(A) No medicare supplement policy or certificate in force in this state shall contain benefits that duplicate benefits provided by medicare.(B) Notwithstanding section 3923.04 of the Revised Code or any other provision of law of this state, a medicare supplement policy or certifi…

Ohio Rev. Code Ann. § 3923.333 Benefits to be reasonable in relation to premium charged

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Medicare supplement policies shall return to policyholders benefits that are reasonable in relation to the premium charged. The superintendent of insurance shall issue reasonable rules to establish minimum standards for loss ratios of medicare supplement policies on the basis of …

Ohio Rev. Code Ann. § 3923.334 Outline of coverage delivered at time application is made

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(A) In order to provide for full and fair disclosure in the sale of medicare supplement policies, no medicare supplement policy or certificate shall be delivered in this state, unless an outline of coverage is delivered to the applicant at the time application is made.(B) The sup…

Ohio Rev. Code Ann. § 3923.335 Right to return policy or certificate and have premium refunded

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Medicare supplement policies and certificates shall have a notice prominently printed on the first page of the policy or certificate or attached thereto stating in substance that the applicant shall have the right to return the policy or certificate within thirty days of its deli…

Ohio Rev. Code Ann. § 3923.336 Review and approval of advertisement by superintendent

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(A) Each issuer of medicare supplement policies or certificates in this state shall provide a copy of any medicare supplement advertisement intended for use in this state, whether through written or electronic media, to the superintendent of insurance for review and approval.(B) …

Ohio Rev. Code Ann. § 3923.337 Rules

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All rules adopted pursuant to section 3923.33 and sections 3923.331 to 3923.339 of the Revised Code shall be subject to Chapter 119. of the Revised Code.

Ohio Rev. Code Ann. § 3923.338 Orders of superintendent

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In addition to any other applicable penalties for violations of Title XVII or XXXIX of the Revised Code, the superintendent of insurance, pursuant to an adjudication conducted in accordance with Chapter 119. of the Revised Code, may issue an order requiring issuers violating any …

Ohio Rev. Code Ann. § 3923.339 Severability

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If any provision of section 3923.33 or sections 3923.331 to 3923.339 of the Revised Code or the application thereof to any person or circumstances is for any reason held to be invalid, the remainder of section 3923.33 and sections 3923.331 to 3923.339 of the Revised Code and the …

Ohio Rev. Code Ann. § 3923.36 Excluding coverage of illness or injury covered by workers' compensation

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No sickness and accident insurance policy shall be construed to exclude illness or injury upon the ground that the insured might have elected to have such illness or injury covered by workers' compensation under division (A)(3) of section 4123.01 of the Revised Code unless the po…

Ohio Rev. Code Ann. § 3923.37 Prohibiting exclusion or reduction of benefits because of benefits payable under supplemental policy

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(A) No individual or group sickness and accident insurance policy shall be delivered, issued for delivery, or renewed in this state that excludes or reduces the benefits payable to or on behalf of an insured because benefits are also payable or have been paid under a supplemental…

Ohio Rev. Code Ann. § 3923.38 Continuing policy upon termination of employment

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(A) As used in this section: (1) "Group policy" includes any group sickness and accident policy or contract delivered, issued for delivery, or renewed in this state on or after June 28, 1984, and any private or public employer self-insurance plan or other plan that provides, or p…

Ohio Rev. Code Ann. § 3923.381 Continuing coverage under group policy when reservist is called or ordered to active duty

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(A) As used in this section:(1) "Eligible person" means any person who, at the time a reservist is called or ordered to active duty, is covered under a group policy and is either of the following:(a) An employee who is a reservist called or ordered to active duty;(b) The spouse o…

Ohio Rev. Code Ann. § 3923.382 Continuing coverage under group plan when reservist is called or ordered to active duty

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(A) As used in this section:(1) "Eligible person" means any person who, at the time a reservist is called or ordered to active duty, is covered under a group plan and is either of the following:(a) An employee who is a reservist called or ordered to active duty;(b) The spouse or …

Ohio Rev. Code Ann. § 3923.39 Consolidated corporation cancelling individual policy for nonpayment

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(A) As used in this section:(1) "Consolidated corporation" means any mutual insurance company that merged or consolidated with a hospital service association.(2) "Individual policy" means a policy other than a policy issued pursuant to section 3923.11, 3923.12, or 3923.13 of the …

Ohio Rev. Code Ann. § 3923.40 Coverage of adopted children

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No individual or group policy of sickness and accident insurance that makes family coverage available may be delivered, issued for delivery, or renewed in this state on or after January 1, 1989, unless the policy covers adopted children of the insured on the same basis as other d…

Ohio Rev. Code Ann. § 3923.41 Long-term care insurance definitions

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As used in sections 3923.41 to 3923.48 of the Revised Code: (A) "Long-term care insurance" means any insurance policy or rider advertised, marketed, offered, or designed to provide coverage for not less than one year for each covered person on an expense incurred, indemnity, prep…

Ohio Rev. Code Ann. § 3923.42 Citing provisions - applicability

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(A) Sections 3923.41 to 3923.48 of the Revised Code may be cited as the "long-term care insurance act."(B) Sections 3923.41 to 3923.48 of the Revised Code do not supersede the obligations of entities subject to these sections to comply with the substance of other applicable insur…

Ohio Rev. Code Ann. § 3923.43 Evidence to be filed by long-term care insurance association

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(A) Prior to advertising, marketing, or offering a policy within this state, the association or the insurer of the association described in division (D)(3) of section 3923.41 of the Revised Code, shall file evidence with the superintendent of insurance that the association has at…

Ohio Rev. Code Ann. § 3923.44 Standards for full and fair disclosure for sale of long-term care insurance policies

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(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 renewabil…

Ohio Rev. Code Ann. § 3923.441 Rescission of long-term care policy for misrepresentation

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(A) Except as otherwise provided in division (C) of this section and notwithstanding division (B) of section 3923.04 of the Revised Code, no insurer shall rescind a long-term care insurance policy or certificate or deny an otherwise valid claim based upon a misrepresentation by t…

Ohio Rev. Code Ann. § 3923.442 Offer of nonforfeiture benefit option with long-term care policy

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(A)(1) Except as provided in division (B) of this section, no insurer shall deliver or issue for delivery a long-term care insurance policy or certificate in this state without offering the policyholder or certificate holder the option of purchasing a nonforfeiture benefit. (2) A…

Ohio Rev. Code Ann. § 3923.443 Training required for agents selling long-term care policies

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(A)(1) No agent shall sell, solicit, or negotiate long-term care insurance without first completing an initial eight-hour partnership program training course as described in division (B) of this section. (2)(a) Any agent that sells, solicits, or negotiates any long-term care insu…

Ohio Rev. Code Ann. § 3923.444 Compensation of agents selling long-term care policies

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(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" mea…

Ohio Rev. Code Ann. § 3923.45 Forms

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The form of all long-term care insurance policies and applications shall be filed and approved in accordance with section 3923.02 of the Revised Code.

Ohio Rev. Code Ann. § 3923.46 Rates for individual policy

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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 Ann. § 3923.47 Rules

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The superintendent of insurance shall, pursuant to Chapter 119. of the Revised Code, adopt rules to carry out the purposes of sections 3923.41 to 3923.48 of the Revised Code including rules related to the state long-term care partnership program.

Ohio Rev. Code Ann. § 3923.48 Violation is unfair and deceptive insurance practice

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Any violation of sections 3923.44 to 3923.46 of the Revised Code is an unfair and deceptive insurance practice under sections 3901.19 to 3901.23 of the Revised Code.

Ohio Rev. Code Ann. § 3923.49 Establishing outreach program to educate consumers

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The department of insurance shall establish an outreach program to educate consumers about the following: (A) The need for long-term care insurance;(B) Mechanisms for financing long-term care;(C) The availability of long-term care insurance;(D) The resource protection provided by…

Ohio Rev. Code Ann. § 3923.50 Notifying department of job and family services of long-term care insurance policies that comply with insurance department requirements

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For the purposes of the Ohio long-term care insurance program established under section 5164.86 of the Revised Code, the department of insurance shall notify the department of medicaid of all long-term care insurance policies that meet all of the following requirements: (A) Compl…

Ohio Rev. Code Ann. § 3923.51 Group contracts of sickness and accident insurance persons under nineteen who are members of impoverished families

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(A) As used in this section, "official poverty line" means the poverty line as defined by the United States office of management and budget and revised by the secretary of health and human services under 95 Stat. 511, 42 U.S.C.A. 9902, as amended. (B) Every insurer that is author…

Ohio Rev. Code Ann. § 3923.52 Screening mammography and cytologic screening benefits

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(A) As used in this section and section 3923.53 of the Revised Code: (1) "Screening mammography" means a radiologic examination utilized to detect unsuspected breast cancer at an early stage in asymptomatic women and includes the x-ray examination of the breast using equipment th…

Ohio Rev. Code Ann. § 3923.53 Public employee benefit plan - breast cancer and cervical cancer screening

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(A) Notwithstanding section 3901.71 of the Revised Code, every public employee benefit plan that is established or modified in this state shall provide benefits for the expenses of all of the following: (1) To detect the presence of breast cancer in adult women, screening mammogr…

Ohio Rev. Code Ann. § 3923.54 Employee health care benefit plan

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(A) As used in this section, "screening mammography" means a radiologic examination utilized to detect unsuspected breast cancer at an early stage in asymptomatic women and includes the x-ray examination of the breast using equipment that is dedicated specifically for mammography…

Ohio Rev. Code Ann. § 3923.55 Policy to include benefits for child health supervision services from moment of birth until age nine

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(A) As used in this section and section 3923.56 of the Revised Code: (1) "Child health supervision services" means periodic review of a child's physical and emotional status performed by a physician, by a health care professional under the supervision of a physician, or, in the c…

Ohio Rev. Code Ann. § 3923.56 Plan to include benefits for child health supervision services from moment of birth until age nine

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(A) Notwithstanding section 3901.71 of the Revised Code, each employee benefit plan established or maintained in this state on or after the effective date of this amendment that provides coverage for family members of the employee shall provide, with respect to that coverage, tha…

Ohio Rev. Code Ann. § 3923.57 Pre-existing conditions provisions

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Notwithstanding any provision of this chapter, every individual policy of sickness and accident insurance that is delivered, issued for delivery, or renewed in this state is subject to the following conditions, as applicable: (A) Pre-existing conditions provisions shall not exclu…

Ohio Rev. Code Ann. § 3923.571 Conditions applying to group policies of sickness and accident insurance sold in connection with employment-related group health plan

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Except as otherwise provided in section 2721 of the "Health Insurance Portability and Accountability Act of 1996," Pub. L. No. 104-191, 110 Stat. 1955, 42 U.S.C.A. 300gg-21, as amended, the following conditions apply to all group policies of sickness and accident insurance that a…

Ohio Rev. Code Ann. § 3923.60 Standard medical reference compendia for coverage of prescription drugs

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(A) Notwithstanding section 3901.71 of the Revised Code, no group or individual policy of sickness and accident insurance that provides coverage for prescription drugs shall limit or exclude coverage for any drug approved by the United States food and drug administration on the b…

Ohio Rev. Code Ann. § 3923.601 Standardized prescription identification information - pharmacy benefits to be included

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(A)(1) This section applies to both of the following:(a) A sickness and accident insurer that issues or requires the use of a standardized identification card or an electronic technology for submission and routing of prescription drug claims pursuant to a policy, contract, or agr…

Ohio Rev. Code Ann. § 3923.602 Medication synchronization for insured

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(A) As used in this section:(1) "Cost-sharing" means the cost to an insured under a policy of sickness and accident insurance or a public employee benefit plan according to any coverage limit, copayment, coinsurance, deductible, or other out-of-pocket expense requirements imposed…