Ohio · statute · Ohio Rev. Code ch. 3924 · 33 active provisions
As used in sections 3924.01 to 3924.06 of the Revised Code: (A) "Actuarial certification" means a written statement prepared by a member of the American academy of actuaries, or by any other person acceptable to the superintendent of insurance, that states that, based upon the person's examination, a carrier offering h…
(A) An individual or group health benefit plan is subject to sections 3924.01 to 3924.06 of the Revised Code if it provides health care benefits covering at least two but no more than fifty employees of a small employer, and if it meets either of the following conditions: (1) Any portion of the premium or benefits is p…
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, health benefit plans covering small employers are subject to the following conditions, as applicable:(A)(1) Pre-existing conditions pr…
(A) As used in this section and section 3924.032 of the Revised Code:(1) "Health status-related factor" means any of the following:(a) Health status;(b) Medical condition, including both physical and mental illnesses;(c) Claims experience;(d) Receipt of health care;(e) Medical history;(f) Genetic information;(g) Eviden…
(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 s…
(A) Each carrier, in connection with the offering of a health benefit plan to a small employer, shall disclose to the employer, as part of its solicitation and sales materials, the following information:(1) The provisions of the plan concerning the carrier's right to change premium rates and the factors that may affect…
(A)(1) With respect to any health benefit plan of a carrier and except as otherwise provided in divisions (A)(2) and (3) of this section, the premium rates charged or offered for a rating period for the same or similar coverage under a health benefit plan covering any small employer with similar case characteristics sh…
(A) Compliance with the underwriting and rating requirements contained in sections 3924.01 to 3924.06 of the Revised Code shall be demonstrated through actuarial certification. Carriers offering health benefit plans to small employers shall file annually with the superintendent of insurance an actuarial certification s…
(A) As used in this section:(1) "Beneficiary," "hospital," and "third-party payer" have the same meanings as in section 3901.38 of the Revised Code.(2) "Overcharged" means charged more than the usual and customary charge, rate, or fee that is charged by the provider or hospital for a particular item or service.(3) "Pro…
(A) As used in this section, "employer" means any person who employs an individual.(B) No employer shall engage in any act or practice that, due solely to the actual or expected health condition of one or more individuals, excludes or causes the exclusion of any individual from coverage under an existing employer-provi…
(A) As used in this section:(1) "Carrier," "dependent," and "health benefit plan" have the same meanings as in section 3924.01 of the Revised Code.(2) "Health status-related factor" means any of the following:(a) Health status;(b) Medical condition, including both physical and mental illnesses;(c) Claims experience;(d)…
(A) As used in sections 3924.41 and 3924.42 of the Revised Code, "health insurer" means any sickness and accident insurer or health insuring corporation. "Health insurer" also includes any group health plan as defined in section 607 of the federal "Employee Retirement Income Security Act of 1974," 88 Stat. 832, 29 U.S.…
No health insurer shall impose requirements on the department of medicaid, when it has been assigned the rights of an individual who is eligible for medicaid and who is covered under a health care policy, contract, or plan issued by the health insurer, that are different from the requirements applicable to an agent or…
(A) As used in sections 3924.46 to 3924.49 of the Revised Code, "health insurer" has the same meaning as in section 3924.41 of the Revised Code.(B) No health insurer shall deny enrollment of a child under the health plan of the child's parent on the basis that any of the following applies:(1) The child was born out of…
If a child has health care coverage through a health insurer of a noncustodial parent, the health insurer shall do all of the following:(A) Provide such information to the custodial parent of the child as may be necessary for the child to obtain benefits through the coverage;(B) Permit the custodial parent, or a provid…
(A) If a parent of a child is required by a court or administrative order to provide health care coverage for the child, and if the parent is eligible for family health care coverage provided by a health insurer, the health insurer shall do both of the following:(1) If the child is otherwise eligible for the coverage,…
(A) If a parent of a child is required by a court or administrative order to provide health insurance coverage for the child, which coverage is available through an employer doing business in this state, the employer shall do all of the following:(1) If the child is otherwise eligible for the family coverage, permit th…
(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) "Placeme…
(A) As used in this section:(1) "Beneficiary" and "benefits contract" have the same meanings as in section 3901.38 of the Revised Code.(2) "Confinement" means any period of time during which a person is in the custody or under the supervision of the department of rehabilitation and correction or is confined in a local…
As used in sections 3924.61 to 3924.74 of the Revised Code:(A) "Account holder" means the natural person who opens a medical savings account or on whose behalf a medical savings account is opened.(B) "Eligible medical expense" means any expense for a service rendered by a licensed health care provider or a Christian Sc…
(A) A medical savings account may be opened by or on behalf of any natural person, to pay the person's eligible medical expenses and the eligible medical expenses of that person's spouse or dependent. A medical savings account may be opened by or on behalf of a person only if that person participates in a sickness or a…
The owners of interest in a medical savings account are the account holder and the account holder's spouse and dependents. No medical savings account shall be subject to garnishment or attachment.
(A) At the time a medical savings account is opened, an administrator for the account shall be designated. If an employer opens an account for an employee, the employer may designate the administrator. If an account is opened by any person other than an employer, or if an employer chooses not to designate an administra…
Each employer that opens a medical savings account for an employee shall inform the employee, in writing at the time the account is opened, of the federal and state tax status of deposits made to the account.
(A) In determining Ohio adjusted gross income under Chapter 5747. of the Revised Code, an account holder may deduct an amount equaling the total of the deposits that the account holder, the account holder's spouse, or the account holder's employer made to the account during the taxable year, to the extent that the fund…