Ohio Revised Code Chapter 3924 - Small Employer Health Benefit Plans; Provision Of Health Care Coverage

• Section 3924.01 - Small Employer Health Benefit Plans - Provision Of Health Care Coverage Definitions.
  As used in sections 3924.01 to 3924.14 of the Revised Code: (A) "Actuarial certification" means a written statement prepared by a member of the...
• Section 3924.02 - Health Care Benefit Plans Covered By Chapter.
  (A) An individual or group health benefit plan is subject to sections 3924.01 to 3924.14 of the Revised Code if it provides health care...
• Section 3924.03 - Health Benefit Plans Covering Small Employers Subject To Conditions.
  Except as otherwise provided in section 2721 of the "Health Insurance Portability and Accountability Act of 1996," Pub. L. No. 104-191 , 110 Stat....
• Section 3924.031 - Carrier Offering Health Benefit Plan In Small Employer Market Through Network Plan.
  (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...
• Section 3924.032 - Refusing To Issue Plans In Small Employer Market.
  (A) A carrier may refuse to issue health benefit plans in the small employer market if the carrier has demonstrated both of the following...
• Section 3924.033 - Information Disclosed By Carrier To Employer.
  (A) Each carrier, in connection with the offering of a health benefit plan to a small employer, shall disclose to the employer, as part...
• Section 3924.04 - Limits On Premium Rates - Low Claim Rates.
  (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• Section 3924.05 - [Repealed].
  Effective Date: 03-22-1999
• Section 3924.06 - Demonstrating Compliance Through Actuarial Certification.
  (A) Compliance with the underwriting and rating requirements contained in sections 3924.01 to 3924.14 of the Revised Code shall be demonstrated through actuarial certification....
• Section 3924.07 - [Suspended Eff. 1/1/2014 Through 1/1/2018; See Note] Ohio Health Reinsurance Program.
  (A) There is hereby established a nonprofit entity to be known as the "Ohio health reinsurance program." Any carrier issuing health benefit plans in...
• Section 3924.08 - [Suspended Eff. 1/1/2014 Through 1/1/2018; See Note] Board Of Directors - Plan Of Operation.
  (A) The board of directors of the Ohio health reinsurance program shall consist of nine appointed members who shall serve staggered terms as determined...
• Section 3924.09 - [Suspended Eff. 1/1/2014 Through 1/1/2018; See Note] General And Specific Powers And Authority Of Program.
  The Ohio health reinsurance program shall have the general powers and authority granted under the laws of the state to insurance companies licensed to...
• Section 3924.10 - [Suspended Eff. 1/1/2014 Through 1/1/2018; See Note] Recommendations Regarding, Analysis And Adoption Of Ohc Plans.
  (A) The board of directors of the Ohio health reinsurance program may make recommendations to the superintendent of insurance, and the superintendent may adopt...
• Section 3924.11 - [Suspended Eff. 1/1/2014 Through 1/1/2018; See Note] Reinsuring Small Employer Groups Or Individuals.
  Any member of the Ohio health reinsurance program may reinsure small employer groups or individuals in accordance with the following conditions and limitations: (A)...
• Section 3924.111 - [Suspended Eff. 1/1/2014 Through 1/1/2018; See Note] Deductible Amount And Maximum Liability Amount.
  (A) The Ohio health reinsurance program shall not provide reinsurance for any individual reinsured under the program until five thousand dollars in benefit payments...
• Section 3924.12 - [Suspended Eff. 1/1/2014 Through 1/1/2018; See Note] Premium Rates.
  (A) Except as provided in division (B) of this section, premium rates charged for coverage reinsured by the Ohio health reinsurance program shall be...
• Section 3924.13 - [Suspended Eff. 1/1/2014 Through 1/1/2018; See Note] Apportioning Assessments.
  (A) Following the close of each calendar year, the administrator of the Ohio health reinsurance program shall determine the net premiums, the program expenses...
• Section 3924.14 - [Suspended Eff. 1/1/2014 Through 1/1/2018; See Note] Immunity.
  Neither the participation as members of the Ohio health reinsurance program or as members of the board of directors of the program, the establishment...
• Section 3924.21 - Overcharges.
  (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)...
• Section 3924.25 - Prohibiting Exclusion Based On Health Condition.
  (A) As used in this section, "employer" means any person who employs an individual. (B) No employer shall engage in any act or practice...
• Section 3924.27 - Prohibiting Premium Increase On The Basis Of Any Health Status-related Factor.
  (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...
• Section 3924.41 - Prohibiting Consideration Of Eligibility For Medical Assistance.
  (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....
• Section 3924.42 - Prohibiting Imposing Different Requirements On Department Of Job And Family Services.
  No health insurer shall impose requirements on the department of medicaid, when it has been assigned the rights of an individual who is eligible...
• Section 3924.46 - Prohibiting Denial Of Enrollment Of Certain Children.
  (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...
• Section 3924.47 - Duties Of Health Insurer Of Noncustodial Parent.
  If a child has health care coverage through a health insurer of a noncustodial parent, the health insurer shall do all of the following:...
• Section 3924.48 - Parent Required By Court Or Administrative Order To Provide Health Care Coverage For Child - Duties Of Health Insurer.
  (A) If a parent of a child is required by a court or administrative order to provide health care coverage for the child, and...
• Section 3924.49 - Parent Required By Court Or Administrative Order To Provide Health Care Coverage For Child - Duties Of Parent.
  (A) If a parent of a child is required by a court or administrative order to provide health insurance coverage for the child, which...
• Section 3924.51 - Plan Benefits For Adopted Children.
  (A) As used in this section: (1) "Child" means, in connection with any adoption or placement for adoption of the child, an individual who...
• Section 3924.53 - Coverage For Person In Custody Or Confined In Jail.
  (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)...
• Section 3924.61 - Medical Savings Account Definitions.
  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...
• Section 3924.62 - Opening Of Medical Savings Account.
  (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...
• Section 3924.63 - Owners Of Interest In Medical Savings Account.
  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...
• Section 3924.64 - Administration Of Accounts.
  (A) At the time a medical savings account is opened, an administrator for the account shall be designated. If an employer opens an account...
• Section 3924.65 - Notice Of Tax Status Of Deposits.
  Each employer that opens a medical savings account for an employee shall inform the employee, in writing at the time the account is opened,...
• Section 3924.66 - Account Deducted From Ohio Adjusted Gross Income.
  (A) In determining Ohio adjusted gross income under Chapter 5747. of the Revised Code, an account holder may deduct an amount equaling the total...
• Section 3924.67 - Withdrawals.
  An account holder may withdraw funds from the account holder's account at any time, for any purpose. However, the administrator of a medical savings...
• Section 3924.68 - Procedure Upon Termination Of Employment.
  (A) If an account holder, whose medical savings account has been opened by the account holder's employer, later ceases to be employed by that...
• Section 3924.69 - Death Of Account Holder.
  (A) An account holder may designate a beneficiary or beneficiaries of the account holder's medical savings account. (B) Any funds remaining in a medical...
• Section 3924.70 - Advances To Cover Employee's Eligible Medical Expenses.
  An employer making deposits to an employee's medical savings account on a periodic installment basis may advance to the employee, interest free, an amount...
• Section 3924.71 - Funds Disbursed Pursuant To Bankruptcy Protection.
  Funds disbursed from a medical savings account pursuant to a filing for protection by an account holder under Title 11 of the United States...
• Section 3924.72 - Brochure Explaining Operation Of Medical Savings Accounts.
  The superintendent of insurance shall prepare and periodically revise a brochure that clearly and concisely explains the operation of medical savings accounts authorized under...
• Section 3924.73 - Rights, Privileges, Or Protections Of Employees Or Small Employers.
  (A) As used in this section: (1) "Health care insurer" means any person legally engaged in the business of providing sickness and accident insurance...
• Section 3924.74 - Coordination Of Benefits.
  The superintendent of insurance may include coordination of benefits regarding medical savings accounts in the rules on coordination of benefits adopted under section 3902.14...

Last modified: October 10, 2016