Ohio Revised Code Chapter 3959 - Third-party Administrators

• Section 3959.01 - Third-party Administrator Definitions.
  (A) "Administration fees" means any amount charged a covered person for services rendered. "Administration fees" includes commissions earned or paid by any person relative...
• Section 3959.02, 3959.03 - [Repealed].
  Effective Date: 12-02-1996
• Section 3959.04 - Administrators Tested And Licensed By Superintendent.
  (A) Administrators may be tested and shall be licensed by the superintendent of insurance in accordance with rules adopted by the superintendent. (B) An...
• Section 3959.05 - License Requirement.
  No person shall solicit a plan or sponsor of a plan to act as an administrator for, or provide administrative services to, a plan...
• Section 3959.06 - Application For License - Filing Fee.
  (A) An administrator shall file with the superintendent of insurance an application for a license on a form prescribed by the superintendent. (B) All...
• Section 3959.07 - Action On Application By Superintendent.
  The superintendent of insurance shall act on all applications submitted for a license within thirty days after receipt. Effective Date: 12-02-1996
• Section 3959.08 - Denying Application For License.
  If the superintendent of insurance denies the application for license, the superintendent shall promptly notify the applicant of the denial and the reasons for...
• Section 3959.09 - Issuing License And Certificate Of Authority.
  Upon approval of the application for an administrators license and payment of appropriate filing fees, the applicant shall be granted a license by the...
• Section 3959.10 - License Renewal.
  (A) The superintendent of insurance shall, at least sixty days before the expiration of the administrators license granted by the superintendent, provide a renewal...
• Section 3959.11 - Written Agreement To Act As Administrator Between The Administrator And The Plan Sponsor.
  (A) No person may act as an administrator without a written agreement between the administrator and the plan sponsor. Such written agreement shall be...
• Section 3959.111 - Access To Information Regarding Maximum Allowable Cost Pricing.
  (A) (1) (a) In each contract between a pharmacy benefit manager and a pharmacy, the pharmacy shall be given the right to obtain from...
• Section 3959.12 - Suspension, Revocation Or Nonrenewal Of License.
  (A) Any license issued under sections 3959.01 to 3959.16 of the Revised Code may be suspended for a period not to exceed two years,...
• Section 3959.13 - Report Of Felony Conviction.
  Any person who, while licensed as an administrator, is convicted of a felony, shall report the conviction to the superintendent of insurance within thirty...
• Section 3959.14 - Administrator Prohibitions.
  No administrator shall do any of the following: (A) Use plan sponsor funds for any purpose or purposes not specifically set forth in written...
• Section 3959.15 - Books And Records.
  (A) Administrators shall maintain detailed books and records that reflect all administered transactions specifically in regard to premiums or contributions received and deposited and...
• Section 3959.16 - Preemption Of Federal Law.
  Sections 3959.01 to 3959.16 of the Revised Code do not apply to an employer's self-insurance plan to the extent that federal law supersedes, preempts,...
• Section 3959.17 - Effect Of Child Support Default On License.
  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...
• Section 3959.99 - Penalty.
  A person who violates section 3959.05 of the Revised Code is guilty of a misdemeanor of the fourth degree. Effective Date: 05-18-1988

Last modified: October 10, 2016