(A) Each health insuring corporation shall accept individuals for open enrollment coverage as provided in sections 3923.58 and 3923.581 of the Revised Code. A health insuring corporation may reinsure coverage of any individual acquired under those sections with the open enrollment reinsurance program in accordance with division (G) of section 3924.11 of the Revised Code. Fixed periodic prepayment rates charged for coverage reinsured by the program shall be established in accordance with section 3924.12 of the Revised Code.

Terms Used In Ohio Code 1751.15

  • Corporation: means a corporation formed under Chapter 1701. See Ohio Code 1751.01
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Health insuring corporation: means a corporation, as defined in division (H) of this section, that, pursuant to a policy, contract, certificate, or agreement, pays for, reimburses, or provides, delivers, arranges for, or otherwise makes available, basic health care services, supplemental health care services, or specialty health care services, or a combination of basic health care services and either supplemental health care services or specialty health care services, through either an open panel plan or a closed panel plan. See Ohio Code 1751.01
  • state: means the state of Ohio. See Ohio Code 1.59
  • Supplemental health care services: means any health care services other than basic health care services that a health insuring corporation may offer, alone or in combination with either basic health care services or other supplemental health care services, and includes:

    (a) Services of facilities for intermediate or long-term care, or both;

    (b) Dental care services;

    (c) Vision care and optometric services including lenses and frames;

    (d) Podiatric care or foot care services;

    (e) Mental health services, excluding diagnostic and treatment services for biologically based mental illnesses;

    (f) Short-term outpatient evaluative and crisis-intervention mental health services;

    (g) Medical or psychological treatment and referral services for alcohol and drug abuse or addiction;

    (h) Home health services;

    (i) Prescription drug services;

    (j) Nursing services;

    (k) Services of a dietitian licensed under Chapter 4759 of the Revised Code;

    (l) Physical therapy services;

    (m) Chiropractic services;

    (n) Any other category of services approved by the superintendent of insurance. See Ohio Code 1751.01

(B) This section does not apply to any of the following:

(1) Any health insuring corporation that offers only supplemental health care services or specialty health care services;

(2) Any health insuring corporation that offers plans only through medicare or medicaid and that has no other commercial enrollment;

(3) Any health insuring corporation that offers plans only through other federal health care programs regulated by federal regulatory bodies and that has no other commercial enrollment;

(4) Any health insuring corporation that offers plans only through contracts covering officers or employees of the state that have been entered into by the department of administrative services and that has no other commercial enrollment.

Last updated March 23, 2022 at 10:25 AM

  Previous section
Next section  
 Chapter 1751 Contents