Ohio Code 3902.11 – Coordination of benefits definitions
As used in sections 3902.11 to 3902.14 of the Revised Code:
Terms Used In Ohio Code 3902.11
- Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
- Contract: A legal written agreement that becomes binding when signed.
- 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.
(A) “Beneficiary” and “third-party payer” have the same meanings as in section 3901.38 of the Revised Code.
(B) “Plan of health coverage” means any of the following if the policy, contract, or agreement contains a coordination of benefits provision:
(1) An individual or group sickness and accident insurance policy, which policy provides for hospital, dental, surgical, or medical services;
(2) Any individual or group contract of a health insuring corporation, which contract provides for hospital, dental, surgical, or medical services;
(3) Any other individual or group policy or agreement under which a third-party payer provides for hospital, dental, surgical, or medical services.
(C) “Provider” means a hospital, nursing home, physician, podiatrist, dentist, pharmacist, chiropractor, or other licensed health care provider entitled to reimbursement by a third-party payer for services rendered to a beneficiary under a benefits contract.