Effective: October 1, 2011
Latest Legislation: House Bill 153 - 129th General Assembly
(A) No health insuring corporation, or agent, employee, or representative of a health insuring corporation, shall use any advertisement or solicitation document, or shall engage in any activity, that is unfair, untrue, misleading, or deceptive.
(B) No health insuring corporation shall use a name that is deceptively similar to the name or description of any insurance or surety corporation doing business in this state.
(C) All solicitation documents, advertisements, evidences of coverage, and enrollee identification cards used by a health insuring corporation shall contain the health insuring corporation's name. The use of a trade name, an insurance group designation, the name of a parent company, the name of a division of an affiliated insurance company, a service mark, a slogan, a symbol, or other device, without the name of the health insuring corporation as stated in its articles of incorporation, shall not satisfy this requirement if the usage would have the capacity and tendency to mislead or deceive persons as to the true identity of the health insuring corporation.
(D) No solicitation document or advertisement used by a health insuring corporation shall contain any words, symbols, or physical materials that are so similar in content, phraseology, shape, color, or other characteristic to those used by an agency of the federal government or this state, that prospective enrollees may be led to believe that the solicitation document or advertisement is connected with an agency of the federal government or this state.
(E) A health insuring corporation that provides basic health care services may use the phrase "health maintenance organization" or the abbreviation "HMO" in its marketing name, advertising, solicitation documents, or marketing literature, or in reference to the phrase "doing business as" or the abbreviation "DBA."
(F) This section does not apply to the coverage of beneficiaries enrolled in medicare pursuant to a medicare risk contract or medicare cost contract, or to the coverage of beneficiaries enrolled in the federal employee health benefits program pursuant to 5 U.S.C.A. 8905, or to the coverage of medicaid recipients or to the coverage of beneficiaries under any federal health care program regulated by a federal regulatory body, or to the coverage of beneficiaries under any contract covering officers or employees of the state that has been entered into by the department of administrative services.
Structure Ohio Revised Code
Title 17 | Corporations-Partnerships
Chapter 1751 | Health Insuring Corporation Law
Section 1751.01 | Health Insuring Corporation Law Definitions.
Section 1751.02 | Applying for Certificate of Authority.
Section 1751.03 | Verification of Application.
Section 1751.04 | Review of Application and Documents by Superintendent.
Section 1751.05 | Issuance or Denial of Certificate of Authority.
Section 1751.06 | Powers Upon Obtaining Certificate.
Section 1751.07 | Responsibility for Funds.
Section 1751.08 | Inapplicability of Insurance Laws.
Section 1751.11 | Evidence of Coverage.
Section 1751.12 | Contractual Periodic Prepayment or Premium Rate.
Section 1751.13 | Contracts With Providers and Health Care Facilities.
Section 1751.14 | Termination of Coverage of Child.
Section 1751.18 | Cancelling or Failing to Renew Coverage.
Section 1751.19 | Complaint System.
Section 1751.20 | Unfair, Untrue, Misleading, or Deceptive Acts.
Section 1751.21 | Peer Review Committee.
Section 1751.25 | Investment of Funds.
Section 1751.26 | Investments in Real Estate.
Section 1751.27 | Deposit of Securities With Superintendent or Custodian.
Section 1751.271 | Medicaid Providers - Performance Bond.
Section 1751.31 | Changes in Corporation's Solicitation Document.
Section 1751.32 | Annual Report.
Section 1751.321 | Audit Report Filed Annually.
Section 1751.33 | Information to Be Provided to Subscribers.
Section 1751.34 | Examinations by Superintendent and Director.
Section 1751.35 | Suspension or Revocation of Certificate of Authority.
Section 1751.38 | Applicability of Other Laws.
Section 1751.40 | Insurance Companies Operating as Health Insuring Corporations.
Section 1751.42 | Rehabilitation, Liquidation, Supervision or Conservation of Corporation.
Section 1751.44 | Fees Paid to Superintendent of Insurance.
Section 1751.45 | Administrative Penalties - Violations.
Section 1751.46 | Recommendations for Expansion of Service Areas.
Section 1751.47 | Adopting Forms, Instructions and Manuals for Providing Financial Information.
Section 1751.51 | Restrictions on Choice of Providers.
Section 1751.52 | Confidentiality of Information.
Section 1751.521 | Medical Information Release.
Section 1751.53 | Continuing Coverage After Termination of Employment.
Section 1751.54 | Continuing Coverage After Reservist Called to Duty.
Section 1751.55 | Effect of Workers Compensation Coverage.
Section 1751.56 | Effect of Supplemental Sickness and Accident Insurance Policy.
Section 1751.57 | Conditions Applying to All Individual Health Insuring Corporation Contracts.
Section 1751.59 | Coverage of Adopted Children.
Section 1751.61 | Coverage for Newly Born Child.
Section 1751.62 | Screening Mammography - Cytologic Screening for Cervical Cancer.
Section 1751.63 | Long-Term Care Insurance.
Section 1751.65 | Health Insuring Corporation - Prohibited Activities.
Section 1751.66 | Prescription Drugs.
Section 1751.67 | Maternity Benefits.
Section 1751.68 | Provisions for Medication Synchronization for Enrollees.
Section 1751.70 | Authorization of Payroll Deductions for Public Employees.
Section 1751.71 | Accepting Payments for Cost of Policies, Contracts, and Agreements.
Section 1751.72 | Policy, Contract, or Agreement Containing a Prior Authorization Requirement.
Section 1751.73 | Implementing Quality Assurance Programs.
Section 1751.74 | Quality Assurance Program Requirements.
Section 1751.75 | Determination That Accreditation Constitutes Compliance.
Section 1751.77 | Utilization Review, Internal and External Review Procedure Definitions.
Section 1751.78 | Application of Provisions.
Section 1751.79 | Utilization Review Program Requirements.
Section 1751.80 | Implementing Utilization Review Programs.
Section 1751.811 | Internal and External Reviews.
Section 1751.82 | Reconsideration of Adverse Determination.
Section 1751.821 | Determination That Accreditation Constitutes Compliance.
Section 1751.822 | Cooperation With Utilization Review Program.
Section 1751.823 | Filing Certificate of Compliance.
Section 1751.83 | Maintaining Internal Review System.
Section 1751.84 | Coverage for Autism Spectrum Disorder.
Section 1751.85 | Information for Vision Care Services or Materials.
Section 1751.86 | Violation Deemed Unfair and Deceptive Act or Practice.
Section 1751.87 | Cause of Action Not Created.
Section 1751.89 | Medicare and Medicaid Exceptions.
Section 1751.90 | Coverage for Teledentistry.
Section 1751.91 | Reimbursement for Pharmacists Providing Health Care.