Ohio Revised Code
Chapter 1751 | Health Insuring Corporation Law
Section 1751.31 | Changes in Corporation's Solicitation Document.

Effective: September 29, 2013
Latest Legislation: House Bill 59, Senate Bill 9 - 130th General Assembly
(A) Any changes in a health insuring corporation's solicitation document shall be filed with the superintendent of insurance thirty days prior to use for informational purposes, and shall comply with the requirements of this section. If the superintendent finds that any solicitation document fails to comply with the requirements of this section, the superintendent may disapprove any solicitation document or require amendment to it on any of the grounds stated in this section. Such disapproval shall be effected by written notice to the health insuring corporation. The notice shall state the grounds for disapproval and shall be issued in accordance with Chapter 119. of the Revised Code.
(B) The solicitation document shall contain all information necessary to enable a consumer to make an informed choice as to whether or not to enroll in the health insuring corporation. The information shall include a specific description of the health care services to be available and the approximate number and type of full-time equivalent medical practitioners. The information shall be presented in the solicitation document in a manner that is clear, concise, and intelligible to prospective applicants in the proposed service area.
(C) Every potential applicant whose subscription to a health care plan is solicited shall receive, at or before the time of solicitation, a solicitation document approved by the superintendent.
(D) Notwithstanding division (A) of this section, a health insuring corporation may use a solicitation document that the corporation uses in connection with policies for medicare beneficiaries pursuant to a medicare risk contract or medicare cost contract, or for policies for beneficiaries of the federal employees health benefits program pursuant to 5 U.S.C.A. 8905, or for policies for medicaid recipients, or for policies for beneficiaries of any other federal health care program regulated by a federal regulatory body, or for policies for beneficiaries of contracts covering officers or employees of the state entered into by the department of administrative services, if both of the following apply:
(1) The solicitation document has been approved by the United States department of health and human services, the United States office of personnel management, the department of medicaid, or the department of administrative services.
(2) The solicitation document is filed with the superintendent of insurance prior to use and is accompanied by documentation of approval from the United States department of health and human services, the United States office of personnel management, the department of medicaid, or the department of administrative services.
(E) No health insuring corporation, or its agents or representatives, shall use monetary or other valuable consideration, engage in misleading or deceptive practices, or make untrue, misleading, or deceptive representations to induce enrollment. Nothing in this division shall prohibit incentive forms of remuneration such as commission sales programs for the health insuring corporation's employees and agents.
(F) Any person obligated for any part of a premium rate in connection with an enrollment agreement, in addition to any right otherwise available to revoke an offer, may cancel such agreement within seventy-two hours after having signed the agreement or offer to enroll. Cancellation occurs when written notice of the cancellation is given to the health insuring corporation or its agents or other representatives. A notice of cancellation mailed to the health insuring corporation shall be considered to have been filed on its postmark date.
(G) Nothing in this section shall prohibit healthy lifestyle programs.
The Legislative Service Commission presents the text of this section as a composite of the section as amended by multiple acts of the General Assembly. This presentation recognizes the principle stated in R.C. 1.52(B) that amendments are to be harmonized if reasonably capable of simultaneous operation.

Structure Ohio Revised Code

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 1751.111 | Standardized Prescription Identification Information - Pharmacy Benefits to Be Included.

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 1751.141 | Dependent Children Living Outside Health Insuring Corporation's Approved Service Area.

Section 1751.15 | [Suspended Eff. 1/1/2014 to 1/1/2026, per Section 3 of s.b. 9 of the 130th General Assembly, as Amended] Annual Open Enrollment Period.

Section 1751.16 | [Suspended Eff. 1/1/2014 to 1/1/2026, per Section 3 of s.b. 9 of the 130th General Assembly, as Amended] Option for Conversion From Group to Individual Contract.

Section 1751.17 | [Suspended Eff. 1/1/2014 to 1/1/2026, per Section 3 of s.b. 9 of the 130th General Assembly, as Amended] Option for Conversion to a Contract Issued on a Direct-Payment Basis.

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 1751.28 | Admitted Assets Held in Corporation's Name and Free and Clear of Encumbrances, Pledges, or Hypothecation.

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 1751.36 | Notification of Grounds for Denial, Suspension or Revocation of Certificate - Hearing.

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 1751.48 | Rules.

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 1751.58 | Conditions Applying to All Group Health Insuring Corporation Contracts Sold in Connection With Employment-Related Group Health Care Plan.

Section 1751.59 | Coverage of Adopted Children.

Section 1751.60 | Provider or Facility Limited to Seek Compensation for Covered Services Solely From Hic.

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 1751.69 | Cancer Chemotherapy; Coverage for Orally and Intravenously Administered Treatments.

Section 1751.691 | Prior Authorization Requirements or Other Utilization Review Measures as Conditions of Providing Coverage of an Opioid Analgesic.

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 1751.81 | Maintaining Written Procedures for Determining Whether Requested Service Is Covered.

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.

Section 1751.92 | Compliance Cost-Sharing Provisions.