Ohio Revised Code
Chapter 1751 | Health Insuring Corporation Law
Section 1751.45 | Administrative Penalties - Violations.

Effective: October 16, 2009
Latest Legislation: House Bill 1 - 128th General Assembly
(A) In lieu of the suspension or revocation of a certificate of authority under section 1751.35 of the Revised Code, the superintendent of insurance, pursuant to an adjudication hearing initiated and conducted in accordance with Chapter 119. of the Revised Code, or by consent of the health insuring corporation without an adjudication hearing, may levy an administrative penalty. The administrative penalty shall be in an amount determined by the superintendent, but the administrative penalty shall not exceed one hundred thousand dollars per violation. Additionally, the superintendent may require the health insuring corporation to correct any deficiency that may be the basis for the suspension or revocation of the health insuring corporation's certificate of authority. All penalties collected shall be paid into the state treasury to the credit of the department of insurance operating fund.
(B) If the superintendent for any reason has cause to believe that any violation of this chapter has occurred or is threatened, the superintendent may give notice to the health insuring corporation and to the representatives or other persons who appear to be involved in the suspected violation to arrange a conference with the suspected violators or their authorized representatives for the purpose of attempting to ascertain the facts relating to the suspected violation, and, if it appears that any violation has occurred or is threatened, to arrive at an adequate and effective means of correcting or preventing the violation.
Proceedings under this division shall not be covered by any formal procedural requirements, and may be conducted in the manner the superintendent may consider appropriate under the circumstances.
(C)(1) The superintendent may issue an order directing a health insuring corporation or a representative of the health insuring corporation to cease and desist from engaging in any act or practice in violation of this chapter. Within thirty days after service of the order to cease and desist, the respondent may request a hearing on the question of whether acts or practices in violation of this chapter have occurred. Such hearings shall be conducted in accordance with Chapter 119. of the Revised Code and judicial review shall be available as provided by that chapter.
(2) If the superintendent has reasonable cause to believe that an order issued pursuant to this division has been violated in whole or in part, the superintendent may request the attorney general to commence and prosecute any appropriate action or proceeding in the name of the state against the violators in the court of common pleas of Franklin county. The court in any such action or proceeding may levy civil penalties, not to exceed one hundred thousand dollars per violation, in addition to any other appropriate relief, including requiring a violator to pay the expenses reasonably incurred by the superintendent in enforcing the order. The penalties and fees collected under this division shall be paid into the state treasury to the credit of the department of insurance operating fund.

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.