Effective: July 21, 2022
Latest Legislation: Senate Bill 256 - 134th General Assembly
(A) Transactions within an insurance holding company system to which an insurer subject to registration is a party shall be subject to the following standards:
(1) The terms shall be fair and reasonable.
(2) Charges or fees for services performed shall be reasonable.
(3) Expenses incurred and payment received shall be allocated to the insurer in conformity with customary insurance accounting practices that are consistently applied.
(4) The books, accounts, and records of each party shall be so maintained as to clearly and accurately disclose the precise nature and details of the transactions including such accounting information as is necessary to support the reasonableness of the charges or fees to the respective parties.
(5) The insurer's surplus as regards policyholders following any dividends or distributions to shareholder affiliates shall be reasonable in relation to the insurer's outstanding liabilities and adequate to its financial needs.
(6) Agreements for cost-sharing services and management services shall include such provisions as required by the superintendent of insurance in rule or regulation;
(7) If an insurer subject to sections 3901.32 to 3901.37 of the Revised Code is deemed by the superintendent to be in a hazardous financial condition or a condition that would be grounds for supervision, conservation, or a delinquency proceeding, then the superintendent may require the insurer to secure and maintain either a deposit, held by the superintendent, or a bond, as determined by the insurer at the insurer's discretion, for the protection of the insurer for the duration of the contract or agreement, or the existence of the condition for which the superintendent required the deposit or the bond.
(8) In determining whether a deposit or a bond is required, the superintendent may consider whether concerns exist with respect to the affiliated person's ability to fulfill the contract or agreement if the insurer were to be put into liquidation. Once the insurer is deemed to be in a hazardous financial condition or a condition that would be grounds for supervision, conservation or a delinquency proceeding, and a deposit or bond is necessary, the superintendent has discretion to determine the amount of the deposit or bond, not to exceed the value of the contract or agreement in any one year, and whether such deposit or bond shall be required for a single contract, multiple contracts, or a contract only with a specific person or persons;
(9)(a) All records and data of the insurer held by an affiliate are and remain the property of the insurer, are subject to control of the insurer, are identifiable, and are segregated or readily capable of segregation, at no additional cost to the insurer, from all other persons' records and data. This includes all records and data that are otherwise the property of the insurer, in whatever form maintained, including:
(i) Claims and claim files;
(ii) Policyholder lists;
(iii) Application files;
(iv) Litigation files;
(v) Premium records;
(vi) Rate books;
(vii) Underwriting manuals;
(viii) Personnel records;
(ix) Financial records or similar records within the possession, custody, or control of the affiliate.
(b) At the request of the insurer, the affiliate shall provide that the receiver can:
(i) Obtain a complete set of all records of any type that pertain to the insurer's business;
(ii) Obtain access to the operating systems on which the data is maintained;
(iii) Obtain the software that runs those systems either through assumption of licensing agreements or otherwise;
(iv) Restrict the use of the data by the affiliate if it is not operating the insurer's business.
(c) The affiliate shall provide a waiver of any landlord lien or other encumbrance to give the insurer access to all records and data in the event of the affiliate's default under a lease or other agreement.
(10) Premiums or other funds belonging to the insurer that are collected by or held by an affiliate are the exclusive property of the insurer and are subject to the control of the insurer. Any right of offset in the event an insurer is placed into receivership is subject to Chapter 3903. of the Revised Code.
(B) For the purposes of this section, in determining whether an insurer's surplus as regards policyholders is reasonable in relation to the insurer's outstanding liabilities and adequate to its financial needs, the following factors, among others, may be considered:
(1) The size of the insurer as measured by its assets, capital, surplus, reserves, premium writings, insurance in force, and other appropriate criteria;
(2) The extent to which the insurer's business is diversified among the several lines of insurance;
(3) The number and size of risks insured in each line of business;
(4) The extent of the geographical dispersion of the insurer's insured risks;
(5) The nature and extent of the insurer's reinsurance program;
(6) The quality, diversification, and liquidity of the insurer's investment portfolio;
(7) The recent past and projected future trend in the size of the insurer's surplus as regards policyholders;
(8) The adequacy of the insurer's reserves;
(9) The quality and liquidity of investments in subsidiaries. The superintendent may discount any such investment or treat any investment as a nonadmitted asset for purposes of determining the adequacy of surplus as regards policyholders whenever the investment so warrants.
(10) The quality of the insurer's earnings and the extent to which the reported earnings include extraordinary items;
(11) The surplus as regards policyholders maintained by other comparable insurers in respect of the factors enumerated in this division.
(C) No insurer subject to registration under section 3901.33 of the Revised Code shall pay any extraordinary dividend or make any other extraordinary distribution to its shareholders and the declaration of any such dividend or distribution shall be conditional and shall confer no rights upon shareholders until thirty days after the superintendent has received notice of the declaration thereof and has not within the thirty-day period disapproved the dividend or distribution, or the superintendent has approved the dividend or distribution within the thirty-day period.
Prior to paying any dividend or distribution, the insurer shall notify the superintendent on a form provided by the superintendent for informational purposes within five business days following its declaration of any dividend or distribution and at least ten calendar days prior to payment of such dividend or distribution, such ten-calendar-day period to be measured from the date of the superintendent's receipt of the notice.
For the purposes of this section, an extraordinary dividend or distribution includes any dividend or distribution of cash or other property, whose fair market value, together with that of other dividends or distributions made within the preceding twelve months, exceeds the greater of ten per cent of the insurer's surplus as regards policyholders as of the thirty-first day of December next preceding, or the net income of the insurer for the twelve-month period ending the thirty-first day of December next preceding, but shall not include pro rata distributions of any class of the insurer's own securities.
Any dividend or distribution paid from other than earned surplus shall be considered an extraordinary dividend or extraordinary distribution. For the purposes of this section, "earned surplus" means an amount equal to an insurer's unassigned funds as set forth in its most recent statutory financial statement submitted to the superintendent, including net unrealized capital gains and losses or revaluation of assets.
Last updated June 8, 2022 at 1:08 PM
Structure Ohio Revised Code
Chapter 3901 | Superintendent of Insurance
Section 3901.01 | Department of Insurance.
Section 3901.011 | Superintendent of Insurance - Powers and Duties.
Section 3901.02 | Appointment or Hiring of Employees.
Section 3901.021 | Department of Insurance Operating Fund.
Section 3901.03 | Warden - Duties - Office of Warden.
Section 3901.04 | Superintendent - Specific Powers.
Section 3901.041 | Rule-Making and Adjudicating Powers of Superintendent.
Section 3901.042 | Service and Transaction Fees.
Section 3901.043 | Fees for Services or Transactions Performed by Department of Insurance.
Section 3901.044 | Rules for Implementing Health Insurance Portability and Accountability Act.
Section 3901.045 | Receiving Confidential or Privileged Documents and Information.
Section 3901.046 | Electronic Signatures.
Section 3901.05 | Deputy Superintendent - Duties.
Section 3901.051 | Assistant Superintendent - Duties.
Section 3901.052 | Application for Innovative Waiver.
Section 3901.06 | Instruments Under Seal of the Superintendent.
Section 3901.07 | Examination of Financial Affairs of Insurer.
Section 3901.071 | Superintendent's Examination Fund.
Section 3901.072 | Corporate Governance Annual Disclosure Act.
Section 3901.073 | Corporate Governance Annual Disclosure.
Section 3901.074 | Format of Disclosure.
Section 3901.075 | Documents Deemed Proprietary.
Section 3901.076 | Retention of Third-Party Consultant.
Section 3901.08 | Information From Banks.
Section 3901.09 | Duty of Bank Officers.
Section 3901.10 | Deficiency of Company Assets.
Section 3901.11 | Acquisition of Stock of Other Insurers.
Section 3901.12 | Interlocking Directorate.
Section 3901.13 | Hearing by Superintendent.
Section 3901.14 | Record and Report of Superintendent.
Section 3901.15 | Application of Law.
Section 3901.17 | Personal Jurisdiction Over Foreign or Alien Insurer.
Section 3901.18 | Requirements for Unauthorized Foreign or Alien Insurer to Enter an Appearance.
Section 3901.19 | Unfair and Deceptive Practices Definitions.
Section 3901.20 | Prohibition Against Unfair or Deceptive Acts.
Section 3901.21 | Unfair and Deceptive Acts or Practices in Business of Insurance Defined.
Section 3901.211 | Lending of Money, Extension of Credit - Prohibited Acts.
Section 3901.212 | Consumer Protection Rules.
Section 3901.213 | Unfair and Deceptive Practices - Exceptions.
Section 3901.214 | Applicability of Prohibition on Inducements.
Section 3901.215 | Intent to Promote Innovation and Maintain Strong Consumer Protection.
Section 3901.22 | Hearings on Violation - Orders - Administrative Remedies.
Section 3901.221 | Cease-and-Desist Orders.
Section 3901.23 | Self-Incrimination.
Section 3901.24 | Unlawful Advertising.
Section 3901.241 | List of Top Twenty per Cent of Services and Expected Contributions.
Section 3901.25 | Action by Superintendent Against Insurer.
Section 3901.27 | Adoption of Emergency Bylaws.
Section 3901.28 | Provisions Effective if No Emergency Bylaws.
Section 3901.29 | Succession List.
Section 3901.30 | Emergency Business Location.
Section 3901.31 | Filing Statements Indicating Ownership.
Section 3901.32 | Insurance Holding Company System Definitions.
Section 3901.321 | Mergers and Acquisitions of Domestic Insurers.
Section 3901.322 | Procedure for Violations.
Section 3901.323 | Jurisdiction.
Section 3901.341 | Prior Review of Proposed Transactions.
Section 3901.35 | Requiring Production of Records.
Section 3901.351 | Participation in Supervisory College.
Section 3901.352 | Group-Wide Supervisor for Internationally Active Insurance Group.
Section 3901.36 | Confidential and Privileged Treatment of Documents and Information - Exceptions.
Section 3901.37 | Suspension, Revocation or Refusal to Renew License - Civil Forfeiture.
Section 3901.371 | Purpose of Sections 3901.371 to 3901.378.
Section 3901.372 | Definitions.
Section 3901.373 | Risk Management Framework.
Section 3901.374 | Own Risk and Solvency Assessment.
Section 3901.375 | Summary Report.
Section 3901.376 | Exemptions.
Section 3901.377 | Form and Content of Report; Review.
Section 3901.378 | Confidentiality.
Section 3901.38 | Prompt Payments to Health Care Providers Definitions.
Section 3901.381 | Third-Party Payers Processing Claims for Payment for Health Care Services.
Section 3901.382 | Electronic Submission of Claims.
Section 3901.383 | Contractual Agreements for Payments by Third-Party Payers.
Section 3901.384 | Untimely Claim Process.
Section 3901.385 | Third-Party Payer - Prohibited Acts.
Section 3901.387 | Duplicative Claims - Claim Information System.
Section 3901.388 | Payments Considered Final - Overpayment.
Section 3901.389 | Computation of Interest.
Section 3901.3810 | Complaints by Provider or Beneficiary - Retaliation by Payer.
Section 3901.3811 | Failure to Comply by Third-Party Payer.
Section 3901.3812 | Administrative Remedies.
Section 3901.3814 | Exceptions to Provisions.
Section 3901.40 | Payment or Reimbursement to Unlicensed or Unaccredited Hospital Prohibited.
Section 3901.41 | Applicability of Uniform Electronics Transactions Act; Automated Transactions.
Section 3901.42 | Annual Filing With National Association of Insurance Commissioners.
Section 3901.44 | Records of Insurance Fraud Investigation.
Section 3901.45 | Effect of Sexual Orientation, Hiv, or AIDS or Related Condition.
Section 3901.46 | Requiring HIV Testing.
Section 3901.47 | Administration of Claims Unpaid Due to Insolvency of Insurer.
Section 3901.48 | Disclosing Work Papers Resulting From Conduct of Audit.
Section 3901.491 | Genetic Screening or Testing.
Section 3901.501 | Genetic Screening or Testing for Self-Insurance Plans.
Section 3901.51 | Uncertified Securities as Deposits Definitions.
Section 3901.53 | Placement of Securities Shall Satisfy Deposit Requirements.
Section 3901.54 | Securities May Not Be Used for Other Purposes.
Section 3901.56 | Rewards or Incentives for Insurer Wellness or Health Improvement Programs.
Section 3901.61 | Credit for Reinsurance Ceded Definitions.
Section 3901.621 | Suspension or Revocation of Reinsurer's Accreditation or Certification.
Section 3901.63 | Credit for Reinsurance Ceded as Reduction of Liability.
Section 3901.631 | Management of Reinsurance Recoverables by Domestic Ceding Insurer.
Section 3901.64 | Terms of Reinsurance or Security Agreement.
Section 3901.67 | Disclosure of Material Transactions Model Act Definitions.
Section 3901.68 | Provisions Application.
Section 3901.69 | Insurer to Report Material Transactions.
Section 3901.70 | Confidentiality of Reports - Exceptions.
Section 3901.71 | Application of Mandated Health Benefits.
Section 3901.72 | Money Advanced to Insurance Company or Health Insuring Corporation.
Section 3901.73 | Department to Forward Copy of Late Filing Notice to Board of Directors.
Section 3901.74 | Notice of Life Insurance Company Discontinuing Business.
Section 3901.75 | Notice of Insurance Companies Other Than Life Discontinuing Business.
Section 3901.76 | Security Valuation Expense Fund.
Section 3901.77 | Forms, Instructions, Manuals - Determination of Accounting Practices and Methods.
Section 3901.78 | Certificate of Compliance.
Section 3901.80 | Discriminating Against Living Organ Donors.
Section 3901.81 | Definitions.
Section 3901.811 | Pharmacy Audits.
Section 3901.812 | Rights of Pharmacy.
Section 3901.813 | Proceedings After Audit.
Section 3901.814 | Appeal Process.
Section 3901.815 | Applicability of Provisions.
Section 3901.82 | Restatement of the Law, Liability Insurance.
Section 3901.83 | Definitions for Sections 3901.83 to 3901.833.
Section 3901.831 | Implementation of Step Therapy Protocol.
Section 3901.832 | Step Therapy Exemption.
Section 3901.833 | Adoption of Rules.
Section 3901.86 | Retaliatory Provisions - Moneys Collected Paid to State Fire Marshal's Fund.
Section 3901.87 | No Coverage for Nontherapeutic Abortion.
Section 3901.88 | Actuarial Study Regarding Costs of Health Care Mandates.
Section 3901.89 | Health Plan Issuers Release Claim Information to Group Plan policyholders..
Section 3901.90 | Education on Mental Health and Addiction Services Insurance Parity.
Section 3901.91 | Adoption or Amendment of Rules Related to Insurance Rating Agencies.
Section 3901.95 | Direct Primary Care Agreement Not to Be Considered Insurance.