Ohio Revised Code
Chapter 3902 | Insurance Policies and Contracts
Section 3902.11 | Coordination of Benefits Definitions.

Effective: July 24, 2002
Latest Legislation: Senate Bill 4 - 124th General Assembly
As used in sections 3902.11 to 3902.14 of the Revised Code:
(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.

Structure Ohio Revised Code

Ohio Revised Code

Title 39 | Insurance

Chapter 3902 | Insurance Policies and Contracts

Section 3902.01 | Purpose of Sections.

Section 3902.02 | Insurance Policy and Contract Definitions.

Section 3902.03 | Policies to Which Sections Apply - Exceptions - Non-English Language Policies.

Section 3902.04 | Requirements for Policy Forms.

Section 3902.05 | Construction.

Section 3902.06 | Superintendent May Authorize Lower Test Score.

Section 3902.07 | Approval of Policy Form Notwithstanding Provisions of Other Laws.

Section 3902.08 | Policy Forms Compliance Date.

Section 3902.11 | Coordination of Benefits Definitions.

Section 3902.12 | Primary or Secondary Health Coverage.

Section 3902.13 | Order of Benefits for Health Coverage Plan.

Section 3902.14 | Rules.

Section 3902.21 | Standard Claim Form Definitions.

Section 3902.22 | Superintendent to Develop Standard Claim Form.

Section 3902.23 | Use of Form Mandatory.

Section 3902.30 | Coverage for Telehealth Services.

Section 3902.31 | Void Contracts.

Section 3902.36 | Compliance With Federal Mental Health and Addiction Parity Laws.

Section 3902.50 | Definitions for r.c. 3902.50 to 3902.72.

Section 3902.51 | Out-of-Network Care Reimbursement Requirement, Negotiations.

Section 3902.52 | Out-of-Network Care Arbitration.

Section 3902.53 | Out-of-Network Care Rules, Prompt Pay Requirements, Violations.

Section 3902.54 | Out-of-Network Care Arbitrator Requirements.

Section 3902.60 | Advanced Cancer Fail First Drug Coverage Definitions.

Section 3902.61 | Advanced Cancer Fail First Drug Coverage Prohibitions.

Section 3902.62 | Coverage for Drugs Refilled Without a Prescription.

Section 3902.70 | Health Plan Issuer Contracts With 340b Program Participants Definitions.

Section 3902.71 | Health Plan Issuer Contracts With 340b Program Participants.

Section 3902.72 | Health Plan Issuer Disclosure of Drug Data.