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Ohio Revised Code

Chapter 3923

Sickness And Accident Insurance

3923.01Policy of sickness and accident insurance defined 3923.011Sickness and accident insurance definitions 3923.02Form of policy filed with superintendent 3923.021Approval or disapproval of premium rates 3923.022Maximum aggregate administrative expenses 3923.03Necessary provisions 3923.04Policy standard provisions 3923.041Policies with prior authorization requirement provisions 3923.05Provisions to conform to prescribed wording 3923.06Order of presentation of policy provisions 3923.061Interest on proceeds payable due to death by sickness or accident 3923.07Omission or substitution of provisions 3923.071Policies, applications, riders or indorsements issued prior to 10-1-53 3923.08Nonconflicting provisions permitted in policy 3923.09Validity of nonconforming policy 3923.10Industrial sickness and accident insurance 3923.11Sickness and accident insurance on a franchise plan 3923.12Group sickness and accident insurance 3923.121Association of insurers to provide basic medical coverage to persons 65 or older 3923.123Association of insurers to provide group health coverage to qualified unemployed persons 3923.13Blanket sickness and accident insurance 3923.14False statement in application - alteration of written application 3923.141Agent of the insurer 3923.15Unfair discrimination prohibited 3923.16Misleading or deceptive advertising prohibited 3923.161Describing cancellability and renewability provisions clearly and with prominence or emphasis 3923.17Prohibition of rebates not to prohibit commissions or dividends 3923.18Rights of insurer in defense of claim not waived 3923.19Benefits exempt from legal process - exception 3923.20Exemptions for certain insurance policies 3923.21Prohibition against delivery of policy on disapproved insurance form 3923.22Appeal - applicability of administrative procedure sections 3923.23Reimbursement for services of licensed osteopath, optometrist, chiropractor or podiatrist 3923.231Reimbursement for services of licensed psychologist 3923.232Reimbursement for services of licensed dentist 3923.233Reimbursement for services of certified nurse-midwife performing service in collaboration with licensed physician 3923.234Reimbursement for services of certified mechanotherapist 3923.24Continuing coverage for dependent children 3923.241Public employee benefit plans - continuing coverage for dependent children 3923.25Kidney dialysis benefits 3923.26Coverage for newly born children from the moment of birth 3923.27Hospitalization coverage for mental illness 3923.28Outpatient coverage for mental or emotional disorders 3923.281Sickness and accident policies - biologically based mental illness 3923.282Health coverage plans - biologically based mental illness 3923.29Outpatient, inpatient, and intermediate primary care benefits for alcoholism 3923.30Requiring provision of coverage of treatment of mental or nervous disorders and alcoholism 3923.301Requiring provision of coverage for services of certified nurse-midwife performing service in collaboration with licensed physician 3923.31Right to rescind individual policy of sickness and accident insurance 3923.32Right of family member to continue coverage after subscriber's death or upon change in marital relation to subscriber 3923.33Medicare supplement policy definitions 3923.331Statutes applicable to medicare supplement policies 3923.332Standards for policy provisions of medicare supplement policies and certificates 3923.333Benefits to be reasonable in relation to premium charged 3923.334Outline of coverage delivered at time application is made 3923.335Right to return policy or certificate and have premium refunded 3923.336Review and approval of advertisement by superintendent 3923.337Rules 3923.338Orders of superintendent 3923.339Severability 3923.36Excluding coverage of illness or injury covered by workers' compensation 3923.37Prohibiting exclusion or reduction of benefits because of benefits payable under supplemental policy 3923.38Continuing policy upon termination of employment 3923.381Continuing coverage under group policy when reservist is called or ordered to active duty 3923.382Continuing coverage under group plan when reservist is called or ordered to active duty 3923.39Consolidated corporation cancelling individual policy for nonpayment 3923.40Coverage of adopted children 3923.41Long-term care insurance definitions 3923.42Citing provisions - applicability 3923.43Evidence to be filed by long-term care insurance association 3923.44Standards for full and fair disclosure for sale of long-term care insurance policies 3923.441Rescission of long-term care policy for misrepresentation 3923.442Offer of nonforfeiture benefit option with long-term care policy 3923.443Training required for agents selling long-term care policies 3923.444Compensation of agents selling long-term care policies 3923.45Forms 3923.46Rates for individual policy 3923.47Rules 3923.48Violation is unfair and deceptive insurance practice 3923.49Establishing outreach program to educate consumers 3923.50Notifying department of job and family services of long-term care insurance policies that comply with insurance department requirements 3923.51Group contracts of sickness and accident insurance persons under nineteen who are members of impoverished families 3923.52Screening mammography and cytologic screening benefits 3923.53Public employee benefit plan - breast cancer and cervical cancer screening 3923.54Employee health care benefit plan 3923.55Policy to include benefits for child health supervision services from moment of birth until age nine 3923.56Plan to include benefits for child health supervision services from moment of birth until age nine 3923.57Pre-existing conditions provisions 3923.571Conditions applying to group policies of sickness and accident insurance sold in connection with employment-related group health plan 3923.60Standard medical reference compendia for coverage of prescription drugs 3923.601Standardized prescription identification information - pharmacy benefits to be included 3923.602Medication synchronization for insured 3923.61Public employee benefit plans - prescription drugs 3923.62Disclosing determination of usual and customary fee for dental benefits 3923.63Coverage of inpatient care and follow-up care for mother and her newborn 3923.64Public employee benefit plans - maternity benefits 3923.65Coverage for emergency services 3923.80Denial of coverage to cancer clinical trial participant 3923.81Covered person's payments not to exceed insurer payments 3923.82Coverage for alcohol or drug related losses or expenses 3923.83Standardized prescription identification information - pharmacy benefits to be included - public employee benefit plan 3923.84Coverage for autism spectrum disorder 3923.85Cancer medication; coverage for orally and intravenously administered treatments 3923.851Prior authorization requirements or other utilization review measures as conditions of providing coverage of an opioid analgesic prescribed for treatment of chronic pain; exceptions 3923.86Statement provided to insureds under vision policy 3923.87Compliance with section 3959.20 3923.89Payment or reimbursement to pharmacist 3923.90Teledentistry to be included in coverage 3923.99Penalty