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Health Resources

Details: Health Insurance for Children Under Age 19. Information regarding the Patient Protection and Affordable Health Care Act provides that children under age 19 cannot be denied coverage or subjected to coverage limitations or exclusions because of a pre-existing health condition. Insurance & Medicare Share.

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Healthcare Fraud

Details: The most common health care fraud scheme involves a medical provider billing an insurance carrier for a service they never provided to a patient. Upcoding This healthcare fraud scheme involves a medical provider billing an insurance company for a higher level of service than what they actually provided.

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› Url: https://insurance.ohio.gov/wps/portal/gov/odi/consumers/health/healthcare-fraud Go Now

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Employer Self-Insured Health Plans

Details: Unpaid health care claims will be treated as claims for unpaid wages. That means if you had medical services that were not covered before the self-funded plan ended, you might have to pay those bills out of your own pocket. Actions you can take: Read and make sure you understand your benefits handbook.

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2021 Federal Exchange Plans

Details: Ohio’s Health Insurance Market 2021. For 2020, the department approved 10 companies to sell on the exchange. Based on the plan information the department approved, most counties had at least three insurers. 29 counties had two insurers, and just one county had only one insurer. For 2021, the department approved those same 10 companies to sell

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OSHIIP Coordinators List

Details: Listing of Ohio Senior Health Insurance Information Program (OSHIIP) Coordinators *Note: Many of our sites are closed during this time and may not be available even for phone appointments. Please call the OSHIIP hotline (800) 686-1578 if you are unable to reach someone locally.

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› Url: https://insurance.ohio.gov/wps/portal/gov/odi/consumers/medicare/oshiip-coordinators-list Go Now

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Ohio Department of Insurance

Details: 440-846-5511. Business Licensing Address. 21792 FAIRFIELD PL. STRONGSVILLE, OH 44149-9237. Mailing Licensing Address. 21792 FAIRFIELD PL. STRONGSVILLE, OH 44149-9237. Agent Printable License. * indicates a required field.

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Guide to Health Insurance

Details: Guide to Health Insurance. September 08, 2019 | ODI. Find information regarding health insurance such as: The Basics of Health Insurance. Possible Additional Benefits in Ohio Plans. Choosing a Plan / Understanding Your plan. Helpful Phone Numbers & Websites. What’s Your Situation?

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Essential Health Benefits Summary

Details: Similarly, health insurers can make approved equivalent substitutions to benefits included within the benchmark. In terms of costs, the percentages paid by a health plan of the total costs of benefits will vary depending on plan generosity. Finally, benefits contained both within EHB and any additional benefits

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Surprise Billing

Details: This law protects patients from receiving surprise medical bills for emergency care or, in certain circumstances, unexpected out-of-network care. Primarily, the law prohibits the practice of balance billing in these instances, leaving any price negotiation to be handled between the health provider and the health plan.

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Individual Agent

Details: Life, Accident & Health, Variable Products, Property, Casualty, and Personal Lines. Agents & Agencies odx-share-caps Resident Agent An individual or an organization registered or authorized to do business in Ohio. Agents & Agencies odx-share-caps. Title Insurance Resident Individual

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Pre-Licensing Education

Details: Surety Bail Bond. Ohio resident applicants must complete pre-licensing education from an approved pre-license provider for each of the above-mentioned lines of authority. The educational requirements may be met by either completing a 20-hour classroom course or successfully completing an approved self-study course.

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Association Health Plan FAQs

Details: In general, an AHP is a health plan sponsored by an association for their members and their employees. Typically, these types of plans are run by an industry or professional association that small businesses can join and that can provide health insurance to their employees.

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Major Lines Resident Individual

Details: Ohio's 6 Major Lines of Authority. Accident & Health: Insurance coverage for sickness, bodily injury, or accidental death, and may include benefits for disability income. Casualty: Insurance coverage against legal liability, including coverage for death, injury, or disability or damage to real or personal property.

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State Continuation Coverage (Mini-COBRA) Subsidies

Details: COBRA generally permits former employees and their qualified dependents to continue receiving coverage under an employer’s group health plan for a specified length of time (18-36 months) following a qualifying event that results in a loss of coverage. COBRA is a federal law that generally applies to employers with 20 or more employees.

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Health External Review

Details: Health Plan Issuer Contact Information Form. TPA (Third Party Administrator) Contact Information Form. IRO Contact Information Form. For technical assistance or questions, contact the External Review program administrator at [email protected]gov or 614-644-0188.

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Ohio Health Insurance Market

Details: Most health insurance is Ohio is not regulated by the Ohio Department of Insurance. As you look at the chart, the plans in yellow are Medicaid plans and are overseen by the Ohio Department of Medicaid. The orange section represents Medicare plans and those are overseen by the Centers for Medicaid and Medicare Services (CMS). Self-insured plans

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How to File an Insurance Complaint

Details: Your health card if a health claim is involved. Detail regarding the solution you are seeking (e.g., pay a claim, issue a refund, etc.). *Do not send originals. Do not send us your medical bill, unless there is a specific problem with the bill itself. Next Steps

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Federal Health Reform FAQs

Details: Please send appropriate questions to [email protected]gov . While the Ohio Department of Insurance (ODI) is the state agency that regulates insurance in the state, the department is not administering the Affordable Care Act mandated exchange. The U.S. Department of Health and Human Services (HHS) will be operating the

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Medicare Predatory Sales Practices

Details: Medicare is a federally funded health insurance program for people 65 and older or people of any age with certain disabilities. People enroll in Medicare through the Social Security Administration. Most people then choose private plans to supplement what Medicare does not cover. Others choose a type of private plan called Medicare Advantage.

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Ohio Essential Health Benefit Resource Document

Details: All medically necessary Basic Health Care services must be covered by an HMO plan. Complications from a non-covered procedure that require the need for any medically necessary Basic Health Care Service must be covered same as any other services. 20 Skilled Nursing Facility . Yes Covered Yes 90 Day(s) per Benefit Period

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How to Appeal a Health Coverage Decision Made by Your Insurer

Details: All health plan issuers must provide a process that allows a person covered under a health benefit plan or a person applying for health benefit plan coverage to request an independent external review of an adverse benefit determination. An adverse benefit determination is a decision by the health plan issuer not to provide benefits because they

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Premium Assistance for COBRA Benefits Notice 2021-31

Details: 4 Eligibility for coverage under any other group health plan does not terminate eligibility for COBRA premium assistance if the other group health plan provides only excepted benefits (as defined in § 9832(c) of the Code, § 733(c) of ERISA, and § 2971(c) of the PHS Act), is a health flexible spending

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Ohio Department of Insurance

Details: Accident & Health Active: 08/24/1992 11/01/2012 Life Active: 08/24/1992 11/01/2012 Variable Active: 09/16/1994 11/01/2012 Appointment Information To view one insurance company appointment at a time, select a company from the drop down list, then click

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Report Fraud Healthcare Fraud

Details: information to a health insurance carrier. It is a serious problem in the United States and it costs insurance companies and consumers billions of dollars each year in the form of higher insurance premiums. The Role of the Ohio Department of Insurance Fraud & Enforcement Division

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Health Insurance

Details: Health Insurance Complaints In 2019, the Ohio Department of Insurance (ODI) received a total of 872 complaints about companies that sold individual health insurance. The chart below shows the top 12 reasons for these complaints. Health Insurance Complaint Ratios

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Mental Health and Substance Use Disorder Benefits Toolkit

Details: Understanding health insurance coverage for mental health and substance use disorder benefits can be complicated or difficult to navigate. This online toolkit was created to help consumers, providers, and advocates understand benefits and coverage for …

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Employer-Provided Health Insurance Open Enrollment

Details: The health section includes basic information about each type of program. Plan materials will detail which medical providers (physicians, hospitals, labs, pharmacies, etc.) are considered in-network and out-of-network. They will also detail how much the …

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PRESS RELEASE: Governor DeWine Encourages Ohioans to Review …

Details: The Ohio Senior Health Insurance Information Program (OSHIIP), a division of the Department of Insurance, is conducting virtual and in-person Medicare Check-up Day events through open enrollment. "OSHIIP provides free and unbiased services as the state of Ohio's official Medicare education and assistance program," DeWine said.

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OHIO DEPARTMENT OF INSURANCE

Details: Ohio Health Reinsurance Program Data ***SUSPENDED THROUGH 1/1/2022*** HEALTH INSURANCE ANNUAL REPORT DATA WILL BE USED TO DETERMINE THE ASSESSMENTS FOR ALL REINSURANCE POOLS. • Ohio offers the reinsurance mechanisms described below: - Open Enrollment pursuant to Ohio Revised Code Section 3923.58, mandating participation of

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The Ohio Life & Health Insurance Guaranty Association

Details: The Ohio Life & Health Insurance Guaranty Association 1840 Mackenzie Drive, Suite 100 Columbus, Ohio 43220 (614) 442-6601, www.olhiga.org Note: Guaranty Association legal requirements can be found in Chapter 3956 of the Ohio Revised Code. There is a similar, separate guaranty association for auto, homeowners and other kinds of

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OSHIIP Volunteer Information

Details: OSHIIP Volunteer Information. Volunteers drive OSHIIP. Dedicated people are needed to be volunteers in all parts of Ohio. As a volunteer you’ll learn Medicare basics; you’ll help people in your community, and you’ll have the satisfaction of taking part in a truly worthy cause. The OSHIIP initial volunteer training consists of self-paced

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Ohio Department of Insurance

Details: 513-891-3304 Extn : 4. Business Licensing Address. ALBERS INSURANCE AGENCY. 9200 MONTGOMERY RD STE 9B. CINCINNATI, OH 45242-7730. Mailing Licensing Address. 7298 TIMBERKNOLL DRIVE. CINCINNATI, OH 45242. Agent Printable License.

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LIFE, ACCIDENT AND HEALTH/FRATERNAL INSURERS

Details: 22 Supplemental Health Care Exhibit (Parts 1, 2 and 3) AFF EO 0 4/1 NAIC M,W 23 Supplemental Health Care Exhibit’s Allocation Report AFF EO 0 4/1 NAIC M,W 24 Supplemental Investment Risk Interrogatories AFF EO 0 4/1 NAIC M,W 25 Supplemental Schedule O AFF EO xxx 3/1 NAIC M,W

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LIFE, ACCIDENT AND HEALTH INSURERS

Details: 22 Supplemental Health Care Exhibit (Parts 1, 2 and 3) AFF EO 0 4/1 NAIC M,W,X 23 Supplemental Health Care Exhibit’s Allocation Report AFF EO 0 4/1 NAIC M,W,X 24 Supplemental Investment Risk Interrogatories AFF EO 0 4/1 NAIC M,W,X 25 Supplemental Schedule O AFF EO xxx 3/1 NAIC M,W,X

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The Annual Health Claims External Review Report For the Year …

Details: The Health Plan’s determination was reversed by the IRO in 35% of these cases, saving Ohio health insurance consumers over $3,762,000 or about 42% of the cost of all health care benefits and services reviewed. About half (51%) of the IRO reviews completed in 2019 were for health care services

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Medicare Counseling and Webinars

Details: Schedule a one-on-one virtual Medicare meeting with our Ohio Senior Health Insurance Information Program's (OSHIIP) Medicare experts today! We're here to answer questions about Medicare Open Enrollment and to help you review your current Medicare health and drug plans to determine if you should update or keep your current plan for 2021.

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Guide to Long-Term Care

Details: home health care, respite care, hospice care, adult day care, nursing home care and assisted living facility care. LTC is different from traditional medical care. It helps one live as he or she is now and may not help to improve or correct medical problems. The way …

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Health Coverage Internal and External Review FAQs

Details: The health plan issuer agrees to waive the exhaustion requirement. You did not receive written confirmation of the health plan issuer’s internal appeal decision within the required time frame. The health plan issuer fails to meet all requirements of …

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STUDY OF THE INDIVIDUAL AND GROUP HEALTH …

Details: The market reforms under the ACA increased access to health insurance coverage, which resulted in a decrease in Ohio’s uninsured rate from 12.4% in 2013 to 6.4% in 2017. The reduction in the uninsured rate was driven by Ohio’s decision to expand Medicaid to cover most adults with incomes

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Ohio Mental Health Parity Report 2021

Details: MHPAEA, often referred to as “mental health parity”, generally requires that mental health conditions and substance use disorders be treated by a health plan in the same or similar manner as the plan treats benefits or medical and surgical conditions and disorders. Financial …

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ACA Form Filing Checklist – Title 39 Student Major Medical …

Details: Mental Health and Substance Abuse Coverage must be provided for treatment of mental health and substance abuse. Insurers must comply with the federal Mental Health Parity and Addiction Equity Act. o Mental health and substance abuse disorder benefits must be provided in parity with medical/surgical benefits within the same

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