Ohio § 1731.09

§ 1731.09.

(A) Nothing contained in this chapter is intended to or shall inhibit or prevent the

application of the provisions of Chapter 3924. of the Revised Code to any health benefit

plan or insurer to which they would otherwise apply in the absence of this chapter,

except as otherwise specified in divisions (B) and (C) of this section or unless such

application conflicts with the provisions of section 1731.05 of the Revised Code . (B) An insurer may establish one or more separate classes of business solely comprised

of one or more alliances.  All of the following shall apply to health plans covering small employers in each

class of business established pursuant to this division: (1) The premium rate limitations set forth in section 3924.04 of the Revised Code apply to each class of business separate and apart from the insurer's other business; (2) For purposes of applying sections 3924.01 to 3924.06 of the Revised Code to a class of business, the base premium rate and midpoint rate shall be determined

with respect to each class of business separate and apart from the insurer's other

business. (3) The midpoint rate for a class of business shall not exceed the midpoint rate for

any other class of business or the insurer's non-alliance business by more than fifteen

per cent. (4) The insurer annually shall file with the superintendent of insurance an actuarial

certification consistent with section 3924.06 of the Revised Code for each class of business demonstrating that the underwriting and rating methods

of the insurer do all of the following: (a) Comply with accepted actuarial practices; (b) Are uniformly applied to health benefit plans covering small employers within the

class of business; (c) Comply with the applicable provisions of this section and sections 3924.01 to 3924.06 of the Revised Code . (5) An insurer shall apply sections 3924.01 to 3924.06 of the Revised Code to the insurer's non-alliance business and coverage sold through alliances not established

as a separate class of business. (6) An insurer shall file with the superintendent a notification identifying any alliance

or alliances to be treated as a separate class of business at least sixty days prior

to the date the rates for that class of business take effect. (7) Any application for a certificate of authority filed pursuant to section 1731.021 of the Revised Code shall include a disclosure as to whether the alliance will be underwritten or rated

as part of a separate class of business. (C) As used in this section: (1) “ Class of business ” means a group of small employers, as defined in section 3924.01 of the Revised Code , that are enrolled employers in one or more alliances. (2) “Actuarial certification,” “base premium rate,” and “midpoint rate” have the same

meanings as in section 3924.01 of the Revised Code .