Ohio § 3923.021

§ 3923.021.

(A) As used in this section: (1) “ Benefits provided are not unreasonable in relation to the premium charged ” means the rates were calculated in accordance with sound actuarial principles. (2) “ Individual policy of sickness and accident insurance ” includes sickness and accident insurance made available by insurers in the individual

market to individuals, with or without family members or dependents, through group

policies issued to one or more associations or entities. (B) With respect to any filing, made pursuant to section 3923.02 of the Revised Code , of any premium rates for any individual policy of sickness and accident insurance

or certificates made available by an insurer to individuals in the individual market

through a group policy or for any indorsement or rider pertaining thereto, the superintendent

of insurance may, within thirty days after filing: (1) Disapprove such filing after finding that the benefits provided are unreasonable

in relation to the premium charged.  Such disapproval shall be effected by written order of the superintendent, a copy

of which shall be mailed to the insurer that has made the filing.  In the order, the superintendent shall specify the reasons for the disapproval and

state that a hearing will be held within fifteen days after requested in writing by

the insurer.  If a hearing is so requested, the superintendent shall also give such public notice

as the superintendent considers appropriate.  The superintendent, within fifteen days after the commencement of any hearing, shall

issue a written order, a copy of which shall be mailed to the insurer that has made

the filing, either affirming the prior disapproval or approving such filing after

finding that the benefits provided are not unreasonable in relation to the premium

charged. (2) Set a date for a public hearing to commence no later than forty days after the filing.  The superintendent shall give the insurer making the filing twenty days' written

notice of the hearing and shall give such public notice as the superintendent considers

appropriate.  The superintendent, within twenty days after the commencement of a hearing, shall

issue a written order, a copy of which shall be mailed to the insurer that has made

the filing, either approving such filing if the superintendent finds that the benefits

provided are not unreasonable in relation to the premium charged, or disapproving

such filing if the superintendent finds that the benefits provided are unreasonable

in relation to the premium charged.  This division does not apply to any insurer organized or transacting the business

of insurance under Chapter 3907. or 3909. of the Revised Code. (3) Take no action, in which case such filing shall be deemed to be approved and shall

become effective upon the thirty-first day after such filing, unless the superintendent

has previously given to the insurer a written approval. (C) At any time after any filing has been approved pursuant to this section, the superintendent

may, after a hearing of which at least twenty days' written notice has been given

to the insurer that has made such filing and for which such public notice as the superintendent

considers appropriate has been given, withdraw approval of such filing after finding

that the benefits provided are unreasonable in relation to the premium charged.  Such withdrawal of approval shall be effected by written order of the superintendent,

a copy of which shall be mailed to the insurer that has made the filing, which shall

state the ground for such withdrawal and the date, not less than forty days after

the date of such order, when the withdrawal of approval shall become effective. (D) The superintendent may retain at the insurer's expense such attorneys, actuaries,

accountants, and other experts not otherwise a part of the superintendent's staff

as shall be reasonably necessary to assist in the preparation for and conduct of any

public hearing under this section.  The expense for retaining such experts and the expenses of the department of insurance

incurred in connection with such public hearing shall be assessed against the insurer

in an amount not to exceed one one-hundredth of one per cent of the sum of premiums

earned plus net realized investment gain or loss of such insurer as reflected in the

most current annual statement on file with the superintendent.  Any person retained shall be under the direction and control of the superintendent

and shall act in a purely advisory capacity.