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Free Ohio Accident and Health Insurance Agent Practice Questions

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Sample Practice Questions

Try these 10 sample questions from the Ohio Accident and Health Insurance Agent practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

  1. 1An Ohio resident applies for an Accident & Health agent license through the ordinary initial-examination pathway. What must occur before the license application is submitted?

    1. A. The applicant must pass the required written examination
    2. B. The applicant must obtain an insurer appointment
    3. C. The applicant must complete one renewal period
    4. D. The applicant must first hold a temporary license

    Answer: A

    Explanation: R.C. 3905.04(A) says the applicant "shall take and pass a written examination prior to application for licensure." The ordinary resident applicant therefore must pass before submitting the license application.

    Reference: Section 3905.04 - Ohio Revised Code | Ohio Laws — R.C. 3905.04(A)

  2. 2A producer notes that an apartment stairway is poorly lit, increasing the chance of a fall. In risk terminology, what is the poor lighting?

    1. A. A hazard
    2. B. A peril
    3. C. A loss
    4. D. An exposure

    Answer: A

    Explanation: The NAIC defines a hazard as a "circumstance which tends to increase the probability or severity of a loss." Poor lighting raises the likelihood of an injury; the fall would be the loss-causing event.

    Reference: NAIC Glossary of Insurance Terms — Glossary, Hazard

  3. 3An insurer refuses an individual health policy solely because the applicant was a victim of domestic violence. What does Ohio law provide?

    1. A. The refusal is an unfair or deceptive practice
    2. B. The refusal is allowed with actuarial certification
    3. C. The refusal is allowed only for individual coverage
    4. D. The refusal is governed solely by the employer

    Answer: A

    Explanation: R.C. 3901.21(Y)(1)(a) prohibits refusing individual health coverage "for the reason that the insured or applicant for insurance is or has been a victim of domestic violence." The stated refusal is an unfair or deceptive practice.

    Reference: Section 3901.21 - Ohio Revised Code | Ohio Laws — R.C. 3901.21(Y)(1)(a)

  4. 4Who may approve a valid change to an Ohio sickness and accident policy under the mandated entire-contract provision?

    1. A. Any appointed producer
    2. B. The policyholder's employer
    3. C. An executive officer of the insurer, with approval endorsed or attached
    4. D. Any claims adjuster

    Answer: C

    Explanation: R.C. 3923.04(A) states: "No change in this policy shall be valid until approved by an executive officer of the insurer" and endorsed or attached. An appointed producer cannot make the change.

    Reference: Section 3923.04 - Ohio Revised Code | Ohio Laws — R.C. 3923.04(A)

  5. 5A surgeon can no longer perform surgery after an injury but can teach medicine. Which disability definition could still qualify the surgeon on the basis of inability to perform the former professional duties?

    1. A. Own-occupation disability
    2. B. Any-occupation disability
    3. C. Residual disability only
    4. D. Presumptive disability only

    Answer: A

    Explanation: The NAIC notes that some policies pay when a person is "unable to perform the duties of your occupation," while others require inability to perform any qualified gainful work. Teaching ability does not itself defeat an own-occupation definition.

    Reference: NAIC, Simplifying the Complications of Disability Insurance — Comparing Disability Policies, Definition of Disability

  6. 6An Ohio producer compares HIC plans that include a basic health service other than the narrow mental-illness exception. What must the producer explain about the service package?

    1. A. Offer only emergency and inpatient services
    2. B. Offer all listed basic health care services
    3. C. Offer at least three basic services
    4. D. Offer only services selected by each employer

    Answer: B

    Explanation: R.C. 1751.01(A)(1) says an HIC generally "shall not offer coverage for a health care service, defined as a basic health care service by this division, unless it offers coverage for all listed basic health care services." Thus the offering must include the statutory basic-service set, subject to the stated exception.

    Reference: Section 1751.01 - Ohio Revised Code | Ohio Laws — R.C. 1751.01(A)(1)

  7. 7An individual seeks coverage under an ordinary Ohio employer group sickness and accident policy, not a membership-organization policy. What may the insurer require regarding HIV testing?

    1. A. A test whenever the employer requests it
    2. B. A test if other lab work is ordered
    3. C. A test after written consent
    4. D. No HIV test may be required for that individual

    Answer: D

    Explanation: R.C. 3901.46(F) says "no insurer shall require an individual seeking coverage" under an ordinary group sickness and accident policy "to submit to an HIV test." The membership-organization exception is excluded by the facts.

    Reference: Section 3901.46 - Ohio Revised Code | Ohio Laws — R.C. 3901.46(F)

  8. 8A dental plan lists categories for covered procedures. A patient needs a root canal. Which category identifies that treatment?

    1. A. Periodontics
    2. B. Prosthodontics
    3. C. Endodontics
    4. D. Orthodontics

    Answer: C

    Explanation: The NAIC lists "endodontics (root canals)" among dental treatment areas. Periodontics concerns gums, prosthodontics replacements, and orthodontics alignment.

    Reference: NAIC, Understanding Your Dental Insurance — What Dental Plans Cover, first paragraph

  9. 9When must an Ohio Medicare supplement applicant receive the required outline of coverage?

    1. A. At the first claim
    2. B. At the time the application is made
    3. C. At the first renewal
    4. D. After the free-look period

    Answer: B

    Explanation: R.C. 3923.334(A) requires that an outline of coverage be delivered "at the time application is made." The applicant must receive it at application, not at a later policy event.

    Reference: Section 3923.334 - Ohio Revised Code | Ohio Laws — R.C. 3923.334(A)

  10. 10An individual pays disability-income insurance premiums with after-tax personal funds and later receives benefits for a covered disability. How are the policy benefits generally treated for federal income tax?

    1. A. Excluded from taxable income
    2. B. Included in taxable income
    3. C. Taxed only above paid premiums
    4. D. Taxed after the benefit period ends

    Answer: A

    Explanation: IRS Publication 525 says that "if you paid the premiums on an accident or health insurance policy, the benefits you receive under the policy aren’t taxable." The individual personally funded this coverage.

    Reference: IRS Publication 525, Taxable and Nontaxable Income (2025) — Publication 525, Sick pay

Topics in this practice bank

These topics describe the available practice for Ohio Accident and Health Insurance Agent. Review the examination outline and its sources for scope and allocation details.

  • 1.0 Insurance Regulation
    • 1.1 Licensing
    • 1.1 Licensing / Maintenance and duration (3905.06, .16; 3901-5-09)
    • 1.1 Licensing / Maintenance and duration (3905.06, .16; 3901-5-09) / Requirements (3905.02, .04, .041, .05, .051, .06; 3901-5-09)
    • 1.1 Licensing / Maintenance and duration (3905.06, .16; 3901-5-09) / Resident/nonresident (3905.06, .061, .07, .071)
    • 1.1 Licensing / Maintenance and duration (3905.06, .16; 3901-5-09) / Change in name, address, email, telephone number (3905.061, 3905.071; 3901-5-09)
    • 1.1 Licensing / Maintenance and duration (3905.06, .16; 3901-5-09) / Renewal/nonrenewal (3905.06; 3901-5-09(J))
    • 1.1 Licensing / Maintenance and duration (3905.06, .16; 3901-5-09) / Temporary license (3905.09)
    • 1.1 Licensing / Maintenance and duration (3905.06, .16; 3901-5-09) / Duty to report criminal convictions and administrative disciplinary actions (3905.22)
    • 1.1 Licensing / Maintenance and duration (3905.06, .16; 3901-5-09) / Assumed business names (3905.11)
    • 1.1 Licensing / Maintenance and duration (3905.06, .16; 3901-5-09) / Continuing education including exemptions and penalties (3905.06, 3905.481; 3901-5-01; 3901-5-05(D), 3901-5-09(L)(7))
    • 1.1 Licensing / Maintenance and duration (3905.06, .16; 3901-5-09) / Inactivity due to military service (3905.06(G)); 3901-5-09(J))
    • 1.1 Licensing / Maintenance and duration (3905.06, .16; 3901-5-09) / Inactivity due to extenuating circumstances (3905.06(G); 3901-5- 09(J))
    • 1.1 Licensing / Disciplinary actions (3905.14)
    • 1.1 Licensing / License denial, probation, surrender, suspension, revocation, or refusal to issue or renew (3901.22(D)(1); 3905.14, 3905.16; 3901-5- 12)
    • 1.1 Licensing / License denial, probation, surrender, suspension, revocation, or refusal to issue or renew (3901.22(D)(1); 3905.14, 3905.16; 3901-5- 12) / Failure to pay taxes (3905.14(B)(14))
    • 1.1 Licensing / License denial, probation, surrender, suspension, revocation, or refusal to issue or renew (3901.22(D)(1); 3905.14, 3905.16; 3901-5- 12) / Failure to appear for an interview (3905.14(B)(22))
    • 1.1 Licensing / License denial, probation, surrender, suspension, revocation, or refusal to issue or renew (3901.22(D)(1); 3905.14, 3905.16; 3901-5- 12) / Failure to provide department with a written response (3905.14(B)(21))
    • 1.1 Licensing / License denial, probation, surrender, suspension, revocation, or refusal to issue or renew (3901.22(D)(1); 3905.14, 3905.16; 3901-5- 12) / Penalties and fines for violations (3901.22(D), (F), 3905.14(B), (D), (E), (F), (G), (H), .99)
    • 1.1 Licensing / License denial, probation, surrender, suspension, revocation, or refusal to issue or renew (3901.22(D)(1); 3905.14, 3905.16; 3901-5- 12) / Penalties and fines for violations (3901.22(D), (F), 3905.14(B), (D), (E), (F), (G), (H), .99) / Cease and desist orders (3901.221; 3905.14(H), 3901.22(D))
    • 1.1 Licensing / License denial, probation, surrender, suspension, revocation, or refusal to issue or renew (3901.22(D)(1); 3905.14, 3905.16; 3901-5- 12) / Penalties and fines for violations (3901.22(D), (F), 3905.14(B), (D), (E), (F), (G), (H), .99) / Civil
    • 1.1 Licensing / License denial, probation, surrender, suspension, revocation, or refusal to issue or renew (3901.22(D)(1); 3905.14, 3905.16; 3901-5- 12) / Penalties and fines for violations (3901.22(D), (F), 3905.14(B), (D), (E), (F), (G), (H), .99) / Criminal
    • 1.1 Licensing / License denial, probation, surrender, suspension, revocation, or refusal to issue or renew (3901.22(D)(1); 3905.14, 3905.16; 3901-5- 12) / Penalties and fines for violations (3901.22(D), (F), 3905.14(B), (D), (E), (F), (G), (H), .99) / Hearings (3901.22; 3905.14(C); 3905.14(D); ORC 119)
    • 1.1 Licensing / License denial, probation, surrender, suspension, revocation, or refusal to issue or renew (3901.22(D)(1); 3905.14, 3905.16; 3901-5- 12) / Consent/Settlement agreements (3901.22(G))
    • 1.2 State regulation
    • 1.2 State regulation / Acts constituting insurance transactions (3901.17; 3905.02, 3905.42)
    • 1.2 State regulation / Acts constituting insurance transactions (3901.17; 3905.02, 3905.42) / Negotiate, sell, solicit (3905.01, .02)
    • 1.2 State regulation / Director's general duties and powers (3901.01, 3901.011, .04, .041; 3905.12)
    • 1.2 State regulation / Company regulation
    • 1.2 State regulation / Company regulation / Certificate of authority (1751.02, 3907.08; 3909.01, .08, 3925.11, 3927.01))
    • 1.2 State regulation / Company regulation / Insolvency (3903.01(O))
    • 1.2 State regulation / Company regulation / Policy forms/rates/exceptions (3918.08; 3935.04; 3937.03; 3923.02, 3923.021; 1751.11, 1751.12)
    • 1.2 State regulation / Company regulation / Financial requirements (3901-1-50; 3901-3-04; 3907.05, 3929.011)
    • 1.2 State regulation / Company regulation / Unfair trade and claims settlement practices (3901.19-.26; 3901- 1-07; 3901-1-54))
    • 1.2 State regulation / Agent regulation
    • 1.2 State regulation / Agent regulation / Commissions, compensations, fees (3905.18; 3905.181; 3901-5- 09(N), 3905.55) Reporting of felony and crimes of moral turpitude (3905.14 (B)(6), (B)(7), .22)
    • 1.2 State regulation / Agent regulation / Policy/application signature (3905.14(B)(11), (26))
    • 1.2 State regulation / Appointment procedures
    • 1.2 State regulation / Appointment procedures / Agent appointment (3905.20; 3901-5-09(K))
    • 1.2 State regulation / Appointment procedures / Cancellation of appointment (3905.16(B)(1))
    • 1.2 State regulation / Appointment procedures / Termination notification (3905.21)
    • 1.2 State regulation / Unfair insurance trade practices (3901.20, .21)
    • 1.2 State regulation / Unfair insurance trade practices (3901.20, .21) / Rebating (3911.20; 3933.01; 3999.05)
    • 1.2 State regulation / Unfair insurance trade practices (3901.20, .21) / Premium refunds and other incentives (3905.14(B)(32); 3999.05, Bulletins 2019-04 and 2019-05)
    • 1.2 State regulation / Unfair insurance trade practices (3901.20, .21) / False advertising (3901.21(A), (B), (C), (D), (E), 3901.24; 3905.43; 3999.10, .11)
    • 1.2 State regulation / Unfair insurance trade practices (3901.20, .21) / Misrepresentation (3901.21(A),(B); 3905.14(B)(5); 3999.08)
    • 1.2 State regulation / Unfair insurance trade practices (3901.20, .21) / Defamation of insurer (3901.21(C ), (D); 3999.09)
    • 1.2 State regulation / Unfair insurance trade practices (3901.20, .21) / Unfair discrimination (3901.21(L), (M), (N))
    • 1.2 State regulation / Unfair insurance trade practices (3901.20, .21) / Illegal inducements (3933.01; 3999.05, 3901.21(G), 3911.20, Bulletins 2019-04 and 2019-05)
    • 1.2 State regulation / Unfair insurance trade practices (3901.20, .21) / General grounds for disciplinary action (3905.14(B))
    • 1.2 State regulation / Examination of books and records (3901.04, .07)
    • 1.2 State regulation / Insurance fraud regulation (3999.21, .31, .37, .41, .42, .99; 2913.47, 3901.44) Insurance information privacy (3901.44; 3904.04, 3904.14, 3965.01- .11)
    • 1.2 State regulation / Consumer information/fees (3905.55; 3901-6-04; 3905.181)
    • 1.3 Federal regulation
    • 1.3 Federal regulation / Fair Credit Reporting Act (15 USC 1681–1681d)
    • 1.3 Federal regulation / Fraud and false statements including 1033 waiver (18 USC 1033, 1034)
    • 1.3 Federal regulation / Other federal regulations (e.g., Do Not Call List) (https://www.donotcall.gov/)
  • 2.0 General Insurance
    • 2.1 Concepts
    • 2.1 Concepts / Risk management key terms
    • 2.1 Concepts / Risk management key terms / Risk
    • 2.1 Concepts / Risk management key terms / Exposure
    • 2.1 Concepts / Risk management key terms / Hazard
    • 2.1 Concepts / Risk management key terms / Peril
    • 2.1 Concepts / Risk management key terms / Loss
    • 2.1 Concepts / Methods of handling risk
    • 2.1 Concepts / Methods of handling risk / Avoidance
    • 2.1 Concepts / Methods of handling risk / Retention
    • 2.1 Concepts / Methods of handling risk / Sharing
    • 2.1 Concepts / Methods of handling risk / Reduction
    • 2.1 Concepts / Methods of handling risk / Transfer
    • 2.1 Concepts / Elements of insurable risks
    • 2.1 Concepts / Adverse selection
    • 2.1 Concepts / Law of large numbers
    • 2.1 Concepts / Reinsurance
    • 2.1 Concepts / Indemnity/pay on behalf of
    • 2.2 Insurers
    • 2.2 Insurers / Types of insurers
    • 2.2 Insurers / Types of insurers / Stock companies
    • 2.2 Insurers / Types of insurers / Mutual companies
    • 2.2 Insurers / Types of insurers / Fraternal benefit societies
    • 2.2 Insurers / Types of insurers / Reciprocals
    • 2.2 Insurers / Types of insurers / Lloyd's associations
    • 2.2 Insurers / Types of insurers / Risk retention groups
    • 2.2 Insurers / Types of insurers / Surplus lines
    • 2.2 Insurers / Authorized/admitted versus unauthorized/nonadmitted insurers
    • 2.2 Insurers / Domestic, foreign and alien insurers
    • 2.2 Insurers / Financial solvency status (e.g., A.M. Best, Standard and Poor's, Moody's, NAIC)
    • 2.2 Insurers / Marketing (distribution) systems
    • 2.3 Agent and general rules of agency
    • 2.3 Agent and general rules of agency / Insurer as principal
    • 2.3 Agent and general rules of agency / Agent/insurer relationship
    • 2.3 Agent and general rules of agency / Authority and powers of agents
    • 2.3 Agent and general rules of agency / Authority and powers of agents / Express
    • 2.3 Agent and general rules of agency / Authority and powers of agents / Implied
    • 2.3 Agent and general rules of agency / Authority and powers of agents / Apparent
    • 2.3 Agent and general rules of agency / Responsibilities to the applicant/insured
    • 2.4 Contracts
    • 2.4 Contracts / Elements of a legal contract
    • 2.4 Contracts / Elements of a legal contract / Offer and acceptance
    • 2.4 Contracts / Elements of a legal contract / Consideration
    • 2.4 Contracts / Elements of a legal contract / Competent parties
    • 2.4 Contracts / Elements of a legal contract / Legal purpose
    • 2.4 Contracts / Distinct characteristics of an insurance contract
    • 2.4 Contracts / Distinct characteristics of an insurance contract / Contract of adhesion
    • 2.4 Contracts / Distinct characteristics of an insurance contract / Aleatory contract
    • 2.4 Contracts / Distinct characteristics of an insurance contract / Personal contract
    • 2.4 Contracts / Distinct characteristics of an insurance contract / Unilateral contract
    • 2.4 Contracts / Distinct characteristics of an insurance contract / Conditional contract
    • 2.4 Contracts / Legal interpretations affecting contracts
    • 2.4 Contracts / Legal interpretations affecting contracts / Ambiguities in a contract of adhesion
    • 2.4 Contracts / Legal interpretations affecting contracts / Reasonable expectations
    • 2.4 Contracts / Legal interpretations affecting contracts / Indemnity
    • 2.4 Contracts / Legal interpretations affecting contracts / Utmost good faith
    • 2.4 Contracts / Legal interpretations affecting contracts / Representations/misrepresentations
    • 2.4 Contracts / Legal interpretations affecting contracts / Warranties
    • 2.4 Contracts / Legal interpretations affecting contracts / Concealment
    • 2.4 Contracts / Legal interpretations affecting contracts / Fraud
    • 2.4 Contracts / Legal interpretations affecting contracts / Waiver and estoppel
  • 3.0 Accident and Health Insurance Basics
    • 3.1 Definitions of perils
    • 3.1 Definitions of perils / Accidental injury
    • 3.1 Definitions of perils / Sickness
    • 3.2 Principal types of losses and benefits
    • 3.2 Principal types of losses and benefits / Loss of income from disability
    • 3.2 Principal types of losses and benefits / Medical expense
    • 3.2 Principal types of losses and benefits / Dental expense
    • 3.2 Principal types of losses and benefits / Vision expense
    • 3.2 Principal types of losses and benefits / Long-term/home health care expense
    • 3.3 Classes of health insurance policies
    • 3.3 Classes of health insurance policies / Individual versus group
    • 3.3 Classes of health insurance policies / Private versus government
    • 3.3 Classes of health insurance policies / Limited versus comprehensive
    • 3.3 Classes of health insurance policies / Self-funded/ERISA
    • 3.3 Classes of health insurance policies / Employee association
    • 3.4 Limited policies
    • 3.4 Limited policies / Limited perils and amounts
    • 3.4 Limited policies / Required notice to insured
    • 3.4 Limited policies / Types of limited policies
    • 3.4 Limited policies / Types of limited policies / Accident-only
    • 3.4 Limited policies / Types of limited policies / Specified (dread) disease
    • 3.4 Limited policies / Types of limited policies / Hospital indemnity (income)
    • 3.4 Limited policies / Types of limited policies / Credit disability
    • 3.4 Limited policies / Types of limited policies / Blanket insurance (teams, passengers, other) (3923.13)
    • 3.4 Limited policies / Types of limited policies / Prescription drugs
    • 3.4 Limited policies / Types of limited policies / Vision care
    • 3.4 Limited policies / Types of limited policies / Critical illness
    • 3.4 Limited policies / Types of limited policies / Dental
    • 3.4 Limited policies / Types of limited policies / Hearing
    • 3.4 Limited policies / Types of limited policies / Group supplemental
    • 3.4 Limited policies / Types of limited policies / Travel
    • 3.4 Limited policies / Types of limited policies / Short-term major medical
    • 3.4 Limited policies / Medicare supplement & Part D (3923.33, .338, .331 - .336; 3901-8-08, 3901-8-09)
    • 3.5 Common exclusions from coverage
    • 3.5 Common exclusions from coverage / War or act of war
    • 3.5 Common exclusions from coverage / Elective cosmetic surgery
    • 3.5 Common exclusions from coverage / Workers' compensation
    • 3.5 Common exclusions from coverage / Commission or attempt of a felony
    • 3.5 Common exclusions from coverage / State child health program
    • 3.6 Agent responsibilities in individual health insurance
    • 3.6 Agent responsibilities in individual health insurance / Marketing requirements
    • 3.6 Agent responsibilities in individual health insurance / Marketing requirements / Advertising
    • 3.6 Agent responsibilities in individual health insurance / Marketing requirements / Life and Health Insurance Guaranty Association (3956.04, .06, .18; 3901-1-52)
    • 3.6 Agent responsibilities in individual health insurance / Marketing requirements / Sales presentations
    • 3.6 Agent responsibilities in individual health insurance / Marketing requirements / Outline of coverage
    • 3.6 Agent responsibilities in individual health insurance / Marketing requirements / Common situation for omission/errors
    • 3.6 Agent responsibilities in individual health insurance / Field underwriting
    • 3.6 Agent responsibilities in individual health insurance / Field underwriting / Nature and purpose
    • 3.6 Agent responsibilities in individual health insurance / Field underwriting / Disclosure of information about individuals
    • 3.6 Agent responsibilities in individual health insurance / Field underwriting / Application procedures
    • 3.6 Agent responsibilities in individual health insurance / Field underwriting / Requirements at delivery of policy
    • 3.6 Agent responsibilities in individual health insurance / Field underwriting / Employee waiver form
    • 3.6 Agent responsibilities in individual health insurance / Field underwriting / Medicare Marketing Rules for Center for Medicare and Medicaid Services (CMS) & Ohio
    • 3.7 Individual underwriting by the insurer
    • 3.7 Individual underwriting by the insurer / Criteria
    • 3.7 Individual underwriting by the insurer / Unfair discrimination (3923.15; 3901.21)
    • 3.7 Individual underwriting by the insurer / Genetic testing (3901.491, .501)
    • 3.7 Individual underwriting by the insurer / Sources of underwriting information (3904; 3901.21(M))
    • 3.7 Individual underwriting by the insurer / Sources of underwriting information (3904; 3901.21(M)) / Application
    • 3.7 Individual underwriting by the insurer / Sources of underwriting information (3904; 3901.21(M)) / Agent report
    • 3.7 Individual underwriting by the insurer / Sources of underwriting information (3904; 3901.21(M)) / Attending physician statement
    • 3.7 Individual underwriting by the insurer / Sources of underwriting information (3904; 3901.21(M)) / Investigative consumer (inspection) report
    • 3.7 Individual underwriting by the insurer / Sources of underwriting information (3904; 3901.21(M)) / Medical Information Bureau (MIB)
    • 3.7 Individual underwriting by the insurer / Sources of underwriting information (3904; 3901.21(M)) / Medical examinations and lab tests (including HIV consent) (3901.46(A), (B)(1))
    • 3.7 Individual underwriting by the insurer / Classification of risks
    • 3.7 Individual underwriting by the insurer / Classification of risks / Preferred
    • 3.7 Individual underwriting by the insurer / Classification of risks / Standard
    • 3.7 Individual underwriting by the insurer / Classification of risks / Substandard
    • 3.7 Individual underwriting by the insurer / Classification of risks / Declined
    • 3.8 Considerations in replacing accident and health insurance
    • 3.8 Considerations in replacing accident and health insurance / Waiting period
    • 3.8 Considerations in replacing accident and health insurance / State requirements
    • 3.8 Considerations in replacing accident and health insurance / Benefits, limitations and exclusions
    • 3.8 Considerations in replacing accident and health insurance / Underwriting requirements
    • 3.8 Considerations in replacing accident and health insurance / Agent liability for errors and omissions
  • 4.0 Individual Accident and Health Insurance Policy General Provisions
    • 4.1 Standard provisions (3923.04)
    • 4.1 Standard provisions (3923.04) / Entire contract; changes (A)
    • 4.1 Standard provisions (3923.04) / Time limit on certain defenses (B)
    • 4.1 Standard provisions (3923.04) / Grace period (C)
    • 4.1 Standard provisions (3923.04) / Reinstatement (D)
    • 4.1 Standard provisions (3923.04) / Claim procedures (E-I)
    • 4.1 Standard provisions (3923.04) / Physical examinations and autopsy (J)
    • 4.1 Standard provisions (3923.04) / Legal actions (K)
    • 4.1 Standard provisions (3923.04) / Change of beneficiary (L)
    • 4.1 Standard provisions (3923.04) / Cancellation by insured (M)
    • 4.2 Optional provisions (3923.05)
    • 4.2 Optional provisions (3923.05) / Change of occupation (A)
    • 4.2 Optional provisions (3923.05) / Misstatement of age (B)
    • 4.2 Optional provisions (3923.05) / Other insurance in this insurer (C)
    • 4.2 Optional provisions (3923.05) / Insurance with other insurers
    • 4.2 Optional provisions (3923.05) / Insurance with other insurers / Expense-incurred benefits (D)
    • 4.2 Optional provisions (3923.05) / Insurance with other insurers / Other than expense-incurred basis (E)
    • 4.2 Optional provisions (3923.05) / Unpaid premium (G)
    • 4.2 Optional provisions (3923.05) / Conformity with state statutes (H)
    • 4.2 Optional provisions (3923.05) / Illegal occupation (I)
    • 4.3 Other general provisions
    • 4.3 Other general provisions / Right to examine (free look) (3923.31)
    • 4.3 Other general provisions / Insuring clause
    • 4.3 Other general provisions / Consideration clause
    • 4.3 Other general provisions / Subrogation
    • 4.3 Other general provisions / Renewability clause
    • 4.3 Other general provisions / Renewability clause / Non-cancelable
    • 4.3 Other general provisions / Renewability clause / Guaranteed renewable
    • 4.3 Other general provisions / Renewability clause / Conditionally renewable
    • 4.3 Other general provisions / Renewability clause / Renewable at option of insurer
    • 4.3 Other general provisions / Renewability clause / Nonrenewable (cancelable, term)
  • 5.0 Disability Income and Related Insurance
    • 5.1 Qualifying for disability benefits
    • 5.1 Qualifying for disability benefits / Inability to perform duties
    • 5.1 Qualifying for disability benefits / Inability to perform duties / Own occupation
    • 5.1 Qualifying for disability benefits / Inability to perform duties / Any occupation
    • 5.1 Qualifying for disability benefits / Pure loss of income (income replacement contracts)
    • 5.1 Qualifying for disability benefits / Presumptive disability
    • 5.1 Qualifying for disability benefits / Requirement to be under physician care
    • 5.1 Qualifying for disability benefits / State minimum benefit standards and exclusions
    • 5.2 Individual disability income insurance
    • 5.2 Individual disability income insurance / Basic total disability plan
    • 5.2 Individual disability income insurance / Basic total disability plan / Income benefits (monthly indemnity)
    • 5.2 Individual disability income insurance / Basic total disability plan / Elimination and benefit periods
    • 5.2 Individual disability income insurance / Basic total disability plan / Waiver of premium feature
    • 5.2 Individual disability income insurance / Coordination with social insurance and workers' compensation benefits
    • 5.2 Individual disability income insurance / Coordination with social insurance and workers' compensation benefits / Additional monthly benefit (AMB)
    • 5.2 Individual disability income insurance / Coordination with social insurance and workers' compensation benefits / Social insurance supplement (SIS)
    • 5.2 Individual disability income insurance / Coordination with social insurance and workers' compensation benefits / Occupational versus nonoccupational coverage, eligibility and benefits
    • 5.2 Individual disability income insurance / At-work benefits
    • 5.2 Individual disability income insurance / At-work benefits / Partial disability benefit
    • 5.2 Individual disability income insurance / At-work benefits / Residual disability benefit
    • 5.2 Individual disability income insurance / Other provisions affecting income benefits
    • 5.2 Individual disability income insurance / Other provisions affecting income benefits / Cost of living adjustment (COLA) rider
    • 5.2 Individual disability income insurance / Other provisions affecting income benefits / Future increase option (FIO) rider
    • 5.2 Individual disability income insurance / Other provisions affecting income benefits / Relation of earnings to insurance (3923.05(F))
    • 5.2 Individual disability income insurance / Other cash benefits
    • 5.2 Individual disability income insurance / Other cash benefits / Accidental death and dismemberment
    • 5.2 Individual disability income insurance / Other cash benefits / Rehabilitation benefit
    • 5.2 Individual disability income insurance / Other cash benefits / Medical reimbursement benefit (non-disabling injury)
    • 5.2 Individual disability income insurance / Benefit and Refund provisions
    • 5.2 Individual disability income insurance / Benefit and Refund provisions / Return of premium
    • 5.2 Individual disability income insurance / Benefit and Refund provisions / Cost of living adjustment
    • 5.2 Individual disability income insurance / Benefit and Refund provisions / Future increase option
    • 5.2 Individual disability income insurance / Benefit and Refund provisions / Annual renewable term
    • 5.2 Individual disability income insurance / Benefit and Refund provisions / Change of occupation
    • 5.2 Individual disability income insurance / Benefit and Refund provisions / Cash surrender value
    • 5.2 Individual disability income insurance / Exclusions
    • 5.3 Unique aspects of individual disability underwriting
    • 5.3 Unique aspects of individual disability underwriting / Occupational considerations
    • 5.3 Unique aspects of individual disability underwriting / Benefit limits
    • 5.3 Unique aspects of individual disability underwriting / Policy issuance alternatives
    • 5.4 Group disability income insurance
    • 5.4 Group disability income insurance / Group versus individual plans
    • 5.4 Group disability income insurance / Short-term disability (STD)
    • 5.4 Group disability income insurance / Long-term disability (LTD)
    • 5.5 Business disability insurance
    • 5.5 Business disability insurance / Key person disability income
    • 5.5 Business disability insurance / Business overhead expense policy
    • 5.5 Business disability insurance / Disability buy-sell policy
    • 5.5 Business disability insurance / Reducing term
    • 5.6 Social Security disability
    • 5.6 Social Security disability / Qualification for disability benefits
    • 5.6 Social Security disability / Definition of disability
    • 5.6 Social Security disability / Waiting period
    • 5.6 Social Security disability / Disability income benefits
    • 5.7 Workers' compensation
    • 5.7 Workers' compensation / Eligibility
    • 5.7 Workers' compensation / Benefits
  • 6.0 Medical Plans
    • 6.1 Medical plan concepts
    • 6.1 Medical plan concepts / Fee-for-service basis versus prepaid basis
    • 6.1 Medical plan concepts / Specified coverages versus comprehensive care
    • 6.1 Medical plan concepts / Benefit schedule versus usual/reasonable/customary charges
    • 6.1 Medical plan concepts / Any provider versus limited choice of providers
    • 6.1 Medical plan concepts / Insureds versus subscribers/participants
    • 6.2 Types of providers and plans
    • 6.2 Types of providers and plans / Major medical insurance (indemnity plans)
    • 6.2 Types of providers and plans / Major medical insurance (indemnity plans) / Characteristics
    • 6.2 Types of providers and plans / Major medical insurance (indemnity plans) / Common limitations
    • 6.2 Types of providers and plans / Major medical insurance (indemnity plans) / Exclusions from coverage
    • 6.2 Types of providers and plans / Major medical insurance (indemnity plans) / Provisions affecting cost to insured
    • 6.2 Types of providers and plans / Health insuring corporations (HICs)(formerly known as health maintenance organizations)
    • 6.2 Types of providers and plans / Preferred provider organizations (PPOs)
    • 6.2 Types of providers and plans / Preferred provider organizations (PPOs) / General characteristics
    • 6.2 Types of providers and plans / Preferred provider organizations (PPOs) / In and out of network
    • 6.2 Types of providers and plans / Preferred provider organizations (PPOs) / Types of parties to the provider contract
    • 6.2 Types of providers and plans / Point-of-service (POS) plans
    • 6.2 Types of providers and plans / Point-of-service (POS) plans / Nature and purpose
    • 6.2 Types of providers and plans / Point-of-service (POS) plans / Out-of-network provider access
    • 6.2 Types of providers and plans / Point-of-service (POS) plans / PCP referral (gatekeeper PPO)
    • 6.2 Types of providers and plans / Point-of-service (POS) plans / Indemnity plan features
    • 6.2 Types of providers and plans / Point-of-service (POS) plans / HIC plan features
    • 6.2 Types of providers and plans / Consumer Driven Plans
    • 6.2 Types of providers and plans / Ohio Children's Health Insurance Program (5160; 5161)
    • 6.3 Cost containment in health care delivery
    • 6.3 Cost containment in health care delivery / Cost-saving services
    • 6.3 Cost containment in health care delivery / Cost-saving services / Preventive care
    • 6.3 Cost containment in health care delivery / Cost-saving services / Hospital outpatient benefits
    • 6.3 Cost containment in health care delivery / Cost-saving services / Alternatives to hospital services
    • 6.3 Cost containment in health care delivery / Utilization management reviews
    • 6.3 Cost containment in health care delivery / Utilization management reviews / Prospective review
    • 6.3 Cost containment in health care delivery / Utilization management reviews / Concurrent review
    • 6.3 Cost containment in health care delivery / Utilization management reviews / Retrospective
    • 6.3 Cost containment in health care delivery / Grievance procedures
    • 6.3 Cost containment in health care delivery / Prior authorization procedures (3923.041, 1751.72)
    • 6.4 Ohio requirements (individual and group)
    • 6.4 Ohio requirements (individual and group) / Eligibility requirements
    • 6.4 Ohio requirements (individual and group) / Eligibility requirements / Dependent child coverage (3923.24, .56; 1751.14, 3923.241)
    • 6.4 Ohio requirements (individual and group) / Eligibility requirements / Newborn child coverage (3923.26; 1751.61)
    • 6.4 Ohio requirements (individual and group) / Eligibility requirements / Coverage of adopted children (3923.40; 3924.51; 1751.59)
    • 6.4 Ohio requirements (individual and group) / Eligibility requirements / Enrollment
    • 6.4 Ohio requirements (individual and group) / Eligibility requirements / Special Enrollment Period
    • 6.4 Ohio requirements (individual and group) / Eligibility requirements / Non-custodial parent
    • 6.4 Ohio requirements (individual and group) / Eligibility requirements / Grandchildren
    • 6.4 Ohio requirements (individual and group) / Eligibility requirements / Immunizations
    • 6.4 Ohio requirements (individual and group) / Eligibility requirements / Physically/mentally handicapped coverage
    • 6.4 Ohio requirements (individual and group) / Women's benefits
    • 6.4 Ohio requirements (individual and group) / Women's benefits / Cytologic screening and mammography (3923.52; 1751.62)
    • 6.4 Ohio requirements (individual and group) / Women's benefits / Infertility
    • 6.4 Ohio requirements (individual and group) / Women's benefits / Maternity
    • 6.4 Ohio requirements (individual and group) / Women's benefits / Postpartum
    • 6.4 Ohio requirements (individual and group) / Coordination of benefits provision
    • 6.5 HIPAA (Health Insurance Portability and Accountability Act) requirements
    • 6.5 HIPAA (Health Insurance Portability and Accountability Act) requirements / Eligibility
    • 6.5 HIPAA (Health Insurance Portability and Accountability Act) requirements / Privacy
    • 6.5 HIPAA (Health Insurance Portability and Accountability Act) requirements / Guaranteed issue
    • 6.5 HIPAA (Health Insurance Portability and Accountability Act) requirements / Renewability
    • 6.5 HIPAA (Health Insurance Portability and Accountability Act) requirements / Mental health parity
    • 6.5 HIPAA (Health Insurance Portability and Accountability Act) requirements / Security provisions
    • 6.6 Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs)
    • 6.6 Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) / Definition
    • 6.6 Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) / Eligibility
    • 6.6 Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) / Eligibility / Contribution limits
    • 6.7 PPACA (Patient Protection and Affordable Care Act)
    • 6.7 PPACA (Patient Protection and Affordable Care Act) / Adverse benefit determination (3922.01-.23)
    • 6.7 PPACA (Patient Protection and Affordable Care Act) / Rollout schedule
    • 6.7 PPACA (Patient Protection and Affordable Care Act) / Employer compliance
    • 6.7 PPACA (Patient Protection and Affordable Care Act) / Department of labor audits
    • 6.7 PPACA (Patient Protection and Affordable Care Act) / Types of plans
    • 6.7 PPACA (Patient Protection and Affordable Care Act) / Enrollment periods
    • 6.7 PPACA (Patient Protection and Affordable Care Act) / Healthcare.gov versus private plans
    • 6.7 PPACA (Patient Protection and Affordable Care Act) / Statement of benefits, coverages and uniform glossary
  • 7.0 Health Insuring Corporations (HICs)
    • 7.1 General characteristics
    • 7.1 General characteristics / Combined health care delivery and financing
    • 7.1 General characteristics / Structure and providers
    • 7.1 General characteristics / Limited service area
    • 7.1 General characteristics / Limited choice of providers
    • 7.1 General characteristics / Gatekeeper concept/Primary care physician versus referral (specialty) physician
    • 7.1 General characteristics / Copayments
    • 7.1 General characteristics / Prepaid basis
    • 7.2 HIC services (1751.01)
    • 7.2 HIC services (1751.01) / Basic health services (1751.01 (A))
    • 7.2 HIC services (1751.01) / Basic health services (1751.01 (A)) / Preventive care services
    • 7.2 HIC services (1751.01) / Basic health services (1751.01 (A)) / Physician services
    • 7.2 HIC services (1751.01) / Basic health services (1751.01 (A)) / Emergency care
    • 7.2 HIC services (1751.01) / Basic health services (1751.01 (A)) / Urgent care
    • 7.2 HIC services (1751.01) / Basic health services (1751.01 (A)) / Hospital services
    • 7.2 HIC services (1751.01) / Basic health services (1751.01 (A)) / Outpatient services
    • 7.2 HIC services (1751.01) / Basic health services (1751.01 (A)) / Diagnostic services
    • 7.2 HIC services (1751.01) / Basic health services (1751.01 (A)) / Cancer clinical trials
    • 7.2 HIC services (1751.01) / Supplemental health care services (1751.01(B))
    • 7.2 HIC services (1751.01) / Supplemental health care services (1751.01(B)) / Intermediate or long-term care facilities
    • 7.2 HIC services (1751.01) / Supplemental health care services (1751.01(B)) / Dental care
    • 7.2 HIC services (1751.01) / Supplemental health care services (1751.01(B)) / Vision care
    • 7.2 HIC services (1751.01) / Supplemental health care services (1751.01(B)) / Podiatric care
    • 7.2 HIC services (1751.01) / Supplemental health care services (1751.01(B)) / Mental health services
    • 7.2 HIC services (1751.01) / Supplemental health care services (1751.01(B)) / Alcohol and drug abuse treatment
    • 7.2 HIC services (1751.01) / Supplemental health care services (1751.01(B)) / Home health services
    • 7.2 HIC services (1751.01) / Supplemental health care services (1751.01(B)) / Prescription drug services
    • 7.2 HIC services (1751.01) / Supplemental health care services (1751.01(B)) / Nursing services
    • 7.2 HIC services (1751.01) / Supplemental health care services (1751.01(B)) / Physical therapy
    • 7.2 HIC services (1751.01) / Supplemental health care services (1751.01(B)) / Chiropractic services
    • 7.2 HIC services (1751.01) / Supplemental health care services (1751.01(B)) / Specialty Health Care Services (1751.01 (C))
    • 7.3 HIC certification and regulation
    • 7.3 HIC certification and regulation / Solicitation documents (1751.31)
    • 7.3 HIC certification and regulation / Advertising (1751.20)
    • 7.3 HIC certification and regulation / Confidentiality of medical and health information (1751.52)
    • 7.3 HIC certification and regulation / Contractual plan
    • 7.3 HIC certification and regulation / Contractual plan / Evidence of coverage (1751.11, .33)
    • 7.3 HIC certification and regulation / Contractual plan / Benefits and exclusions
    • 7.3 HIC certification and regulation / Contractual plan / Open enrollment provision
    • 7.3 HIC certification and regulation / Contractual plan / Member rights (1751.18)
    • 7.3 HIC certification and regulation / Renewal (1751.18)
  • 8.0 Group Accident and Health Insurance
    • 8.1 Characteristics of group insurance
    • 8.1 Characteristics of group insurance / Group contract
    • 8.1 Characteristics of group insurance / Certificate of coverage
    • 8.1 Characteristics of group insurance / Experience rating versus community rating
    • 8.2 Types of eligible groups
    • 8.2 Types of eligible groups / Employment-related groups
    • 8.2 Types of eligible groups / Employment-related groups / Individual employer groups
    • 8.2 Types of eligible groups / Employment-related groups / Multiple-Employer Trusts (METs) or Welfare Arrangements (MEWAs) (Chapter 1739)
    • 8.2 Types of eligible groups / Employment-related groups / Associations
    • 8.2 Types of eligible groups / Employment-related groups / Blanket (3923.13)
    • 8.2 Types of eligible groups / Students health plans
    • 8.2 Types of eligible groups / Customer groups (depositors, creditor-debtor, other)
    • 8.3 Marketing considerations
    • 8.3 Marketing considerations / Advertising
    • 8.3 Marketing considerations / Regulatory jurisdiction/place of delivery
    • 8.3 Marketing considerations / Disclosure form
    • 8.4 Employer group health insurance
    • 8.4 Employer group health insurance / Insurer underwriting criteria
    • 8.4 Employer group health insurance / Insurer underwriting criteria / Characteristics of group
    • 8.4 Employer group health insurance / Insurer underwriting criteria / Nondiscrimination
    • 8.4 Employer group health insurance / Insurer underwriting criteria / Plan design factors
    • 8.4 Employer group health insurance / Insurer underwriting criteria / Plan design factors / Contributory/non-contributory
    • 8.4 Employer group health insurance / Insurer underwriting criteria / Persistency factors
    • 8.4 Employer group health insurance / Insurer underwriting criteria / Administrative capability
    • 8.4 Employer group health insurance / Insurer underwriting criteria / State requirements
    • 8.4 Employer group health insurance / Eligibility for coverage
    • 8.4 Employer group health insurance / Eligibility for coverage / Annual open enrollment
    • 8.4 Employer group health insurance / Eligibility for coverage / Part-time employees
    • 8.4 Employer group health insurance / Eligibility for coverage / Dependent, spousal eligibility
    • 8.4 Employer group health insurance / Eligibility for coverage / Domestic partners/civil unions
    • 8.4 Employer group health insurance / Coordination of benefits provision
    • 8.4 Employer group health insurance / Change of insurance companies or loss of coverage
    • 8.4 Employer group health insurance / Change of insurance companies or loss of coverage / Coinsurance and deductible carryover
    • 8.4 Employer group health insurance / Change of insurance companies or loss of coverage / No-loss no-gain
    • 8.4 Employer group health insurance / Change of insurance companies or loss of coverage / Events that terminate coverage
    • 8.4 Employer group health insurance / Change of insurance companies or loss of coverage / Extension of benefits
    • 8.4 Employer group health insurance / Change of insurance companies or loss of coverage / Continuation of coverage under COBRA 29 USC1161 and Ohio- specific rules (3923.38)
    • 8.4 Employer group health insurance / Change of insurance companies or loss of coverage / Cancellation or nonrenewal
    • 8.4 Employer group health insurance / Change of insurance companies or loss of coverage / Reinstatement for military personal
    • 8.5 Small employer medical plans
    • 8.5 Small employer medical plans / Definition of small employer (3924.01(N))
    • 8.5 Small employer medical plans / Eligibility of employees (3924.01(G))
    • 8.5 Small employer medical plans / Open/late enrollment (3924.01(I))
    • 8.5 Small employer medical plans / Service waiting period (3924.01(M)
    • 8.5 Small employer medical plans / Guaranteed issue (3924.03(E))
    • 8.5 Small employer medical plans / Renewability (3924.03(B))
    • 8.5 Small employer medical plans / Premium rates (3924.04)
    • 8.5 Small employer medical plans / Disclosure rules (3924.033)
  • 9.0 Dental Care Plans
    • 9.1 Categories of dental treatment
    • 9.1 Categories of dental treatment / Diagnostic and preventive
    • 9.1 Categories of dental treatment / Restorative
    • 9.1 Categories of dental treatment / Oral surgery
    • 9.1 Categories of dental treatment / Endodontics
    • 9.1 Categories of dental treatment / Periodontics
    • 9.1 Categories of dental treatment / Prosthodontics
    • 9.1 Categories of dental treatment / Orthodontics
    • 9.2 Indemnity plans
    • 9.2 Indemnity plans / Choice of providers
    • 9.2 Indemnity plans / Choice of providers / Network versus out-of-network
    • 9.2 Indemnity plans / Scheduled versus nonscheduled plans
    • 9.2 Indemnity plans / Deductibles
    • 9.2 Indemnity plans / Coinsurance
    • 9.2 Indemnity plans / Exclusions, limitations
    • 9.2 Indemnity plans / Benefit categories
    • 9.2 Indemnity plans / Benefit categories / Diagnostic/preventive services
    • 9.2 Indemnity plans / Benefit categories / Basic services
    • 9.2 Indemnity plans / Benefit categories / Major services
    • 9.2 Indemnity plans / Deductibles and coinsurance
    • 9.2 Indemnity plans / Combination plans
    • 9.2 Indemnity plans / Exclusions
    • 9.2 Indemnity plans / Limitations
    • 9.2 Indemnity plans / Predetermination of benefits
    • 9.3 Employer group dental expense
    • 9.3 Employer group dental expense / Integrated deductibles versus stand-alone plans
    • 9.3 Employer group dental expense / Minimizing adverse selection
    • 9.3 Employer group dental expense / Stand-alone plans
  • 10.0 Insurance for Senior Citizens and Special Needs Individuals
    • 10.1 Medicare
    • 10.1 Medicare / Nature, financing, administration and terminology
    • 10.1 Medicare / Part A — Hospital Insurance
    • 10.1 Medicare / Part A — Hospital Insurance / Individual eligibility requirements
    • 10.1 Medicare / Part A — Hospital Insurance / Enrollment
    • 10.1 Medicare / Part A — Hospital Insurance / Coverages and cost-sharing amounts
    • 10.1 Medicare / Part A — Hospital Insurance / Exclusions
    • 10.1 Medicare / Part B — Medical Insurance
    • 10.1 Medicare / Part B — Medical Insurance / Individual eligibility requirements
    • 10.1 Medicare / Part B — Medical Insurance / Enrollment
    • 10.1 Medicare / Part B — Medical Insurance / Coverages and cost-sharing amounts
    • 10.1 Medicare / Part B — Medical Insurance / Exclusions
    • 10.1 Medicare / Part B — Medical Insurance / Claims terminology and other key terms
    • 10.1 Medicare / Part C — Medicare Advantage
    • 10.1 Medicare / Part C — Medicare Advantage / Nature, financing, administration and terminology
    • 10.1 Medicare / Part C — Medicare Advantage / Eligibility Requirements
    • 10.1 Medicare / Part C — Medicare Advantage / Enrollment timelines
    • 10.1 Medicare / Part C — Medicare Advantage / Plan types and definitions
    • 10.1 Medicare / Part C — Medicare Advantage / Coverages and cost-sharing amounts
    • 10.1 Medicare / Part C — Medicare Advantage / Supplemental Benefits
    • 10.1 Medicare / Part C — Medicare Advantage / Exclusions/limitations
    • 10.1 Medicare / Part D — Prescription Drug Insurance
    • 10.1 Medicare / Part D — Prescription Drug Insurance / Nature, financing, administration and terminology
    • 10.1 Medicare / Part D — Prescription Drug Insurance / Eligibility and enrollment
    • 10.1 Medicare / Part D — Prescription Drug Insurance / Coverage, formulary, tiering, exceptions/appeals
    • 10.1 Medicare / Part D — Prescription Drug Insurance / Cost Sharing, premium, deductible, coverage gap, catastrophic
    • 10.1 Medicare / Part D — Prescription Drug Insurance / Low Income Subsidy
    • 10.1 Medicare / Part D — Prescription Drug Insurance / Late enrollment penalty
    • 10.1 Medicare / Part D — Prescription Drug Insurance / Limitations- Prior auth, step therapy, quantity limits
    • 10.1 Medicare / Part D — Prescription Drug Insurance / Preferred, network pharmacies
    • 10.2 Medicare supplements (3923.33, .338.331-.336; OAC 3901-8-08 Amended, including Appendix C and D)
    • 10.2 Medicare supplements (3923.33, .338.331-.336; OAC 3901-8-08 Amended, including Appendix C and D) / Purpose
    • 10.2 Medicare supplements (3923.33, .338.331-.336; OAC 3901-8-08 Amended, including Appendix C and D) / Open enrollment
    • 10.2 Medicare supplements (3923.33, .338.331-.336; OAC 3901-8-08 Amended, including Appendix C and D) / Solicitation of Medicare supplements (3923.33, .338.331-.336; 3901- 8-08, 3901-8-09)
    • 10.2 Medicare supplements (3923.33, .338.331-.336; OAC 3901-8-08 Amended, including Appendix C and D) / Standardization Medicare supplement plans
    • 10.2 Medicare supplements (3923.33, .338.331-.336; OAC 3901-8-08 Amended, including Appendix C and D) / Standardization Medicare supplement plans / Core benefits
    • 10.2 Medicare supplements (3923.33, .338.331-.336; OAC 3901-8-08 Amended, including Appendix C and D) / Standardization Medicare supplement plans / Additional benefits
    • 10.2 Medicare supplements (3923.33, .338.331-.336; OAC 3901-8-08 Amended, including Appendix C and D) / Ohio regulations and required provisions
    • 10.2 Medicare supplements (3923.33, .338.331-.336; OAC 3901-8-08 Amended, including Appendix C and D) / Ohio regulations and required provisions / Standards for marketing
    • 10.2 Medicare supplements (3923.33, .338.331-.336; OAC 3901-8-08 Amended, including Appendix C and D) / Ohio regulations and required provisions / Certification requirements
    • 10.2 Medicare supplements (3923.33, .338.331-.336; OAC 3901-8-08 Amended, including Appendix C and D) / Ohio regulations and required provisions / Advertising
    • 10.2 Medicare supplements (3923.33, .338.331-.336; OAC 3901-8-08 Amended, including Appendix C and D) / Ohio regulations and required provisions / Appropriateness of recommended purchase and excessive insurance
    • 10.2 Medicare supplements (3923.33, .338.331-.336; OAC 3901-8-08 Amended, including Appendix C and D) / Ohio regulations and required provisions / Outline of coverage
    • 10.2 Medicare supplements (3923.33, .338.331-.336; OAC 3901-8-08 Amended, including Appendix C and D) / Ohio regulations and required provisions / Right to return (free look)
    • 10.2 Medicare supplements (3923.33, .338.331-.336; OAC 3901-8-08 Amended, including Appendix C and D) / Ohio regulations and required provisions / Replacement
    • 10.2 Medicare supplements (3923.33, .338.331-.336; OAC 3901-8-08 Amended, including Appendix C and D) / Ohio regulations and required provisions / Required disclosure provisions
    • 10.2 Medicare supplements (3923.33, .338.331-.336; OAC 3901-8-08 Amended, including Appendix C and D) / Ohio regulations and required provisions / Permitted compensation arrangements
    • 10.2 Medicare supplements (3923.33, .338.331-.336; OAC 3901-8-08 Amended, including Appendix C and D) / Ohio regulations and required provisions / Notice of change
    • 10.2 Medicare supplements (3923.33, .338.331-.336; OAC 3901-8-08 Amended, including Appendix C and D) / Ohio regulations and required provisions / Guaranteed issue
    • 10.2 Medicare supplements (3923.33, .338.331-.336; OAC 3901-8-08 Amended, including Appendix C and D) / Medicare SELECT
    • 10.3 Other options for individuals with Medicare
    • 10.3 Other options for individuals with Medicare / Employer group health plans
    • 10.3 Other options for individuals with Medicare / Employer group health plans / Disabled employees
    • 10.3 Other options for individuals with Medicare / Employer group health plans / Employees with kidney failure
    • 10.3 Other options for individuals with Medicare / Employer group health plans / Individuals age 65 or older
    • 10.3 Other options for individuals with Medicare / Employer group health plans / Connector Models
    • 10.3 Other options for individuals with Medicare / Medicaid
    • 10.3 Other options for individuals with Medicare / Medicaid / Eligibility
    • 10.3 Other options for individuals with Medicare / Medicaid / Benefits
    • 10.3 Other options for individuals with Medicare / Medicaid / Differences
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50)
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / LTC, Medicare and Medicaid compared
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Eligibility for benefits
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Levels of care
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Levels of care / Skilled care
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Levels of care / Intermediate care
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Levels of care / Custodial care
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Levels of care / Home health care
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Levels of care / Adult day care
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Levels of care / Respite care
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Levels of care / Assisted living
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Benefit periods
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Benefit amounts
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Optional benefits
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Optional benefits / Guarantee of insurability
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Optional benefits / Return of premium
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Qualified LTC plans
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Exclusions
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Underwriting considerations
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Ohio regulations and required provisions
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Ohio regulations and required provisions / Standards for marketing (3901-4-01(V))
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Ohio regulations and required provisions / Advertising (3901-4-01(U))
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Ohio regulations and required provisions / Appropriateness of recommended purchase (3901-4-01(W))
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Ohio regulations and required provisions / Inflation protection (3901-4-01(M))
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Ohio regulations and required provisions / Replacement (3901-4-01 (N)))
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Ohio regulations and required provisions / Unintentional lapse (3901-4-01(G))
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Ohio regulations and required provisions / Outline of coverage (3901-4-01, (DD); 3923.44(I))
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Ohio regulations and required provisions / Shopper's guide (3901-4-01(EE))
    • 10.4 Long-term care (LTC) policies (3901-4-01; 1751.63, 3923.41- .50) / Ohio regulations and required provisions / Pre-existing conditions (3923.44(B)(4)(5), (D))
  • 11.0 Federal Tax Considerations for Accident and Health Insurance
    • 11.1 Personally-owned health insurance
    • 11.1 Personally-owned health insurance / Disability income insurance
    • 11.1 Personally-owned health insurance / Disability income insurance / Benefits subject to FICA
    • 11.1 Personally-owned health insurance / Medical expense insurance
    • 11.1 Personally-owned health insurance / Long-term care insurance
    • 11.2 Employer group health insurance
    • 11.2 Employer group health insurance / Disability income (STD, LTD)
    • 11.2 Employer group health insurance / Disability income (STD, LTD) / Benefits subject to FICA
    • 11.2 Employer group health insurance / Medical, dental and vision expense
    • 11.2 Employer group health insurance / Long-term care insurance
    • 11.2 Employer group health insurance / Accidental death and dismemberment
    • 11.3 Medical expense coverage for sole proprietors and partners
    • 11.4 Business disability insurance
    • 11.4 Business disability insurance / Key person disability income
    • 11.4 Business disability insurance / Buy-sell policy
    • 11.5 Medical Savings Accunts (MSAs) and Health savings accounts (HSAs)
    • 11.6 Health Reimbursement Accounts (HRAs)

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