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State RegulationsOH specificDifficulty 2/5

A small employer's health plan in Cincinnati refuses to add an employee's newly adopted child to family coverage. Which Ohio provision specifically addresses adopted-child coverage in this small-employer context?

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Answer & full 3-part explanation (select an option above, or peek)

Why C is correct

The small-employer provisions include an adopted-child coverage requirement at ORC 3924.51, paralleling ORC 3923.40 for A&H policies and ORC 1751.59 for HIC contracts. A small employer's plan therefore may not treat an adopted child differently from a natural child for family-coverage purposes.

Why the other options are wrong

  • A) ORC 3923.26 governs newborn children from the moment of birth; the adopted-child rule for small employers is ORC 3924.51.
  • B) ORC 1751.61 addresses newborn coverage in HIC contracts, not adopted children in small-employer plans.
  • D) ORC 3923.041 governs prior-authorization procedures, which is unrelated to adding an adopted child.

Memory hook

Small employer, adopted kid: 3924.51 has the say.

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