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State RegulationsOH specificDifficulty 3/5

A health insuring corporation in Cleveland is preparing the evidence-of-coverage document for a new product. Under Ohio law, which statement correctly describes the evidence of coverage?

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

Why C is correct

The evidence of coverage is the health insuring corporation document that sets out a member's coverage, and under ORC 1751.11 it is subject to filing with the Superintendent. It is a coverage document, distinct from advertising governed by ORC 1751.20 and from solicitation documents governed by ORC 1751.31, and it does not displace the filing requirement.

Why the other options are wrong

  • A) Wrong: the evidence of coverage describes the member's coverage and is filed with the Superintendent under ORC 1751.11; it is not a secret underwriting file.
  • B) Wrong: advertising is governed by ORC 1751.20; the evidence of coverage is a coverage document filed under ORC 1751.11.
  • D) Wrong: the evidence of coverage does not eliminate the Superintendent filing requirement of ORC 1751.11.

Memory hook

EOC explains coverage and files under ORC 1751.11.

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