State RegulationsOH specificDifficulty 2/5
A Toledo employee enrolled in an HIC asks how her medical care will actually be organized. Which description reflects the HIC's structure and provider arrangement?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
Ohio's HIC framework under the Ohio Revised Code Chapter 1751 combines delivery with financing, which in practice means the HIC maintains an organized system of affiliated and contracted providers through which members receive care. The member's physicians, hospitals, and related services are drawn from that system, and the arrangement is supervised by the Ohio Department of Insurance rather than left to ad hoc provider selection.
Why the other options are wrong
- A) An HIC does not pay for care from any provider without limit; its delivery system is organized through participating providers.
- B) Member-directed bank accounts resemble certain consumer-directed designs, not the HIC delivery model.
- C) Declining any role in delivery describes pure indemnity insurance; arranging care is central to the HIC model.
Memory hook
HIC members get care through the plan's own organized provider system.