State RegulationsOH specificDifficulty 2/5
A draft HIC contract in Ohio omits preventive care and urgent care from its list of offered core benefits in order to reduce costs. How should this design be evaluated?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
ORC 1751.01(A) defines basic health services as the core package an Ohio HIC must make available, and that package includes preventive care and urgent care among its categories. An HIC cannot trim required basic services to cut costs; the Ohio Department of Insurance supervises HIC products under Ohio Revised Code Chapter 1751 to ensure the basic tier is actually delivered, and disclosure or advertising cannot substitute for a required statutory service.
Why the other options are wrong
- A) The basic tier is statutorily required, not a menu from which the HIC may freely pick and choose.
- B) Disclosure does not cure the omission of a service the statute requires the HIC to make available.
- D) Advertising a narrower package does not convert an impermissible omission into a lawful one; the statutory duty to provide basic services remains.
Memory hook
Preventive and urgent care are locked into basics — an HIC cannot cut the core.