State RegulationsOH specificDifficulty 2/5
A Cincinnati-based HIC enrolls members who live or work in the counties that make up its approved region. What does this limited service area mean for the plan's day-to-day operation?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
The limited service area defines where the HIC's organized provider system operates: under the Ohio Revised Code Chapter 1751 model, the HIC provides or arranges routine covered services for members within its approved geographic region, which is why the Cincinnati HIC ties enrollment to residence or employment in its counties. The Ohio Department of Insurance oversees the HIC's service-area-based operation.
Why the other options are wrong
- A) A limited service area is by definition geographically limited; no statewide arrangement obligation exists.
- B) Routine care is arranged through the HIC's own network within the service area, not from any provider statewide.
- D) The service area governs where care is provided or arranged, not merely where advertising may appear.
Memory hook
Members live or work in the area; that is where the HIC arranges their routine care.