State RegulationsOH specificDifficulty 2/5
After a year of unusually high claims, an insurer notifies a Dayton small employer that the group health plan will not be renewed, citing only the claims experience. Under ORC 3924.03, this nonrenewal is:
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
ORC 3924.03 ties the insurer's renewal duty to the small employer's own conduct — paying premiums and meeting the plan's eligibility conditions — not to the group's claims results. A bad claims year therefore cannot be the sole reason to drop the plan; the employer retains the renewability protection precisely when a carrier would most want to escape it.
Why the other options are wrong
- A) Claims experience alone is not a valid nonrenewal ground under ORC 3924.03.
- C) Refunding the last premium does not create a nonrenewal right that ORC 3924.03 withholds.
- D) Departmental approval is not a pathway around the renewability requirement in ORC 3924.03.
Memory hook
High claims can't push a paying, eligible small employer off the plan.