Chapter 4151. THIRD-PARTY ADMINISTRATORS  


Subchapter A. GENERAL PROVISIONS
§ 4151.001. DEFINITIONS
§ 4151.002. EXEMPTIONS
§ 4151.0021. APPLICABILITY TO CERTAIN PROCESSING AGENTS
§ 4151.003. APPLICABILITY OF OTHER PROVISIONS OF CODE
§ 4151.0031. MARKET ANALYSIS
§ 4151.004. APPLICABILITY TO CERTAIN INSURERS AND HEALTH MAINTENANCE ORGANIZATIONS
§ 4151.005. ADMINISTRATOR NOT INSURANCE AGENT
§ 4151.0051. REFERRAL TO ADJUSTER BY ADMINISTRATOR
§ 4151.006. RULES
Subchapter B. CERTIFICATE OF AUTHORITY
§ 4151.051. CERTIFICATE OF AUTHORITY REQUIRED
§ 4151.052. APPLICATION
§ 4151.053. APPROVAL OF APPLICATION
§ 4151.054. DENIAL OF APPLICATION
§ 4151.055. FIDELITY BOND REQUIRED
§ 4151.056. DURATION OF CERTIFICATE OF AUTHORITY
Subchapter C. POWERS AND DUTIES OF ADMINISTRATORS AND INSURERS
§ 4151.101. WRITTEN AGREEMENT WITH INSURER OR PLAN SPONSOR REQUIRED
§ 4151.102. CONTENTS OF WRITTEN AGREEMENT
§ 4151.103. RETENTION OF WRITTEN AGREEMENT; INSPECTION BY COMMISSIONER
§ 4151.104. NOTICE OF USE OF ADMINISTRATOR'S SERVICES
§ 4151.1041. REFERRAL BY INSURER
§ 4151.1042. RESPONSIBILITIES OF INSURER; SEMIANNUAL AUDIT
§ 4151.105. PAYMENTS TO ADMINISTRATOR
§ 4151.106. CERTAIN FUNDS COLLECTED OR RECEIVED BY ADMINISTRATOR
§ 4151.107. DELIVERY OR DEPOSIT OF CERTAIN FUNDS RECEIVED BY ADMINISTRATOR
§ 4151.108. WITHDRAWALS FROM FIDUCIARY ACCOUNT
§ 4151.109. PAYMENT OF CLAIMS FROM FIDUCIARY ACCOUNT PROHIBITED
§ 4151.110. UNDERWRITING STANDARDS
§ 4151.111. ADJUDICATION OF CLAIMS
§ 4151.112. MAINTENANCE OF BOOKS AND RECORDS
§ 4151.113. ACCESS TO BOOKS AND RECORDS
§ 4151.114. DISPOSITION OF BOOKS AND RECORDS ON TERMINATION OF WRITTEN AGREEMENT
§ 4151.115. CONFIDENTIALITY OF PERSONAL INFORMATION
§ 4151.116. ADVERTISING
§ 4151.117. COMPENSATION OF ADMINISTRATOR
Subchapter D. PHARMACY BENEFIT PLANS
§ 4151.151. DEFINITION
§ 4151.152. IDENTIFICATION CARDS
§ 4151.153. DISCLOSURE OF CERTAIN PATIENT INFORMATION PROHIBITED
Subchapter E. DEPARTMENT REGULATION OF ADMINISTRATORS
§ 4151.201. EXAMINATION OF ADMINISTRATOR
§ 4151.202. CONTENTS OF EXAMINATION; ON-SITE EVALUATION
§ 4151.203. COST OF EXAMINATION
§ 4151.204. EXAMINATION UNDER OATH
§ 4151.205. ANNUAL REPORT
§ 4151.206. FEES
§ 4151.210. EFFECT OF REVOCATION OF OTHER CERTIFICATES
§ 4151.211. RESTRICTIONS ON ACQUISITION OF OWNERSHIP INTEREST
§ 4151.212. MAINTENANCE OF QUALIFICATIONS REQUIRED
Subchapter F. WORKERS' COMPENSATION BENEFIT PLANS
§ 4151.251. DEFINITION
§ 4151.252. APPLICATION
§ 4151.253. AGREEMENTS BETWEEN ADMINISTRATORS AND CARRIERS
§ 4151.254. AGREEMENTS BETWEEN ADMINISTRATORS AND EMPLOYERS
§ 4151.255. ADMINISTRATOR COMPENSATION
§ 4151.256. LARGE DEDUCTIBLE POLICIES
§ 4151.257. RULES
Subchapter G. DISCIPLINARY ACTIONS; PENALTIES
§ 4151.301. GROUNDS FOR DENIAL, SUSPENSION, OR REVOCATION OF CERTIFICATE OF AUTHORITY
§ 4151.302. REMEDIES FOR VIOLATION OF INSURANCE LAWS OR COMMISSIONER RULES
§ 4151.303. PROBATED SUSPENSION
§ 4151.304. HEARING
§ 4151.305. APPLICATION FOR CERTIFICATE OF AUTHORITY AFTER DENIAL OR REVOCATION
§ 4151.306. DISCIPLINARY PROCEEDING FOR CONDUCT COMMITTED BEFORE SURRENDER OR FORFEITURE OF CERTIFICATE
§ 4151.307. EMERGENCY CERTIFICATE SUSPENSION
§ 4151.308. GENERAL ADMINISTRATIVE SANCTIONS
§ 4151.309. CRIMINAL PENALTY