Ohio Code § 3961.04

Ohio Code § 3961.04. Reproduced from the official Ohio Revised Code, with a citation summary, verification link, and related provisions.

§ 3961.04.

(A) A discount medical plan organization or marketer shall disclose all of the following

information in writing in not less than twelve-point type on the first content page

of any advertisements, marketing materials, or brochures made available to the public

relating to a discount medical plan and with any enrollment forms: (1) A statement that the discount medical plan is not insurance; (2) A statement that the range of discounts for medical services offered under the discount

medical plan will vary depending on the type of provider and medical services; (3) A statement that the discount medical plan is prohibited from making members' payments

to providers for medical services received under the discount medical plan; (4) A statement that the member is obligated to pay for all discounted medical services

received under the discount medical plan; (5) The discount medical plan organization's toll-free telephone number and internet

web site address that a member or prospective member may use to obtain additional

information about and assistance with the discount medical plan and up-to-date lists

of providers participating in the discount medical plan. (B) If a discount medical plan organization's or marketer's initial contact with a prospective

member is by telephone, the organization or marketer shall disclose all of the information

listed in division (A) of this section orally in addition to including such disclosures

in the initial written materials provided to the prospective or new member. (C) In addition to the disclosures required under division (A) of this section, a discount

medical plan organization shall provide to each prospective member, at the time of

enrollment, a copy of the terms and conditions of the discount medical plan, including

any limitations or restrictions on the refund of any processing fees or periodic charges

associated with the discount medical plan.  A discount medical plan organization also shall provide each new member a written

document containing the terms and conditions of the discount medical plan and including

all of the following: (1) Name of the member; (2) Benefits provided under the discount medical plan; (3) Any processing fees and periodic charges associated with the discount medical plan,

including, but not limited to, if applicable, the procedures for changing the mode

of payment and any accompanying additional charges; (4) Any limitations, exclusions, or exceptions regarding the receipt of discount medical

plan benefits; (5) Any waiting periods for certain medical services under the discount medical plan; (6) Procedures for obtaining discounts under the discount medical plan, such as requiring

members to contact the discount medical plan organization to request that the organization

make an appointment with a provider on the member's behalf; (7) Cancellation and refund rights described in section 3961.06 of the Revised Code ; (8) Membership renewal, termination, and cancellation terms and conditions; (9) Procedures for adding new family members to the discount medical plan; (10) Procedures for filing complaints under the discount medical plan organization's complaint

system and a statement explaining that, if the member remains dissatisfied after completing

the organization's complaint system, the member may contact the department of insurance; (11) Name, mailing address, and toll-free telephone number of the discount medical plan

organization that a member may use to make inquiries about the discount medical plan,

send cancellation notices, and file complaints. (D) A discount medical plan organization shall maintain on an internet web site page

an up-to-date list of the names and addresses of the providers with which the organization

has contracted directly or indirectly through a provider network.  The organization's internet web site address shall be prominently displayed on all

of the organization's advertisements, marketing materials, brochures, and discount

medical plan cards. (E) When a discount medical plan organization or marketer sells a discount medical plan

together with any other product, the organization or marketer shall do either of the

following: (1) Provide the charges for each discount medical plan in writing to the member; (2) Reimburse the member for all periodic charges for the discount medical plan and all

periodic charges for any other product if the member cancels membership in accordance

with division (B) of section 3961.06 of the Revised Code .

Source: official Ohio text · Last verified 2026-08-27

At a glance

  • Citation: Ohio Revised Code § 3961.04
  • Jurisdiction: Ohio
  • Code: Ohio Revised Code
  • Text: transcribed from the official source (verify below)

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Common questions

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