State RegulationsOH specificDifficulty 1/5
In the coverage structure ORC 1751.01 defines for an Ohio health insuring corporation, which pairing of service category and example service is correct?
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
ORC 1751.01(B) places mental health services in the supplemental health care services tier of health insuring corporation coverage, while ORC 1751.01(A) lists hospital and outpatient services in the basic tier. Reading each service against its statutory tier is the dependable way for an Ohio producer to interpret an HIC contract, and the Ohio Department of Insurance tests this classification scheme on the examination.
Why the other options are wrong
- A) Reversed: ORC 1751.01(A) puts hospital care in the basic tier, and mental health services belong to the supplemental tier of ORC 1751.01(B).
- C) Mental health services are supplemental, not specialty; dental care is likewise a supplemental service under ORC 1751.01(B), not a basic one.
- D) Cancer clinical trials belong to the basic tier under ORC 1751.01(A), and mental health services are supplemental, so both halves of the pairing are wrong.
Memory hook
Pair them right: hospital is basic, the mind is an add-on — mental health rides the supplemental tier (B).