State RegulationsOH specificDifficulty 3/5
An Ohio consumer holds several policies with the same failed insurer across multiple benefit categories. Under the Ohio Life and Health Insurance Guaranty Association, what is the most the association is liable to expend in the aggregate for this one individual across the covered benefit categories?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
ORC 3956.04(D)(2)(d) provides that the association is not liable to expend more than $300,000 in the aggregate for any one individual across the covered benefit categories, with a single exception: the aggregate limit is $500,000 where the exposure is health benefit plan coverage. This aggregate cap operates on top of the per-category limits, so stacking several policies does not multiply the protection.
Why the other options are wrong
- B) $500,000 applies only to health benefit plan coverage; the general aggregate cap under ORC 3956.04(D)(2)(d) is $300,000.
- C) An aggregate cap does exist under ORC 3956.04(D)(2)(d); category limits cannot simply be stacked.
- D) $5,000,000 is the limit for one contract holder of an unallocated annuity contract under ORC 3956.04(D)(2)(c), not the individual aggregate cap.
Memory hook
Aggregate $300,000 — half a million only for health benefit plans.