Frequently Asked Questions Concerning Health Plans

1. What is a health insuring corporation (HIC)? Is it the same thing as a health maintenance organization (HMO)?
    

   Health insuring corporations were formerly known as HMOs and this term is often still applied. These health plans, pursuant to contract, agreement, or certificate, pay for, reimburse or provide, deliver, arrange for, or otherwise makes available basic health care services, supplemental health care services, or specialty health care services to its membership.

2. I thought HICs were authorized and regulated by the Ohio Department of Insurance. What does the Department of Health have to do with these insurers?
    

   Under the authority of section 1751.04 of the Ohio Revised Code, the director of health, through the Bureau of Community Healthcare Facilities and Services staff, reviews the application for certificate of authority or service area changes for health plans. The review determines if the plan is demonstrating the willingness and potential ability to ensure that all basic health care services and supplemental health care services described in the plan’s coverage will be provided to all of its enrollees in a prompt and consistent manner.
    

Last Updated: 5/9/01