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    <title>Annual Survey - Ohio Health Insurance Business</title>
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                    Annual Report of Ohio Health Insurance Business (LHSurvey) - Contact Page
                          <a style="margin-left: 150px;" class="main" onmouseover="window.status='Context Sensitive Help';return true;" onmouseout="window.status='';return true;"
                              href="Instructions/Help.pdf" target="helpwindow">Help</a>
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                    <table class="FrmInfo" width="100%" border="0" role="presentation">
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                            <td class="medfont"><b>This is an annual health insurance report required by the Ohio Department of 
																		Insurance. This report is due by April 1st of each year. The contact person 
																		will receive an annual e-mail notification that the application is available 
																		for submission (approx. 2nd week in March)</b>
                            </td>
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                            <%--<td class="newInstructions">
																	    <br /><br /> IMPORTANT NOTICE!<br /><br />
                                                                       NEW categories of data related to Administrative Expenses and Open Enrollment must be reported starting in 2010 for calendar year 2009 business!<br /><br />
                                                                       See the  <a href="http://www.insurance.ohio.gov/Company/Documents/2010%20New%20Reporting%20Information%20and%20Instructions.pdf" target="_blank">Instructions and Information</a> section for detailed instructions on these new reporting requirements.<br /><br /><br />
                                                                        
                                                                    </td>--%>

                            <td class="newInstructions">
                                <br />
                                <br />
                                IMPORTANT NOTICE!<br />
                                <br />
                                &#61558; The "Non-Transitional Health Plan" categories have been replaced with "Other Health Plans". Refer to definition #36 in the <em>Instructions and Information</em> document for guidance.<br />
                                <br />
                                Pursuant to Section 3 of Substitute Senate Bill 9 of the 130th General Assembly, during the period beginning on January 1, 2014, and expiring January 1, 2018, the requirements related to the Ohio Open Enrollment Program and the option for conversion of a health insurance contract or policy are suspended. As such, we will not be collecting this data during this time.
                                                                        <br />
                                <br />
                                &#61558; See the <a href="Instructions/Help.pdf" target="_blank">Instructions and Information</a> section for detailed instructions on these new reporting requirements.<br />
                                <br />
                                <br />
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                            <td class="medfont">
                                <p><b>Purpose of this report</b></p>
                            </td>
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                            <td class="medfont">&nbsp;&nbsp;&nbsp;This report will provide:</td>
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                            <td class="medfont">
                                <p>
                                    <ul>
                                        <li>Statistical information regarding health insurance coverage on Ohio citizens.</li>
                                        <li>Information to the Ohio Health Reinsurance Program to determine assessments for 
																				all reinsurance pools.</li>
                                        <li>Website information to consumers regarding the availability of open enrollment 
																					coverage and specific product marketing availability by company.
                                        </li>
                                    </ul>
                                    <p></p>
                            </td>
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                        <tr>
                            <td class="medfont">
                                <p><b>General Instructions</b></p>
                            </td>
                        </tr>
                        <tr>
                            <td class="medfont">&nbsp;&nbsp;&nbsp;Follow these instructions when completing 
																		this report:</td>
                        </tr>
                        <tr>
                            <td class="medfont">
                                <p>
                                    <ul>
                                        <li>Report only Ohio health insurance business.
																				<li>Use data that reflects the previous calendar year ("Reported Year").
																				<li>Read all instructions and the "DEFINITIONS" section of the <a href="Instructions/Help.pdf" target="_blank">Help</a> file carefully before completing this report. <i>The "Type of 
																						Business" definitions provided are specific to this report.</i>
                                                                                    <li>Eliminate discrepancies by correcting the data or by providing an explanatory 
																					comment. <i>Data will be validated against the annual statement submitted to the 
																						NAIC and any discrepancies will be indicated.</i>
                                                                                        <li>Complete the Company Statement portion of this report before submission.
                                                                                        </li>
                                    </ul>
                                    <p></p>
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                            <td nowrap="nowrap" bgcolor="#cccccc" colspan="5" height="20"><span class="FrmSecHead">Company Information</span></td>
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                            <td class="FrmFieldTxt" nowrap="nowrap" width="20%">Company Name: </td>
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                            <td class="FrmFieldTxt" nowrap="nowrap">NAIC Number: </td>
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                            <td class="FrmFieldTxt" nowrap="nowrap">NAIC Annual Statement Type: </td>
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                            <td class="FrmFieldTxt" nowrap="nowrap"><b>For the year ending: </b></td>
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                            <td class="FrmFieldTxt" nowrap="nowrap">&nbsp;</td>
                            <td class="FrmFieldTxt" nowrap="nowrap" colspan="4">&nbsp;</td>
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                            <td nowrap="nowrap" bgcolor="#cccccc" colspan="5" height="20"><span class="FrmSecHead">Contact 
																						Person Information</span></td>
                        </tr>

                        <tr>
                            <td class="FrmFieldTxt" colspan="5" style="text-align: left"><b>Complete all required fields (marked with <span class="errormsg">*</span>) below.</b></td>
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                                <label id="lblTitle" runat="server" for="txtContactTitle">Title:</label>&nbsp;<span class="Required">*</span>&nbsp;<asp:Label ID="Label3" runat="server" CssClass="Required"></asp:Label></td>
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                                <uc5:wucEmail ID="wucContactEmail" runat="server" REQUIRED="true"></uc5:wucEmail>
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