Ohio

Regulator: Ohio Department of Insurance
External review: State-run. Request it through the regulator after the plan's final internal denial; the federal floor is 4 months (45 CFR 147.136).
Published reversal rate: Not published by the regulator · source
Notes: Data gap on count fields: Most recent publicly posted Annual Health Claims External Review Report is 2019. Ohio law requires annual publication but current-year reports not published online; flag as significant transparency gap.

Before external review

File the plan's internal appeal first (at least 180 days for ACA-compliant plans; the letter states the date). Ask for the claim file and the criteria the plan applied; both are free on request. Self-funded employer plans use the federal external review and the U.S. Department of Labor, not the state.

More on Ohio: state appeal rights · External Review Index entry · insurer denial rates (HealthCare.gov states).

Verified 2026-09-15. The regulator's site and your denial notice control.