What This License Is
The Ohio Accident and Health line of authority sits at ORC 3905.06(B)(2). It carries major medical and small-group health, disability income, Medicare supplement, Medicare Advantage and Part D (with the federal certifications those require on top), dental and vision, and long-term care — which comes with its own training requirement that no other Ohio line carries.
You can license for it alone. PSI's Ohio catalogue offers Series 11-45, "Ohio Accident and Health Insurance Agent" — 100 questions in 2 hours — as well as the combined Series 11-35 paper at 150 questions in 2.5 hours. Both are $49. The combined route costs you a second 20-hour course and a second certificate at the test-center door.
The judgment call is about your book, not the exam. Health-only is a clean fit if you are selling employee benefits, Medicare, or disability. If you expect to write life insurance or annuities alongside it — and most Medicare-facing producers eventually do — the Life & Health guide sets out the combined path, and it is cheaper to do in one pass than to add later.
Exam Options & Format
Series 11-45 is 100 scored questions in 2 hours, delivered by PSI at a test center, with 1 to 10 unscored experimental items added on top of the scored count. Those items are not scored but they do use your time. The passing standard is 70%, reported as a true percentage — Ohio does not scale.
In-person only. The bulletin's cover carries the notice that remote proctored examinations ended 3/13/2026. If you have been comparing Ohio to a state where you can test at your kitchen table, that comparison is out of date.
Book at test-takers.psiexams.com/ohins with at least 24 hours' notice, or by phone on (855) 807-3995. Credit card, company check, money order or cashier's check; no personal checks. The $49 is good for a year from payment, but your pre-licensing certificate — or your waiver — expires at 180 days, and that is the clock that actually binds.
Retakes are unlimited and cost $49 each, with one restriction: no same-day rebooking, because scores need to process overnight. The Personal Lines guide covers score reporting and retake strategy in detail.
Most Tested Topics on the Ohio Accident & Health Exam
Ohio's health content clusters in ORC Chapter 3923 (individual and group sickness and accident), the prompt-pay sections at ORC 3901.381 and 3901.389, and the external review scheme in Chapter 3922. Every row is verified against the section cited:
| Concept | The Ohio rule |
|---|---|
| Free look, individual sickness and accident | 10 days — the policyholder may return the policy "at least until midnight of the tenth day after the date on which the policyholder receives the policy," and no reason need be stated (ORC 3923.31(A)(1)) |
| Premium the insurer may keep on a free-look return | A strictly per diem pro rata charge for the days covered, never loaded or weighted; a policy that does not provide pro-rata coverage is void from the beginning when returned (ORC 3923.31(A)(2)) |
| Where the free-look notice must appear | Printed prominently on the first page of the policy; the right does not apply to single-premium nonrenewable policies (ORC 3923.31(C), (D)) |
| Free look, long-term care | 30 days from delivery, using the same procedures as the individual health free look (ORC 3923.44 → 3923.31) |
| Clean claim, no documentation needed | Pay within 30 days (ORC 3901.381(B)(1)) |
| Clean claim requiring supporting documentation | 45 days, where the payer determines reasonable supporting documentation is necessary to establish payment responsibility (ORC 3901.381(B)(2)(a)) |
| Materially deficient claim | The payer has 15 days to notify the provider or beneficiary; the 30- or 45-day clock then runs (ORC 3901.381(B)(3)) |
| When a claim counts as received | Fifth business day after mailing, or 24 hours after electronic submission — both rebuttable presumptions (ORC 3901.381(C)(1), (C)(2)) |
| Interest on a late claim | 18% per year, automatic — the payer "shall pay interest" — paid directly to the provider and it "shall not be used to reduce benefits" (ORC 3901.389(A), (B), (D)) |
| Who prompt pay does not reach | Property and casualty policies under Chapters 3935 and 3937, self-funded ERISA plans, Medicare Advantage, Medicaid and TRICARE (ORC 3901.3814) |
| Group continuation eligibility | Any Ohio group sickness and accident policy — no employer-size threshold and no COBRA cross-reference — for an employee covered at least 3 months (ORC 3923.38(A)(1), (A)(2)(a)) |
| Deadline to elect continuation | The earliest of three: 31 days after the coverage would otherwise terminate; 10 days after that termination date if the employer gave notice before it; or 10 days after the employer gives notice, where notice comes later (ORC 3923.38(C)(3)) |
| How long continuation lasts | 12 months (ORC 3923.38(C)(5)(b)) |
| Premium ceiling on continuation | Not more than the group rate for the coverage being continued — Ohio adds no COBRA-style 2% administrative load (ORC 3923.38(C)(4)) |
| Continuation after death or divorce | A separate right for covered family members: elect and pay within 31 days, and the right to renew ends at Medicare eligibility age (ORC 3923.32) |
| External review, standard | The independent review organization must decide within 30 days of the health plan issuer's receipt of the request (ORC 3922.05(H)) |
| External review, expedited | 72 hours (ORC 3922.09(E)), with coverage provided immediately on a reversal (ORC 3922.09(H)) |
| Effect of an external review decision | Binding on both sides — but expressly subject to other remedies available to the issuer under state law and to a superintendent-ordered second review (ORC 3922.12(A), (B)) |
The row that costs the most marks is the clean-claim split, because almost every study aid outside Ohio teaches it as electronic-versus-paper. It is not. The 30 and the 45 turn on whether the payer needs supporting documentation; the submission method decides something else entirely — when the claim is presumed received. Learn the two pairs separately and the whole section becomes easy.
The second is continuation. Ohio's 3923.38 is not a small-employer bridge to COBRA and does not mention COBRA at all; it applies to group policies generally, runs 12 months, and caps the premium at 100% of the group rate. The trap sits in the election window: candidates remember 31 days and miss the two ten-day prongs that can close it sooner — ten days after the termination date where the employer gave notice beforehand, or ten days after a later notice.
Finally, do not let the life-side habit of "Ohio mandates no free look" bleed into this exam. On the life side that is broadly true. On the health side, ORC 3923.31 gives an affirmative, mandatory 10 days on every individual sickness and accident policy, and long-term care inherits a 30-day version of it.
Ohio's Waivers — What a Designation Actually Buys You
Ohio publishes two entirely different sets of relief and the words used for them look alike, so start by separating them. A pre-licensing exemption removes your 20 hours of coursework. An exam waiver removes the examination. In Ohio, a professional designation does the first and never the second.
The designation lists — coursework only, and they are line-specific. ODI runs three lists, and a designation on one list does nothing for another line. For Life: a bachelor's or associate's degree in insurance, CEBS, ChFC, CIC, CFP, CLU, FLMI, LUTCF. For Accident & Health: a bachelor's or associate's degree in insurance, RHU, CEBS, REBC, HIA. For Property, Casualty or Personal Lines: a bachelor's or associate's degree in insurance, AAI, ARM, CIC, CPCU. Two designations appear twice — CIC on the Life and the property-side lists, CEBS on Life and Accident & Health — and nothing else crosses over. A CPCU waives no Life or Health coursework whatsoever.
How to claim it. File ODI form INS3276, "Pre-License Education Waiver," with official documentation of the designation. ODI's published route is fax to (614) 387-0051. On approval ODI issues an education waiver, valid 180 calendar days from issuance, and the original paper waiver must be presented on the day of testing — it substitutes for the course-completion certificate at the test-center door, and PSI treats it the same way: paper only, no electronic copies.
The disqualifier, and it is absolute. The bulletin states it in bold: no person who has surrendered a license, or who has had an insurance license suspended, inactivated, canceled for nonrenewal or revoked, may use any pre-license education exemption. Note how far that reaches — inactivated and canceled for nonrenewal are ordinary administrative events, not misconduct. A CPCU who let an Ohio license lapse for nonrenewal sits the 20 hours like a first-timer. OAC 3901-5-09 reinforces it: an agent who surrendered a license and wants another must meet the education and examination requirements "as if the person had never been licensed."
The statutory exam waivers are a different list, and the candidate bulletin does not contain it. ORC 3905.041 has exactly three exceptions. First, the 90-day relocation exemption at (A): a producer who establishes a principal place of residence or business in Ohio and applies within 90 days, while licensed and in good standing elsewhere for the lines requested, is exempt from both the education and the examination — verified through the NAIC producer database. Second, temporary licenses under ORC 3905.09 need neither. Third, the superintendent may exempt limited lines from the exam, and has: ODI states affirmatively that pre-licensing education and examinations are not required for limited-lines applicants. The Property & Casualty guide walks the 90-day route in full, including what "good standing" is verified against.
Two Ohio oddities to keep straight. Title is the mirror image of every other line: no pre-licensing, but an exam is required (ORC 3905.04(C)). Variable life and variable annuity products need neither pre-licensing nor an exam — because the examination requirement at ORC 3905.04(B) reaches the lines at ORC 3905.06(B)(1) through (5), title and surety bail bonds, and variable sits outside that list at 3905.06(B)(6) — but ORC 3905.05 requires your CRD number instead, so FINRA registration is doing the work the exam would have done. Surety bail bond pre-licensing cannot be waived at all.
What It Costs
Ohio's fees for a health-only license: $49 for Series 11-45, up to $72.25 for the National WebCheck background check, and $10 for the Accident & Health line of authority on the NIPR application — roughly $131 if you pass on the first attempt.
The 20-hour pre-licensing course is a private-provider expense on top of that, and it is the one line item a designation can erase. If you hold RHU, CEBS, REBC, HIA or an insurance degree, the INS3276 waiver is worth filing the moment you decide to license: it costs nothing and removes the largest number in your budget.
Two years out, renewal is $25 by statute and waived for resident individual agents who have met their CE — so the recurring cost of the license is the continuing education itself, plus the LTC training if you sell long-term care.
Eligibility Requirements
You must be at least 18 (ORC 3905.06(A)(1)(a)), hold 20 hours of ODI-approved Accident & Health pre-licensing or an approved waiver, pass Series 11-45, submit to the ORC 3905.051 background check, and file through NIPR inside the 180-day post-exam window.
Ohio does not treat a criminal record as an automatic bar, but it does check: BCI and FBI results go directly to ODI, and the application carries a sworn declaration of truthfulness. Disclose fully — the gap between what you reported and what the check returns is the thing that causes problems, not the record itself.
If you are moving to Ohio with a health license from another state, do not start with the coursework. ORC 3905.041(A) may waive the education and the exam outright if you apply within 90 days of establishing residence, and the clock is unforgiving; the Property & Casualty guide covers it.
Keeping Your License Active
Important CE details: 24 hours per two-year renewal period including 3 hours of ethics, finished before the renewal is filed. Health producers who sell long-term care owe an 8-hour LTC course before their first LTC sale and a 4-hour refresher every renewal period after that — and both count inside the 24 rather than on top of it.
24 hours every two years, including 3 hours of ethics (ORC 3905.481), completed before you file the renewal that is due by the last day of your birth month. The $25 renewal fee is waived for resident individual agents who have met CE (ORC 3905.40(E)(1)).
Health producers carry the heaviest product-training load in Ohio, and all of it counts inside the 24 hours rather than on top: long-term care requires an 8-hour approved course before you sell, solicit or negotiate LTC insurance and a 4-hour refresher every renewal period thereafter. If you also hold a life line and sell annuities, add the one-time 4-credit best-interest course (OAC 3901-6-13(G)(2)(a)).
Carryover is capped at 50% of the next period's requirement — 12 hours on a 24-hour cycle — and carried hours count only as general credit, so they can never cover your three ethics hours or the LTC refresher. Repeating the same course inside one period earns credit once; the same course in a different period is fine.
The Property & Casualty guide owns renewal mechanics: the late and reinstatement tiers, inactive status, and the reactivation rules.
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