The Ohio Health Insurance Disclosure Affidavit is a form used to help verify the accuracy of insurance information provided by applicants who are applying for health insurance coverage in Ohio. This affidavit is required by the Ohio Department of Insurance and must be completed and signed by the applicant before their application can be processed. The Ohio Health Insurance Disclosure Affidavit is used to confirm the applicant’s name, address, date of birth, Social Security number, coverage details, and any other information provided on the application. It also verifies the accuracy of the information and serves as an acknowledgement that the applicant understands the terms and conditions of the coverage they are applying for. There are two types of Ohio Health Insurance Disclosure Affidavit: Individual and Group. The Individual Ohio Health Insurance Disclosure Affidavit is used when an applicant is applying for individual health coverage. The Group Ohio Health Insurance Disclosure Affidavit is used when an applicant is applying for health coverage for a group plan.