27 R.I. Gen. Laws § 27-41-27.2. Health insurance rates: Health Maintenance Organization Act – Rhode Island
Status: Enacted Year Enacted: 1999
No insurance company organized as a stock or mutual corporation which merges or consolidates with, acquires ownership or control or possession of twenty percent (20%) or greater of the operating assets of, or acquires control …
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27 R.I. Gen. Laws § 27-41-29.1. Uniform explanation of benefits and coverage: Health Maintenance Organization Act – Rhode Island
Status: Enacted Year Enacted: 2012
A health maintenance organization shall file all policy forms and rates used by it in the state with the commissioner. No such form shall be used if disapproved by the commissioner under this section
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27 R.I. Gen. Laws § 27-41-52. Restricted annual rate payments prohibited: Health Maintenance Organization Act – Rhode Island
Status: Enacted Year Enacted: 1998
(a) No corporation organized under this chapter shall compensate any provider of outpatient service by using the restricted annual rate method of payment. (b) The restricted annual rate method of payment is defined as any …
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27 R.I. Gen. Laws § 27-41-69. Post-payment audits: Health Maintenance Organization Act – Rhode Island
Status: Enacted Year Enacted: 2006
Except as otherwise provided herein, any review, audit, or investigation by a health maintenance organization of a health-care provider’s claims that results in the recoupment or set-off of funds previously paid to the health-care provider …
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27 R.I. Gen. Laws § 27-41-78. Medical loss ratio reporting and rebates: Health Maintenance Organization Act – Rhode Island
Status: Enacted Year Enacted: 2012
Health maintenance organizations required to report medical loss ratio and rebate calculations and other medical loss ratio and rebate information to the U.S. Department of Health and Human Services shall concurrently file such information with …
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27 R.I. Gen. Laws § 27-41-79. Emergency services: Health Maintenance Organization Act – Rhode Island
Status: Enacted Year Enacted: 2012
If a nonprofit medical service corporation offering health insurance coverage provides any benefits with respect to services in an emergency department of a hospital, it must cover emergency services consistent with the rules of this …
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27 R.I. Gen. Laws § 27-41-8. Evidence of coverage and charges for health care services: Health Maintenance Organization Act – Rhode Island
Status: Enacted Year Enacted: 1983
Every enrollee is entitled to evidence of coverage for the payment and for the provision of health care services under a health maintenance organization. No schedule of charges, rates, or rating formulae for enrollee coverage …
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27 R.I. Gen. Laws § 27-41-9. Required reports: Health Maintenance Organization Act – Rhode Island
Status: Enacted Year Enacted: 1983
Every health maintenance organization shall also file quarterly statements with the insurance commissioner, due on or before forty-five (45) days after the quarter ending in accordance with the National Association of Insurance Commissioners’ guidelines and …
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27 R.I. Gen. Laws § 27-50-12. Standards to assure fair marketing: Small Employer Health Insurance Availability Act – Rhode Island
Status: Enacted Year Enacted: 2000
Each small employer carrier shall actively market and offer all health benefit plans sold by the carrier to eligible small employers in the state.
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27 R.I. Gen. Laws § 27-50-12.1. Renewal rating: Small Employer Health Insurance Availability Act – Rhode Island
Status: Enacted Year Enacted: 2006
To ensure ease of understanding of renewal rate calculation and related information, the health insurance commissioner may, by regulation, prescribe the presentation formats for delivery of renewal rates to small employers.
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27 R.I. Gen. Laws § 27-50-17. Affordable health plan reinsurance program for small businesses: Small Employer Health Insurance Availability Act – Rhode Island
Status: Enacted Year Enacted: 2006
The commissioner shall allocate funds from the affordable health plan reinsurance fund for the affordable health reinsurance program.
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27 R.I. Gen. Laws § 27-50-2. Purpose: Small Employer Health Insurance Availability Act – Rhode Island
Status: Enacted Year Enacted: 2000
The purpose and intent of this chapter are to enhance the availability of health insurance coverage to small employers regardless of their health status or claims experience, to prevent abusive rating practices, to prevent segmentation …
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27 R.I. Gen. Laws § 27-50-3. Definitions: Small Employer Health Insurance Availability Act – Rhode Island
Status: Enacted Year Enacted: 2000
Definitions related to Small Employer Health Insurance Availability Act
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27 R.I. Gen. Laws § 27-50-4. Applicability and scope: Small Employer Health Insurance Availability Act – Rhode Island
Status: Enacted Year Enacted: 2000
This chapter applies to any health benefit plan that provides coverage to the employees of a small employer in this state, whether issued directly by a carrier or through a trust, association, or other intermediary, …
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27 R.I. Gen. Laws § 27-50-5. Restrictions relating to premium rates: Small Employer Health Insurance Availability Act – Rhode Island
Status: Enacted Year Enacted: 2000
Premium rates for health benefit plans subject to this chapter are subject to various rate adjustment restriction provisions.
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27 R.I. Gen. Laws § 27-50-9. Periodic market evaluation: Small Employer Health Insurance Availability Act – Rhode Island
Status: Enacted Year Enacted: 2000
The report shall analyze the effectiveness of the chapter in promoting rate stability, product availability, and coverage affordability. The report may contain recommendations for actions to improve the overall effectiveness, efficiency, and fairness of the …
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