Rhode Island General Laws 42-7.4-14. Impact on health insurance rates
(a) Allocation. An insurer required to make a healthcare services funding contribution may pass on the cost of that contribution in the cost of its services, such as its premium rates (for insurers), without being required to specifically allocate those costs to individuals or populations that actually incurred the contribution. The costs are to be fairly allocated among the market segments incurring such costs.
Terms Used In Rhode Island General Laws 42-7.4-14
- Healthcare services funding contribution: means per capita amount each contributing insurer must contribute to support the programs funded by the method established under this section, with respect to each contribution enrollee; provided, however, that, with respect to an insurer that is a Medicaid managed care organization offering managed Medicaid, the healthcare funding services contribution for any contribution enrollee whose healthcare services are paid or reimbursed under Title XIX of the Social Security Act (Medicaid) shall not include the children's health services funding requirement described in §?42-12-29. See Rhode Island General Laws 42-7.4-2
- Insurer: means all persons offering, administering, and/or insuring healthcare services, including, but not limited to:
(A) Policies of accident and sickness insurance, as defined by chapter 18 of Title 27:
(B) Nonprofit hospital or medical-service plans, as defined by chapters 19 and 20 of title 27;
(C) Any person whose primary function is to provide diagnostic, therapeutic, or preventive services to a defined population on the basis of a periodic premium;
(D) All domestic, foreign, or alien insurance companies, mutual associations, and organizations;
(E) Health maintenance organizations, as defined by chapter 41 of Title 27;
(F) All persons providing health benefits coverage on a self-insurance basis;
(G) All third-party administrators described in Rhode Island General Laws 42-7.4-2
(b) Oversight. The health insurance commissioner shall ensure, through the rate review and approval process, that the rates filed for fully insured groups and individuals, pursuant to chapter 18.5, 18.6 or 50 of title 27, reflect the transition to the funding method described in this section.
History of Section.
P.L. 2014, ch. 145, art. 16, § 4.