Rhode Island General Laws 42-7.4-3. Imposition of healthcare services funding contribution
(a) Each insurer is required to pay the healthcare services funding contribution for each contribution enrollee of the insurer at the time the contribution is calculated and paid, at the rate set forth in this section.
(1) Beginning January 1, 2016, the secretary shall set the healthcare services funding contribution each fiscal year in an amount equal to: (i) The child immunization funding requirement described in § 23-1-46; plus (ii) The adult immunization funding requirement described in § 23-1-46; plus (iii) The children’s health services funding requirement described in § 42-12-29; and all as divided by (iv) The number of contribution enrollees of all insurers.
(2) The contribution set forth herein shall be in addition to any other fees or assessments upon the insurer allowable by law.
Terms Used In Rhode Island General Laws 42-7.4-3
- Contribution enrollee: means an individual residing in this state, with respect to whom an insurer administers, provides, pays for, insures, or covers healthcare services, unless excepted by this section. See Rhode Island General Laws 42-7.4-2
- Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
- 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
- Person: means any individual, corporation, company, association, partnership, limited liability company, firm, state governmental corporations, districts, and agencies, joint stock associations, trusts, and the legal successor thereof. See Rhode Island General Laws 42-7.4-2
- Secretary: means the secretary of health and human services. See Rhode Island General Laws 42-7.4-2
(b) The contribution shall be paid by the insurer; provided, however, a person providing health benefits coverage on a self-insurance basis that uses the services of a third-party administrator shall not be required to make a contribution for a contribution enrollee where the contribution on that enrollee has been or will be made by the third-party administrator.
(c) The secretary shall create a process to facilitate the transition to the healthcare services funding contribution method that: (i) assures adequate funding beginning July 1, 2016, (ii) reflects that funding via the healthcare services funding contribution method initially will be for only a portion of the state’s fiscal year, and (iii) avoids duplicate liability for any insurer that made a payment under the premium assessment method in effect prior to January 1, 2016, for a period for which it would also be liable for a contribution under the healthcare services funding contribution method as described in this chapter.
History of Section.
P.L. 2014, ch. 145, art. 16, § 4.