R.I. Gen. Laws § 27-34-3_27-34-3 — RI Code / Title 27 / Chapter 27-34 / Section 27-34-3_27-34-3
§ 27-34-3. Scope. [Effective until January 1, 2026.]27-34-3. Scope. [Effective January 1, 2026.]
Status: in_force

This chapter shall apply to all kinds of direct insurance, but shall not be applicable to the following:

(1) Life, annuity, health, or disability insurance;

(2) Mortgage guaranty, financial guaranty, or other forms of insurance offering protection against investment risks. For purposes of this section, financial guaranty insurance includes any insurance under which loss is payable upon proof of occurrence of any of the following events to the damage of an insured claimant or obligee:

(i) Failure of any obligor or obligors on any debt instrument or other monetary obligation, including common or preferred stock, to pay when due the principal, interest, dividend, or purchase price of such instrument or obligation, whether failure is the result of a financial default or insolvency and whether or not the obligation is incurred directly or as a guarantor by, or on behalf of, another obligor which has also defaulted;

(ii) Changes in the level of interest rates whether short-term or long-term, or in the difference between interest rates existing in various markets;

(iii) Changes in the rate of exchange of currency, or from the inconvertibility of one currency into another for any reason;

(iv) Changes in the value of specific assets or commodities, or price levels in general;

(3) Fidelity or surety bonds, or any other bonding obligations;

(4) Credit insurance, vendors single interest insurance, or collateral protection insurance or any similar insurance protecting the interests of a creditor arising out of a creditor-debtor transaction. For purposes of this section, credit insurance means insurance on accounts receivable;

(5) Insurance of warranties or service contracts including insurance that provides for the repair, replacement, or service of goods or property, indemnification for repair, replacement, or service for the operational or structural failure of the goods or property due to a defect in materials, workmanship, or normal wear and tear, or provides reimbursement for the liability incurred by the issuer of agreements or service contracts that provide such benefits;

(6) Title insurance;

(7) Ocean marine insurance, except that portion of the marine protection and indemnity insurance covering liability of the insured for personal injury, illness, or death to employees and insurance covering pleasure craft;

(8) Any transaction or combination of transactions between a person, including affiliates of the person, and an insurer, including affiliates of such insurer, which involves the transfer of investment or credit risk unaccompanied by transfer of insurance risk;

(9) Any insurance provided by or guaranteed by government; or

(10) Any transaction or combination of transactions between a protected cell and the general account or another protected cell of a protected cell company organized under the Protected Cell Companies Act, chapter 64 of this title, as those terms are defined in this chapter.
R.I. Gen. Laws § 27-18-24 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-24
§ 27-18-24. Immunity of benefits from process.
Status: in_force

The proceeds, avails, and benefits to be paid by virtue of any policy of accident and sickness insurance shall not be liable to attachment, garnishment, or other process, or be seized, taken, appropriated, or applied by any legal or equitable process or operation of law to pay any debt or liability of the owner, insured, beneficiary, or any person who may have any right under the policy; provided, that, subject to any statute of limitations, the amount of any premiums for the insurance paid with the intent to defraud creditors, with interest on that amount, shall inure to their benefit from the proceeds of the policy, but the company issuing the policy shall be discharged of all liability on it by payment of its proceeds in accordance with its terms unless, before the payment, the company shall have written notice by or on behalf of a creditor of a claim to recover for premiums paid with intent to defraud creditors with specifications of the amounts claimed.
R.I. Gen. Laws § 27-20-57 — RI Code / Title 27 / Chapter 27-20 / Section 27-20-57
§ 27-20-57. Prohibition on preexisting condition exclusions.
Status: in_force

(a) A health insurance policy, subscriber contract, or health plan offered, issued, issued for delivery, or issued to cover a resident of this state by a health insurance company licensed pursuant to this title and/or chapter:

(1) Shall not limit or exclude coverage for an individual under the age of nineteen (19) by imposing a preexisting condition exclusion on that individual.

(2) For plan or policy years beginning on or after January 1, 2014, shall not limit or exclude coverage for any individual by imposing a preexisting condition exclusion on that individual.

(b) As used in this section:

(1) Preexisting condition exclusion means a limitation or exclusion of benefits, including a denial of coverage, based on the fact that the condition (whether physical or mental) was present before the effective date of coverage, or if the coverage is denied, the date of denial, under a health benefit plan whether or not any medical advice, diagnosis, care, or treatment was recommended or received before the effective date of coverage.

(2) Preexisting condition exclusion means any limitation or exclusion of benefits, including a denial of coverage, applicable to an individual as a result of information relating to an individuals health status before the individuals effective date of coverage, or if the coverage is denied, the date of denial, under the health benefit plan, such as a condition (whether physical or mental) identified as a result of a pre-enrollment questionnaire or physical examination given to the individual, or review of medical records relating to the pre-enrollment period.

(c) This section shall not apply to grandfathered health plans providing individual health insurance coverage.

(d) This section shall not apply to insurance coverage providing benefits for: (1) Hospital confinement indemnity; (2) Disability income; (3) Accident only; (4) Long-term care; (5) Medicare supplement; (6) Limited benefit health; (7) Specified disease indemnity; (8) Sickness or bodily injury or death by accident or both; and (9) Other limited benefit policies.
R.I. Gen. Laws § 27-41-69 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-69
§ 27-41-69. Post-payment audits.
Status: in_force

(a) Except as otherwise provided herein, any review, audit, or investigation by a health maintenance organization of a healthcare providers claims that results in the recoupment or set-off of funds previously paid to the healthcare provider in respect to such claims shall be completed no later than eighteen (18) months after the completed claims were initially paid, except that the period for recoupment or set-off for claims submitted by a mental health and/or substance use disorder provider, for those services, licensed by this state, and participating with the health insurer or health plan, shall be no later than twelve (12) months. This section shall not restrict any review, audit, or investigation regarding claims that are submitted fraudulently; are known, or should have been known, by the healthcare provider to be a pattern of inappropriate billing according to the standards for provider billing of their respective medical or dental specialties; are related to coordination of benefits; are duplicate claims; or are subject to any federal law or regulation that permits claims review beyond the period provided herein.

(b) No healthcare provider shall seek reimbursement from a payer for underpayment of a claim later than eighteen (18) months from the date the first payment on the claim was made, except if the claim is the subject of an appeal properly submitted pursuant to the payers claims appeal policies or the claim is subject to continual claims submission.

(c) For the purposes of this section, healthcare provider means an individual clinician, either in practice independently or in a group, who provides healthcare services, and any healthcare facility, as defined in § 27-41-2, including any mental health and/or substance abuse treatment facility, physician, or other licensed practitioner identified to the review agent as having primary responsibility for the care, treatment, and services rendered to a patient.

(d) Except for those contracts where the health insurer or plan has the right to unilaterally amend the terms of the contract, the parties shall be able to negotiate contract terms that allow for different time frames than are prescribed herein.
R.I. Gen. Laws § 27-35-7 — RI Code / Title 27 / Chapter 27-35 / Section 27-35-7
§ 27-35-7. Rules and regulations.
Status: in_force

The commissioner may, upon notice and opportunity for all interested persons to be heard, issue rules, regulations, and orders that are necessary to carry out the provisions of this chapter.
R.I. Gen. Laws § 27-5-14 — RI Code / Title 27 / Chapter 27-5 / Section 27-5-14
§ 27-5-14. Reinsurance by mutual insurers  Agreements with policyholders.
Status: in_force

(a) Whenever any mutual company of this or any other state shall reinsure in a similar company the whole or any portion of a risk covered by its policy or policies of insurance, it may do so either:

(1) By existing methods of reinsurance; or

(2) By agreement with its policyholder or policyholders attached to and made a part of its policy or policies.

(b) This agreement shall contain a schedule giving:

(1) The name and location of each reinsuring company; and

(2) The portion of the risk reinsured in each company.

(c) This agreement shall also provide that the dividend or return of the premium or premium deposit to be paid or credited upon termination of the policy or policies shall be the sum of:

(1) The dividend or return of the premium or premium deposit to be paid or credited upon that portion of the premium or premium deposit retained by the company issuing the policy or policies; and

(2) The aggregate amount of the dividends or returns of the premium or premium deposit paid or credited upon all portions of the premium or premium deposit ceded to all the reinsuring companies.
R.I. Gen. Laws § 27-9-21 — RI Code / Title 27 / Chapter 27-9 / Section 27-9-21
§ 27-9-21. Filed schedules and plans not to be disapproved if rates meet requirements.
Status: in_force

No manual of classifications, rules, rating plan, or any modification of any of these that establishes standards for measuring variations in hazards or expense provisions, or both, and that has been filed pursuant to the requirements of §§ 27-9-7  27-9-15, shall be disapproved if the rates produced by it meet the requirements of this chapter.
R.I. Gen. Laws § 27-58-6 — RI Code / Title 27 / Chapter 27-58 / Section 27-58-6
§ 27-58-6. Anti-tying provisions.
Status: in_force

(a) No financial institution may offer a banking product or service, or fix or vary the conditions of this offer, on a condition or requirement that the customer obtains insurance from the financial institution, or any particular insurance producer.

(b) No person shall require or imply that the purchase of an insurance product from a financial institution by a customer or prospective customer of the institution is required as a condition of, or is in any way related to, the lending of money or extension of credit, the establishment or maintenance of a trust account, the establishment or maintenance of a checking or savings account or other deposit account, or the provision of services related to any of these activities.
R.I. Gen. Laws § 27-19-29.1 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-29.1
§ 27-19-29.1. No derogation of attorney general.
Status: in_force

No provision of this chapter shall derogate from the common law or statutory authority of the attorney general nor shall any provision be construed as a limitation on the common law or statutory authority of the attorney general, including the authority to investigate at any time charitable assets for the purpose of determining and ascertaining whether they are being administered in accordance with law and with its terms and purposes.
R.I. Gen. Laws § 27-35-11 — RI Code / Title 27 / Chapter 27-35 / Section 27-35-11
§ 27-35-11. Revocation, suspension, or nonrenewal of insurers license.
Status: in_force

Whenever it appears to the commissioner that any person has committed a violation of this chapter which makes the continued operation of an insurer contrary to the interests of policyholders or the public, the commissioner may, after giving notice and an opportunity to be heard, determine to suspend, revoke, or refuse to renew the insurers license or authority to do business in this state for any period that he or she finds is required for the protection of policyholders or the public. That determination shall be accompanied by specific findings of fact and conclusions of law.
R.I. Gen. Laws § 27-1-6 — RI Code / Title 27 / Chapter 27-1 / Section 27-1-6
§ 27-1-6. Holding of deposits  Income  Replacement.
Status: in_force

The general treasurer shall hold stocks or securities deposited as security for policyholders in the company, but any company depositing stocks or securities shall be permitted to receive and to collect the interest and dividends on its securities deposited, and to withdraw the securities upon depositing with the general treasurer other securities of the same character, the market value of which at the time of the deposit shall equal or exceed the amount required to be deposited.
R.I. Gen. Laws § 27-25-22 — RI Code / Title 27 / Chapter 27-25 / Section 27-25-22
§ 27-25-22. Funds.
Status: in_force

(a) All assets shall be held, invested, and disbursed for the use and benefit of the society, and no member or beneficiary shall have or acquire individual rights in the assets or become entitled to any apportionment on the surrender of any part of them, except as provided in the benefit contract.

(b) A society may create, maintain, invest, disburse, and apply any special fund or funds necessary to carry out any purpose permitted by the laws of the society.

(c) A society may, pursuant to resolution of its supreme governing body, establish and operate one or more separate accounts and issue contracts on a variable basis, subject to the provisions of law regulating life insurers establishing those accounts and issuing those contracts. To the extent the society deems it necessary in order to comply with any applicable federal or state laws, or any rules issued under applicable federal or state laws, the society may:

(1) Adopt special procedures for the conduct of the business and affairs of a separate account;

(2) For persons having beneficial interests in a separate account, provide special voting and other rights, including, without limitation, special rights and procedures relating to investment policy, investment advisory services, selection of certified public accountants, and selection of a committee to manage the business and affairs of the account; and

(3) Issue contracts on a variable basis to which § 27-25-19(b) and (d) shall not apply.
R.I. Gen. Laws § 27-20-25.2 — RI Code / Title 27 / Chapter 27-20 / Section 27-20-25.2
§ 27-20-25.2. Health insurance rates.
Status: in_force

No insurance company organized as a stock or mutual corporation that merges or consolidates with; acquires ownership or control or possession of twenty percent (20%) or greater of the operating assets of; or acquires control of a nonprofit hospital service corporation organized under chapter 19 of this title, a nonprofit medical service corporation organized under this chapter, or a health maintenance organization organized under chapter 41 of this title may: (1) File with any state agency for review or approval any proposed rate to be used by the company in the state, or (2) Charge to any party in the state any rate or premium, that takes into account or reflects in any manner the value of any contribution, distribution, or allocation the company expends or incurs in establishing or funding a charitable foundation organized to maintain or account for the assets of a nonprofit hospital service corporation, nonprofit medical service corporation, or health maintenance organization. For any rate that is to be charged to policyholders, regardless of whether this rate is subject to approval by a state agency under this or another chapter, the company shall at least thirty (30) days before implementing the rate submit under oath to the commissioner of insurance an accounting that documents the cost structure on which the rate is based and demonstrates the companys compliance with this section.
R.I. Gen. Laws § 27-2-1.1 — RI Code / Title 27 / Chapter 27-2 / Section 27-2-1.1
§ 27-2-1.1. Telephone number  Toll-free or collect.
Status: in_force

Every insurer doing business within this state shall have a toll-free telephone number or provide collect charge telephone service for use by the general public when calling the insurer from any location within the state.
R.I. Gen. Laws § 27-9-1 — RI Code / Title 27 / Chapter 27-9 / Section 27-9-1
§ 27-9-1. Purpose of chapter.
Status: in_force

The purpose of this chapter is to promote the public welfare by regulating insurance rates to the end that they shall not be excessive, inadequate, or unfairly discriminatory, and to authorize and regulate cooperative action among insurers in ratemaking and in other matters within the scope of this chapter. Nothing in this chapter is intended to: (1) prohibit or discourage reasonable competition; or (2) prohibit or encourage, except to the extent necessary to accomplish the stated purpose of this chapter, uniformity in insurance rates, rating systems, or rating plans or practices. This chapter shall be liberally interpreted to carry into effect the provisions of this section.
R.I. Gen. Laws § 27-30-13 — RI Code / Title 27 / Chapter 27-30 / Section 27-30-13
§ 27-30-13. Judicial review.
Status: in_force

Any party to the proceeding affected by any order of the commissioner shall be entitled to judicial review pursuant to chapter 35 of title 42.
R.I. Gen. Laws § 27-10-7 — RI Code / Title 27 / Chapter 27-10 / Section 27-10-7
§ 27-10-7. Exemptions from examination.
Status: in_force

(a) An individual who applies for an adjuster license in this state who was previously licensed as an adjuster in another state based on an adjuster examination shall not be required to complete the examination. This exemption is only available if the person is currently licensed in that state, or if the application is received within twelve (12) months of the cancellation of the applicants previous license and if the prior state issues a certification that, at the time of cancellation, the applicant was in good standing in that state or the states database records or records maintained by the NAIC, its affiliates or subsidiaries, indicate that the adjuster is or was licensed in good standing.

(b) A person licensed as an adjuster in another state based on an adjuster examination who moves to this state shall make application within ninety (90) days of establishing legal residence to become a resident licensee. No examination shall be required of that person to obtain an adjuster license.
R.I. Gen. Laws § 27-20-78 — RI Code / Title 27 / Chapter 27-20 / Section 27-20-78
§ 27-20-78. Mandatory coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome.
Status: in_force

(a) Every group health insurance contract, or every group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state, by any health insurance carrier, on or after January 1, 2023, shall provide coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome, including, but not limited to, the use of intravenous immunoglobulin therapy.

(b) [Deleted by P.L. 2025, ch. 286, § 3 and P.L. 2025, ch. 287, § 3.]

(c) The healthcare benefits outlined in this section apply only to services delivered within the state of Rhode Island; provided, that all health insurance carriers shall be required to provide coverage for those benefits mandated by this section outside of the state of Rhode Island where it can be established through a pre-authorization process that the required services are not available in the state of Rhode Island from a provider in the health insurance carriers network.

(d), (e) [Deleted by P.L. 2025, ch. 286, § 3 and P.L. 2025, ch. 287, § 3.]
R.I. Gen. Laws § 27-6-29 — RI Code / Title 27 / Chapter 27-6 / Section 27-6-29
§ 27-6-29. Adherence to rating organization filings  Deviation filings.
Status: in_force

Every member of or subscriber to a rating organization shall adhere to the filings made on its behalf by the organization; except that any insurer that is a member or subscriber may file with the commissioner a deviation from the class rates, schedules, rating plans, or rules respecting any kind of insurance or class of risk within a kind of insurance or combination of it. The deviation filing shall specify the basis for the modification and a copy shall also be sent simultaneously to the rating organization. Any deviation filing shall be on file for a waiting period of thirty (30) days before it becomes effective unless the commissioner reviews and authorizes the filing to become effective before the expiration of that period and shall be subject to the provisions of §§ 27-6-17  27-6-22. Each deviation shall be effective for a period of not less than one year from the date the deviation is filed unless terminated with the approval of the commissioner or in accordance with the provisions of §§ 27-6-17  27-6-22.
R.I. Gen. Laws § 27-25-4 — RI Code / Title 27 / Chapter 27-25 / Section 27-25-4
§ 27-25-4. Definitions.
Status: in_force

Whenever used in this chapter:

(1) Benefit contract means the agreement for provision of benefits authorized by § 27-25-16, as that agreement is described in § 27-25-19(a).

(2) Benefit member means an adult member who is designated by the laws or rules of the society to be a benefit member under a benefit contract.

(3) Certificate means the document issued as written evidence of the benefit contract.

(4) Laws means the societys articles of incorporation, constitution, and bylaws, however designated.

(5) Lodge means subordinate member units of the society, known as camps, courts, councils, branches, or by any other designation.

(6) Premiums means premiums, rates, dues, or other required contributions by whatever name known, that are payable under the certificate.

(7) Rules means all rules, regulations, or resolutions adopted by the supreme governing body or board of directors that are intended to have general application to the members of the society.

(8) Society means fraternal benefit society, unless otherwise indicated.
R.I. Gen. Laws § 27-25-37 — RI Code / Title 27 / Chapter 27-25 / Section 27-25-37
§ 27-25-37. Penalties.
Status: in_force

(a) Any person who willfully makes a false or fraudulent statement in or relating to an application for membership or for the purpose of obtaining money from or a benefit in any society, shall upon conviction be fined not less than one hundred dollars ($100) nor more than five hundred dollars ($500) or imprisonment for not less than thirty (30) days nor more than one year, or both.

(b) Any person who willfully makes a false or fraudulent statement in any verified report or declaration under oath required or authorized by this chapter, or of any material fact or thing contained in a sworn statement concerning the death or disability of an insured for the purpose of procuring payment of a benefit named in the certificate, shall be guilty of perjury and shall be subject to the penalties prescribed by law.

(c) Any person who solicits membership for, or in any manner assists in procuring membership in, any society not licensed to do business in this state shall upon conviction be fined not less than fifty dollars ($50.00) nor more than two hundred dollars ($200).

(d) Any person guilty of a willful violation of, or neglect or refusal to comply with, the provisions of this chapter for which a penalty is not prescribed, shall upon conviction, be subject to a fine not exceeding five hundred dollars ($500).
R.I. Gen. Laws § 27-16-4 — RI Code / Title 27 / Chapter 27-16 / Section 27-16-4
§ 27-16-4. Purpose of process provisions.
Status: in_force

(a) The purpose of §§ 27-16-3  27-16-14 is to subject certain insurers to the jurisdiction of the courts of this state in suits by or on behalf of insureds or beneficiaries under insurance contracts.

(b) The legislature declares that it is a subject of concern that many residents of this state hold policies of insurance issued or delivered in this state by insurers while not authorized to do business in this state, thus presenting to the residents the often insuperable obstacle of resorting to distant forums for the purpose of asserting legal rights under the policies. In furtherance of the state interest, the legislature provides in these sections a method of substituted service of process upon the insurers and declares that in doing this that it exercises its power to protect its residents and to define, for the purpose of §§ 27-16-3  27-16-14 what constitutes doing business in this state, and also exercises powers and privileges available to the state by virtue of 15 U.S.C. § 1011 et seq., which declares that the business of insurance and every person engaged in that business shall be subject to the laws of the several states.
R.I. Gen. Laws § 27-49-1 — RI Code / Title 27 / Chapter 27-49 / Section 27-49-1
§ 27-49-1. Purpose.
Status: in_force

The purpose of this chapter is to allow for the sharing of information as to motor vehicle theft and/or motor vehicle insurance fraud between automobile insurers and certain governmental agencies. This chapter allows the governmental agencies to request and receive from the insurers information relating to motor vehicle theft or motor vehicle insurance fraud losses; to provide for insurers to notify these agencies of motor vehicle theft and insurance fraud; and to provide for immunity to the insurers providing this information, and protecting the confidentiality of the information exchanged or released pursuant to this chapter.
R.I. Gen. Laws § 27-43-9 — RI Code / Title 27 / Chapter 27-43 / Section 27-43-9
§ 27-43-9. Tax on premiums collected.
Status: in_force

(a) Each captive insurance company shall pay to the division of taxation, on or before the first day of March of each year, a tax at the rate of two tenths of one percent (0.2%) on the first twenty million dollars ($20,000,000), and fifteen one hundredths of one percent (0.15%) on the next twenty million dollars ($20,000,000), and one tenth of one percent (0.1%) on the next twenty million dollars ($20,000,000), and thirty-seven and one-half thousandths of one percent (0.0375%) on each dollar thereafter on the direct premiums collected or contracted for on policies or contracts of insurance written by the captive insurance company during the year ending December 31 next preceding, after deducting from the direct premiums subject to the tax the amounts paid to policyholders as return premiums which shall include dividends on unabsorbed premiums or premium deposits returned or credited to policyholders.

(b) Each captive insurance company shall pay to the division of taxation on or before the first day of March of each year a tax at the rate of one hundred and twelve and one-half thousandths of one percent (0.1125%) on the first twenty million dollars ($20,000,000) of assumed reinsurance premium, and seventy-five thousandths of one percent (0.075%) on the next twenty million dollars ($20,000,000), and twenty-five thousandths of one percent (0.025%) on the next twenty million dollars ($20,000,000), and twelve and one-half thousandths of one percent (0.0125%) of each dollar thereafter. No reinsurance tax applies to premiums for risks or portions of risks that are subject to taxation on a direct basis pursuant to subsection (a) of this section. No reinsurance premium tax is payable in connection with the receipt of assets in exchange for the assumption of loss reserves and other liabilities of another insurer under common ownership and control if this transaction is part of a plan to discontinue the operations of the other insurer, and if the intent of the parties to this transaction is to renew or maintain this business with the captive insurance company.

(c) If the aggregate taxes to be paid by a captive insurance company calculated under subsections (a) and (b) of this section amount to less than twenty-five hundred dollars ($2,500) in any year, the captive insurance company shall pay a tax of twenty-five hundred dollars ($2,500) for that year.

(d) Two (2) or more captive insurance companies under common ownership and control are taxed as though they were a single captive insurance company.

(e) For the purposes of this section, common ownership and control means:

(1) In the case of stock corporations, the direct or indirect ownership of eighty percent (80%) or more of the outstanding voting stock of two (2) or more corporations by the same shareholder or shareholders; and

(2) In the case of mutual corporations, the direct or indirect ownership of eighty percent (80%) or more of the surplus and the voting power of two (2) or more corporations by the same member or members.

(f) A captive insurance company is not subject to the gross premium tax imposed under chapter 17 of title 44.
R.I. Gen. Laws § 27-9-27 — RI Code / Title 27 / Chapter 27-9 / Section 27-9-27
§ 27-9-27. Appeals from action of rating organization on changes in filings.
Status: in_force

(a) Any member of or subscriber to a rating organization may appeal to the commissioner from the action or decision of the rating organization in the promulgation of rates or with regard to any proposed change in or addition to the filings of the rating organization, and the commissioner shall after a hearing held upon not less than ten (10) days written notice to the appellant and to the rating organization issue an order approving or disapproving the action or decision of the rating organization. Provided, that if the appeal is from the action of the rating organization with regard to a rate on a proposed change in or addition to its filings, the commissioner shall approve the rate applied by the rating organization or the rate suggested by the appellant if either rate is in accordance with this chapter.

(b) If the appeal is based upon the failure of the rating organization to make a filing on behalf of any member or subscriber that is based on a system of expense provisions that differs in accordance with the right granted in § 27-9-4(a)(2) from the system of expense provisions included in a filing made by the rating organization, the commissioner shall, if the commissioner grants the appeal, order the rating organization to make the requested filing for use by the appellant. In deciding the appeal, the commissioner shall apply the standards set forth in §§ 27-9-4  27-9-6.
R.I. Gen. Laws § 27-43-13 — RI Code / Title 27 / Chapter 27-43 / Section 27-43-13
§ 27-43-13. Captive insurance regulatory and supervision fund.
Status: in_force

(a)(1) There is created a fund to be known as the captive insurance regulatory and supervision fund for the purpose of providing the financial means for the commissioner to administrate this chapter and for reasonable expenses incurred in promoting the captive insurance industry in Rhode Island. An appropriation of ten percent (10%) of the premiums taxed under § 27-43-9, and all fees and assessments received by the department pursuant to the administration of this chapter with regards to the captive insurance industry shall be credited to this fund. Of this amount, not more than two percent (2%) of the premium tax under § 27-43-9 may be transferred to the Rhode Island economic development corporation, with approval of the director of administration, for promotional expenses.

(2) All payments from the captive insurance regulatory and supervision fund for the maintenance of staff and associated expenses including contractual services as necessary, shall be disbursed from the state treasury only upon written request issued by the commissioner, after receipt of proper documentation regarding services rendered and expenses incurred.

(b) At the end of each fiscal year, that portion of the balance in the captive insurance regulatory and supervision fund that exceeds one hundred thousand dollars ($100,000), shall be transferred to the general fund.

(c) The commissioner may anticipate receipts for the captive insurance regulatory and supervision fund and issue a written request for payments based on it.
R.I. Gen. Laws § 27-18-18 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-18
§ 27-18-18. Acceptance of premiums after effective period of policy.
Status: in_force

If a policy contains a provision establishing, as an age limit or otherwise, a date after which the coverage provided by the policy will not be effective, and if the date falls within a period for which a premium is accepted by the insurer or if the insurer accepts a premium after the date, the coverage provided by the policy will continue in force subject to any right of cancellation until the end of the period for which the premium has been accepted. In the event the age of the insured has been misstated and if, according to the correct age of the insured, the coverage provided by the policy would not have become effective, or would have ceased prior to the acceptance of the premium or premiums, then the liability of the insurer shall be limited to the refund, upon request, of all premiums paid for the period not covered by the policy.
R.I. Gen. Laws § 27-1-33 — RI Code / Title 27 / Chapter 27-1 / Section 27-1-33
§ 27-1-33. Exempted arbitrage transactions.
Status: in_force

The provisions of §§ 27-1-30, 27-1-31, 27-1-32, and 27-1-34 shall not apply to foreign or domestic arbitrage transactions unless made in contravention of the rules and regulations that the commissioner may adopt in order to carry out the purposes of §§ 27-1-29  27-1-36.
R.I. Gen. Laws § 27-18-86 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-86
§ 27-18-86. Health insurance contracts  Copayments exemption for COVID-19 related services.
Status: in_force

(a) Any individual or group health insurance plan or policy shall not impose any copayment, coinsurance, or charge any out-of-pocket deductible to the insured for COVID-19 related services, including, but not limited to: emergency services, inpatient services, provider office visits, and inpatient hospital stays, as long as the COVID-19 state of emergency remains in effect.

(b) Any individual or group health insurance plan or policy shall not impose any copayment, coinsurance, or charge any out-of-pocket deductible to the insured for the administration of the COVID-19 vaccine or a COVID-19 test.

(c) The health insurance commissioner shall promulgate any rules and regulations as the commissioner deems necessary for the efficient administration and enforcement of this section.
R.I. Gen. Laws § 27-41-98 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-98
§ 27-41-98. Dispensing and administration of HIV PrEP or PEP drugs.
Status: in_force

(a) Notwithstanding any provision of law to the contrary and as authorized by the Rhode Island board of pharmacy (the board) in accordance with rules and regulations adopted under subsection (e) of this section, a pharmacist may prescribe, dispense, and administer HIV PrEP or PEP drugs (hereinafter sometimes referred to as prevention drugs) as described in § 27-41-96(a) pursuant to a standing order or collaborative practice agreement or to protocols developed by the board for when there is no prescription drug order, standing order, or collaborative practice agreement in accordance with the requirements in this subsection and may also order laboratory testing for HIV infection as necessary.

(b) Before furnishing an HIV PrEP or PEP drug to a patient, a pharmacist shall complete a training program approved by the board on the use of protocols developed by the board for prescribing, dispensing, and administering an HIV prevention drug, on the requirements for any laboratory testing for HIV infection, and on guidelines for prescription adherence and best practices to counsel patients prescribed an HIV prevention drug.

(c) A pharmacist shall dispense or administer a PrEP or PEP drug in at least a thirty-day (30) supply, and up to a sixty-day (60) supply, as long as all of the following conditions are met:

(1) The patient tests negative for HIV infection, as documented by a negative HIV test result obtained within the previous seven (7) days. If the patient does not provide evidence of a negative HIV test result, the pharmacist shall order an HIV test. If the test results are not transmitted directly to the pharmacist, the pharmacist shall verify the test results to the pharmacists satisfaction. If the patient tests positive for HIV infection, the pharmacist or person administering the test shall direct the patient to a primary care provider and provide a list of primary care providers and clinics within a reasonable travel distance of the patients residence;

(2) The patient does not report any signs or symptoms of acute HIV infection on a self-reporting checklist of acute HIV infection signs and symptoms;

(3) The patient does not report taking any contraindicated medications;

(4) The pharmacist provides counseling to the patient, consistent with CDC guidelines, on the ongoing use of a PrEP or PEP drug. The pharmacist shall notify the patient that the patient shall be seen by a primary care provider to receive subsequent prescriptions for a PrEP or PEP drug and that a pharmacist shall not dispense or administer more than a sixty-day (60) supply of a PrEP or PEP drug to a single patient once every two (2) years without a prescription;

(5) The pharmacist documents, to the extent possible, the services provided by the pharmacist in the patients record in the patient profile record system maintained by the pharmacy. The pharmacist shall maintain records of PrEP or PEP drugs dispensed or administered to each patient;

(6) The pharmacist does not dispense or administer more than a sixty-day (60) supply of a PrEP or PEP drug to a single patient once every two (2) years, unless otherwise directed by a practitioner; and

(7) The pharmacist notifies the patients primary care provider that the pharmacist completed the requirements specified in this subsection. If the patient does not have a primary care provider, or refuses consent to notify the patients primary care provider, the pharmacist shall provide the patient a list of physicians, clinics, or other healthcare providers to contact regarding follow-up care.

(d) A pharmacist shall dispense or administer a complete course of a post-exposure prophylaxis drug as long as all of the following conditions are met:

(1) The pharmacist screens the patient and determines that the exposure occurred within the previous seventy-two (72) hours and the patient otherwise meets the clinical criteria for a post-exposure prophylaxis drug under CDC guidelines;

(2) The pharmacist provides HIV testing to the patient or determines that the patient is willing to undergo HIV testing consistent with CDC guidelines. If the patient refuses to undergo HIV testing but is otherwise eligible for a post-exposure prophylaxis drug under this subsection, the pharmacist may dispense or administer a post-exposure prophylaxis drug;

(3) The pharmacist provides counseling to the patient, consistent with CDC guidelines, on the use of a post-exposure prophylaxis drug. The pharmacist shall also inform the patient of the availability of a PrEP or PEP drug for persons who are at substantial risk of acquiring HIV; and

(4) The pharmacist notifies the patients primary care provider of the dispensing or administering of the post-exposure prophylaxis drug. If the patient does not have a primary care provider, or refuses consent to notify the patients primary care provider, the pharmacist shall provide the patient a list of physicians, clinics, or other healthcare providers to contact regarding follow-up care.

(e) The board shall promulgate rules and regulations establishing standards for authorizing pharmacists to prescribe, dispense, and administer HIV prevention drugs in accordance with this section, including adequate training requirements and protocols for when there is no prescription drug order, standing order, or collaborative practice agreement.
R.I. Gen. Laws § 27-66-11 — RI Code / Title 27 / Chapter 27-66 / Section 27-66-11
§ 27-66-11. Perjury.
Status: in_force

Any person who is found to have testified falsely under oath before the general assembly, department of business regulation, or department of attorney general, pursuant to this chapter shall be subject to prosecution for perjury and be subject to the penalties set forth in § 11-33-1.
R.I. Gen. Laws § 27-61-3 — RI Code / Title 27 / Chapter 27-61 / Section 27-61-3
§ 27-61-3. Unfair discrimination against subjects of abuse prohibited.
Status: in_force

No insurer issuing or renewing a policy of life insurance in this state shall engage in an unfairly discriminatory act or practice against a subject of abuse, and that act or practice is deemed to be an unfair or deceptive act or practice under chapter 29 of this title.
R.I. Gen. Laws § 27-29-1 — RI Code / Title 27 / Chapter 27-29 / Section 27-29-1
§ 27-29-1. Declaration of purpose.
Status: in_force

The purpose of this chapter is to regulate trade practices in the business of insurance in accordance with the intent of Congress as expressed in 15 U.S.C. § 1011 et seq., by defining, or providing for the determination of, all trade practices in this state that constitute unfair methods of competition or unfair or deceptive acts or practices, and by prohibiting the trade practices so defined or determined. Nothing in this chapter shall be construed to create or imply a private cause of action for a violation of this chapter.
R.I. Gen. Laws § 27-58-4 — RI Code / Title 27 / Chapter 27-58 / Section 27-58-4
§ 27-58-4. Authorization for implementing regulations.
Status: in_force

The commissioner may promulgate administrative regulations to effectuate the purposes of this chapter and to ensure the safety and soundness of the banking and insurance businesses.
R.I. Gen. Laws § 27-8-7 — RI Code / Title 27 / Chapter 27-8 / Section 27-8-7
§ 27-8-7. Terms to be stated in policy  Rebates prohibited.
Status: in_force

No insurance corporation authorized to do any insurance business within this state, or any officer, insurance producer, or their representative, shall make any contract for insurance, on property or risks located within this state, or against any liability, casualty, accident, or hazard that may arise or occur in this state, or any agreement as to that contract, other than as plainly expressed in the policy issued or to be issued; nor shall any corporation, or officer, insurance producer, or their representative, directly or indirectly, in any manner, pay or allow or offer to pay or allow to the insured named in the policy or to any employee of the insured as an inducement to the insurance, or after the insurance has been effected, any rebate from the premium that is specified in the policy or any special favor or advantage in the dividends or other benefit to accrue on the policy; or any valuable consideration or inducement, not specified in the policy or contract of insurance, or give, sell, or purchase, as an inducement to the insurance, or in connection with it, any stock, bonds, or other securities of any insurance or other corporation or association, or any dividends or profits accrued on the stock, bonds, or securities, or anything of value, not specified in the policy; nor shall any insurance producer or representative, or any other person, directly or indirectly, either by sharing commissions or in any manner, pay or allow or offer to pay or allow to the insured named in the policy, or to any employee of the insured, as an inducement to the insurance, or after the insurance has been effected, any rebate from the premium that is specified in the policy. Nothing in this chapter shall prevent any corporation lawfully doing insurance business in this state from the distribution of surplus and dividends to policyholders, nor shall this chapter prevent any corporation, or its agent, from paying commissions to a licensed insurance producer who has negotiated for the insurance, nor shall it prevent any licensed insurance producer from sharing or dividing a commission earned or received by the insurance producer with any other licensed insurance producer, who has aided the insurance producer in respect to the insurance for the negotiation of which the commission has been earned or paid.
R.I. Gen. Laws § 27-64-7 — RI Code / Title 27 / Chapter 27-64 / Section 27-64-7
§ 27-64-7. Conservation, rehabilitation and liquidation of protected cell companies.
Status: in_force

(a) Notwithstanding any contrary provision in the insurance code of this state, the rules and regulations promulgated under the insurance code, or any other applicable law or regulation, upon placement under administrative supervision or upon any order of conservation, rehabilitation or liquidation of a protected cell company, the receiver shall be bound to deal with the protected cell companys assets and liabilities, including protected cell assets and protected cell liabilities, in accordance with the requirements set forth in this chapter.

(b) With respect to amounts recoverable under a protected cell company insurance securitization, the amount recoverable by the receiver shall not be reduced or diminished as a result of the placement under administrative supervision or entry of an order of conservation, rehabilitation or liquidation with respect to the protected cell company or any of its protected cells, notwithstanding any provisions to the contrary in the contracts or other documentation governing the protected cell company insurance securitization.
R.I. Gen. Laws § 27-18-19 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-19
§ 27-18-19. Insurance exempt from chapter.
Status: in_force

Nothing in the chapter shall apply to or affect:

(1) Any policy of workers compensation insurance or any policy of liability insurance with or without supplementary expense coverage in the policy;

(2) Any policy or contract of reinsurance; or

(3) [Deleted by P.L. 2017, ch. 196, § 4 and P.L. 2017, ch. 322, § 4].

(4) Life insurance, endowment, or annuity contracts, or contracts supplemental to those contracts, that contain only those provisions relating to accident and sickness insurance as: (i) Provide additional benefits in case of death or dismemberment or loss of sight by accident; or (ii) Operate to safeguard those contracts against lapse, or to give a special surrender value or special benefit or an annuity in the event that the insured or annuitant shall become totally and permanently disabled, as defined by the contract or supplemental contract.
R.I. Gen. Laws § 27-39-4 — RI Code / Title 27 / Chapter 27-39 / Section 27-39-4
§ 27-39-4. Exclusions.
Status: in_force

(a) The second surgical opinion benefit provisions of a policy may exclude: (1) Benefits while the patient is confined in a hospital as an inpatient; (2) Any surgical procedures not covered by the policy; and (3) Surgical procedures in the following categories: cosmetic surgery, pregnancy-related surgery, dental surgery, podiatric surgery, and sterilization.

(b) If an eligible physician who furnishes a second or third surgical opinion also performs the surgical procedure, the policy need not provide payment for the second and third opinion services of that physician.
R.I. Gen. Laws § 27-81-1 — RI Code / Title 27 / Chapter 27-81 / Section 27-81-1
§ 27-81-1. Title.
Status: in_force

This act shall be known as, and may be cited as, the Telemedicine Coverage Act.
R.I. Gen. Laws § 27-25-15 — RI Code / Title 27 / Chapter 27-25 / Section 27-25-15
§ 27-25-15. Conversion of fraternal benefit society into mutual life insurance company.
Status: in_force

Any domestic fraternal benefit society may be converted and licensed as a mutual life insurance company by compliance with all of the requirements of the general laws relating to the financial requirements of mutual life insurance companies. A plan of conversion shall be prepared, in writing, by the board of directors setting forth, in full, the terms and conditions of conversion. The affirmative vote of two-thirds ( ) of all members of the supreme governing body at a regular or special meeting shall be necessary for the approval of the plan. No conversion shall take effect unless and until approved by the commissioner of insurance, who may give approval if the commissioner finds that the proposed change is in conformity with the requirements of law and not prejudicial to the certificate holders of the society.
R.I. Gen. Laws § 27-18-82 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-82
§ 27-18-82. Opioid antagonists.
Status: in_force

(a) Every individual or group health insurance contract, plan, or policy that provides prescription coverage that is delivered, issued for delivery, amended, or renewed in this state on or after January 1, 2017, shall provide coverage for at least one generic opioid antagonist and device. Prior authorization may be required for non-generic forms of opioid antagonists and devices.

(b) As used in this section:

Opioid antagonist means naloxone hydrochloride and any other drug approved by the United States Food and Drug Administration for the treatment of opioid overdose.

(c) The coverage mandated by this section shall include generic opioid antagonists prescribed or dispensed via standing order or collaborative practice agreement intended for use on patients other than the insured. Prior authorization may be required for non-generic forms of opioid antagonists and devices.

(d) Notwithstanding §27-18-19, or any other provision to the contrary, this section shall apply to blanket or group policies of insurance.
R.I. Gen. Laws § 27-20-62 — RI Code / Title 27 / Chapter 27-20 / Section 27-20-62
§ 27-20-62. Emergency services.
Status: in_force

(a) As used in this section:

(1) Emergency medical condition means a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) so that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in a condition: (i) Placing the health of the individual, or with respect to a pregnant woman her unborn child, in serious jeopardy; (ii) Constituting a serious impairment to bodily functions; or (iii) Constituting a serious dysfunction of any bodily organ or part.

(2) Emergency services means, with respect to an emergency medical condition:

(i) A medical screening examination (as required under section 1867 of the Social Security Act, 42 U.S.C. §1395dd) that is within the capability of the emergency department of a hospital, including ancillary services routinely available to the emergency department to evaluate the emergency medical condition; and

(ii) Further medical examination and treatment, to the extent they are within the capabilities of the staff and facilities available at the hospital, as are required under section 1867 of the Social Security Act (42 U.S.C. §1395dd) to stabilize the patient.

(3) Stabilize, with respect to an emergency medical condition has the meaning given in section 1867(e)(3) of the Social Security Act (42 U.S.C. §1395dd(e)(3)).

(b) 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 section.

(c) A nonprofit medical service corporation shall provide coverage for emergency services in the following manner:

(1) Without the need for any prior authorization determination, even if the emergency services are provided on an out-of-network basis;

(2) Without regard to whether the healthcare provider furnishing the emergency services is a participating network provider with respect to the services;

(3) If the emergency services are provided out of network, without imposing any administrative requirement or limitation on coverage that is more restrictive than the requirements or limitations that apply to emergency services received from in-network providers;

(4) If the emergency services are provided out of network, by complying with the cost-sharing requirements of subsection (d) of this section; and

(5) Without regard to any other term or condition of the coverage, other than:

(i) The exclusion of or coordination of benefits;

(ii) An affiliation or waiting period permitted under part 7 of federal ERISA, part A of title XXVII of the federal Public Health Service Act, or chapter 100 of the federal Internal Revenue Code; or

(iii) Applicable cost sharing.

(d)(1) Any cost-sharing requirement expressed as a copayment amount or coinsurance rate imposed with respect to a participant or beneficiary for out-of-network emergency services cannot exceed the cost-sharing requirement imposed with respect to a participant or beneficiary if the services were provided in-network. However, a participant or beneficiary may be required to pay, in addition to the in-network cost sharing, the excess of the amount the out-of-network provider charges over the amount the plan or health insurance carrier is required to pay under subsection (d)(1). A group health plan or health insurance carrier complies with the requirements of this subsection (d) if it provides benefits with respect to an emergency service in an amount equal to the greatest of the three amounts specified in subsections (d)(1)(i), (d)(1)(ii), and (d)(1)(iii) of this section (which are adjusted for in-network cost-sharing requirements).

(i) The amount negotiated with in-network providers for the emergency service furnished, excluding any in-network copayment or coinsurance imposed with respect to the participant or beneficiary. If there is more than one amount negotiated with in-network providers for the emergency service, the amount described under this subsection (d)(1)(i) is the median of these amounts, excluding any in-network copayment or coinsurance imposed with respect to the participant or beneficiary. In determining the median described in the preceding sentence, the amount negotiated with each in-network provider is treated as a separate amount (even if the same amount is paid to more than one provider). If there is no per-service amount negotiated with in-network providers (such as under a capitation or other similar payment arrangement), the amount under this subsection (d)(1)(i) is disregarded.

(ii) The amount for the emergency service shall be calculated using the same method the plan generally uses to determine payments for out-of-network services (such as the usual, customary, and reasonable amount), excluding any in-network copayment or coinsurance imposed with respect to the participant or beneficiary. The amount in this subsection (d)(1)(ii) is determined without reduction for out-of-network cost sharing that generally applies under the plan or health insurance coverage with respect to out-of-network services.

(iii) The amount that would be paid under Medicare (part A or part B of title XVIII of the Social Security Act, 42 U.S.C. §1395 et seq.) for the emergency service, excluding any in-network copayment or coinsurance imposed with respect to the participant or beneficiary.

(2) Any cost-sharing requirement other than a copayment or coinsurance requirement (such as a deductible or out-of-pocket maximum) may be imposed with respect to emergency services provided out of network if the cost-sharing requirement generally applies to out-of-network benefits. A deductible may be imposed with respect to out-of-network emergency services only as part of a deductible that generally applies to out-of-network benefits. If an out-of-pocket maximum generally applies to out-of-network benefits, that out-of-pocket maximum must apply to out-of-network emergency services.

(f) The provisions of this section shall apply to grandfathered health plans. This section shall not apply to insurance coverage providing benefits for: (1) Hospital confinement indemnity; (2) Disability income; (3) Accident only; (4) Long-term care; (5) Medicare supplement; (6) Limited benefit health; (7) Specified disease indemnity; (8) Sickness or bodily injury or death by accident or both; and (9) Other limited benefit policies.
R.I. Gen. Laws § 27-6-7 — RI Code / Title 27 / Chapter 27-6 / Section 27-6-7
§ 27-6-7. Use of rates.
Status: in_force

Rates made in accordance with §§ 27-6-4  27-6-6 may be used subject to the provisions of this chapter.
R.I. Gen. Laws § 27-20-53 — RI Code / Title 27 / Chapter 27-20 / Section 27-20-53
§ 27-20-53. Tobacco cessation programs.
Status: in_force

(a) Every individual or group health insurance contract, plan, or policy delivered, issued for delivery, or renewed in this state on or after January 1, 2010, that provides medical coverage that includes coverage for physician services in a physicians office, and every policy that provides major medical or similar comprehensive-type coverage, shall include coverage for smoking cessation treatment, provided that if the medical coverage does not include prescription drug coverage, the contract, plan, or policy shall not be required to include coverage for FDA approved smoking cessation medications.

(b) As used in this section, smoking cessation treatment includes the use of an over-the-counter (OTC) or prescription U.S. Food and Drug Administration (FDA) approved smoking cessation medication, when used in accordance with FDA approval, for not more than two (2) courses of medication of up to fourteen (14) weeks each, annually, when recommended and prescribed by a prescriber who holds prescriptive privileges in the state in which they are licensed, and used in combination with an annual outpatient benefit of sixteen (16) one-half (Â½) hour evidence-based smoking cessation counseling sessions provided by a qualified practitioner for each covered individual. Smoking cessation treatment may be redefined through regulation promulgated by the health insurance commissioner in accordance with the most current clinical practice guidelines sponsored by the United States Department of Health and Human Services or its component agencies.

(c) Health insurance contracts, plans, or policies to which this section applies, may impose copayments and/or deductibles for the benefits mandated by this section consistent with the contracts, plans, or policies copayments and/or deductibles for physician services and medications. Nothing contained in this section shall impact the reimbursement; medical necessity or utilization review; managed care; or case management practices of these health insurance contracts, plans, or policies.

(d) This section shall not apply to insurance coverage providing benefits for:

(1) Hospital confinement indemnity;

(2) Disability income;

(3) Accident only;

(4) Long-term care;

(5) Medicare supplement;

(6) Limited benefit health;

(7) Specified disease indemnity;

(8) Sickness or bodily injury or death by accident or both; and

(9) Other limited benefit policies.
R.I. Gen. Laws § 27-47-1 — RI Code / Title 27 / Chapter 27-47 / Section 27-47-1
§ 27-47-1. Definitions.
Status: in_force

As used in this chapter:

(1) Chief executive officer is the person, irrespective of his or her title, designated by the board of directors or trustees of an insurer as the person charged with the responsibility of administering and implementing the insurers policies and procedures.

(2) Commissioner means the commissioner of insurance or the commissioners equivalent of the state of domicile of any insurer.

(3) Impaired is a financial situation in which the assets of an insurer are less than the sum of the insurers minimum required capital, minimum required surplus, and all liabilities as determined in accordance with the requirements for the preparation and filing of the annual statement of an insurer under chapter 12 of this title.

(4) Insurer means any insurance company or other insurer licensed to do business in this state.
R.I. Gen. Laws § 27-41-8 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-8
§ 27-41-8. Evidence of coverage and charges for healthcare services.
Status: in_force

(a) Every enrollee residing in this state is entitled to evidence of coverage for the payment and for the provision of healthcare services under a health maintenance organization. The health maintenance organization shall issue that evidence of coverage.

(b) Any evidence of coverage issued by a health maintenance organization licensed under this chapter shall comply with the minimum standards protection of § 42-62-12 and regulations pursuant to that section.

(c) No schedule of charges, rates, or rating formulae for enrollee coverage for healthcare services, or amendment to any schedule, may be used by any health maintenance organization until a copy of that schedule, rate, or rating formula, or amendment to it, has been filed with and approved by the director under the provisions of § 42-62-13.
R.I. Gen. Laws § 27-18-3.5 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-3.5
§ 27-18-3.5. Non-applicability.
Status: in_force

Sections 27-18-3.1  27-18-3.5 shall not apply to dental plans offered by any health maintenance organization, its parent, or subsidiary, which as of December 31, 1985, was licensed or had filed an application for a license, under the laws of this state.
R.I. Gen. Laws § 27-1-47 — RI Code / Title 27 / Chapter 27-1 / Section 27-1-47
§ 27-1-47. Notification of a cybersecurity event.
Status: in_force

(a) Each domestic insurer shall notify the commissioner as promptly as possible but in no event later than three (3) business days from a determination that a cybersecurity event has occurred when either of the following criteria has been met:

(1) A cybersecurity event impacting the insurer of which notice is required to be provided to any government body, self-regulatory agency, or any other supervisory body pursuant to any state or federal law; or

(2) A cybersecurity event that has a reasonable likelihood of materially harming:

(i) Any consumer residing in this state; or

(ii) Any material part of the normal operation(s) of the insurer.

(b) The insurer shall provide any information required by this section in electronic form as directed by the commissioner. The insurer shall have a continuing obligation to update and supplement initial and subsequent notifications to the commissioner concerning the cybersecurity event. The insurer shall provide as much of the following information as possible. The insurer should indicate whether it is making claims under chapter 2 of title 38 to any of the information provided. The following information shall be provided:

(1) Date of the cybersecurity event;

(2) Description of how the information was exposed, lost, stolen, or breached, including the specific roles and responsibilities of third-party service providers, if any;

(3) How the cybersecurity event was discovered;

(4) Whether any lost, stolen, or breached information has been recovered and if so, how this recovery was achieved;

(5) The identity of the source of the cybersecurity event;

(6) Whether the insurer has filed a police report or has notified any regulatory, government, or law enforcement agencies and, if so, when such notification was provided;

(7) Description of the specific types of information acquired without authorization. Specific types of information consisting of particular data elements including, for example, types of medical information, types of financial information, or types of information allowing identification of the consumer;

(8) The period during which the information system was compromised by the cybersecurity event;

(9) The number of total consumers in this state affected by the cybersecurity event. The insurer shall provide the best estimate in the initial report to the commissioner and update this estimate with each subsequent report to the commissioner pursuant to this section;

(10) The results of any internal review identifying a lapse in either automated controls or internal procedures, or confirming that all automated controls or internal procedures were followed;

(11) Description of efforts being undertaken to remediate the situation that permitted the cybersecurity event to occur;

(12) A copy of the insurer privacy policy and a statement outlining the steps the insurer will take to investigate and notify consumers affected by the cybersecurity event; and

(13) Name of a contact person who is both familiar with the cybersecurity event and authorized to act for the insurer.

(c) An insurer shall comply with chapter 49.3 of title 11, as applicable, and provide a copy of the notice sent to consumers under that chapter to the commissioner, when an insurer is required to notify the commissioner.

(d) Notice regarding cybersecurity events of third-party service providers.

(1) In the case of a cybersecurity event involving an insurers nonpublic information in a system maintained by a third-party service provider, of which the insurer has become aware, the insurer shall treat that event as it would under subsection (a) of this section;

(2) The computation of the insurers deadlines shall begin on the day after the third-party service provider notifies the insurer of the cybersecurity event or the insurer otherwise has actual knowledge of the cybersecurity event, whichever is sooner;

(3) Nothing in this chapter shall prevent or abrogate an agreement between an insurer and another insurer, a third-party service provider, or any other party to fulfill any of the investigation requirements or notice requirements imposed under this section.

(e) Notice regarding cybersecurity events of reinsurers to insurers.

(1)(i) In the case of a cybersecurity event involving nonpublic information that is used by the insurer that is acting as an assuming insurer or in the possession, custody, or control of an insurer that is acting as an assuming insurer and that does not have a direct contractual relationship with the affected consumers, the assuming insurer shall notify its affected ceding insurers and the commissioner of its state of domicile within seventy-two (72) hours of making the determination that a cybersecurity event has occurred;

(ii) The ceding insurers that have a direct contractual relationship with affected consumers shall fulfill the consumer notification requirements imposed under chapter 49.3 of title 11 (Identity Theft Protection Act of 2015), and any other notification requirements relating to a cybersecurity event imposed under this section.

(2)(i) In the case of a cybersecurity event involving nonpublic information that is in the possession, custody, or control of a third-party service provider of an insurer that is an assuming insurer, the assuming insurer shall notify its affected ceding insurers and the commissioner of its state of domicile within seventy-two (72) hours of receiving notice from its third-party service provider that a cybersecurity event has occurred;

(ii) The ceding insurers that have a direct contractual relationship with affected consumers shall fulfill the consumer notification requirements imposed under chapter 49.3 of title 11 and any other notification requirements relating to a cybersecurity event imposed under this section.

(f) Notice regarding cybersecurity events of insurers to producers of record.

(1) In the case of a cybersecurity event involving nonpublic information that is in the possession, custody, or control of an insurer or its third-party service provider and for which a consumer accessed the insurers services through an independent insurance producer, the insurer shall notify the producers of record of all affected consumers as soon as practicable as directed by the commissioner.

(2) The insurer is excused from this obligation for those instances in which it does not have the current producer of record information for any individual consumer.
R.I. Gen. Laws § 27-8-10 — RI Code / Title 27 / Chapter 27-8 / Section 27-8-10
§ 27-8-10. Life insurance and preexisting contracts.
Status: in_force

Sections 27-8-7 to 27-8-9 shall not apply to any contract of life insurance nor shall it affect any contract existing on April 22, 1927.
R.I. Gen. Laws § 27-2-5 — RI Code / Title 27 / Chapter 27-2 / Section 27-2-5
§ 27-2-5. Minimum capital and surplus requirements  Maximum amount of single risk.
Status: in_force

No insurance company not incorporated under the authority of this state shall make any contract of insurance with any person in this state unless the capital stock of the company is at least equal to one million dollars ($1,000,000) and the gross paid in and contributed surplus of the company is at least equal to two million dollars ($2,000,000) or, if a mutual company, its net assets over all liabilities amount to not less than three million dollars ($3,000,000), nor unless the company, if other than a life insurance company, shall be restricted, by its charter or otherwise, so that it cannot lawfully incur in any one risk a greater hazard than one-tenth ( ) part of its capital and surplus if a stock company or of its net assets if a mutual company; provided, that no fire, marine, or fire and marine insurance company of any foreign country shall make any contract of insurance with any person in this state unless the company has two million dollars ($2,000,000) paid-in capital stock and four million dollars ($4,000,000) surplus, or if a foreign mutual company its net assets over all liabilities amount to not less than six million dollars ($6,000,000) and shall have made a deposit with the insurance commissioner of this state, or with the proper officer of some other state of the United States, of not less than two million dollars ($2,000,000) in securities which shall be at all times at or above par and in trust for the benefit of its policyholders in the United States, or if a mono-line business company as defined in this title, has a combined capital and surplus of two million dollars ($2,000,000). Nothing contained in this section shall be construed to apply to foreign insurance companies licensed prior to May 13, 1977.
R.I. Gen. Laws § 27-58-12 — RI Code / Title 27 / Chapter 27-58 / Section 27-58-12
§ 27-58-12. Physical location of insurance activities.
Status: in_force

The place of solicitation or sale of insurance by any financial institution shall be from an office physically separated from the banking activities of the institution. Physical separation shall not be defined as a separate building. The commissioner shall have the authority to promulgate rules and regulations to implement this section pursuant to § 27-58-4.
R.I. Gen. Laws § 27-2-11 — RI Code / Title 27 / Chapter 27-2 / Section 27-2-11
§ 27-2-11. License required  Expiration date.
Status: in_force

No company shall transact any business of insurance in this state until it has obtained from the insurance commissioner of this state a license stating that it has complied with the laws of this state and specifying the kinds of business it is authorized to transact. The insurance commissioner may refuse to issue the license if the commissioner is of the opinion that the refusal will be in the public interest. Every license shall be continuous unless revoked or suspended as provided in chapter 13 of this title.
R.I. Gen. Laws § 27-20-27 — RI Code / Title 27 / Chapter 27-20 / Section 27-20-27
§ 27-20-27. New cancer therapies  Under investigation. [Repealed on effective date of § 27-20-64.]
Status: in_force

Every individual or group hospital or medical expense insurance policy or individual or group hospital or medical service plan contract delivered, issued for delivery or renewed in this state shall provide coverage for new cancer therapies still under investigation as outlined in this chapter.
R.I. Gen. Laws § 27-12-6 — RI Code / Title 27 / Chapter 27-12 / Section 27-12-6
§ 27-12-6. Rules and regulations.
Status: in_force

The insurance commissioner shall have the authority to promulgate rules and regulations necessary to carry out the purposes of this chapter.
R.I. Gen. Laws § 27-19-18 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-18
§ 27-19-18. Coverage for adoptive children.
Status: in_force

Subscribers to any nonprofit hospital service plan who have satisfied the continuous membership requirements of the plan, and who adopt children under the guardianship and custody of the director of the department of children, youth and families, shall be afforded coverage under the plan for any adopted child without any waiting period, notwithstanding the fact that the adopted child may have any preexisting medical condition.
R.I. Gen. Laws § 27-59-6 — RI Code / Title 27 / Chapter 27-59 / Section 27-59-6
§ 27-59-6. Regulations.
Status: in_force

The commissioner shall promulgate any rules and regulations required to implement this chapter.
R.I. Gen. Laws § 27-8-4 — RI Code / Title 27 / Chapter 27-8 / Section 27-8-4
§ 27-8-4. Classification of risks by mutual companies.
Status: in_force

Any mutual insurance company incorporated by this state and any mutual insurance company incorporated by any other state or country authorized to transact business in this state may classify the property and risks insured in it at the time of issuing policies on the property, and may issue policies upon that property and those risks under different rates of premium or premium deposit, corresponding as nearly as may be to the greater or lesser risk from the causes insured against and the loss that may attach to the several assumed risks, and the directors of any mutual insurance company may, by vote, fix and determine the percentage of dividend or unused or unabsorbed premium or premium deposit return to be paid or credited on expiring policies, which percentages may differ, following the different loss experience of different classes of risks of the same term. But all policies insuring risks in the same classification shall have an equal rate of dividend or return of unused or unabsorbed premium or premium deposit upon expiration, and in case of an assessment, the rate may be different for each different class of risks.
R.I. Gen. Laws § 27-9-6 — RI Code / Title 27 / Chapter 27-9 / Section 27-9-6
§ 27-9-6. Contracts as to commissions or compensation.
Status: in_force

Nothing in §§ 27-9-4 and 27-9-5 or in this chapter shall abridge or restrict the freedom of contract between insurers and insurance producers with respect to commissions or between insurers and their employees or other persons with respect to compensation for goods or services.
R.I. Gen. Laws § 27-19-54 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-54
§ 27-19-54. Dental insurance assignment of benefits.
Status: in_force

Every entity providing a contract of insurance subject to this chapter shall allow, as a provision in a group or individual policy, contract, or health benefit plan for coverage of dental services, any person insured by the entity to direct, in writing, that benefits from a health benefit plan, policy, or contract be paid directly to a dental care provider who has not contracted with the entity to provide dental services to persons covered by the entity but otherwise meets the credentialing criteria of the entity and has not previously been terminated by the entity as a participating provider. If written direction to pay is executed and written notice of the direction to pay is provided to the entity, the insuring entity shall pay the benefits directly to the dental care provider. Any efforts to modify the amount of benefits paid directly to the dental care provider under this section may include a reduction in benefits paid of no more than five percent (5%) less than the benefits paid to participating dentists. The entity paying the dentist, pursuant to a direction to pay duly executed by the subscriber, shall have the right to review the records of the dentist receiving the payment that relate exclusively to that particular subscriber/patient to determine that the service in question was rendered.
R.I. Gen. Laws § 27-52-2 — RI Code / Title 27 / Chapter 27-52 / Section 27-52-2
§ 27-52-2. Definitions.
Status: in_force

As used in this chapter:

(1) Actuary means a person who is a member in good standing of the American Academy of Actuaries.

(2) Controlling person means any person, firm, association, or corporation who or that directly or indirectly has the power to direct or cause to be directed, the management, control, or activities of the reinsurance intermediary.

(3) Insurer means any person, firm, association, or corporation duly licensed in this state pursuant to the applicable provisions of the insurance law as an insurer.

(4) Licensed producer means an agent, broker, or reinsurance intermediary licensed pursuant to the applicable provisions of this title.

(5) Qualified U.S. financial institutions, for the purposes of this chapter, means an institution that:

(i) Is organized or in the case of a U.S. office of a foreign banking organization licensed, under the laws of the United States or any state of the United States;

(ii) Is regulated, supervised, and examined by U.S. federal or state authorities having regulatory authority over banks and trust companies; and

(iii) Has been determined by either the commissioner, or the securities valuation office of the National Association of Insurance Commissioners, to meet the standards of financial condition and standing that are considered necessary and appropriate to regulate the quality of financial institutions whose letters of credit will be acceptable to the commissioner.

(6) Reinsurance intermediary means a reinsurance intermediary broker or a reinsurance intermediary manager as these terms are defined in subsections (7) and (8) of this section, but shall not mean an intermediary in an insurance securitization or reinsurance transaction with a protected cell established by a protected cell company organized under the Protected Cell Companies Act, chapter 64 of this title, as those terms are defined or utilized in that act.

(7) Reinsurance intermediary broker (RB) means any person, other than an officer or employee of the ceding insurer, firm, association, or corporation who or that solicits, negotiates, or places reinsurance cessions or retrocessions on behalf of a ceding insurer without the authority or power to bind reinsurance on behalf of the insurer.

(8) Reinsurance intermediary manager (RM) means any person, firm, association, or corporation who or that has authority to bind or manages all or part of the assumed reinsurance business of a reinsurer, including the management of a separate division, department, or underwriting office, and acts as an agent for the reinsurer which is known as a RM, manager, or other similar term. Notwithstanding this definition, the following persons shall not be considered a RM, with respect to the reinsurer, for the purposes of this chapter:

(i) Any employee of the reinsurer;

(ii) A U.S. manager of the United States branch of an alien reinsurer;

(iii) An underwriting manager which, pursuant to contract, manages all the reinsurance operations of the reinsurer, is under common control with the reinsurer, subject to the Insurance Holding Company Systems Act, chapter 35 of this title, and whose compensation is not based on the volume of premiums written;

(iv) The manager of a group, association, pool, or organization of insurers who or that engage in joint underwriting or joint reinsurance and who or that are subject to examination by the insurance commissioner of the state in which the managers principal business office is located.

(9) Reinsurer means any person, firm, association, or corporation duly licensed in this state pursuant to the applicable provisions of this title as an insurer with the authority to assume reinsurance.

(10) To be in violation means that the reinsurance intermediary, insurer, or reinsurer for whom the reinsurance intermediary was acting failed to substantially comply with the provisions of this chapter.
R.I. Gen. Laws § 27-17-6 — RI Code / Title 27 / Chapter 27-17 / Section 27-17-6
§ 27-17-6. Certificate of authority to do business.
Status: in_force

If it shall appear upon examination by the commissioner that an exchange or interinsurer has complied with all of the requirements of this chapter and that the persons holding positions of executive and managerial authority are of good repute and will conduct the affairs of the exchange with safety to the public and its policyholders, the commissioner shall issue a certificate stating that the exchange or interinsurer has complied with all of the requirements of this chapter which shall authorize the exchange or interinsurer to transact the kind of business specifically provided in the certificate. The certificate shall expire on the first day of April of the following year, and shall be renewed every year as of the first day of April of that year. The commissioner may, after a hearing, revoke or suspend any certificate of authority issued pursuant to this section, in the case of violation of any of the provisions of this chapter, after reasonable notice of the hearing has been given to the attorney in fact in writing, which notice shall be sufficiently adequate to allow the attorney in fact to appear and show cause why the action should not be taken.
R.I. Gen. Laws § 27-8-12 — RI Code / Title 27 / Chapter 27-8 / Section 27-8-12
§ 27-8-12. Subrogation  Payment to insured of deductible.
Status: in_force

Whenever, through subrogation, an insurance company or its agent collects a casualty loss from a third party, that company or agent shall, from the funds collected, first pay to the insured the deductible portion of the casualty loss less the prorated share of subrogation expenses and only after this retain any funds in excess of the deductible portion of the recovery.
R.I. Gen. Laws § 27-20-68 — RI Code / Title 27 / Chapter 27-20 / Section 27-20-68
§ 27-20-68. Consumer notification.
Status: in_force

Every nonprofit medical service corporation providing dental benefits to subscribers shall include on the identification card provided to its subscribers on the front of the cards the following language when the underlying plan contains a nonduplication of benefits clause: NO DUPLICATION OF BENEFITS.
R.I. Gen. Laws § 27-4-27 — RI Code / Title 27 / Chapter 27-4 / Section 27-4-27
§ 27-4-27. Insurable interest.
Status: in_force

(a) Any individual of competent legal capacity may procure or effect an insurance contract upon the individuals life or body for the benefit of any person. Any life insurance company doing business within the state may issue policies of insurance predicated upon the life or lives of any person or persons with the consent of the insured, payable at maturity to any educational, religious, benevolent, or charitable corporation or association that can legally take and receive testamentary legacies and that are exempt from taxation under 26 U.S.C. § 501(c), irrespective of a financial interest on the part of the corporation in the life of the person or persons insured. No person shall procure or cause to be procured any insurance contract upon the life or body of another individual unless the benefits under the contract are payable to the individual insured or the individual insureds personal representatives, or to a person having, at the time when the contract was made, an insurable interest in the individual insured.

(b) If the beneficiary, assignee, or other payee under any contract made in violation of this section receives from the insurer any benefits under that contract accruing upon the death, disablement, or injury of the individual insured, the individual insured or the individual insureds executor or administrator may maintain an action to recover the benefits from the person so receiving them.

(c) Insurable interest as to personal insurance means that every individual has an insurable interest in the life, body, and health of himself or herself and of other persons as follows:

(1) In the case of individuals related closely by blood or by law, a substantial interest engendered by love and affection;

(2) In the case of other persons, a lawful and substantial economic interest in having the life, health, or bodily safety of the individual insured continue, as distinguished from an interest that would arise only by, or would be enhanced in value by the death, disablement, or injury of the individual insured;

(3) In the case of employees of public and private corporations, with respect to whom the corporate employer or an employer-sponsored trust is the beneficiary under the insurance contract, a lawful and substantial economic interest exists in:

(i) Key employees; and

(ii) Employees other than those identified in subsection (c)(3)(i), and former employees and retirees for the purpose of funding, in the aggregate, all or part of the corporations cost for pre-retirement and post-retirement benefits; provided, (A) That the amount of insurance coverage on these employees will be limited to an amount commensurate with employer-provided benefits to those employees; (B) That an insurance program used to finance these employee benefits includes former employees, retirees, or a broad class of employees selected by objective standards related to age, service, sex, or category of employment; and (C) That the proceeds created by that insurance program are used for the sole purpose of funding the corporations pre-retirement or post-retirement benefit programs; and

(4) An individual party to a contract or option for the purchase or sale of an interest in a business, partnership, or firm or of shares of stock of a corporation or of an interest in the shares, has an insurable interest in the life of each individual party to the contract and for the purposes of the contract only, in addition to any insurable interest that may exist as to the life of that individual.

(d) Insurance effectuated under a group life insurance policy pursuant to the program described in subsection (c)(3)(ii) need not comply with the provisions of § 27-4-22 to the extent the provisions of that section would be inconsistent or would conflict with the purposes expressed in subsection (c)(3)(ii).

(e) An insurer shall be entitled to rely upon all statements, declarations, and representations made by an applicant for insurance relative to insurable interest of the applicant in the insured, and no insurer shall incur legal liability except as set forth in the policy by virtue of any untrue statements, declarations, or representations relied upon in good faith by the insurer.
R.I. Gen. Laws § 27-7-7 — RI Code / Title 27 / Chapter 27-7 / Section 27-7-7
§ 27-7-7. Written notice to claimants of payment of claim in settlements.
Status: in_force

Upon payment of five thousand dollars ($5,000) or more in settlement of any liability claim, the insurer shall cause written notice of the payment to be mailed to the claimant, at the same time payment is made by the insurer or its representative, including the insurers attorney, to the claimants attorney or other representative of the claimant by draft, check, or otherwise.
R.I. Gen. Laws § 27-19-4 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-4
§ 27-19-4. Certificate of public convenience and advantage.
Status: in_force

No articles of association of a nonprofit hospital service corporation shall be filed in the office of the secretary of state unless and until the insurance commissioner has certified in writing upon those articles that he or she has determined that public convenience and advantage will be promoted by the establishment of the corporation.
R.I. Gen. Laws § 27-18-79 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-79
§ 27-18-79. Discretionary clauses.
Status: in_force

(a) No new or existing policy or certificate issued by an insurer or healthcare entity may contain any provision:

(1) Purporting to reserve sole discretion to the insurer or healthcare entity to determine eligibility for benefits or interpret the terms of a policy or certificate; or

(2) Specifying or affecting a standard of review upon which a court may review denial of a claim or any other decision made by an insurance company with respect to a policyholder or certificate holder.

(b) For purposes of this section, healthcare entity means a health insurance company or nonprofit hospital or medical or dental service corporation or plan or health maintenance organization that operates or administers a health plan in this state.

(c) Any such clause or language included in a contract, policy, or certificate issued to or covering a resident of this state that is contrary to or inconsistent with the provisions of this section is void and unenforceable.

(d) Nothing in this section prohibits an insurer from including a provision in a contract that informs an insured that as part of its routine operations the insurer applies the terms of its contracts for making decisions, including making determinations regarding eligibility, receipt of benefits and claims, or explaining policies, procedures, and processes, so long as the provision could not give rise to a deferential standard of review by any reviewing court.
R.I. Gen. Laws § 27-19-60 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-60
§ 27-19-60. Licensed ambulance service.
Status: in_force

(a) No individual or group health insurance contract, plan, or policy delivered, issued for delivery, or renewed in this state on or after January 1, 2009, shall provide for a copayment for ground ambulance services in excess of fifty dollars ($50.00).

(b) As used in this section, the term ground ambulance services shall mean those services provided by an ambulance service licensed to operate in Rhode Island in accordance with § 23-4.1-6. The term excludes air and water ambulance services and ambulance services provided outside of Rhode Island.

(c) This section shall not apply to insurance coverage providing benefits for: (1) Hospital confinement indemnity; (2) Disability income; (3) Accident only; (4) Long-term care; (5) Medicare supplement; (6) Limited benefit health; (7) Specified disease indemnity; (8) Sickness or bodily injury or death by accident, or both; and (9) Other limited benefit policies.
R.I. Gen. Laws § 27-58-13 — RI Code / Title 27 / Chapter 27-58 / Section 27-58-13
§ 27-58-13. Penalties.
Status: in_force

Any person who violates the provisions of this chapter, or who fails to perform any duties imposed by this chapter, or who violates any administrative regulation promulgated pursuant to this chapter shall be liable for a civil penalty not to exceed the sum of one hundred dollars ($100) for each day the violation continues, and in addition, may be concurrently enjoined from any further violations by the superior court upon petition of the insurance commissioner.
R.I. Gen. Laws § 27-25-5 — RI Code / Title 27 / Chapter 27-25 / Section 27-25-5
§ 27-25-5. Purposes and powers.
Status: in_force

(a) A society shall operate for the benefit of members and their beneficiaries by:

(1) Providing benefits as specified in § 27-25-16; and

(2)(i) Operating for one or more social, intellectual, educational, charitable, benevolent, moral, fraternal, patriotic, or religious purposes for the benefit of its members, which may also be extended to others;

(ii) These purposes may be carried out directly by the society, or indirectly through subsidiary corporations or affiliate organizations.

(b) Every society shall have the power to adopt laws and rules for the government of the society, the admission of its members, and the management of its affairs. It shall have the power to change, alter, add to, or amend those laws and rules, and shall have any other powers as are necessary and incidental to carrying into effect the objects and purposes of the society.
R.I. Gen. Laws § 27-41-85 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-85
§ 27-41-85. Consumer notification.
Status: in_force

Every health maintenance organization providing dental benefits to subscribers shall include on the identification card provided to its subscribers on the front of the cards the following language when the underlying plan contains a nonduplication of benefits clause: NO DUPLICATION OF BENEFITS.
R.I. Gen. Laws § 27-58-7 — RI Code / Title 27 / Chapter 27-58 / Section 27-58-7
§ 27-58-7. Disclosures.
Status: in_force

(a) A financial institution shall prominently disclose in writing, in clear and concise language, to the institutions customers, including in any advertisement or promotional material, pursuant to regulations prescribed by the commissioner, that insurance offered, recommended, sponsored, or sold by the financial institution:

(1) Is not a deposit;

(2) Is not insured by the Federal Deposit Insurance Corporation;

(3) Is not guaranteed by the financial institution or an affiliated insured depository institution; and

(4) Where appropriate, involves investment risk, including potential loss of principal.

(b) A financial institution, for any loan for which insurance is required, shall disclose in writing to the institutions customers, in clear and concise language prior to the signing of a loan or mortgage application, that by law the purchase of insurance from that financial institution cannot be required as a condition of loan or mortgage approval.
R.I. Gen. Laws § 27-76-1 — RI Code / Title 27 / Chapter 27-76 / Section 27-76-1
§ 27-76-1. Applicability.
Status: in_force

Except for the provisions of § 27-76-6, the provisions of this chapter shall be applicable only to personal lines residential property insurance on dwelling houses.
R.I. Gen. Laws § 27-76-3 — RI Code / Title 27 / Chapter 27-76 / Section 27-76-3
§ 27-76-3. Residential property insurance hurricane deductible application.
Status: in_force

(a) For all deductibles as provided for in § 27-76-2, the deductible may only be applied once to all hurricane losses that are subject to the hurricane deductible during the calendar year.

(b) If an insured incurs a hurricane loss from more than one hurricane during a calendar year that are subject to the separate deductible referred to in subsection (a), the insurer may apply the deductible to the succeeding hurricane that is equal to the remaining amount of the separate deductible or the amount of the deductible that applies to all perils other than a hurricane, whichever is greater. Insurers may require policyholders to produce receipts or other records of such losses in order to apply such losses to subsequent hurricane claims.
R.I. Gen. Laws § 27-41-90 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-90
§ 27-41-90. Prohibition on discrimination in organ transplants.
Status: in_force

Pursuant to chapter 95 of title 23, any health maintenance organization that provides coverage for anatomical gifts, organ transplants, or related treatment and services shall not:

(1) Deny coverage to a covered person solely on the basis of the persons disability;

(2) Deny to a patient eligibility, or continued eligibility, to enroll or to renew coverage under the terms of the health benefit plan, solely for the purpose of avoiding the requirements of this section;

(3) Penalize or otherwise reduce or limit the reimbursement of an attending provider, or provide monetary or nonmonetary incentives to an attending provider, to induce the provider to provide care to an insured or enrollee in a manner inconsistent with this section; or

(4) Reduce or limit coverage benefits to a patient for the medical services or other services related to organ transplantation performed pursuant to this section as determined in consultation with the attending physician and patient.
R.I. Gen. Laws § 27-64-11 — RI Code / Title 27 / Chapter 27-64 / Section 27-64-11
§ 27-64-11. No transaction of insurance business.
Status: in_force

A protected cell company insurance securitization shall not be deemed to be an insurance or reinsurance contract. An investor in a protected cell company insurance securitization shall not, by sole means of this investment, be deemed to be transacting an insurance business in this state. The underwriters or selling agents (and their partners, directors, officers, members, managers, employees, agents, representatives and advisors) involved in a protected cell company insurance securitization shall not be deemed to be conducting an insurance or reinsurance agency, brokerage, intermediary, advisory or consulting business by virtue of their activities in connection with those businesses.
R.I. Gen. Laws § 27-19-74 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-74
§ 27-19-74. Healthcare provider credentialing.
Status: repealed

(a) For applications received on or after January 1, 2018, a healthcare entity or health plan operating in the state shall be required to issue a decision regarding the credentialing of a healthcare provider as soon as practicable, but no later than forty-five (45) calendar days after the date of receipt of a complete credentialing application.

(b) For minor changes to the demographic information of an individual healthcare provider who is already credentialed with a particular healthcare entity or health plan, such healthcare entity or health plan shall complete such change within seven (7) business days of receipt of the healthcare providers request. Minor changes to demographic information requested by individual providers shall be submitted in the timeframe, and manner required by the healthcare entity or health plan, and shall include all supporting documentation required by the particular healthcare entity or health plan. For purposes of this section, minor changes to the information profile of a healthcare provider shall include, but not be limited to, changes of address and changes to a healthcare providers tax identification number.

(c) Each healthcare entity or health plan shall establish a written standard defining what elements constitute a complete credentialing application and shall distribute this standard with the written version of the credentialing application and make such standard available on the healthcare entitys or health plans website.

(d) Each healthcare entity or health plan shall respond to inquiries by the applicant regarding the status of an application.

(1) Each healthcare entity or health plan shall provide the applicant with automated application status updates, at least once every fifteen (15) calendar days, informing the applicant of any missing application materials until the application is deemed complete;

(2) Each healthcare entity or health plan shall inform the applicant within five (5) business days that the credentialing application is complete; and

(3) If the healthcare entity or health plan denies a credentialing application, the healthcare entity or health plan shall notify the healthcare provider in writing and shall provide the healthcare provider with any and all reasons for denying the credentialing application.

(e) The effective date for billing privileges for healthcare providers under a particular healthcare entity or health plan shall be the next business day following the date of approval of the credentialing application.

(f) For applications received from resident graduates on or after January 1, 2018, a healthcare entity or health plan shall offer a transitional or conditional approval process such that a resident graduate who has submitted an otherwise complete application and met all other criteria, may be conditionally approved, effective upon successful graduation from the training program.

(g) For the purposes of this section, the following definitions apply:

(1) Complete credentialing application means all the requested material has been submitted.

(2) Date of receipt means the date the healthcare entity or health plan receives the completed credentialing application whether via electronic submission or as a paper application.

(3) Healthcare entity means a licensed insurance company or nonprofit hospital or medical or dental service corporation or plan or health maintenance organization, or a contractor as defined in § 23-17.13-2 [repealed] that operates a health plan.

(4) Healthcare provider means a healthcare professional.

(5) Health plan means a plan operated by a healthcare entity that provides for the delivery of healthcare services to persons enrolled in those plans through:

(i) Arrangements with selected providers to furnish healthcare services; and

(ii) Financial incentives for persons enrolled in the plan to use the participating providers and procedures provided for by the health plan.
R.I. Gen. Laws § 27-51-6 — RI Code / Title 27 / Chapter 27-51 / Section 27-51-6
§ 27-51-6. Examination authority.
Status: in_force

The acts of the MGA are considered to be the acts of the insurer on whose behalf it is acting. An MGA may be examined as if it was the insurer and cost of examination will be borne by the insurer pursuant to § 27-13-1.
R.I. Gen. Laws § 27-41-58 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-58
§ 27-41-58. Prohibition against requiring indemnification from dentists.
Status: in_force

No contract between a health maintenance organization (HMO) and a dentist containing provisions for the provision of services to patients may require that the dentist indemnify or hold harmless the health maintenance organization for any expenses and liabilities, including, without limitation, judgments, settlements, attorneys fees, court costs, and any associated charges, incurred in connection with any claim or action brought against the HMO based on the HMOs management decisions, or utilization review provisions for any patient.
R.I. Gen. Laws § 27-43-8 — RI Code / Title 27 / Chapter 27-43 / Section 27-43-8
§ 27-43-8. Exemption from chapter 34 of this title.
Status: in_force

No captive insurance company shall be required to join or to contribute financially to any plan, pool, association, or guaranty or insolvency fund in this state including, but not limited to, the fund established by chapter 34 of this title, nor shall any captive insurance company, or its insured, or its parent or any affiliated company, or any member organization of its association, receive any benefit from the plan, pool, association, or guaranty or insolvency funds for claims arising out of the operations of the captive insurance company.
R.I. Gen. Laws § 27-20-38 — RI Code / Title 27 / Chapter 27-20 / Section 27-20-38
§ 27-20-38. Restricted annual rate payments prohibited.
Status: in_force

(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 method of payment that sets, as all or part of its payment scheme, a total payment limit for mental health and/or substance abuse treatment services for each person seeking treatment based on a per person per unit of time criterion that disregards the extent of treatment and/or degree of services rendered.

(c) This prohibition shall not be construed to prohibit or limit capitation or other risk-sharing agreements between providers and insurers permissible by law.
R.I. Gen. Laws § 27-1-15 — RI Code / Title 27 / Chapter 27-1 / Section 27-1-15
§ 27-1-15. Collection and distribution of assets by receiver  Reinsurance.
Status: in_force

The receiver may take evidence and property into the receivers possession and shall collect the debts, dispose of the property, and pay out of the proceeds of the disposition, if the proceeds are sufficient, all of the debts of the corporation, first reserving to the receiver a reasonable compensation that shall be allowed by the court for the receivers services; provided, the receiver may reinsure, upon the written consent of the insurance commissioner and the attorney general, all the policy obligations of the corporation in any solvent corporation authorized to do business in this state, if the assets of the corporation of which he or she is a receiver are sufficient to effect the reinsurance. If the assets are insufficient for that purpose, the receiver, upon the written consent of the insurance commissioner and the attorney general, may reinsure a percentage of each policy obligation of the corporation outstanding to the extent that its assets may be sufficient for that purpose. No contract of reinsurance shall be entered into by the receiver except in pursuance of an order of the court in which the receiver was appointed directing the reinsurance and establishing the general form of the contract for the reinsurance.
R.I. Gen. Laws § 27-81-2 — RI Code / Title 27 / Chapter 27-81 / Section 27-81-2
§ 27-81-2. Purpose.
Status: in_force

The general assembly hereby finds and declares that:

(1) The advancements and continued development of medical and communications technology have had a profound impact on the practice of medicine and offer opportunities for improving the delivery, cost, and accessibility of health care, particularly in the area of telemedicine.

(2) Geography, weather, availability of specialists, transportation, and other factors can create barriers to accessing the appropriate health care, including behavioral health care, and one way to provide, ensure, or enhance access to health care given these barriers is through the appropriate use of technology to allow healthcare consumers access to qualified healthcare providers.

(3) There is a need in this state to embrace efforts that will encourage health insurers and healthcare providers to support the use of telemedicine, and that will also encourage all state agencies to evaluate and amend their policies and rules to remove any regulatory barriers prohibiting the use of telemedicine services.
R.I. Gen. Laws § 27-19-30 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-30
§ 27-19-30. Regulations.
Status: in_force

The director of the department of business regulation may adopt reasonable rules and regulations for the implementation and administration of the provisions of this chapter.
R.I. Gen. Laws § 27-54-4 — RI Code / Title 27 / Chapter 27-54 / Section 27-54-4
§ 27-54-4. Duty to notify.
Status: in_force

(a) Whenever an officer or director of an insurance company knows that a material false statement or representation has been made to the director, or the directors designee, or that false testimony has been given, or that a material false entry has been made in the books of the insurance company, or that the assets, property, or securities of an insurance company have been materially overvalued, or that material information has been withheld from the director, or the directors designee, in violation of § 27-54-1, he or she shall notify the director, or the directors designee, of those matters as soon as reasonably possible but in no event later than ten (10) days after the officer or director knows or has reasons to know of those matters. Failure to report as such will subject the violator to a fine of up to one thousand dollars ($1,000) and imprisonment of up to one year, or both.

(b) The director, or the directors designee, shall review each report and undertake any further investigations he or she deems necessary and proper to determine the validity of the allegations.
R.I. Gen. Laws § 27-19-87 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-87
§ 27-19-87. Acute mental health crisis mobile response and stabilization services. [Effective January 1, 2026.]
Status: in_force

(a) As used in this section, mobile response and stabilization services means a behavioral health crisis intervention system providing immediate de-escalation, stabilization services, and follow-up care, provided by a certified provider. These services are delivered to provide rapid response to, assessment of, and early intervention for a child or youth eighteen (18) years of age and younger experiencing an acute mental health crisis. Symptoms might include, but are not limited to:

(1) Aggression;

(2) Self-injury;

(3) Trauma;

(4) Acute depression/anxiety;

(5) Challenges at school; Suicidal or homicidal thoughts/behaviors; and

(6) Extreme parent/child conflict.

Mobile response and stabilization services are provided by certified providers meaning licensed behavioral health organizations providing outpatient services, which have demonstrated expertise in delivering child-specific mobile response and stabilization services, and have obtained relevant state licensure or certification.

(b) Every individual or group health insurance contract, or every individual or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state on or after January 1, 2026, shall provide coverage for mobile response and stabilization services, consistent with the core components of the mobile crisis model, and in accordance with the insurers existing reimbursement, credentialing, and contracting processes, provided any utilization review processes do not limit timely access or fidelity to the model.

(c) This section shall not apply to insurance coverage providing benefits for:

(1) Hospital confinement indemnity;

(2) Disability income;

(3) Accident only;

(4) Long-term care;

(5) Medicare supplement;

(6) Limited benefit health;

(7) Specified disease indemnity;

(8) Sickness or bodily injury or death by accident or both; and

(9) Other limited benefit policies.
R.I. Gen. Laws § 27-5-9 — RI Code / Title 27 / Chapter 27-5 / Section 27-5-9
§ 27-5-9. Standard form not required for reinsurance.
Status: in_force

The standard fire insurance policy provided for in this chapter need not be used for effecting reinsurance between insurers.
R.I. Gen. Laws § 27-25-44 — RI Code / Title 27 / Chapter 27-25 / Section 27-25-44
§ 27-25-44. Fraternal benefit society assessment.
Status: in_force

(a) Notwithstanding any other provisions of law, each domestic fraternal benefit society shall be charged an assessment to partially support the activities of the division of insurance in the department of business regulation.

(b) Each societys assessment shall be determined in accordance with the following ratio: (1) By dividing the societys total direct premiums, including annuities, less policyholder dividends by total direct premiums, including annuities, less policyholder dividends of all domestic insurance companies plus the total direct premiums of domestic companies licensed or regulated pursuant to chapters 19, 20, 20.1, 20.2, 20.3, 25, and 41 of this title, and chapter 62 of title 42, and then by (2) Multiplying the resulting ratio times two hundred thousand dollars ($200,000).

(c) The minimum assessment charged shall be the greater of the sum determined by subsection (b) of this section or one thousand dollars ($1,000).
R.I. Gen. Laws § 27-10-8 — RI Code / Title 27 / Chapter 27-10 / Section 27-10-8
§ 27-10-8. Emergency licenses.
Status: in_force

(a) In the event of a declared catastrophe, an insurer shall notify the department, via an application for temporary emergency licensure, of each individual, not already licensed in the state where the catastrophe has been declared, who will act as an emergency company or independent adjuster on behalf of the insurer.

(b) A person who is otherwise qualified to adjust claims, but not already licensed in this state where the catastrophe has been declared, may act as an emergency company or independent adjuster and adjust claims, if, within five (5) days of deployment to adjust claims arising from the declared catastrophe, the insurer notifies the department by providing the following information in a format prescribed by the insurance commissioner:

(1) Name of the individual;

(2) Social security number of individual;

(3) Name of insurer the company or independent adjuster will represent;

(4) Effective date of the contract between the insurer and company or independent adjuster, if applicable;

(5) Catastrophe or loss control number;

(6) Catastrophe event name; and

(7) Other information the department deems necessary.

(c) An emergency company or independent adjusters license shall remain in force for a period not to exceed ninety (90) days, unless extended by the department.

(d) Any person licensed as an emergency company or independent adjuster must comply with all laws of this state in the same manner as if he or she had been issued a company or independent adjuster and both he or she and the insurer for whom the adjuster is working are responsible in the same manner as they would be if the adjuster was a fully licensed adjuster.

(e) There is no fee payable to the state for the licensing of the emergency adjuster. However, in order to assist in the performance of the departments duties, the department may contract with nongovernmental entities, including the NAIC, its affiliates or subsidiaries, to perform any ministerial functions related to licensing that the department may deem appropriate and the applicant is responsible for the fee associated with these services as determined by the department.

(f) Public adjusters are not eligible for licensing under this section.
R.I. Gen. Laws § 27-41-39 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-39
§ 27-41-39. Certified registered nurse practitioners and psychiatric and mental health nurse clinical specialists.
Status: in_force

(a) Every individual or group policy or contract delivered, issued for delivery, or renewed by a health maintenance organization in this state shall provide coverage for the services of certified registered nurse practitioners, practicing collaboratively, and psychiatric and mental health nurse clinical specialists to subscribers, if those services are within the certified registered nurse practitioners or psychiatric and mental health nurse clinical specialists area of professional competence as established by education and certification, and are currently reimbursed when rendered by any other healthcare provider. No health maintenance organization may be required to pay for duplicative services actually rendered by a certified nurse practitioner and any other healthcare provider.

(b) Nothing in this chapter shall preclude the conducting of managed care reviews and medical necessity reviews by an insurer or hospital or medical service corporation or health maintenance organization.

(c) Every individual or group policy or contract delivered, issued for delivery, or renewed by a health maintenance organization in this state shall provide coverage for certified registered nurse practitioners to provide primary care, intermediate, home, long-term, and inpatient care as primary care providers, when the certified registered nurse practitioner is a participating provider, consistent with, and practicing within, the scope of his or her professional license.

(d) Notwithstanding any law to the contrary, all insurers, nonprofit medical service corporations, nonprofit hospital service corporations, and health maintenance organizations shall provide subscribers with an opportunity to select a certified registered nurse practitioner, who is a participating provider, as a primary care provider.

(e) Notwithstanding any law to the contrary, all insurers, nonprofit medical service corporations, nonprofit hospital service corporations, and health maintenance organizations shall insure that all participating primary care provider certified registered nurse practitioners are included on any publicly accessible list of participating providers for the respective organization.
R.I. Gen. Laws § 27-59-3 — RI Code / Title 27 / Chapter 27-59 / Section 27-59-3
§ 27-59-3. Approval of the commissioner.
Status: in_force

The commissioner in determining whether to approve an alien insurance company may consider:

(1) Maintenance of an appropriate trust account, surplus account, or other financial mechanisms in this state;

(2) Maintenance of all books and records of the United States operations in this state;

(3) Maintenance of a separate financial reporting system for its United States operations; and

(4) Any other provisions deemed necessary by the insurance commissioner.
R.I. Gen. Laws § 27-18-8.2 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-8.2
§ 27-18-8.2. Notice of disapproval.
Status: in_force

If within the waiting period the commissioner finds that a filing does not meet the requirements of this chapter, the commissioner shall send to the insurer that made the filing written notice of disapproval of the filing, specifying in the notice in what respects the commissioner finds that the filing fails to meet the requirements of this chapter, and stating that the filing is disapproved.
R.I. Gen. Laws § 27-48-2 — RI Code / Title 27 / Chapter 27-48 / Section 27-48-2
§ 27-48-2. Definitions.
Status: in_force

As used in this chapter:

(1) Accredited state means a state in which the insurance department or regulatory agency has qualified as meeting the minimum financial regulatory standards promulgated and established from time to time by the National Association of Insurance Commissioners (NAIC).

(2) Control or controlled has the meaning ascribed in § 27-35-1.

(3) Controlled insurer means a licensed insurer that is controlled, directly or indirectly, by a producer.

(4) Controlling producer means a producer who, directly or indirectly, controls an insurer.

(5) Director means the director of the department of business regulation, or the director's designee.

(6) Licensed insurer or insurer means any person, firm, association, or corporation duly licensed to transact a property or casualty insurance business in this state. The following, inter alia, are not licensed insurers for the purposes of this chapter:

(i) All risk retention groups as defined in the Risk Retention Act, 15 U.S.C. § 3901 et seq., and chapter 46 of this title;

(ii) All residual market pools and joint underwriting authorities or associations; and

(iii) All captive insurers; for the purposes of this chapter, captive insurers means insurance companies owned by another organization whose exclusive purpose is to insure risks of the parent organization and affiliated companies or, in the case of groups and associations, insurance organizations owned by the insured whose exclusive purpose is to insure risks to member organizations and/or group members and their affiliates.

(7) Producer means an insurance broker or brokers or any other person, firm, association, or corporation, when, for any compensation, commission, or other thing of value, that person, firm, association, or corporation acts or aids in any manner in soliciting, negotiating, or procuring the making of any insurance contract on behalf of an insured other than the person, firm, association, or corporation.
R.I. Gen. Laws § 27-9-31 — RI Code / Title 27 / Chapter 27-9 / Section 27-9-31
§ 27-9-31. Documents filed by advisory organizations.
Status: in_force

Every advisory organization shall file with the commissioner:

(1) A copy of its constitution, articles of agreement or association, or certificate of incorporation, and bylaws, rules, and regulations governing its activities;

(2) A list of its members;

(3) The name and address of a resident of this state upon whom notices or orders of the commissioner or process issued at the commissioners direction may be served; and

(4) An agreement that the commissioner may examine that advisory organization in accordance with the provisions of §§ 27-9-36 and 27-9-37.
R.I. Gen. Laws § 27-33-8 — RI Code / Title 27 / Chapter 27-33 / Section 27-33-8
§ 27-33-8. Insolvency.
Status: in_force

In the event any insurer fails, by reason of insolvency, to pay any assessment, the fund shall cause the reimbursement ratios, computed under § 27-33-6, to be immediately recalculated, excluding from them the insolvent insurer, so that its assessment is in effect, assumed, and redistributed among the remaining insurers.
R.I. Gen. Laws § 27-16-2.3 — RI Code / Title 27 / Chapter 27-16 / Section 27-16-2.3
§ 27-16-2.3. Short title.
Status: in_force

Sections 27-16-1.1  27-16-2.6 may be cited as the Uniform Unauthorized Insurers Act.
R.I. Gen. Laws § 27-9-40 — RI Code / Title 27 / Chapter 27-9 / Section 27-9-40
§ 27-9-40. Cooperation with other states.
Status: in_force

In order to further the uniform administration of rate regulatory laws, the commissioner and every insurer and rating organization may exchange information and experience data with insurance supervisory officials, insurers, and rating organizations in other states and may consult and cooperate with them with respect to rate-making and the application of rating systems.
R.I. Gen. Laws § 27-9-5.1 — RI Code / Title 27 / Chapter 27-9 / Section 27-9-5.1
§ 27-9-5.1. Uniform safe driver point system.
Status: in_force

The director of the department of business regulation is authorized and empowered to promulgate rules and regulations regarding a uniform safe driver point system on either a flat dollar rate or on a percentage rate for motor vehicle accidents and/or motor vehicle convictions without regard to age, sex, or the location of the garaging of the motor vehicle. Those rules shall be promulgated in accordance with the Administrative Procedures Act, chapter 35 of title 42.
R.I. Gen. Laws § 27-77-10 — RI Code / Title 27 / Chapter 27-77 / Section 27-77-10
§ 27-77-10. Severability clause.
Status: in_force

If any provision of this chapter, or the application thereof to any person or circumstance, is held invalid, such determination shall not affect the provisions or applications of this chapter which can be given effect without the invalid provision or application, and to that end the provisions of this chapter are severable.
R.I. Gen. Laws § 27-52-10 — RI Code / Title 27 / Chapter 27-52 / Section 27-52-10
§ 27-52-10. Examination authority.
Status: in_force

(a) A reinsurance intermediary shall be subject to examination by the commissioner. The commissioner shall have access to all books, bank accounts, and records of the reinsurance intermediary in a form usable to the commissioner. The cost of the examination shall be paid by the insurer in the same manner as the cost of examination of an insurer pursuant to chapter 13 of this title.

(b) A RM may be examined as if it were the reinsurer.
R.I. Gen. Laws § 27-41-46 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-46
§ 27-41-46. Whistleblowers protection.
Status: in_force

No health maintenance organizations pursuant to this chapter or any other insurer offering and/or insuring health services on a prepaid basis as defined in § 42-62-4(7) shall engage in any retaliation or retribution, directly or indirectly, or shall terminate or modify the terms of a medical service agreement that it maintains with a physician or other medical services provider because the physician or other provider reports or is about to report verbally or in writing, to a public body, a regulatory agency, a subscriber or member of the insured, the family or heirs or personal representative of the subscriber or member, or to any other person or public or private agency a violation by the insurer of a subscriber or membership agreement, a law, rule, or regulation promulgated under the laws of this state.
R.I. Gen. Laws § 27-20-71 — RI Code / Title 27 / Chapter 27-20 / Section 27-20-71
§ 27-20-71. Unfair discrimination prohibited.
Status: repealed

Notwithstanding any provision of any policy of insurance, certificate, or service contract issued in this state, whenever the insurance policy, certificate, or service contract provides for reimbursement for any services that may be legally performed by any person licensed under the provisions of chapters 29, 30, 35 [repealed], and 37 of title 5, reimbursement under the insurance policy, certificate, or service contract shall be based upon a determination of medical necessity and shall not be denied because of race, color, or creed, nor shall any insurer make or permit any unfair discrimination against particular individuals or persons licensed under chapters 29, 30, 35 [repealed], and 37 of title 5.
R.I. Gen. Laws § 27-4-24.2 — RI Code / Title 27 / Chapter 27-4 / Section 27-4-24.2
§ 27-4-24.2. Notice of disapproval.
Status: in_force

If within the waiting period or any extension of it as provided in § 27-4-24.1 the commissioner finds that a filing does not meet the requirements of this chapter, the commissioner shall send to the insurer or organization which made that filing written notice of disapproval of that filing specifying in the notice in what respects the commissioner finds that filing fails to meet the requirements of this chapter and stating that the filing shall not become effective.
R.I. Gen. Laws § 27-6-27 — RI Code / Title 27 / Chapter 27-6 / Section 27-6-27
§ 27-6-27. Examination of policies and records by rating organizations.
Status: in_force

Any rating organization may provide for the examination of policies, daily reports, binders, renewal certificates, endorsements, or other evidences of insurance, or the cancellation of insurance, and may make reasonable rules governing their submission. Those rules shall contain a provision that in the event any insurer does not within sixty (60) days furnish satisfactory evidence to the rating organization of the correction of any error or omission previously called to its attention by the rating organization, it shall be the duty of the rating organization to notify the commissioner. All information submitted for examination shall be confidential.
R.I. Gen. Laws § 27-76-2 — RI Code / Title 27 / Chapter 27-76 / Section 27-76-2
§ 27-76-2. Hurricane deductibles, triggers, and policyholder notice.
Status: in_force

(a) The provisions of this section shall be applicable to policies issuing or renewing on or after July 1, 2008.

(b) In all instances where an insurance company licensed to do business in this state offers or includes any deductible and/or mitigation measure related to the deductible for any type of personal lines residential property insurance on dwelling houses, the insurance company shall provide prominent and clear notice to insureds that shall be included in the policy issuance or renewal package and shall fully disclose all details pertaining to any such deductible and/or mitigation measure.

(c) The insurer may apply a deductible specific to windstorm coverage where:

(1) The deductible is specifically approved by the director and shall not exceed five percent (5%) of the insured value.

(2) The deductible shall be applicable to losses due to a hurricane during the period commencing with the issuance of a hurricane-warning bulletin for any part of the state by the National Hurricane Center and concluding twenty-four (24) hours after the termination of the last hurricane warning bulletin for any part of the state.

(3) The deductible, whether it is a flat dollar deductible or a percentage deductible, shall be presented by at least two (2) examples that illustrate the application of the deductible to the insured. Nothing herein shall prohibit the insurer from providing any additional information to the insured to assist in the insureds understanding of the deductible to be applied to the insureds policy.

(4) The deductible set forth above shall not be applied to any insured, if the insured has installed approved mitigation measures to protect against windstorm damage and the insurer has either inspected the property or the insured has submitted satisfactory proof of installation of the approved mitigation measures. The insurance commissioner, in consultation with the state building code commissioner, shall adopt and may amend or revise a list of mitigation measures, based so far as reasonably feasible on national standards for such measures and practices in other comparable states. The list of mitigation measures adopted by the insurance commissioner shall be considered approved mitigation measures for purposes of this subsection (c)(4).

(5) For the application of the hurricane deductible on Block Island, losses are due to a hurricane when a hurricane results in hurricane force sustained winds as reported by the National Weather Service for Block Island. For the application of the hurricane deductible in the remainder of the state, losses are due to a hurricane when a hurricane results in hurricane force sustained winds as reported by the National Weather Service for any other location in the state. All terms are as defined by the National Weather Service.

(d) Premium credits shall be applied to policies with deductibles as set forth in subsection (c) of this section.

(e)(1) An insurer may require mitigation measures to protect against windstorm damage only after specific approval of the substance of such mitigation measures by the director;

(2) Mitigation measures to be taken by an insured are clearly explained, including a complete illustration of the dollar impact upon the premiums to be charged to insureds if the requested mitigation activities are undertaken;

(3) No mandatory deductible for windstorm damage shall be included in the policy;

(4) An insurer shall write the requested coverage at the premium rate that includes the premium credit to be realized with the completion of the mitigation efforts;

(5) The insurer shall affirmatively state the length of time during which discount given for the mitigation efforts will apply; and

(6) No insurer shall subsequently nonrenew an insured who has taken the mitigation steps requested by the insurer for reasons of the insurers exposure to catastrophe loss, unless for nonpayment of premium, fraud, breach by the insured of a provision of the policy, reversal or a lack of maintenance of the mitigation steps, or insurer solvency concerns or adverse loss history.

(f) Penalties for failure to comply with the provisions of this section shall be administered by the director in accordance with the provisions of § 42-14-16.

(g) The department of business regulation shall have authority to adopt rules, including emergency rules, as may be necessary or desirable to effectuate the purposes of this section.
R.I. Gen. Laws § 27-5-8 — RI Code / Title 27 / Chapter 27-5 / Section 27-5-8
§ 27-5-8. Supplemental contract forms.
Status: in_force

Appropriate forms of supplemental contracts or extended coverage endorsements where the interest in the property described in a fire insurance policy shall be insured against one or more of the perils that the insurer is empowered to assume, in addition to the peril covered by the standard fire insurance policy, may be approved by the director of business regulation, and their use in connection with a standard fire insurance policy may be authorized by the director. The first page of the policy may, in a form approved by the director of business regulation, be rearranged to provide space for the listing of amounts of insurance, rates, and premiums for the basic coverages insured under the standard form of policy, and for additional coverages or perils insured under endorsements attached, and any other data that may be conveniently included for duplication on daily reports for office records.
R.I. Gen. Laws § 27-19-46 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-46
§ 27-19-46. Magnetic resonance imaging  Quality assurance standards.
Status: in_force

(a) Except as otherwise provided in subsection (b) of this section, a magnetic resonance imaging examination eligible for reimbursement under the provisions of any individual or group health insurance contract, plan, or policy delivered in this state shall be reimbursed only if the facility at which the examination has been conducted and processed is accredited by either the American College of Radiology (ACR), the Intersocietal Accreditation Commission (IAC), or an alternate nationally recognized accrediting organization whose accreditation standards are substantially similar to and no less stringent than current or subsequent ACR or IAC standards and have been reviewed and deemed adequate by the department of health. All accreditation standards under this section, whether promulgated by the ACR, IAC, or an alternate nationally recognized accrediting organization, shall include, but shall not be limited to: provisions for establishing the qualifications of the physician; standards for quality control and routine performance monitoring by a medical physicist; qualifications of the technologist including minimum standards of supervised clinical experience; personnel and patient safety guidelines; and standards for initial and ongoing quality control using clinical image review and quantitative testing.

(b) Any facility conducting and processing magnetic resonance imaging examinations that as of June 30, 2006, is receiving reimbursement for these services by a health insurer, health maintenance organization, or health plan but is not accredited pursuant to subsection (a), shall file its application for accreditation within eighteen (18) months of June 28, 2007. The accreditation shall be obtained not later than twelve (12) months after submission of its application. A facility that begins conducting and processing of magnetic resonance imaging examinations after June 30, 2006, shall file its application for accreditation within twelve (12) months of the date of initiation of the magnetic resonance imaging examinations. This accreditation shall be obtained not later than twelve (12) months after submission of its application. After this accreditation is obtained, a facility conducting and processing magnetic resonance imaging examinations shall, at all times, maintain accreditation with the appropriate accrediting body. Notwithstanding anything herein to the contrary, any facility that has filed for accreditation pursuant to this subsection (b) and that has not been refused accreditation or withdrawn its application, will be deemed provisionally accredited for the twelve-month (12) period dating from the application filing date. Provided, further, that notwithstanding any provisions of the general or public laws to the contrary, any facility conducting and processing magnetic resonance imaging examinations shall conform to the standards of the appropriate accrediting body at all times, including during the accreditation process, and shall certify said conformance to any reimbursing health insurer, health maintenance organization, or health plan.
R.I. Gen. Laws § 27-42-3 — RI Code / Title 27 / Chapter 27-42 / Section 27-42-3
§ 27-42-3. How to show jurisdiction.
Status: in_force

A person or entity may show that it is subject to the jurisdiction of another department of this state, any subdivision of this state, or the federal government, by providing to the director of business regulation the appropriate certificate, license, or other document issued by the other governmental agency that permits or qualifies it to provide those services.
R.I. Gen. Laws § 27-77-3 — RI Code / Title 27 / Chapter 27-77 / Section 27-77-3
§ 27-77-3. Risk management framework.
Status: in_force

An insurer shall maintain a risk management framework to assist the insurer with identifying, assessing, monitoring, managing, and reporting on its material and relevant risks. This requirement may be satisfied if the insurance group of which the insurer is a member maintains a risk management framework applicable to the operations of the insurer.
R.I. Gen. Laws § 27-67-3 — RI Code / Title 27 / Chapter 27-67 / Section 27-67-3
§ 27-67-3. Definitions.
Status: in_force

As used in this chapter:

(1) Department means the department of business regulation.

(2) Health insurer means a health insurance corporation, health maintenance organization, nonprofit hospital service corporation, or nonprofit medical service corporation as defined in chapters 1, 18, 19, and 20 of this title.
R.I. Gen. Laws § 27-18-70 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-70
§ 27-18-70. Enteral nutrition products.
Status: in_force

(a) Every individual or group health insurance contract, or every individual or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state on or after January 1, 2009, shall provide coverage for nonprescription enteral formulas for home use for which a physician has issued a written order and that are medically necessary for the treatment of malabsorption caused by Crohns disease, ulcerative colitis, gastroesophageal reflux, chronic intestinal pseudo-obstruction, and inherited diseases of amino acids and organic acids. Coverage for inherited diseases of amino acids and organic acids shall include food products modified to be low protein and shall extend to all recipients regardless of age.

(b) Benefit plans offered by an insurer may impose a copayment and/or deductibles for the benefits mandated by this section, however, in no instance shall the copayment or deductible amount be greater than the copayment or deductible amount imposed for prescription enteral formulas or nutritional aids. Benefits for services under this chapter shall be reimbursed in accordance with the respective principles and mechanisms of reimbursement for each insurer, hospital, or medical service corporation, or health maintenance organization. Reimbursement shall be provided according to the respective principles and policies of the accident and sickness insurer. Nothing contained in this section precludes the accident and sickness insurer from conducting managed care, medical necessity, or utilization review.

(c) This section shall not apply to insurance coverage providing benefits for: (1) Hospital confinement indemnity; (2) Disability income; (3) Accident only; (4) Long-term care; (5) Medicare supplement; (6) Limited benefit health; (7) Specified disease indemnity; (8) Sickness or bodily injury or death by accident or both; and (9) Other limited benefit policies.
R.I. Gen. Laws § 27-4-1.1 — RI Code / Title 27 / Chapter 27-4 / Section 27-4-1.1
§ 27-4-1.1. Denial of application based on an opioid antagonist prescription.
Status: in_force

(a) No life insurance company organized or doing business within this state shall:

(1) Deny the application of an individual seeking coverage for any life insurance policy pursuant to this chapter solely on the basis that the applicant has a prescription to carry or possess an opioid antagonist as defined in § 16-21-35(a);

(2) Otherwise discriminate in the offering, issuance, cancellation, amount of coverage, price, or any other condition of a life insurance policy based solely and without any additional actuarial justification upon the fact that an individual has been issued a prescription for, or has purchased an opioid antagonist as defined in § 16-21-35(a).

(b) Any denial of insurance coverage in violation of the provisions of this section:

(1) Shall be void;

(2) The insurer shall reopen the application and underwriting process for consideration of coverage and the life insurance company shall be deemed to have provided coverage to the eligible person retroactive to the date of the initial application.
R.I. Gen. Laws § 27-41-15 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-15
§ 27-41-15. Powers of insurers and hospital and medical service corporations.
Status: in_force

An insurance company licensed in this state may either directly or through a subsidiary or affiliate organize and operate a health maintenance organization under the provisions of this chapter. Notwithstanding any other law that may be inconsistent with this section, any two (2) or more state insurance companies, or subsidiaries or affiliates of those companies, may jointly organize and operate a health maintenance organization. A hospital or medical service corporation may own and operate a health maintenance organization. With respect to those corporations, operation of a health maintenance organization shall not be deemed to be participation in the business of insurance. The business of insurance is deemed to include the providing of health care by a health maintenance organization owned or operated by an insurer or a subsidiary of an insurer.
R.I. Gen. Laws § 27-81-5 — RI Code / Title 27 / Chapter 27-81 / Section 27-81-5
§ 27-81-5. Severability.
Status: in_force

If any provision of this chapter or of any rule or regulation made under this chapter, or its application to any person or circumstance is held invalid by a court of competent jurisdiction, the remainder of the chapter, rule, or regulation and the application of the provision to other persons or circumstances shall not be affected by this invalidity. The invalidity of any section or sections or parts of any section or sections shall not affect the validity of the remainder of the chapter.
R.I. Gen. Laws § 27-25-27 — RI Code / Title 27 / Chapter 27-25 / Section 27-25-27
§ 27-25-27. Annual license.
Status: in_force

(a) The authority of all societies shall be continuous unless sooner revoked or suspended as provided in this chapter. For each license the society shall pay the commissioner of insurance one hundred dollars ($100). The society shall pay a license fee of one hundred dollars ($100) annually prior to April 30 of each year. A duly certified copy or duplicate of the license shall be prima facie evidence that the licensee is a fraternal benefit society within the meaning of this chapter.

(b) The commissioner may assess a late fee of ten dollars ($10.00) per day for each day the society is late in remitting its annual license fee.
R.I. Gen. Laws § 27-43-6 — RI Code / Title 27 / Chapter 27-43 / Section 27-43-6
§ 27-43-6. Reports, statements, examinations, and investigations.
Status: in_force

(a) Captive insurance companies shall annually file a statement of condition as provided in § 27-12-1; provided, that the commissioner may by regulation modify the required filing and content of the statements of captive insurance companies. Captive insurance companies are also subject to the further provisions of chapter 12 of this title; provided, that statements filed pursuant to this section, except for those reports filed by industrial insured captive insurance companies insuring the risks of industrial insured groups as defined in § 27-43-1(8)(ii), are not subject to the public inspection provisions of § 27-12-1(b).

(b) The commissioner, either personally or by a committee appointed by him or her, consisting of one or more persons not directors or officers of any captive insurance company doing business in this state, may, at any time, examine the affairs of any captive insurance company incorporated by or doing business in this state. The officers of the company shall exhibit its books to the commissioner or committee, and facilitate the examination, and the commissioner or the committee may examine, under oath, the officers of the company in relation to its affairs, and the commissioner shall, if he or she deems it advisable, publish the result of the investigation in one or more newspapers published in the state. The total cost of the examinations shall be borne by the examined companies and shall be one hundred fifty percent (150%) of the total salaries paid to the examining personnel of the insurance division engaged in the examinations, less any salary reimbursements, and shall be paid to the commissioner to and for the use of the insurance division. The assessment shall be in addition to any taxes and fees payable to the state.

(c) Whenever it shall appear to the commissioner, from the statements, or from an examination of the affairs of any captive insurance company, that the company is insolvent, or is in an unsound financial condition, or that its business policies are unsound or improper, or that its condition or management is such as to render its further transaction of business hazardous to the public or its policyholders, or that the amount of its funds, net cash, or contingent assets is deficient, or that its capital is impaired, or that it is conducting its business fraudulently or refuses or neglects to comply with the laws of the state relating to captive insurance companies, it shall be the duty of the commissioner, after notice and hearing, to revoke the license issued to the company and the licenses issued to all of its insurance producers, or he or she may revoke the licenses or suspend them for a period not exceeding the unexpired terms of the licenses.
R.I. Gen. Laws § 27-71-14 — RI Code / Title 27 / Chapter 27-71 / Section 27-71-14
§ 27-71-14. Additional duties of the commissioner.
Status: in_force

(a) At least once per year, or more frequently if deemed necessary, the commissioner shall make available in an appropriate manner to insurers and other entities subject to the scope of this chapter information on new laws and regulations, and other information the commissioner deems pertinent to ensure compliance with market conduct requirements. The failure of the commissioner to provide information shall not be a defense for an insurer that fails to comply with any insurance laws of this state.

(b) Insurers who or that wish to receive the information indicated in subsection (a) above shall provide to the commissioner, in a form specified by the commissioner, contact information. The insurer is responsible for keeping that contact information up-to-date and informing the commissioner of any changes.

(c) The commissioner shall designate a specific person or persons whose responsibilities shall include the receipt of information from employees of insurers and licensed entities concerning violations of laws, rules, or regulations by employers, as defined in this section. Such person or persons shall be provided with proper training on the handling of such information, which shall be deemed a confidential communication for the purposes of this section.

(d) For any change made by the commissioner to procedures, guidelines, handbooks, or other work products of the NAIC referenced in this chapter, which materially changes the way in which market analysis, market conduct actions, or market conduct examinations are conducted, the commissioner shall give notice and provide parties with an opportunity for a public hearing pursuant to the Administrative Procedures Act, chapter 35 of title 42.
R.I. Gen. Laws § 27-74-15 — RI Code / Title 27 / Chapter 27-74 / Section 27-74-15
§ 27-74-15. Injunctions.
Status: in_force

(a) In addition to the penalties and other enforcement provisions of this act, the commissioner or the department of the attorney general may seek both temporary and permanent injunctive relief when:

(1) A discount medical plan is being operated by a person or entity that is not registered pursuant to this chapter; or

(2) Any person, entity, or discount medical plan organization has engaged in any activity prohibited by this chapter or any regulation adopted pursuant to this chapter.

(b) The superior court shall have jurisdiction over any proceeding brought pursuant to this section.

(c) The authority to seek injunctive relief is not conditioned on the commissioner having conducted any proceeding pursuant to the provisions of the Administrative Procedures Act, chapter 35 of title 42.
R.I. Gen. Laws § 27-32-5 — RI Code / Title 27 / Chapter 27-32 / Section 27-32-5
§ 27-32-5. Benefits on variable basis.
Status: in_force

If the agreement provides for the payment of benefits in variable amounts, it shall contain a statement of the essential features of the procedure to be followed by the company in determining the dollar amount of the variable benefits. Any agreement and any certificate issued under it shall state that the dollar amount may decrease or increase and shall contain on its first page a statement that the benefits under it are on a variable basis.
R.I. Gen. Laws § 27-50-10 — RI Code / Title 27 / Chapter 27-50 / Section 27-50-10
§ 27-50-10. Wellness health benefit plan.
Status: in_force

(a) No provision contained in this chapter prohibits the sale of health benefit plans that differ from the wellness health benefit plans provided for in this section.

(b) The wellness health benefit plan shall be determined by regulations promulgated by the office of health insurance commissioner (OHIC). The OHIC shall develop the criteria for the wellness health benefit plan, including, but not limited to, benefit levels, cost-sharing levels, exclusions, and limitations, in accordance with the following:

(1)(i) The OHIC shall form an advisory committee to include representatives of employers, health insurance brokers, local chambers of commerce, and consumers who pay directly for individual health insurance coverage.

(ii) The advisory committee shall make recommendations to the OHIC concerning the following:

(A) The wellness health benefit plan requirements document. This document shall be disseminated to all Rhode Island small group and individual market health plans for responses, and shall include, at a minimum, the benefit limitations and maximum cost-sharing levels for the wellness health benefit plan. If the wellness health benefit product requirements document is not created by November 1, 2006, it will be determined by regulations promulgated by the OHIC.

(B) The wellness health benefit plan design. The health plans shall bring proposed wellness health plan designs to the advisory committee for review on or before January 1, 2007. The advisory committee shall review these proposed designs and provide recommendations to the health plans and the commissioner regarding the final wellness plan design to be approved by the commissioner in accordance with § 27-50-5(h)(4), and as specified in regulations promulgated by the commissioner on or before March 1, 2007.

(2) Set a target for the average annualized individual premium rate for the wellness health benefit plan to be less than ten percent (10%) of the average annual statewide wage, as reported by the Rhode Island department of labor and training, in their report entitled Quarterly Census of Rhode Island Employment and Wages. In the event that this report is no longer available, or the OHIC determines that it is no longer appropriate for the determination of maximum annualized premium, an alternative method shall be adopted in regulation by the OHIC. The maximum annualized individual premium rate shall be determined no later than August 1 of each year, to be applied to the subsequent calendar year premium rates.

(3) Ensure that the wellness health benefit plan creates appropriate incentives for employers, providers, health plans, and consumers to, among other things:

(i) Focus on primary care, prevention, and wellness;

(ii) Actively manage the chronically ill population;

(iii) Use the least cost, most appropriate setting; and

(iv) Use evidence-based, quality care.

(4) To the extent possible, the health plans may be permitted to utilize existing products to meet the objectives of this section.

(5) The plan shall be made available in accordance with this chapter as required by regulation on or before May 1, 2007.
R.I. Gen. Laws § 27-5-15 — RI Code / Title 27 / Chapter 27-5 / Section 27-5-15
§ 27-5-15. Power to create guaranty surplus and special reserve funds.
Status: in_force

Any insurance company organized under the laws of this state authorized to transact a fire insurance business may create the funds provided for in §§ 27-5-16  27-5-31, to be known and designated as the guaranty surplus fund and the special reserve fund, and may avail itself of the provisions of this section and §§ 27-5-16  27-5-31, upon complying with the requirements of those sections.
R.I. Gen. Laws § 27-47-3 — RI Code / Title 27 / Chapter 27-47 / Section 27-47-3
§ 27-47-3. Penalty.
Status: in_force

(a) Any person who violates § 27-47-2 shall, upon conviction, be fined not more than fifty thousand dollars ($50,000) or be imprisoned for not more than one year, or both.

(b) Any person who does any of the following:

(1) Conceals any property belonging to an insurer;

(2) Transfers or conceals in contemplation of a state insolvency proceeding his own property or property belonging to an insurer;

(3) Conceals, destroys, mutilates, alters, or makes a false entry in any document that affects or relates to the property of an insurer or withholds any document from a receiver, trustee, or other officer of a court entitled to its possession; or

(4) Gives, obtains, or receives a thing of value for acting or forbearing to act in any court proceedings, and that act or acts results in or contributes to an insurer becoming impaired or insolvent, then that person shall be guilty of a felony and, upon conviction, be punished by imprisonment for not more than five (5) years.
R.I. Gen. Laws § 27-34-11 — RI Code / Title 27 / Chapter 27-34 / Section 27-34-11
§ 27-34-11. Effect of paid claims.
Status: in_force

(a) Any person recovering under this chapter shall be deemed to have assigned any rights under the policy to the association to the extent of his or her recovery from the association. Every insured or claimant seeking the protection of this chapter shall cooperate with the association to the same extent as the person would have been required to cooperate with the insolvent insurer. The association shall have no cause of action against the insured of the insolvent insurer for sums it has paid out except any causes of action as the insolvent insurer would have had if the sums had been paid by the insolvent insurer and except as provided in subsection (b) of this section and § 27-34-11.5. In the case of an insolvent insurer operating on a plan with assessment liability, payments of claims of the association shall not operate to reduce the liability of the insureds to the receiver, liquidator, or statutory successor for unpaid assessments.

(b) The association shall have the right to recover from a person who is an affiliate of the insolvent insurer all amounts paid by the association on behalf of that person pursuant to the chapter, whether for indemnity, defense, or otherwise.

(c) The receiver, liquidator, or statutory successor of an insolvent insurer shall be granted the utmost deference with regard to settlements of covered claims by the fund or a similar organization in another state.

(d) The association and any association similar to the association in another state shall be entitled to file a claim in the liquidation of an insolvent insurer for any amounts paid by them on covered claim obligations as determined under this chapter or similar laws in other states and shall receive dividends and other distributions at the priority set forth in § 27-14.3-46.

(e) The association shall periodically file with the receiver or liquidator of the insolvent insurer statements of the covered claims paid by the association and estimates of anticipated claims on the association which shall preserve the rights of the association against the assets of the insolvent insurer.
R.I. Gen. Laws § 27-43-4 — RI Code / Title 27 / Chapter 27-43 / Section 27-43-4
§ 27-43-4. Minimum capital.
Status: in_force

(a) No subsidiary captive insurance company, association captive insurance company incorporated as a stock insurance company, or industrial insured captive insurance company incorporated as a stock insurance company shall be issued a license unless it possesses and after this maintains unimpaired paid in capital of:

(1) In the case of a subsidiary captive insurance company, not less than one hundred thousand dollars ($100,000);

(2) In the case of an association captive insurance company incorporated as a stock insurance company, not less than four hundred thousand dollars ($400,000); and

(3) In the case of an industrial insured captive insurance company incorporated as a stock insurance company, not less than two hundred thousand dollars ($200,000). The capital may be in the form of cash or an irrevocable letter of credit issued by a bank chartered by the state of Rhode Island or a member bank of the Federal Reserve System and approved by the commissioner.

(b) The commissioner may prescribe additional capital based upon the type, volume, and nature of insurance business transacted, which capital may be in the form of an irrevocable letter of credit issued by a bank chartered by the state of Rhode Island, or a member bank of the Federal Reserve System.

(c) No captive insurance company may pay a dividend out of, or other distribution with respect to, capital or surplus, in excess of the limitations set forth in § 27-43-12, without the prior approval of the commissioner. Approval of an ongoing plan for the payment of dividends or other distributions shall be conditioned upon the retention, at the time of each payment, of the capital or surplus in excess of amounts specified by, or determined in accordance with formulas approved by, the commissioner.
R.I. Gen. Laws § 27-34-17 — RI Code / Title 27 / Chapter 27-34 / Section 27-34-17
§ 27-34-17. Stay of proceedings.
Status: in_force

All proceedings in which the insolvent insurer is a party or is obligated to defend a party in any court in this state shall, subject to waiver by the association in specific cases involving covered claims, be stayed for six (6) months and such additional time as may be determined by the court from the date the insolvency is determined or an ancillary proceeding is instituted in this state, whichever is later, to permit proper defense by the association of all pending causes of action. The liquidator, receiver, or statutory successor of an insolvent insurer covered by this chapter shall permit access by the board or its authorized representative to such of the insolvent insurers records that are necessary for the board in carrying out its functions under this chapter with regard to covered claims. In addition, the liquidator, receiver, or statutory successor shall provide the board or its representative with copies of the records upon the request by the board and at the expense of the board.
R.I. Gen. Laws § 27-1-39 — RI Code / Title 27 / Chapter 27-1 / Section 27-1-39
§ 27-1-39. Discrimination in rates prohibited.
Status: in_force

(a) No insurance company organized to do business within this state shall make any distinction or discrimination as to the premiums or rates charged for policies of casualty, fire, home owners, accident and health, or marine insurance, nor shall the company make or permit the rejection of an individuals application for insurance coverage, and the determination of the rate class for the individual, solely on the basis of a disability unless the disability is relevant to the risk of loss, nor shall any insurance company make or require any rebate, diminution, or discount upon the sum to be paid on any policy based on any disability discrimination, nor insert in the policy any condition nor make any stipulation, where the person insured shall bind himself or herself, his or her heirs, executors, administrators, and assigns, to accept any less sum than the full value or amount of the policy in case of a claim accruing on the policy by reason of the claim of the person insured, other than those stipulations or conditions as are imposed upon all persons in similar cases, and any stipulation or condition made in this manner or inserted shall be void.

(b) No insurance company organized to do business within this state shall make any distinction or discrimination as to the premiums or rates charged for automobile insurance policies, nor shall the company make or permit the rejection of an individuals application for insurance coverage, and the determination of the rate class of the individual, solely on the basis of a disability or the modification of the automobile with specialized equipment that permits an individual with a disability to operate the automobile, unless the disability or modification of the automobile is relevant to the risk or loss, nor shall any insurance company make or require any rebate, diminution, or discount upon the sum to be paid on any policy based on any disability discrimination, nor insert in the policy any condition nor make any stipulation where the person insured shall bind himself or herself, his or her heirs, executors, administrators, and assigns, to accept any less sum than the full value or amount of the policy in case of a claim accruing on the policy by reason of the claim of the person insured, other than those stipulations or conditions as are imposed upon all persons in similar cases, and any stipulation or condition made in this manner or inserted shall be void. The department of business regulation shall enforce the provisions of this section.
R.I. Gen. Laws § 27-41-25 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-25
§ 27-41-25. Holding company systems.
Status: in_force

Except to the extent superseded by chapter 64 of this title, all of the provisions of chapter 35 of this title apply to corporations organized or licensed pursuant to this chapter.
R.I. Gen. Laws § 27-20-23 — RI Code / Title 27 / Chapter 27-20 / Section 27-20-23
§ 27-20-23. Drug coverage.
Status: in_force

No group health insurer subject to the provisions of this chapter that provides coverage for prescription drugs under a group plan master contract delivered, issued for delivery, or renewed in this state may require any person covered under the contract to obtain prescription drugs from a mail order pharmacy as a condition of obtaining benefits for the drugs.
R.I. Gen. Laws § 27-43-11 — RI Code / Title 27 / Chapter 27-43 / Section 27-43-11
§ 27-43-11. Laws applicable.
Status: in_force

No provisions of this title, other than those contained in this chapter or contained in specific references contained in this chapter, shall apply to captive insurance companies. Insofar as the provisions of this chapter are inconsistent with the provisions of any other law, general, special, or local, the provisions of this chapter shall be controlling.
R.I. Gen. Laws § 27-19-83 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-83
§ 27-19-83. Coverage for treatment of pre-exposure prophylaxis (PrEP) for the prevention of HIV and post-exposure prophylaxis (PEP) to prevent HIV infection.
Status: in_force

(a) Every group health insurance contract, or every group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state, by any health insurance carrier, on or after January 1, 2024, shall provide coverage for treatment of pre-exposure prophylaxis (PrEP) for the prevention of HIV and post-exposure prophylaxis (PEP) to prevent HIV infection. Each long-acting injectable drug with a different duration shall constitute a separate method of administration.

(b) The healthcare benefits outlined in this section apply only to services delivered within the health insurers provider network; provided that, all health insurers shall be required to provide coverage for those benefits mandated by this section outside of the health insurers provider network where it can be established that the required services are not available from a provider in the health insurers network.

(c) A health insurer shall provide access to at least one pre-exposure (PrEP) drug in each method of administration and at least one of the Centers for Disease Control and Prevention preferred post-exposure (PEP) drug treatment regimen, without any prior authorization or step therapy requirement. There shall be no copayment required, and no deductible shall need to be met, to obtain the prescription covered by the contract, plan, or policy.
R.I. Gen. Laws § 27-29-17.1 — RI Code / Title 27 / Chapter 27-29 / Section 27-29-17.1
§ 27-29-17.1. Definitions.
Status: in_force

For the purpose of §§ 27-29-17  27-29-17.4:

(1) Commissioner means the commissioner of insurance.

(2) Expiration date means the date upon which coverage under a policy ends. It also means, for a policy written for a term longer than one year or with no fixed expiration date, each annual anniversary date of such policy.

(3) Nonrenewal means termination of a policy at its expiration date.

(4) Renewal or to renew means the issuance of or the offer by an insurer to issue a policy succeeding a policy previously issued and delivered by the same insurer or an insurer within the same group of insurers, or the issuance of a certificate or notice extending the term of an existing policy for a specified period beyond its expiration date.
R.I. Gen. Laws § 27-41-56 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-56
§ 27-41-56. Magnetic resonance imaging  Quality assurance standards.
Status: in_force

(a) Except as otherwise provided in subsection (b) of this section, a magnetic resonance imaging examination eligible for reimbursement under the provisions of any individual or group health insurance contract, plan, or policy delivered in this state shall be reimbursed only if the facility at which the examination has been conducted and processed is accredited by either the American College of Radiology (ACR), the Intersocietal Accreditation Commission (IAC), or an alternate nationally recognized accrediting organization whose accreditation standards are substantially similar to and no less stringent than current or subsequent ACR or IAC standards and have been reviewed and deemed adequate by the department of health. All accreditation standards under this section, whether promulgated by the ACR, IAC, or an alternate nationally recognized accrediting organization, shall include, but shall not be limited to: provisions for establishing the qualifications of the physician; standards for quality control and routine performance monitoring by a medical physicist; qualifications of the technologist, including minimum standards of supervised clinical experience; personnel and patient safety guidelines; and standards for initial and ongoing quality control using clinical image review and quantitative testing.

(b) Any facility conducting and processing magnetic resonance imaging examinations that, as of June 30, 2006, is receiving reimbursement for these services by a health insurer, health maintenance organization, or health plan, but is not accredited pursuant to subsection (a), shall file its application for accreditation within eighteen (18) months of June 28, 2007. The accreditation shall be obtained not later than twelve (12) months after submission of its application. A facility that begins conducting and processing, of magnetic resonance imaging examinations after June 30, 2006, shall file its application for accreditation within twelve (12) months of the date of initiation of the magnetic resonance imaging examinations. The accreditation shall be obtained not later than twelve (12) months after submission of its application. After the accreditation is obtained, a facility conducting and processing magnetic resonance imaging examinations shall, at all times, maintain accreditation with the appropriate accrediting body. Notwithstanding anything herein to the contrary, any facility that has filed for accreditation pursuant to this subsection (b) and that has not been refused accreditation or withdrawn its application, will be deemed provisionally accredited for the twelve-month (12) period dating from the application filing date. Provided, further, that notwithstanding any provisions of the general or public laws to the contrary, any facility conducting and processing magnetic resonance imaging examinations shall conform to the standards of the appropriate accrediting body at all times, including during the accreditation process, and shall certify conformance to any reimbursing health insurer, health maintenance organization, or health plan.
R.I. Gen. Laws § 27-25-25 — RI Code / Title 27 / Chapter 27-25 / Section 27-25-25
§ 27-25-25. Valuation.
Status: in_force

(a) Standards of valuation for certificates issued prior to January 1, 1986, shall be those provided by the laws applicable immediately prior to January 1, 1985.

(b)(1) The minimum standards of valuation for certificates issued on or after January 1, 1986, shall be based on the following tables:

(i) For certificates of life insurance, the commissioners 1941 standard ordinary mortality table, the commissioners 1941 standard industrial mortality table, the commissioners 1958 standard ordinary mortality table, the commissioners 1980 standard ordinary mortality table, or any more recent table made applicable to life insurers; and

(ii) For annuity and pure endowment certificates, for total and permanent disability benefits, for accidental death benefits, and for non-cancelable accident and health benefits, these tables authorized for use by life insurers in this state;

(2) All of the above shall be under valuation methods and standards, including interest assumptions, in accordance with the laws of this state applicable to life insurers issuing policies containing like benefits.

(c) The commissioner of insurance may, in his or her discretion, accept other standards for valuation if the commissioner finds that the reserves produced will not be less in the aggregate than reserves computed in accordance with the minimum valuation standard prescribed in this section. The commissioner of insurance may, in his or her discretion, vary the standards of mortality applicable to all benefit contracts on substandard lives or other extra hazardous lives by any society authorized to do business in this state.

(d) Any society, with the consent of the commissioner of insurance of the state of domicile of the society and under the conditions, if any, that the commissioner may impose, may establish and maintain reserves on its certificates in excess of the reserves required under those conditions, but the contractual rights of any benefit member shall not be affected by the reserves.
R.I. Gen. Laws § 27-1-10 — RI Code / Title 27 / Chapter 27-1 / Section 27-1-10
§ 27-1-10. State not liable for deposits.
Status: in_force

Nothing in this chapter shall be construed to render this state liable for the value of any stocks or other securities deposited by any insurance company according to the provisions of this chapter.
R.I. Gen. Laws § 27-52-9 — RI Code / Title 27 / Chapter 27-52 / Section 27-52-9
§ 27-52-9. Duties of reinsurers utilizing the services of a reinsurance intermediary manager.
Status: in_force

(a) A reinsurer shall not engage the services of any person, firm, association, or corporation to act as a RM on its behalf unless that person is licensed as required by the provisions of this chapter.

(b) The reinsurer shall annually obtain a copy of statements of the financial condition of each RM that the reinsurer has engaged prepared by an independent certified accountant in a form acceptable to the commissioner.

(c) If a RM establishes loss reserves, the reinsurer shall annually obtain the opinion of an actuary attesting to the adequacy of loss reserves established for losses incurred and outstanding on business produced by the RM. This opinion shall be in addition to any other required loss reserve certification.

(d) Binding authority for all retrocessional contracts or participation in reinsurance syndicates shall rest with an officer of the reinsurer who shall not be affiliated with the RM.

(e) Within thirty (30) days of the termination of a contract with a RM, the reinsurer shall provide written notification of the termination to the commissioner.

(f) A reinsurer shall not appoint to its board of directors any officer, director, employee, controlling shareholder, or subproducer of its RM. This subsection shall not apply to relationships governed by the Insurance Holding Systems Act, chapter 35 of this title.
R.I. Gen. Laws § 27-8-6 — RI Code / Title 27 / Chapter 27-8 / Section 27-8-6
§ 27-8-6. Notice to mutual policyholders of dividend or unused premium.
Status: in_force

Every policyholder of a mutual fire insurance company incorporated by this state, and every policyholder of a mutual fire insurance company incorporated by any other state or country and authorized to transact business in this state, shall be notified at the policyholders last known address within six (6) months after the expiration of the policyholders policy of the amount of dividend or unused or unabsorbed premium or premium deposit return declared and payable on it, unless that dividend or unused or unabsorbed premium or premium deposit return has been paid in cash or credited to the policyholder or applied in payment of the premium or premium deposit on the renewal of the policyholders policy.
R.I. Gen. Laws § 27-5-1 — RI Code / Title 27 / Chapter 27-5 / Section 27-5-1
§ 27-5-1. Standard fire insurance policy.
Status: in_force

The printed form of a policy of fire insurance, as set forth in §27-5-3, shall be known and designated as the standard fire insurance policy of the state of Rhode Island.
R.I. Gen. Laws § 27-9-15 — RI Code / Title 27 / Chapter 27-9 / Section 27-9-15
§ 27-9-15. Review of rates not covered by filings.
Status: in_force

Within ten (10) days after any insurer has made or issued a contract or policy at a rate or premium other than is provided for by any filing made with the commissioner by or in its behalf, that insurer shall notify the commissioner, in writing, of that action in the form the commissioner may require. The commissioner shall review the notice as soon as reasonably possible after it has been received by the commissioner, in order to determine whether the contract or policy has been written at a rate or premium that meets the requirements of this chapter. When the notice is not accompanied by the information upon which the insurer supports the rate or premium, and the commissioner does not have sufficient information to determine whether the rate or premium meets the requirements of the chapter, the commissioner shall require the insurer to furnish, within ten (10) days after the receipt of the notice of the requirement, the information upon which it supports the rate or premium. Unless, within thirty (30) days after the receipt of the notice or the supporting information, the commissioner shall issue an order following a hearing, as provided in § 27-9-18, the rate or premium charged for the contract or policy shall be deemed to meet the requirements of this chapter; provided, that all contracts and policies issued under the provisions of this section shall state that the rate or premium charged for the contract or policy has not been reviewed by the commissioner and that it is subject to disapproval or modification as of the effective date of the contracts or policies.
R.I. Gen. Laws § 27-41-26.1 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-26.1
§ 27-41-26.1. Patient responsibility  Administrative requirements.
Status: in_force

For health benefit contracts issued, renewed, or delivered in this state the following shall apply:

(1) The amount of copayments for physician office visits and hospital emergency room visits shall be printed on the subscriber identification cards issued to the insured.

(2) A schedule of all applicable copayments, by product or by group, in paper or electronic format, or both, shall be published, updated, and distributed to participating providers.

(3) On an annual basis, notification shall be provided to subscribers regarding their responsibility for copayments and deductibles.
R.I. Gen. Laws § 27-41-92 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-92
§ 27-41-92. Perinatal doulas.
Status: in_force

(a) As used in this section, doula or perinatal doula means a trained professional providing continuous physical, emotional, and informational support to a pregnant individual, from antepartum, intrapartum, and up to the first twelve (12) months of the postpartum period. Doulas also provide assistance by referring childbearing individuals to community-based organizations and certified and licensed perinatal professionals in multiple disciplines.

(b) Every individual or group health insurance contract, or every individual or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state on or after July 1, 2022, shall provide coverage for the services of perinatal doulas in accordance with each health insurers respective principles and mechanisms of reimbursement, credentialing, and contracting, if the services are within the perinatal doulas area of professional competence as defined by the doula certification standard developed and maintained by the Rhode Island certification board in collaboration with the department of health, and are currently reimbursed when rendered by any other healthcare provider. No insurer or hospital or medical service corporation may require supervision, signature, or referral by any other healthcare provider as a condition of reimbursement, except when those requirements are also applicable to other categories of healthcare providers. No insurer or hospital or medical service corporation or patient may be required to pay for duplicate services actually rendered by both a perinatal doula and any other healthcare provider.

(c) Every individual or group health insurance contract, or every individual or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state that is required to cover perinatal doula services, as defined in subsections (a) and (b) of this section, shall report utilization and cost information related to perinatal doula services to the office of the health insurance commissioner on or before July 1, 2023, and each July 1 thereafter. The office of the health insurance commissioner shall define the utilization and cost information required to be reported.

(d) This section shall not apply to insurance coverage providing benefits for:

(1) Hospital confinement indemnity;

(2) Disability income;

(3) Accident only;

(4) Long-term care;

(5) Medicare supplement;

(6) Limited benefit health;

(7) Specified disease indemnity;

(8) Sickness or bodily injury or death by accident or both; and

(9) Other limited benefit policies.
R.I. Gen. Laws § 27-10-9 — RI Code / Title 27 / Chapter 27-10 / Section 27-10-9
§ 27-10-9. Investigative and subpoena powers.
Status: in_force

(a) The insurance commissioner shall have the power to examine and investigate into the affairs of every person engaged in the business of negotiating adjustments of insurance claims and claims under fidelity and surety bonds.

(b) The insurance commissioner, upon a hearing, may administer oaths, examine and cross-examine witnesses, and receive oral and documentary evidence, and shall have the power to subpoena witnesses, compel their attendance, and require the production of books, papers, records, correspondence, or other documents that the commissioner deems relevant to the inquiry.
R.I. Gen. Laws § 27-4-4 — RI Code / Title 27 / Chapter 27-4 / Section 27-4-4
§ 27-4-4. Penalty for unlawful discrimination.
Status: in_force

Any life insurance company, and any officer or agent of any life insurance company, violating any of the provisions of §§ 27-4-1 and 27-4-3 shall be subject to penalties determined in accordance with § 42-14-16.
R.I. Gen. Laws § 27-35-1 — RI Code / Title 27 / Chapter 27-35 / Section 27-35-1
§ 27-35-1. Definitions.
Status: in_force

As used in this chapter:

(1) Affiliate. An affiliate of, or person affiliated with, a specific person, is a person that directly, or indirectly through one or more intermediaries, controls, or is controlled by, or is under common control with, the person specified. An affiliate does not include a protected cell of a protected cell company organized under the protected cell companies act, chapter 64 of this title.

(2) Commissioner The term commissioner means the definition prescribed by § 42-14-5.

(3) Control. The term control (including the terms controlling, controlled by, and under common control with), means the possession, direct or indirect, of the power to direct or cause the direction of the management and policies of a person, whether through the ownership of voting securities, by contract other than a commercial contract for goods or management services, or otherwise, unless the power is the result of an official position with or corporate office held by the person. Control shall be presumed to exist if any person, directly or indirectly, owns, controls, holds with the power to vote, or holds proxies representing, ten percent (10%) or more of the voting securities of any other person. This presumption may be rebutted by a showing made in the manner provided by § 27-35-3(k) that control does not exist in fact. The commissioner may determine, after furnishing all persons in interest notice and opportunity to be heard and making specific findings of fact to support the determination, that control exists in fact, notwithstanding the absence of a presumption to that effect.

(4) Group capital calculation instructions means the group capital calculation instructions, as adopted by the NAIC and as amended by the NAIC from time to time, in accordance with the procedures adopted by the NAIC.

(5) Group-wide supervisor means the regulatory official authorized to engage in conducting and coordinating group-wide supervision activities who is determined or acknowledged by the commissioner under § 27-35-5.5(d) to have sufficient significant contacts with the internationally active insurance group.

(6) Insurance holding company system. An insurance holding company system consists of two (2) or more affiliated persons, one or more of which is an insurer.

(7) Insurer. The term insurer means any person or persons or corporation, partnership, or company authorized by the laws of this state to transact the business of insurance in this state, including entities organized or authorized to transact business in this state pursuant to chapters 19, 20, 20.1, 20.2, 20.3, and 41 of this title, except that it shall not include agencies, authorities, or instrumentalities of the United States, its possessions and territories, the Commonwealth of Puerto Rico, the District of Columbia, or a state or political subdivision of a state.

(8) Internationally active insurance group means an insurance holding company system that:

(i) Includes an insurer registered under § 27-35-3; and

(ii) Meets the following criteria:

(A) Premiums written in at least three (3) countries;

(B) The percentage of gross premiums written outside the United States is at least ten percent (10%) of the insurance holding company systems total gross written premiums; and

(C) Based on a three-year (3) rolling average, the total assets of the insurance holding company system are at least fifty billion dollars ($50,000,000,000) or the total gross written premiums of the insurance holding company system are at least ten billion dollars ($10,000,000,000).

(9) Enterprise risk. Enterprise risk means any activity, circumstance, event or series of events involving one or more affiliates of an insurer that, if not remedied promptly, is likely to have a material adverse effect upon the financial condition or liquidity of the insurer or its insurance holding company system as a whole, including, but not limited to, anything that would cause the insurers risk-based capital to fall into company action level as set forth in chapters 4.6 and 4.7 of this title or would cause the insurer to be in a hazardous financial condition as set forth in chapter 14.2 of this title.

(10) NAIC means the National Association of Insurance Commissioners.

(11) NAIC liquidity stress test framework. The NAIC liquidity stress test framework is a separate NAIC publication that includes a history of the NAICs development of regulatory liquidity stress testing, the scope criteria applicable for a specific data year, and the liquidity stress test instructions and reporting templates for a specific data year, such scope criteria, instructions and reporting template being as adopted by the NAIC and as amended by the NAIC from time to time, in accordance with the procedures adopted by the NAIC.

(12) Person. A person is an individual, a corporation, a limited liability company, a partnership, an association, a joint stock company, a trust, an unincorporated organization, or any similar entity or any combination of the foregoing acting in concert, but shall not include any joint venture partnership exclusively engaged in owning, managing, leasing or developing real or tangible personal property.

(13) Scope criteria. The scope criteria, as detailed in the NAIC liquidity stress test framework, are the designated exposure bases along with minimum magnitudes thereof for the specified data year, used to establish a preliminary list of insurers considered scoped into the NAIC liquidity stress test framework for that data year.

(14) Securityholder. A securityholder of a specified person is one who owns any security of such person, including common stock, preferred stock, debt obligations, and any other security convertible into or evidencing the right to acquire any of the foregoing.

(15) Subsidiary. A subsidiary of a specified person is an affiliate controlled by such person directly, or indirectly, through one or more intermediaries.

(16) Voting security. The term voting security shall include any security convertible into or evidencing a right to acquire a voting security.
R.I. Gen. Laws § 27-66-26 — RI Code / Title 27 / Chapter 27-66 / Section 27-66-26
§ 27-66-26. Conflict of law.
Status: in_force

The provisions of this chapter shall supersede the provisions of chapters 19, 20, and 41 of this title in conflict with this chapter. Except as expressly provided in this chapter, this chapter shall supersede chapter 35 of this title with respect to conversions subject to this chapter, except for conversions involving domestic insurance companies subject to chapter 1 of this title, which conversion shall be subject to chapter 35 of this title.
R.I. Gen. Laws § 27-18-80 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-80
§ 27-18-80. Orally administered anticancer medication  Cost-sharing requirement.
Status: in_force

(a) Every individual or group hospital or medical expense insurance policy or individual or group hospital or medical services plan contract, plan, or certificate of insurance delivered, issued for delivery, or renewed in this state, on or after January 1, 2014, that offers both medical and prescription drug coverage, and provides coverage for intravenously administered anticancer medication, shall provide coverage for prescribed, orally administered anticancer medications used to kill or slow the growth of cancerous cells on a basis no less favorable than intravenously administered or injected cancer medications that are covered as medical benefits. An increase in patient cost sharing for anticancer medications shall not be allowed to achieve compliance with this section. Notwithstanding the above, the requirements shall not be construed to impose any form of cap on cost-sharing.

(b) This section does not apply to insurance coverage providing benefits for: (1) Hospital confinement indemnity; (2) Disability income; (3) Accident only; (4) Long-term care; (5) Medicare supplement; (6) Limited benefit health; (7) Specified disease indemnity; (8) Sickness or bodily injury or death by accident or both; and (9) Other limited benefit policies.
R.I. Gen. Laws § 27-41-33 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-33
§ 27-41-33. Coverage for infertility.
Status: in_force

(a) Any health maintenance organization service contract plan or policy delivered, issued for delivery, or renewed in this state, except a contract providing supplemental coverage to Medicare or other governmental programs, that includes pregnancy-related benefits, shall provide coverage for medically necessary expenses of diagnosis and treatment of infertility for women between the ages of twenty-five (25) and forty-two (42) years and for standard fertility-preservation services when a medically necessary medical treatment may directly or indirectly cause iatrogenic infertility to a covered person. To the extent that a health maintenance organization provides reimbursement for a test or procedure used in the diagnosis or treatment of conditions other than infertility, those tests and procedures shall not be excluded from reimbursement when provided attendant to the diagnosis and treatment of infertility for women between the ages of twenty-five (25) and forty-two (42) years; provided, that subscriber copayment, not to exceed twenty percent (20%), may be required for those programs and/or procedures the sole purpose of which is the treatment of infertility.

(b) For purposes of this section, infertility means the condition of an otherwise healthy individual who is unable to conceive or sustain a pregnancy during a period of one year.

(c) For purposes of this section, standard fertility-preservation services means procedures consistent with established medical practices and professional guidelines published by the American Society for Reproductive Medicine, the American Society of Clinical Oncology, or other reputable professional medical organizations.

(d) For purposes of this section, iatrogenic infertility means an impairment of fertility by surgery, radiation, chemotherapy, or other medical treatment affecting reproductive organs or processes.

(e) For purposes of this section, may directly or indirectly cause means treatment with a likely side effect of infertility as established by the American Society for Reproductive Medicine, the American Society of Clinical Oncology, or other reputable professional organizations.

(f) The health insurance contract may limit coverage to a lifetime cap of one hundred thousand dollars ($100,000).
R.I. Gen. Laws § 27-1-29 — RI Code / Title 27 / Chapter 27-1 / Section 27-1-29
§ 27-1-29. Reports of directors, officers, and principal shareholders.
Status: in_force

Every person who is directly or indirectly the beneficial owner of more than ten percent (10%) of any class of any equity security of a domestic stock insurance company, or who is a director or an officer of a domestic stock insurance company, shall file in the office of the commissioner within ten (10) days after the person becomes the beneficial owner, director, or officer, a statement, in a form as the commissioner may prescribe, of the amount of all equity securities of the company of which the person is the beneficial owner. Within ten (10) days after the close of each calendar month, if there has been a change in ownership during the month, the person shall file in the office of the commissioner a statement, in a form as the commissioner may prescribe, indicating the persons ownership at the close of the calendar month and any changes in the persons ownership as have occurred during the calendar month.
R.I. Gen. Laws § 27-19-26.1 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-26.1
§ 27-19-26.1. Medication synchronization.
Status: in_force

(a) An individual or group health insurance plan or policy delivered, issued for delivery, or renewed in this state on or after January 1, 2017, providing prescription drug coverage in the state, must permit and apply a prorated, daily cost-sharing rate to covered prescriptions for a chronic condition that are dispensed by an in-network pharmacy for less than a thirty (30) days supply if the prescriber and pharmacist determine the fill or refill to be in the best interest of the patient for the management or treatment of a chronic, long-term care condition and the patient requests or agrees to less than a thirty (30) days supply for the purpose of synchronizing the patients medications and the insureds or enrollees maintenance-prescription drug(s) to be synchronized meets all of the following requirements:

(1) Is covered by the policy, certificate, or contract described in this chapter;

(2) Is used for the management and treatment of a chronic, long-term care condition and has authorized refills that remain available to the insured or enrollee;

(3) Except as otherwise provided in this subparagraph, is not a controlled substance included in schedules II to V;

(4) Meets all utilization management requirements specific to the maintenance-prescription drugs at the time of the request to synchronize the insureds or enrollees multiple maintenance-prescription drugs;

(5) Is of a formulation that can be effectively split over required short-fill periods to achieve synchronization; and

(6) Does not have quantity limits or dose-optimization criteria or requirements that will be violated when synchronizing the insureds or enrollees multiple maintenance-prescription drugs.

(b) The plan or policy described in subsection (a) shall apply a prorated, daily cost-sharing rate for maintenance-prescription drugs that are dispensed by an in-network pharmacy for the purpose of synchronizing the insureds or enrollees multiple maintenance-prescription drugs.

(c) The plan or policy described in subsection (a) shall not reimburse or pay any dispensing fee that is prorated. The insurer shall only pay or reimburse a dispensing fee that is based on each maintenance-prescription drug dispensed.

(d) A synchronization shall only occur once per year per maintenance-prescription drug.
R.I. Gen. Laws § 27-34-7 — RI Code / Title 27 / Chapter 27-34 / Section 27-34-7
§ 27-34-7. Board of directors.
Status: in_force

(a) The board of directors of the association shall consist of not less than five (5) nor more than eleven (11) persons serving terms as established in the plan of operation. The members of the board shall be selected by member insurers subject to the approval of the commissioner. Vacancies on the board shall be filled for the remaining period of the term by a majority vote of the remaining insurer members subject to the approval of the commissioner. Two (2) persons may be public representatives, and may be appointed by the commissioner to the board of directors. Vacancies of positions held by public representatives shall be filled by the commissioner. A public representative may not be an officer, director, or employee of an insurance company or any person engaged in the business of insurance. For the purposes of this section, the term director shall mean an individual serving on behalf of an insurer member of the board of directors or a public representative on the board of directors.

(b) In approving selections to the board, the commissioner shall consider among other things whether all member insurers are fairly represented.

(c) Members of the board of directors may be reimbursed from the assets of the association for expenses incurred by them as members of the board of directors.

(d) Any board member who is an insurer in receivership shall be terminated as a board member, effective as of the date of the entry of the order of receivership. Any resulting vacancies on the board shall be filled for the remaining period of the term in accordance with the provisions of subsection (a).

(e) In the event that a director shall, because of illness, nonattendance at meetings, or any other reason, be deemed unable to satisfactorily perform the designated functions as a director by missing three (3) consecutive board meetings, the board of directors may declare the office vacant and the member or director shall be replaced in accordance with the provisions of subsection (a).

(f) If the commissioner has reasonable cause to believe that a director failed to disclose a known conflict of interest with his or her duties on the board; failed to take appropriate action based on a known conflict or interest with his or her duties on the board; or has been indicted or charged with a felony, or misdemeanor involving moral turpitude, the commissioner may suspend that director pending the outcome of an investigation or hearing by the commissioner or the conclusion of any criminal proceedings. A company elected to the board may replace a suspended director prior to the completion of an investigation, hearing, or criminal proceeding. In the event that the allegations are substantiated at the conclusion of an investigation, hearing, or criminal proceeding, the office shall be declared vacant and the member or director shall be replaced in accordance with the provisions of subsection (a).