R.I. Gen. Laws § 27-74-11 — RI Code / Title 27 / Chapter 27-74 / Section 27-74-11
§ 27-74-11. Marketing restrictions and disclosure requirements.
Status: in_force

(a) All advertisements, marketing materials, brochures, discount medical plan cards, and any other communications of a discount medical plan organization provided to prospective members and members shall be truthful and not misleading in fact or in implication. An advertisement, any marketing material, brochure, discount medical plan card, or other communication is misleading in fact or in implication if it has a capacity or tendency to mislead or deceive based on the overall impression that it is reasonably expected to create within the segment of the public to which it is directed.

(b) A discount medical plan organization shall not:

(1) Except as otherwise provided in this chapter or as a disclaimer of any relationship between discount medical plan benefits and insurance, or as a description of an insurance product connected with a discount medical plan, use in its advertisements, marketing material, brochures, and discount medical plan cards the term insurance;

(2) Except as otherwise provided in state law, describe or characterize the discount medical plan as being insurance whenever a discount medical plan is bundled with an insured product and the insurance benefits are incidental to the discount medical plan benefits;

(3) Use in its advertisements, marketing material, brochures, and discount medical plan cards the terms health plan, coverage, copay, copayments, deductible, preexisting conditions, guaranteed issue, premium, PPO, preferred provider organization, or other terms in a manner that could reasonably mislead an individual into believing that the discount medical plan is health insurance;

(4) Use language in its advertisements, marketing material, brochures, and discount medical plan cards with respect to being registered by the health insurance commissioner in a manner that could reasonably mislead an individual into believing that the discount medical plan is insurance or has been endorsed by the state;

(5) Make misleading, deceptive, or fraudulent representations regarding the discount or range of discounts offered by the discount medical plan card or the access to any range of discounts offered by the discount medical plan card;

(6) Have restrictions on access to discount medical plan providers, including, except for hospital services, waiting periods and notification periods; or

(7) Pay providers any fees for medical or ancillary services or collect or accept money from a member to pay a provider for medical or ancillary services provided under the discount medical plan, unless the discount medical plan organization has an active certificate of authority to act as a third-party administrator in accordance with chapter 20.7 of this title.

(c) Each discount medical plan organization shall make the following general disclosures:

(1) In writing in not less than twelve-point font and in a manner that is clear and conspicuous and achieves a grade level score of no higher than eighth (8th) grade on the Flesch-Kincaid readability test;

(2) On the first content page of any advertisements, marketing materials, or brochures made available to the public relating to a discount medical plan; and

(3) Along with any enrollment forms given to a prospective member:

(i) That the plan is a discount plan and is not insurance coverage;

(ii) That the range of discounts for medical or ancillary services provided under the plan will vary depending on the type of provider and medical or ancillary service received;

(iii) Unless the discount medical plan organization has an active certificate of authority to act as a third-party administrator, that the plan does not make payments to providers for the medical or ancillary services received under the discount medical plan;

(iv) That the plan member is obligated to pay for all medical or ancillary services, but will receive a discount from those providers that have contracted with the discount medical plan organization; and

(v) The toll-free telephone number and internet website address for the registered discount medical plan organization for prospective members and members to obtain additional information about and assistance on the discount medical plan and up-to-date lists of providers participating in the discount medical plan.

(d) If the initial contact with a prospective member is by telephone, the disclosures required under subsection (c) shall be made orally and shall be included in the initial written materials that describe the benefits under the discount medical plan provided to the prospective or new member.

(e) In addition to the general disclosures required under this section, each discount medical plan organization shall provide to:

(1) Each prospective member, at the time of enrollment, information in writing in not less than twelve-point (12) font and in a manner that is clear and conspicuous and achieves a grade level score of no higher than eighth (8th) grade on the Flesch-Kincaid readability test that describes the terms and conditions of the discount medical plan, including any limitations or restrictions on the refund of any processing fees or periodic charges associated with the discount medical plan;

(2) Each new member a document in writing in not less than twelve-point (12) font and written in a manner that is clear and conspicuous and achieves a grade level score of no higher than eighth (8th) grade on the Flesch-Kincaid readability test that contains the terms and conditions of the discount medical plan and includes information on:

(i) The name of the member;

(ii) The benefits to be provided under the discount medical plan;

(iii) Any processing fees and periodic charges associated with the discount medical plan, including any limitations or restrictions on the refund of any processing fees and periodic charges;

(iv) The mode of payment of any processing fees and periodic charges, such as monthly, quarterly, etc., and procedures for changing the mode of payment;

(v) Any limitations, exclusions, or exceptions regarding the receipt of discount medical plan benefits;

(vi) Any waiting periods for certain medical or ancillary services under the discount medical plan;

(vii) Procedures for obtaining discounts under the discount medical plan, such as requiring members to contact the discount medical plan organization to make an appointment with a provider on the members behalf;

(viii) Cancellation procedures, including information on the members thirty-day (30) cancellation rights and refund requirements and procedures for obtaining refunds;

(ix) Renewal, termination, and cancellation terms and conditions;

(x) Procedures for adding new members to a family discount medical plan, if applicable;

(xi) Procedures for filing complaints under the discount medical plan organizations complaint system and information that, if the member remains dissatisfied after completing the organizations complaint system, the plan member may contact his or her local state insurance department; and

(xii) The name and mailing address of the registered discount medical plan organization or other entity where the member can make inquiries about the plan, send cancellation notices, and file complaints.
R.I. Gen. Laws § 27-20-16 — RI Code / Title 27 / Chapter 27-20 / Section 27-20-16
§ 27-20-16. Changing coverage.
Status: in_force

No group health insurer subject to the provisions of this chapter shall change contract provisions as specified in the group plan master contract during the term of that contract without prior written agreement of the employer, except for changes mandated under state or federal legislative enactment and changes resulting from a labor/management collective bargaining agreement, or changes necessary to meet insurance regulations promulgated by the department of business regulation.
R.I. Gen. Laws § 27-20-6 — RI Code / Title 27 / Chapter 27-20 / Section 27-20-6
§ 27-20-6. Rates charged subscribers  Hearing by commissioner.
Status: in_force

(a) General. The rates proposed to be charged or a rating formula proposed to be used by any corporation organized under this chapter to its subscribers, employers, the state, or any political subdivision of the state, or individuals, shall be filed by the corporation at the office of the health insurance commissioner (the commissioner).

(b) Public hearings. Within ten (10) days after receipt of a filing, the commissioner shall determine, subject to the provisions of subsection (f) of this section, whether they intend to hold a public meeting or a public hearing at which time notice of such determination shall be sent to the insurance advocacy unit of the attorney general. Any such public hearing shall commence within sixty (60) days after receipt of the application, upon not less than ten (10) days written notice prior to the hearing, published by the commissioner in a newspaper or newspapers having aggregate general circulation throughout the state, at least ten (10) days prior to the hearing. The notice shall contain a description of the rates proposed to be charged and a copy of the notice shall be sent to the applicant and to the department of the attorney general. In the event there is a public hearing, the attorney general may engage the services of any expert or consultant necessary to assist in reviewing the filing, including having the ability to seek additional relevant information from the filer. All public hearings held pursuant to this section shall be held in accordance with the provisions of chapter 35 of title 42.

(c) Filings with the attorney generals office . The applicant shall provide a copy of the filing on all rates proposed for health insurance coverage offered in the individual market as defined in § 27-18.5-2 or for a Medicare supplement policy as defined in § 27-18.2-1 to the insurance advocacy unit of the attorney generals office simultaneously with the filing at the office of the health insurance commissioner.

(d) Procedures. (1) The applicant shall be required to establish that the rates proposed to be charged are consistent with the proper conduct of its business and with the interest of the public. (2) Any documents presented in support of a filing of proposed rates under this section shall be made available for public examination at a time and place that the commissioner may deem reasonable. (3) If a public hearing is held pursuant to subsection (b) of this section, the commissioner, or designee, upon the hearing, may administer oaths, examine and cross-examine witnesses, 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 they deem relevant. Any designee who shall conduct a hearing pursuant to this section shall report their findings, in writing, to the commissioner, within a reasonable time following the conclusion of the hearing, with a recommendation for approval, disapproval, or modification of the rates proposed to be charged by the applicant. The commissioner shall make and issue a decision not later than ten (10) days following the issuance of the recommended decision or, if the commissioner hears the application without the appointment of a designee, as soon as is reasonably possible following the completion of the hearing on the proposed rate change. The decision may approve, disapprove, or modify the rates proposed to be charged by the applicant.

(e) The term designee, as used in this section, shall mean a person who is impartial; a member in good standing of the Rhode Island bar; and a person who is sufficiently acquainted with the rules of evidence as used in the superior court of the state so as to enable that person to conduct a hearing as designee of the commissioner. The reasonable per diem cost of the designee, as appointed by the commissioner, shall be paid by the applicant requesting changes in the rates.

(f) Notwithstanding any provision of this section to the contrary, the commissioner shall hold a public hearing in any instance where the applicant covers ten thousand (10,000) or more enrolled individuals in the individual market, and the rates proposed in the filing for the annual rate increase for products offered in the individual market produce an overall average-rate increase of ten percent (10%) or more. The commissioner shall require that any filing for a rate increase for products offered in the individual market shall include the calculation of the overall average-rate increase in order to determine whether a public hearing is required.

(1) For the purposes of this section, the calculation of the overall average-rate increase shall be based on the overall average-increase percent weighted by member premiums, excluding the effects of age scale increases. To calculate the overall average-rate increase, the applicant shall multiply the proposed rate increase by product, times the total monthly renewing premium for each product, and then divide the product by the sum of monthly renewing premiums for all products. The commissioner shall require this calculation to be provided as part of the applicants individual market rate filing.

(g) In the event that subsection (f) of this section, in combination with § 42-62-13(b), would result in more than one public hearing in any given calendar year, the commissioner may defer one or more public hearing(s) for an applicant resulting from subsection (f) of this section or § 42-62-13(b) until the subsequent calendar year, with the provision that one of the deferred applicants shall be required to have a public hearing in the subsequent year, whether or not the applicants filing satisfies the requirements of subsection (f) of this section or § 42-62-13(b) in that subsequent calendar year.

(h) The commissioner shall notify the attorney general of the filing(s) to be deferred and the attorney general shall be given the opportunity to provide written comments and recommendations to the commissioner regarding any such filing(s) deferred in accordance with subsection (g) of this section.

(i) Notwithstanding any other provision of law to the contrary, the filing of proposed rates or a rating formula, and the holding and conducting of any public hearing in connection with these proposed rates or rating formula, shall be held in accordance with the provisions of chapter 35 of title 42.

(j) Public comment. Whether or not a public hearing is held pursuant to subsection (f) of this section, the commissioner shall solicit public comment regarding the rates proposed to be charged. Public comment shall be solicited upon not less than ten (10) days written notice prior to the date that either:

(1) A public meeting at which verbal comments may be provided; or

(2) That written comment must be received by the commissioner.

The notice shall contain a description of the rates proposed to be charged, or the formula proposed to be used, and a copy of the notice shall be sent to the applicant and to the insurance advocacy unit of the department of the attorney general. The attorney general shall be permitted to conduct discovery in relation to the actuarial analyses and actuarial assumptions of the filer regarding any filing in the individual market as defined in § 27-18.5-2. Any documents presented in support of the filing under this section shall be made available for public examination at a time and place that the commissioner may deem reasonable.

(k) The applicant shall bear reasonable expenses of the commissioner in connection with a filing made pursuant to this section, including any costs related to advertisements, stenographic reporting, and expert fees, regardless of whether a public hearing is held. The applicant shall bear reasonable expenses of the attorney general in relation to any public hearing conducted pursuant to this section. The applicant shall bear reasonable expenses of the attorney general in relation to any filing in the individual market that is not subject to a public hearing.
R.I. Gen. Laws § 27-62-10 — RI Code / Title 27 / Chapter 27-62 / Section 27-62-10
§ 27-62-10. Annual certifications.
Status: in_force

(a) The board of directors of each insurer shall appoint one or more illustration actuaries.

(b) The illustration actuary shall certify that the disciplined current scale used in illustrations is in conformity with the actuarial standard of practice for compliance with the NAIC model regulation on life insurance illustrations promulgated by the actuarial standards board, and that the illustrated scales used in insurer-authorized illustrations meet the requirements of this regulation.

(c) The illustration actuary shall:

(1) Be a member in good standing of the American Academy of Actuaries;

(2) Be familiar with the standard of practice regarding life insurance policy illustrations;

(3) Not have been found by the director of the department of business regulation, following appropriate notice and hearing, to have:

(i) Violated any provision of, or any obligation imposed by, the insurance law or other law in the course of his or her dealings as an illustration actuary;

(ii) Been found guilty of fraudulent or dishonest practices;

(iii) Demonstrated incompetence, lack of cooperation, or untrustworthiness to act as an illustration actuary; or

(iv) Resigned or been removed as an illustration actuary within the past five (5) years as a result of acts or omissions indicated in any adverse report on examination or as a result of a failure to adhere to generally acceptable actuarial standards;

(4) Not fail to notify the insurance division of the department of business regulation of any action taken by another state similar to that under subsection (c)(3) of this section;

(5) Disclose in the annual certification whether, since the last certification, a currently payable scale applicable for business issued within the previous five (5) years and within the scope of the certification has been reduced for reasons other than changes in the experience factors underlying the disciplined current scale. If non-guaranteed elements illustrated for new policies are not consistent with those illustrated for similar in force policies, this must be disclosed in the annual certification. If non-guaranteed elements illustrated for both new and in force policies are not consistent with the non-guaranteed elements actually being paid, charged or credited to the same or similar forms, this must be disclosed in the annual certification; and

(6) Disclose in the annual certification the method used to allocate overhead expenses for all illustrations:

(i) Fully allocated expenses;

(ii) Marginal expenses; or

(iii) A generally recognized expense table based on fully allocated expenses representing a significant portion of insurance companies and approved by the commissioner.

(d)(1) The illustration actuary shall file a certification with the board and with the insurance division of the department of business regulation:

(i) Annually for all policy forms for which illustrations are used; and

(ii) Before a new policy form is illustrated.

(2) If an error in a previous certification is discovered, the illustration actuary shall promptly notify the board of directors of the insurer and the insurance division of the department of business regulation.

(e) If an illustration actuary is unable to certify the scale for any policy form illustration the insurer intends to use, the actuary shall notify the board of directors of the insurer and the commissioner promptly of his or her inability to certify.

(f) A responsible officer of the insurer, other than the illustration actuary, shall annually certify:

(1) That the illustration formats meet the requirements of this regulation and that the scales used in insurer-authorized illustrations are those scales certified by the illustration actuary; and

(2) That the company has provided its agents with information about the expense allocation method used by the company in its illustrations and disclosed as required in subsection (c)(6).

(g) The annual certifications shall be provided to the insurance division of the department of business regulation by a date determined by the insurer.

(h) If an insurer changes the illustration actuary responsible for all or a portion of the companys policy forms, the insurer shall promptly notify the insurance division of the department of business regulation of that fact and disclose the reason for the change.
R.I. Gen. Laws § 27-18-59 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-59
§ 27-18-59. Eligibility for childrens benefits.
Status: in_force

(a)(1) Every health benefit plan delivered, issued for delivery, or renewed in this state and every group health insurance contract, plan, or policy delivered, issued for delivery, or renewed in this state that provides health benefits coverage for dependents, except for supplemental policies that only provide coverage for specified diseases and other supplemental policies, shall make coverage available for children, including children under guardianship, until attainment of twenty-six (26) years of age, and an unmarried child of any age who is financially dependent upon the parent and medically determined to have a physical or mental impairment that can be expected to result in death or that has lasted or can be expected to last for a continuous period of not less than twelve (12) months.

(2) With respect to a child who has not attained twenty-six (26) years of age, a health insurance carrier shall not define dependent for purposes of eligibility for dependent coverage of children other than the terms of a relationship between a child and the plan participant, or subscriber; provided, however, that a child in the care of a court-appointed guardian who is a plan participant or subscriber shall have rights of eligibility identical to a natural born child of the plan participant or subscriber.

(3) A health insurance carrier shall not deny or restrict coverage for a child who has not attained twenty-six (26) years of age based on the presence or absence of the childs financial dependency upon the participant, primary subscriber, or any other person, residency with the participant and in the individual market the primary subscriber, or with any other person, marital status, student status, employment, or any combination of those factors. A health carrier shall not deny or restrict coverage of a child based on eligibility for other coverage, except as provided in subsection (b)(1) of this section.

(4) Nothing in this section shall be construed to require a health insurance carrier to make coverage available for the child of a child receiving dependent coverage, unless the grandparent becomes the legal guardian or adoptive parent of that grandchild.

(5) The terms of coverage in a health benefit plan offered by a health insurance carrier providing dependent coverage of children cannot vary based on age except for children who are twenty-six (26) years of age or older.

(b)(1) For plan years beginning before January 1, 2014, a health insurance carrier providing group health insurance coverage that is a grandfathered health plan and makes available dependent coverage of children may exclude an adult child who has not attained twenty-six (26) years of age from coverage only if the adult child is eligible to enroll in an eligible employer-sponsored health benefit plan, as defined in section 5000A(f)(2) of the federal Internal Revenue Code, other than the group health plan of a parent.

(2) For plan years, beginning on or after January 1, 2014, a health insurance carrier providing group health insurance coverage that is a grandfathered health plan shall comply with the requirements of subsections (a) through (e) of this section.

(c) 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; or (8) Sickness or bodily injury or death by accident or both; or (9) Other limited benefit policies.
R.I. Gen. Laws § 27-20-76 — RI Code / Title 27 / Chapter 27-20 / Section 27-20-76
§ 27-20-76. Gender rating.
Status: in_force

(a) No individual or group health insurance contract, plan, or policy delivered, issued for delivery, or renewed in this state, that provides medical coverage that includes coverage for physician services in a physicians office, and no policy that provides major medical or similar comprehensive-type coverage, excluding disability income, long-term care, and insurance supplemental policies that only provide coverage for specified diseases or other supplemental policies, shall vary the premium rate for a health coverage plan based on the gender of the individual policyholders, enrollees, subscribers, or members.

(b) This section shall not apply to insurance coverage providing benefits for any of the following:

(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 of bodily injury or death by accident or both; and

(9) Other limited benefit policies.
R.I. Gen. Laws § 27-16-10 — RI Code / Title 27 / Chapter 27-16 / Section 27-16-10
§ 27-16-10. Security or certificate required before defensive pleadings.
Status: in_force

Before any unauthorized foreign or alien insurer shall file or cause to be filed any pleading in any action, suit, or proceeding instituted against it, the unauthorized insurer shall deposit with the clerk of the court in which the action, suit, or proceeding is pending, cash or securities, or file with the clerk a bond with good and sufficient sureties, to be approved by the court, in an amount to be fixed by the court sufficient to secure the payment of any final judgment which may be rendered in the action, or procure a certificate of authority to transact the business of insurance in this state.
R.I. Gen. Laws § 27-18-8.1 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-8.1
§ 27-18-8.1. Waiting period  Effective date of filings.
Status: in_force

Each filing shall be on file for a waiting period of sixty (60) days before it becomes effective. The commissioner may authorize a filing that the commissioner has reviewed to become effective before the expiration of the waiting period or any extension of the waiting period. A filing shall be deemed to meet the requirements of this chapter and become effective unless disapproved by the commissioner within the waiting period.
R.I. Gen. Laws § 27-41-52 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-52
§ 27-41-52. 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 § 27-41-71 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-71
§ 27-41-71. Mandatory coverage for scalp hair prosthesis.
Status: in_force

(a) Every individual or group hospital or medical expense insurance policy or individual or group hospital or medical services plan contract delivered, issued for delivery, or renewed in this state on or after January 1, 2007, that provides coverage for any other prosthesis shall provide coverage for expenses for scalp hair prosthesis worn for hair loss suffered as a result of the treatment of any form of cancer or leukemia; provided, however, that coverage shall be subject to the same limitations and guidelines as other prosthesis, and that coverage shall not exceed an amount of three hundred fifty dollars ($350) per covered member per year, exclusive of any deductible.

(b) 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 § 27-41-81 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-81
§ 27-41-81. 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 or chapter, or both:

(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 § 27-76-6 — RI Code / Title 27 / Chapter 27-76 / Section 27-76-6
§ 27-76-6. State of emergency  Effect upon insurance policies  Rules.
Status: in_force

(a) The department of business regulation may promulgate regulations to take effect upon the declaration of a catastrophe, as declared by a nationally recognized catastrophe loss index provider, that address any of the following or other matters related to the catastrophe for insurance policies issued in this state:

(1) Reporting requirements for claims related to the emergency;

(2) Grace periods for payment of insurance premiums and performance of other duties by insureds (other than the duty to mitigate); and/or

(3) Temporary postponement of cancellations and nonrenewals of insurance policies.

(b) Subsections (a)(2) and (a)(3) above apply to all insurance policies, regardless of the line of insurance, issued to residents of this state displaced as a result of the catastrophe. The regulations shall require the insurer to make reasonable efforts to contact the policyholder and provide the accommodations requested by the policyholder, within the limits of accommodations detailed in the regulation, upon confirmation that the policyholder has been displaced by the catastrophe.
R.I. Gen. Laws § 27-25-8 — RI Code / Title 27 / Chapter 27-25 / Section 27-25-8
§ 27-25-8. No personal liability.
Status: in_force

(a) The officers and members of the supreme governing body or any subordinate body of a society shall not be personally liable for any benefits provided by a society.

(b)(1) Any person may be indemnified and reimbursed by any society for expenses reasonably incurred by, and liabilities imposed upon, that person in connection with or arising out of any action, suit, or proceeding, whether civil, criminal, administrative, or investigative, or threat of those actions, in which the person may be involved by reason of the fact that he or she is or was a director, officer, employee, or agent of the society or of any firm, corporation, or organization which he or she served in any capacity at the request of the society. A person shall not be so indemnified or reimbursed (i) In relation to any matter in the action, suit, or proceeding as to which he or she shall finally be adjudged to be or have been guilty of breach of a duty as a director, officer, employee, or agent of the society or (ii) In relation to any matter in the action, suit, or proceeding, or threat of an action, suit, or proceeding, that has been made the subject of a compromise settlement; unless in either case the person acted in good faith for a purpose the person reasonably believed to be in or not opposed to the best interest of the society and, in a criminal action or proceeding, in addition, had no reasonable cause to believe that his or her conduct was unlawful.

(2) The determination whether the conduct of the person met the standard required in order to justify indemnification and reimbursement in relation to any matter described in subsection (b)(1) may only be made by the supreme governing body or board of directors by a majority vote of a quorum consisting of persons who were not parties to the action, suit, or proceeding, or by a court of competent jurisdiction. The termination of any action, suit, or proceeding by judgment, order, settlement, conviction, or upon a plea of no contest, as to the person, shall not in itself create a conclusive presumption that the person did not meet the standard of conduct required in order to justify indemnification and reimbursement. The right of indemnification and reimbursement described in this subsection (b) shall not be exclusive of other rights to which the person may be entitled as a matter of law and shall inure to the benefit of his or her heirs, executors, and administrators.

(c) A society shall have the power to purchase and maintain insurance on behalf of any person who is or was a director, officer, employee, or agent of the society, or who is or was serving at the request of the society as a director, officer, employee, or agent of any other firm, corporation, or organization against any liability asserted against the person and incurred by him or her in that capacity or arising out of his or her status as a director, officer, employee or agent of the society, whether or not the society would have the power to indemnify the person against the liability under this section.
R.I. Gen. Laws § 27-66-3 — RI Code / Title 27 / Chapter 27-66 / Section 27-66-3
§ 27-66-3. Applicability.
Status: in_force

This chapter shall apply to health insurance corporations subject to chapter 1 of this title, nonprofit hospital or medical service corporations subject to chapter 19 or 20 of this title, and health maintenance organizations incorporated or resident in the state of Rhode Island.
R.I. Gen. Laws § 27-1-12 — RI Code / Title 27 / Chapter 27-1 / Section 27-1-12
§ 27-1-12. Summons of witnesses  Obstruction or refusal to testify.
Status: in_force

The insurance commissioner, or the commissioners duly authorized agent, may summon and examine under oath all directors, officers, and other agents of the insurance company and any other witnesses as the commissioner may think proper in relation to the affairs, transactions, and condition of the company. Any director, officer, agent, or other person who refuses without justifiable cause to appear and testify whenever required, or who in any way obstructs the commissioner or the commissioners agent in the discharge of the commissioners duties as prescribed in this chapter, shall be fined not exceeding five thousand dollars ($5,000) or be imprisoned not exceeding two (2) years, and if the person refusing or obstructing is a director, officer, or agent of the company, the company may also be proceeded against.
R.I. Gen. Laws § 27-19-22 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-22
§ 27-19-22. Pap smears  Quality assurance standards.
Status: in_force

A pap smear eligible for reimbursement under § 27-19-20 shall be reimbursed only if the laboratory in which the pap smear is processed is licensed by the department of health specifically to perform cervical cytology, or is accredited by the American Society of Cytology, or is accredited by the College of American Pathologists, or is a hospital accredited by the Joint Commission on Accreditation of Healthcare Organizations or the American Osteopathic Association at the time the pap smear is processed.
R.I. Gen. Laws § 27-34-19 — RI Code / Title 27 / Chapter 27-34 / Section 27-34-19
§ 27-34-19. Prohibition against advertising of membership in association.
Status: in_force

No person shall make, publish, or circulate, or cause to be made, published, or circulated, any statement that uses the existence of the association for the purposes of sale, solicitation, or inducement to purchase any form of insurance within the scope of this chapter.
R.I. Gen. Laws § 27-19-76 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-76
§ 27-19-76. Health insurance contracts  Full year coverage for contraception.
Status: in_force

Beginning on the first day of each plan year after April 1, 2019, every health insurance issuer offering group or individual health insurance coverage that covers prescription contraception shall not restrict reimbursement for dispensing a covered prescription contraceptive up to three hundred sixty-five (365) days at a time.
R.I. Gen. Laws § 27-58-10 — RI Code / Title 27 / Chapter 27-58 / Section 27-58-10
§ 27-58-10. Confidential customer information.
Status: in_force

(a) As used in this section, unless the context requires otherwise:

(1) Customer means a person with an investment, security, deposit, trust, or credit relationship with a financial institution.

(2) Nonpublic customer information means information regarding a person that has been derived from a record of a financial institution, including information concerning the terms and conditions of insurance coverage, insurance expirations, insurance claims, or insurance history of an individual. Nonpublic customer information does not include customer names, addresses, or telephone numbers.

(b) No financial institution shall use any nonpublic customer information for the purpose of selling or soliciting the purchase of insurance or provide the nonpublic customer information to a third party for the purpose of anothers sale or solicitation of the purchase of insurance.
R.I. Gen. Laws § 27-19-5.2 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-5.2
§ 27-19-5.2. Patient responsibility  Administrative requirements.
Status: in_force

For health benefit contracts issued, renewed, or delivered on or after April 1, 2002, 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 insureds.

(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) Notification shall be provided to subscribers on an annual basis regarding their responsibility for copayments and deductibles.
R.I. Gen. Laws § 27-30-10 — RI Code / Title 27 / Chapter 27-30 / Section 27-30-10
§ 27-30-10. Claims.
Status: in_force

(a) All claims shall be promptly reported to the insurer or its designated claim representative, and the insurer shall maintain adequate claim files. All claims shall be settled as soon as possible and in accordance with the terms of the insurance contract.

(b) All claims shall be paid either by draft drawn upon the insurer, by electronic funds transfer, or by check of the insurer to the order of the claimant to whom payment of the claim is due pursuant to the policy provisions, or upon direction of the claimant to one specified.

(c) No plan or arrangement shall be used by which any person, firm, or corporation other than the insurer or its designated claim representative shall be authorized to settle or adjust claims. The creditor shall not be designated as claim representative for the insurer in adjusting claims; provided, that a group policyholder may, by arrangement with the group insurer, draw drafts, checks, or electronic transfers in payment of claims due to the group policyholder subject to audit and review by the insurer.

(d) All claims for consumer credit insurance shall be subject to all applicable chapters of this title and title 42, including chapter 9.1 of this title.
R.I. Gen. Laws § 27-6-44 — RI Code / Title 27 / Chapter 27-6 / Section 27-6-44
§ 27-6-44. Rules and regulations.
Status: in_force

The commissioner may make reasonable rules and regulations necessary to effect the purposes of this chapter.
R.I. Gen. Laws § 27-8-14 — RI Code / Title 27 / Chapter 27-8 / Section 27-8-14
§ 27-8-14. Lost and salvage vehicle reporting.
Status: in_force

All casualty insurers licensed to do business in Rhode Island shall report all vehicle thefts within thirty (30) days of the theft and all salvage declarations to the National Insurance Crime Bureau (NICB), or a similar organization acceptable to the department, that maintains a central database of automobile theft and salvage.
R.I. Gen. Laws § 27-80-5 — RI Code / Title 27 / Chapter 27-80 / Section 27-80-5
§ 27-80-5. Penalties.
Status: in_force

A violation of this chapter shall subject the insurer to penalties as determined appropriate in accordance with § 42-14-16 (Insurance Administrative Penalties).
R.I. Gen. Laws § 27-41-60 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-60
§ 27-41-60. Prostate and colorectal examinations  Coverage mandated  The Maryellen Goodwin Colorectal Cancer Screening Act.
Status: in_force

(a) Subscribers to any health maintenance organization plan shall be afforded coverage under that plan for prostate and colorectal examinations and laboratory tests for cancer for any nonsymptomatic person covered under the policy or plan. The coverage required by this section shall include preventive colorectal cancer screening coverage for all colorectal cancer examinations and laboratory tests in accordance with American Cancer Society guidelines, including for colorectal cancer screening of average risk individuals, including an initial colonoscopy or other medical test or procedure for colorectal cancer screening and a follow-up colonoscopy if the results of the initial medical test or procedure are abnormal.

(b) An insurer or the organization may not impose cost sharing on the coverage required by subsection (a) when the services are delivered within the health insurers provider network.
R.I. Gen. Laws § 27-19-40.1 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-40.1
§ 27-19-40.1. Third-party reimbursement for services of registered nurse first assistants.
Status: in_force

(a) Every individual or group health insurance contract, plan, or policy delivered, issued, or renewed by an insurer or nonprofit or for-profit health service corporation that provides benefits to individual subscribers and members within the state, or to all group members having a principal place of employment within the state, shall provide benefits for services rendered by a registered nurse first assistant designated as a registered nurse first assistant provided, that the following conditions are met:

(1) The registered nurse first assistant provides certain healthcare services under the supervision of a licensed physician; is currently licensed as a registered nurse in Rhode Island; has successfully completed a course in preparing the registered nurse as a first assistant in accordance with the Association of Operating Room Nurses core curriculum guide for the registered nurse first assistant and includes a minimum of one academic year in a college or university with didactic instruction and clinical internship programs; and is certified in perioperative nursing by the Certification Board Perioperative Nursing (minimum of two (2) years perioperative experience);

(2) The policy or contract currently provides benefits for identical services rendered by a provider of health care licensed by the state; and

(3) The registered nurse first assistant is not a salaried employee of the licensed hospital or facility for which the nonprofit hospital service corporation has an alternative contractual relationship to fund the services of a registered nurse first assistant.

(b) It shall remain within the sole discretion of the nonprofit hospital service corporation as to which registered nurse first assistant it shall contract with. Reimbursement shall be provided according to the respective principles and policies of the nonprofit hospital service corporation; provided, that no nonprofit hospital service corporation may be required to provide direct reimbursement, or pay for duplicative services actually rendered by a registered nurse first assistant in surgery and any other healthcare provider. Nothing contained in this section precludes the nonprofit hospital service corporations from conducting managed care, medical necessity, or utilization review.
R.I. Gen. Laws § 27-16-14 — RI Code / Title 27 / Chapter 27-16 / Section 27-16-14
§ 27-16-14. Severability.
Status: in_force

If any provision of §§ 27-16-3  27-16-14 or the application of any of these provisions to any person or circumstances is held invalid, the invalidity shall not affect other provisions or applications of the sections which can be given effect without the invalid provision or application, and to this end the provisions of §§ 27-16-3  27-16-14 are declared to be severable.
R.I. Gen. Laws § 27-83-4 — RI Code / Title 27 / Chapter 27-83 / Section 27-83-4
§ 27-83-4. Policy conditions. [Effective January 1, 2026.]
Status: in_force

(a) A pet insurer may issue policies that exclude coverage on the basis of one or more preexisting conditions with appropriate disclosure to the consumer. The pet insurer has the burden of proving that the preexisting condition exclusion applies to the condition for which a claim is being made.

(b) A pet insurer may issue policies that impose waiting periods upon effectuation of the policy that do not exceed thirty (30) days for illnesses or orthopedic conditions not resulting from an accident. Waiting periods for accidents are prohibited; provided, however, an insurer shall issue coverage to be effective at 12:01 a.m. on the second calendar day after the purchase, subject only to the following exceptions:

(1) If an insurer elects to conduct individualized underwriting on a specific pet, then coverage shall be effective by 12:01 a.m. on the second calendar day after the insurer has determined such pet is eligible for coverage;

(2) An insurer may delay coverage from becoming effective to establish a method for the consumer or group administrator to pay the premium;

(3) For pet insurance coverage acquired by an individual through an employer or organization, the coverage effective date of such pet insurance may be delayed to align with the eligibility and effective date requirements of the employers organizations benefit plan; or

(4) If a policy does not include a waiting period for an illness or orthopedic condition, an insurer may set a policy effectuation date that is up to fifteen (15) calendar days after purchase, as long as such policy effectuation date is clearly disclosed and no premium is earned before the policy becomes effective.

(c)(1) A pet insurer utilizing a waiting period permitted in subsection (b) of this section shall include a provision in its contract that allows the waiting periods to be waived upon completion of a medical examination. Pet insurers may require the examination to be conducted by a licensed veterinarian after the purchase of the policy.

(i) A medical examination under this subsection shall be paid for by the policyholder, unless the policy specifies that the pet insurer will pay for the examination.

(ii) A pet insurer can specify elements to be included as part of the examination and require documentation thereof; provided that, the specifications do not unreasonably restrict a consumers ability to waive the waiting periods in subsection (b) of this section.

(2) Waiting periods, and the requirements applicable to them, shall be clearly and prominently disclosed to consumers prior to the policy purchase.

(3) If a policy does not include a waiting period for an illness or orthopedic condition, an insurer may set a policy effectuation date that is up to fifteen (15) days after purchase, as long as such policy effectuation date is clearly disclosed and no premium is earned before the policy becomes effective.

(d) A pet insurer shall not require a veterinary examination of the covered pet for the insured to have their policy renewed.

(e) If a pet insurer includes any prescriptive, wellness, or non-insurance benefits in the policy form, then it is made part of the policy contract and shall follow all applicable laws and regulations in the insurance code.

(f) An insureds eligibility to purchase a pet insurance policy shall not be based on participation, or lack of participation, in a separate wellness program.
R.I. Gen. Laws § 27-41-53.1 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-53.1
§ 27-41-53.1. Genetic information.
Status: in_force

(a) Except as provided in chapter 37.3 of title 5, insurance administrators, health plans, and providers shall be prohibited from releasing genetic information without prior written authorization of the individual. Written authorization shall be required for each disclosure and include to whom the disclosure is being made. An exception shall exist for those participating in research settings governed by the federal policy for the protection of human research subjects (also known as The Common Rule). Tests conducted purely for research are excluded from the definition, as are tests for somatic (as opposed to heritable) mutations, and testing for forensic purposes.

(b) No individual or group health insurance contract, plan, or policy delivered, issued for delivery, or renewed in this state 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 excluding disability income, long-term care and insurance supplemental policies that only provide coverage for specified diseases or other supplemental policies, shall:

(1) Use genetic information or request for genetic information or the results of genetic information or other genetic information to reject, deny, limit, cancel, refuse to renew, increase the rates of, affect the terms or conditions of, or affect a group or an individuals health insurance policy, contract, or plan;

(2) Request or require genetic information for the purpose of determining whether or not to issue or renew an individuals health benefits coverage, to set reimbursement/copay levels, or determine covered benefits and services;

(3) Release the results of genetic information without the prior written authorization of the individual from whom the information was obtained, except in a format by which individual identifiers are removed, encrypted, or encoded so that the identity of the individual is not disclosed. A recipient of information pursuant to this section may use or disclose the information solely to carry out the purpose for which the information was disclosed. Authorization shall be required for each re-disclosure. An exception shall exist for participation in research settings governed by the federal policy for the protection of human research subjects (also known as The Common Rule);

(4) Request or require information as to whether an individual has genetic information, or participated in genetic information of any kind, whether for clinical or research purposes.

(c) For the purposes of this section, genetic information is information about genes, gene product, or inherited characteristics that may derive from the individual or a family member.
R.I. Gen. Laws § 27-1-5 — RI Code / Title 27 / Chapter 27-1 / Section 27-1-5
§ 27-1-5. Deposits with general treasurer to comply with laws of other states.
Status: in_force

In all cases in which the laws of any other state of the United States now require and may subsequently require that the insurance companies incorporated by the laws of other states shall deposit, with some officer of the state in which the insurance company is incorporated, stocks or other securities in trust or for the benefit of policyholders of the companies as a condition for doing business in the other state, the general treasurer, or the general treasurers custodian, shall receive from any insurance company incorporated under the laws of this state stocks or other securities, including mortgages insured and debentures issued by the federal housing administration and obligations of national mortgage associations, in an amount as may be required by the laws of the other state or states, on deposit and in trust for the benefit of the policyholders of the company. In the event the security required under this section is one that is maintained in the federal reserve book entry system or by the depository trust company book entry system or any similar entity, then the insurance company required to make the deposit shall designate the general treasurer as the pledgee of the security and provide written notification to the general treasurer identifying the security.
R.I. Gen. Laws § 27-18-25 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-25
§ 27-18-25. Unfair discrimination prohibited.
Status: in_force

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, 35.1, 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, 35.1, and 37 of title 5.
R.I. Gen. Laws § 27-3-38.1 — RI Code / Title 27 / Chapter 27-3 / Section 27-3-38.1
§ 27-3-38.1. Insurance independently procured  Duty to report and pay tax.
Status: in_force

(a) Each insured in this state who procures or continues or renews insurance with an insurer not licensed to do an insurance business in this state on properties, risks, or exposures located or to be performed in whole or in part in this state, other than insurance procured through a surplus lines licensee, shall, within thirty (30) days after the date the insurance was so procured, continued, or renewed, file a written report with the tax administrator, upon forms prescribed by the tax administrator, showing the name and address of the insured or insureds, name and address of the insurer, the subject of the insurance, a general description of the coverage, the amount of premium currently charged, and additional pertinent information reasonably requested by the tax administrator.

(b) Where the insurance covers properties, risks, or exposures located or to be performed both in and out of this state, the sum payable shall be computed based on: (1) An amount equal to four percent (4%) on that portion of the gross premiums allocated to this state pursuant to § 27-3-38.3; plus (2) An amount equal to the portion of the premiums allocated to other states or territories on the basis of the tax rates and fees applicable to properties, risks, or exposures located or to be performed outside of this state.

(c) Pursuant to applicable sections of the general laws, the commissioner shall participate in a multistate surplus lines compact or agreement for the purpose of collecting and disbursing to reciprocal states any funds collected pursuant to subsection (b)(2) of this section applicable to other properties, risks, or exposures located or to be performed outside of this state. To the extent that other states where portions of the properties, risks, or exposures reside have failed to enter into compact or reciprocal allocation procedure with this state, the net premium tax collected shall be retained by this state.

(d) Gross premiums charged for the insurance, less any return premiums, are subject to a tax at the rate of four percent (4%). At the time of filing the report required in subsection (a) of this section, the insured shall file with the tax administrator, in the form that the administrator may prescribe, a return under oath or affirmation containing information that may be deemed necessary for the determination of the tax imposed by this section. The insured shall at the same time pay the tax due to the tax administrator.

(e) If an independently procured policy covers properties, risks, or exposures only partially located or to be performed in this state, the tax payable by the insured shall be computed on the portion of the premium properly attributable to the properties, risks, or exposures located or to be performed in this state in the manner provided in § 27-3-38.3.

(f) This section does not abrogate or modify chapter 16 of this title (Unauthorized Insurance Business), or any other provision of this title.
R.I. Gen. Laws § 27-62-7 — RI Code / Title 27 / Chapter 27-62 / Section 27-62-7
§ 27-62-7. Standards for supplemental illustrations.
Status: in_force

(a) A supplemental illustration may be provided so long as:

(1) It is appended to, accompanied by, or preceded by a basic illustration that complies with this chapter;

(2) The non-guaranteed elements shown are not more favorable to the policy owner than the corresponding elements based on the scale used in the basic illustration;

(3) It contains the same statement required of a basic illustration that non-guaranteed elements are not guaranteed; and

(4) For a policy that has a contract premium, the contract premium underlying the supplemental illustration is equal to the contract premium shown in the basic illustration. For policies that do not require a contract premium, the premium outlay underlying the supplemental illustration shall be equal to the premium outlay shown in the basic illustration.

(b) The supplemental illustration shall include a notice referring to the basic illustration for guaranteed elements and other important information.
R.I. Gen. Laws § 27-74-14 — RI Code / Title 27 / Chapter 27-74 / Section 27-74-14
§ 27-74-14. Penalties.
Status: in_force

(a) In addition to the penalties and other enforcement provisions of this chapter or under § 42-14-16, any person who willfully violates this chapter is subject to civil penalties of up to ten thousand dollars ($10,000) per violation.

(b) A person that willfully operates as or aids and abets another operating as a discount medical plan organization in violation of this chapter shall, upon conviction, be fined not more than fifty thousand dollars ($50,000) or be imprisoned for not more than one year, or both.

(c) A person that collects fees for purported membership in a discount medical plan, but purposefully fails to provide the promised benefits shall be deemed guilty of larceny and upon conviction is subject to penalties provided for in § 11-41-5. In addition, upon conviction, the person shall be ordered to pay restitution to persons aggrieved by the violation of this chapter. Restitution shall be ordered in addition to a fine or imprisonment, but not in lieu of a fine or imprisonment.
R.I. Gen. Laws § 27-42-1 — RI Code / Title 27 / Chapter 27-42 / Section 27-42-1
§ 27-42-1. Purpose.
Status: in_force

The purpose of this chapter is to give this state jurisdiction to determine jurisdiction of providers of healthcare benefits; to indicate how each provider of healthcare benefits may show under what jurisdiction it falls; to allow for examinations by this state if the provider of healthcare benefits is unable to show it is subject to another jurisdiction; to make a provider of healthcare benefits subject to the laws of this state if it cannot show that it is subject to another jurisdiction; and to disclose to purchasers of healthcare benefits whether or not the plans are fully insured.
R.I. Gen. Laws § 27-19-55 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-55
§ 27-19-55. Coverage for early intervention services.
Status: in_force

(a) Every individual or group hospital or medical expense insurance policy or contract providing coverage for dependent children, delivered or renewed in this state on or after July 1, 2004, shall include coverage of early intervention services which coverage shall take effect no later than January 1, 2005. The coverage shall be limited to a benefit of five thousand dollars ($5,000) per dependent child per policy or calendar year and shall not be subject to deductibles and coinsurance factors. Any amount paid by an insurer under this section for a dependent child shall not be applied to any annual or lifetime maximum benefit contained in the policy or contract. For the purpose of this section, early intervention services means, but is not limited to: speech and language therapy, occupational therapy, physical therapy, evaluation, case management, nutrition, service plan development and review, nursing services, and assistive technology services and devices for dependents from birth to age three (3) who are certified by the department of human services as eligible for services under part C of the Individuals with Disabilities Education Act (20 U.S.C. § 1431 et seq.).

(b) Subject to the annual limits provided in this section, insurers shall reimburse certified early intervention providers, who are designated as such by the department of human services, for early intervention services as defined in this section at rates of reimbursement equal to or greater than the prevailing integrated state/Medicaid rate for early intervention services as established by the department of human services.

(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 § 27-25-7 — RI Code / Title 27 / Chapter 27-25 / Section 27-25-7
§ 27-25-7. Location of office and meetings  Communications to members  Grievance procedures.
Status: in_force

(a) The principal office of any domestic society shall be located in this state. The meetings of its supreme governing body may be held in any state, district, province, or territory in which the society has at least one subordinate lodge, or in any other location determined by the supreme governing body, and all business transacted at the meetings shall be as valid in all respects as if the meetings were held in this state. The minutes of the proceedings of the supreme governing body and of the board of directors shall be in the English language.

(b) A society may provide in its laws for an official publication in which any notice, report, or statement required by law to be given to members, including notice of election, may be published. The required reports, notices, and statements shall be printed conspicuously in the publication. If the records of a society show that two (2) or more members have the same mailing address, an official publication mailed to one member is deemed to be mailed to all members at the same address unless a member requests a separate copy.

(c) Not later than June 1 of each year, a synopsis of the societys annual statement providing an explanation of the facts concerning the condition of the society disclosed in the statement shall be printed and mailed to each benefit member of the society or, in lieu of that, the synopsis may be published in the societys official publication.

(d) A society may provide in its laws or rules for grievance or complaint procedures for members.
R.I. Gen. Laws § 27-10-7.1 — RI Code / Title 27 / Chapter 27-10 / Section 27-10-7.1
§ 27-10-7.1. Nonresident license reciprocity.
Status: in_force

(a) Unless denied licensure, a nonresident person shall receive a nonresident adjuster license if:

(1) The person is currently licensed as a resident adjuster and is in good standing in the persons home state;

(2) The person has submitted the proper request for licensure and has paid the fees required by § 27-10-3(a)(6);

(3) The person has submitted or transmitted to the department the appropriate, completed application for licensure for the equivalent type of license and lines of authority; and

(4) The persons home state awards nonresident adjuster licenses to residents of this state on the same basis.

(b) The insurance commissioner may verify the adjusters licensing status through the database maintained by the NAIC, its affiliates or subsidiaries.

(c) As a condition to continuation of an adjuster license issued under this section, the licensee shall maintain a resident adjuster license in the licensees home state. The nonresident adjuster license issued under this section shall terminate and be surrendered immediately if the home state adjuster license terminates for any reason, unless the adjuster has been issued a license as a resident adjuster in the adjusters new home state. Notification to any state where a nonresident license is issued must be made as soon as possible, yet no later than thirty (30) days of change in new state resident license. The licensee shall include new and old addresses in the notification to the department. A new state resident license is required for nonresident licenses to remain valid. The new state resident license must have reciprocity with the licensing nonresident state(s) for the nonresident license not to terminate.

(d) The department may grant a nonresident license to an adjuster who holds a current certificate issued by a national or state based claims association with a program, approved by the department, that includes at a minimum, a proctored exam of sufficient length and rigor to adequately determine the competence of the applicant and any other requirements set by the department of business regulation.
R.I. Gen. Laws § 27-18-89 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-89
§ 27-18-89. Coverage for biomarker testing.
Status: in_force

(a) As used in this section:

(1) Biomarker means a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a specific therapeutic intervention. Biomarkers include, but are not limited to, gene mutations or protein expression.

(2) Biomarker testing means the analysis of a patients tissue, blood, or other biospecimen for the presence of a biomarker. Biomarker testing includes, but is not limited to, single-analyte tests, multi-plex panel tests, and whole genome sequencing.

(3) Clinical utility means the test result provides information that is used in the formulation of a treatment or monitoring strategy that informs a patients outcome and impacts the clinical decision. The most appropriate test may include both information that is actionable and some information that cannot be immediately used in the formulation of a clinical decision.

(4) Consensus statements means statements developed by an independent, multidisciplinary panel of experts utilizing a transparent methodology and reporting structure and with a conflict of interest policy. These statements are aimed at specific clinical circumstances and base the statements on the best available evidence for the purpose of optimizing the outcomes of clinical care.

(5) Nationally recognized clinical practice guidelines means evidence-based clinical practice guidelines developed by independent organizations or medical professional societies utilizing a transparent methodology and reporting structure and with a conflict of interest policy. Clinical practice guidelines establish standards of care informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options and include recommendations intended to optimize patient care.

(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, 2024, shall provide coverage for the services of biomarker testing in accordance with each health insurers respective principles and mechanisms of reimbursement, credentialing, and contracting. Biomarker testing must be covered for the purposes of diagnosis, treatment, appropriate management, or ongoing monitoring of an enrollees disease or condition to guide treatment decisions, when the test provides clinical utility as demonstrated by medical and scientific evidence, including, but not limited to:

(1) Labeled indications for an FDA-approved or -cleared test or indicated tests for an FDA-approved drug;

(2) Centers for Medicare Services (CMS) national coverage determinations or Medicare Administrative Contractor (MAC) local coverage determinations; or

(3) Nationally recognized clinical practice guidelines and consensus statements.

(c) Coverage as defined in subsection (b) of this section shall be provided in a manner that limits disruptions in care including the need for multiple biopsies or biospecimen samples.

(d) The patient and prescribing practitioner shall have access to clear, readily accessible, and convenient processes to request an exception to a coverage policy of a health insurer, nonprofit health service plan, and health maintenance organization. The process shall be made readily accessible on the health insurers, nonprofit health service plans, or health maintenance organizations website.
R.I. Gen. Laws § 27-7-2.1 — RI Code / Title 27 / Chapter 27-7 / Section 27-7-2.1
§ 27-7-2.1. Uninsured motorist coverage.
Status: in_force

(a) No policy insuring against loss resulting from liability imposed by law for property damage caused by collision, bodily injury, or death suffered by any person arising out of the ownership, maintenance, or use of a motor vehicle shall be delivered or issued for delivery in this state with respect to any motor vehicle registered or principally garaged in this state unless coverage is provided in or supplemental to the policy, for bodily injury or death in limits set forth in each policy, but in no instance less than the limits set forth in § 31-47-2(13)(i)(A) under provisions approved by the insurance commissioner, for the protection of persons insured under the policy who are legally entitled to recover damages from owners or operators of uninsured motor vehicles and hit-and-run motor vehicles because of property damage, bodily injury, sickness, or disease, including death, resulting from that injury, sickness, or disease. The insurer shall provide uninsured motorist coverage in an amount equal to the insureds bodily injury liability limits. The named insured shall have the option of selecting a limit in writing less than the bodily injury liability coverage, but in no event less than the limits set forth in § 31-47-2(13)(i)(A), unless the named insured is purchasing only the minimum coverage required by compulsory insurance provisions of the general laws, in which case the limit can be reduced to zero, but only after signing an advisory notice approved by the director of business regulation concerning the hazard of uninsured and underinsured motorists. That coverage shall also apply in the case of a responsible party whose liability insurance carrier was insolvent at the time of the accident or became insolvent subsequent to the accident.

(b) Notwithstanding the provisions of subsection (a), the named insured shall have the option to reject, in writing, uninsured motorist coverage for loss resulting from damage to property. If the named insured has collision coverage for property damage to his or her vehicle, then no coverage for uninsured motorist property damage shall be required unless the insured at his or her option chooses to purchase that coverage.

(c) For the purposes of this section:

(1) Policy insuring against loss means a policy that provides primary coverage for the insured motor vehicle; and

(2) Property damage means injury to or destruction of the insured vehicle, including its loss of use and any property, excluding business property, owned by the insured while contained in the insured vehicle.

(d) After the selection of limits by the named insured or the exercise of the right to reject that portion of the coverage that applies to property damage, the insurer or any affiliated insurer shall be required to notify the policyholder, in any renewal, reinstatement, substitute, amended, altered, modified, transfer, or replacement policy, as to the availability of that coverage or optional limits. The insured may, subject to the limitations expressed in this chapter, make a written request for higher limits, newly added coverage, or coverage more extensive than that provided on a prior policy.

(e) Property damage caused by collision shall be subject to a two hundred dollar ($200) deductible per claim unless otherwise agreed. Any claim submitted under the property damage portion of this section must include the name, address, and other means of identification to establish that the at-fault operator is without insurance. The rate for this coverage will be established as a percentage of the existing base collision insurance rate as utilized by the majority of companies, to be determined by the insurance commissioner.

(f) Whenever, through subrogation, an insurance company or its insurance producer collects a casualty loss from a third party, that company or insurance producer shall, from the funds collected, first pay to the insured the deductible portion of the casualty loss less the prorated share of subrogation expense and only after this retain any funds in excess of the deductible portion of the recovery.

(g) For the purposes of this section uninsured motorist shall include an underinsured motorist. An underinsured motorist is the owner or operator of a motor vehicle who carries automobile liability insurance with coverage in an amount less than the limits or damages that persons insured pursuant to this section are legally entitled to recover because of bodily injury, sickness, or disease, including death, resulting from that injury, sickness, or disease.

(h) A person entitled to recover damages pursuant to this section shall not be required to make a claim against or bring an action against the uninsured or underinsured tortfeasor as a prerequisite to recover damages from the insurer providing coverage pursuant to this section. In the event that the person entitled to recover against an underinsured motorist recovers from the insurer providing coverage pursuant to this section, that insurer shall be entitled to subrogation rights against the underinsured motorist and his or her insurance carrier. Release of the tortfeasor with the consent of the company providing the underinsured coverage shall not extinguish or bar the claim of the insured against the underinsurance carrier regardless of whether the claim has been liquidated.

(i) Whenever an insured has paid two (2) or more separate premiums for uninsured motorists coverage in a single policy of insurance or under several policies with the same insurance company, the insured shall be permitted to collect up to the aggregate amount of coverage for all of the vehicles insured, regardless of any language in the policy to the contrary.
R.I. Gen. Laws § 27-10-13 — RI Code / Title 27 / Chapter 27-10 / Section 27-10-13
§ 27-10-13. Rules and regulations.
Status: in_force

The insurance commissioner shall have the authority to promulgate all reasonable rules and regulations necessary to effect and to enforce the purposes and provisions of this chapter. Included within this authority is the power to set standards for public adjuster fees, the terms of the contract between a public adjuster and a consumer, and requirements for escrow accounts held by public adjusters for funds held on behalf of others.
R.I. Gen. Laws § 27-25-16 — RI Code / Title 27 / Chapter 27-25 / Section 27-25-16
§ 27-25-16. Benefits.
Status: in_force

(a) A society may provide the following contractual benefits in any form:

(1) Death benefits;

(2) Endowment benefits;

(3) Annuity benefits;

(4) Temporary or permanent disability benefits;

(5) Hospital, medical, or nursing benefits;

(6) Monument or tombstone benefits to the memory of deceased members; and

(7) Any other benefits authorized for life insurers and which are not inconsistent with this chapter.

(b) A society shall specify in its rules those persons who may be issued, or covered by, the contractual benefits in subsection (a) of this section, consistent with providing benefits to members and their dependents. A society may provide benefits on the lives of children under the minimum age for adult membership upon application of an adult person.
R.I. Gen. Laws § 27-20-35 — RI Code / Title 27 / Chapter 27-20 / Section 27-20-35
§ 27-20-35. Third-party reimbursement for services of certain healthcare workers.
Status: in_force

(a) Every individual or group health insurance contract, plan, or policy delivered, issued, or renewed by an insurer or nonprofit or for-profit health service corporation that provides benefits to individual subscribers and members within the state, or to all group members having a principal place of employment within the state, shall provide benefits for services rendered by a certified registered nurse anesthetist designated as a certified registered nurse anesthetist by the board of nurse registration and nursing education; provided, that the following conditions are met:

(1) The certified registered nurse anesthetist adheres to the practice of certified registered nurse anesthesia as defined by and in accordance with § 5-34.2-2;

(2) The policy or contract currently provides benefits for identical services rendered by a provider of health care licensed by the state; and

(3) The certified registered nurse anesthetist is not a salaried employee of the licensed hospital or facility for which the nonprofit medical service corporation has an alternative contractual relationship to fund the services of a certified registered nurse anesthetist.

(b) It shall remain within the sole discretion of the nonprofit medical service corporation as to which certified registered nurse anesthetists it shall contract with. Reimbursement shall be provided according to the respective principles and policies of the nonprofit medical service corporation; provided, that no nonprofit medical service corporation may be required to pay for duplicative services actually rendered by a certified registered nurse anesthetist and any other healthcare provider. Nothing contained in this section shall preclude the nonprofit medical service corporation from conducting managed care, medical necessity, or utilization review.

(c) Providers. A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any healthcare provider who is acting within the scope of that providers license or certification under applicable state law. This section shall not require that a group health plan or health insurance issuer contract with any healthcare provider willing to abide by the terms and conditions for participation established by the plan or issuer. Nothing in this section shall be construed as preventing a group health plan or a health insurance issuer from establishing varying reimbursement rates based on quality or performance measures.
R.I. Gen. Laws § 27-66-12 — RI Code / Title 27 / Chapter 27-66 / Section 27-66-12
§ 27-66-12. Licensing fees.
Status: in_force

Nothing contained in this chapter shall be deemed to affect the licensing fees set forth in chapters 19, 20, and 41 of this title.
R.I. Gen. Laws § 27-50-8 — RI Code / Title 27 / Chapter 27-50 / Section 27-50-8
§ 27-50-8. Certification of creditable coverage.
Status: in_force

(a) Small employer carriers shall provide written certification of creditable coverage to individuals in accordance with subsection (b) of this section.

(b) The certification of creditable coverage shall be provided:

(1) At the time an individual ceases to be covered under the health benefit plan or otherwise becomes covered under a COBRA continuation provision;

(2) In the case of an individual who becomes covered under a COBRA continuation provision, at the time the individual ceases to be covered under that provision; and

(3) At the time a request is made on behalf of an individual if the request is made not later than twenty-four (24) months after the date of cessation of coverage described in subsection (b)(1) or (b)(2) of this section, whichever is later.

(c) Small employer carriers may provide the certification of creditable coverage required under subsection (b)(1) of this section at a time consistent with notices required under any applicable COBRA continuation provision.

(d) The certificate of creditable coverage required to be provided pursuant to subsection (a) shall contain:

(1) Written certification of the period of creditable coverage of the individual under the health benefit plan and the coverage, if any, under the applicable COBRA continuation provision; and

(2) The waiting period, if any, and, if applicable, affiliation period imposed with respect to the individual for any coverage under the health benefit plan.

(e) To the extent medical care under a group health plan consists of group health insurance coverage, the plan is deemed to have satisfied the certification requirement under subsection (a) of this section if the carrier offering the coverage provides for certification in accordance with subsection (b) of this section.

(f)(1) If an individual enrolls in a group health plan that uses the alternative method of counting creditable coverage pursuant to § 27-50-7(c)(3) and the individual provides a certificate of coverage that was provided to the individual pursuant to subsection (b) of this section, on request of the group health plan, the entity that issued the certification to the individual promptly shall disclose to the group health plan information on the classes and categories of health benefits available under the entitys health benefit plan.

(2) The entity providing the information pursuant to subsection (f)(1) of this section may charge the requesting group health plan the reasonable cost of disclosing the information.
R.I. Gen. Laws § 27-9-7.4 — RI Code / Title 27 / Chapter 27-9 / Section 27-9-7.4
§ 27-9-7.4. Automobile insurance  Persons on active duty in United States armed forces.
Status: in_force

An insurer shall not refuse to insure, or continue to insure, limit coverage available to, charge a reinstatement fee for, or increase the premiums for automobile insurance solely because a person failed to maintain insurance for a vehicle owned by the person during the six-month (6) period immediately preceding application if the person certifies, on a form provided by the insurer, that the lapse in coverage was because the person was on active duty in the armed forces of the United States for at least thirty (30) consecutive days and that the vehicle was not driven or moved during the six-month (6) period immediately preceding the application for insurance, or during the period of time the insurance was not maintained, whichever period is shorter.
R.I. Gen. Laws § 27-66-13 — RI Code / Title 27 / Chapter 27-66 / Section 27-66-13
§ 27-66-13. Concurrent approval  License.
Status: in_force

A decision of the director required by this chapter shall be subject to chapter 35 of title 42. For any conversion subject to this chapter, the director may combine any hearings required by this chapter with any hearings on similar or related matters required by chapters 19, 20, and 41 of this title and shall consider issues of market share especially as they affect quality, access, and affordability of service.
R.I. Gen. Laws § 27-29-4.2 — RI Code / Title 27 / Chapter 27-29 / Section 27-29-4.2
§ 27-29-4.2. Penalty.
Status: in_force

For each violation of § 27-29-4.1, the offending insurance company shall be fined a sum of five hundred dollars ($500) by the department of business regulation.
R.I. Gen. Laws § 27-1-24 — RI Code / Title 27 / Chapter 27-1 / Section 27-1-24
§ 27-1-24. Meetings to approve reorganization plan  Filing of approved plan.
Status: in_force

On the application by a receiver, the court may enter an order determining, in accordance with the provisions of § 27-1-26, the various classes of creditors and stockholders, and may order a meeting of the creditors or classes of creditors and stockholders or classes of stockholders, or separate meetings of the creditors or classes of creditors and stockholders or classes of stockholders, the meeting or meetings to be summoned in a manner or upon any notice as the court may direct. The receiver shall preside at all meetings of creditors and/or stockholders held pursuant to the order. If the holders of two-thirds ( ) in value of the claims held by each class of creditors, acting in person or by proxy, and the holders of a majority in number of shares of each class of stockholders, acting in person or by proxy, agree to the plan or to any amendment and to any reorganization of the company as a consequence of the plan, the receiver shall, within five (5) days after the approval, file the plan as originally submitted or as amended and the receivers petition for instructions with reference to the plan with the court. The court shall order the plan as filed or as amended and the petition set down for hearing before it at a time and subject to further notice as may be provided in the order.
R.I. Gen. Laws § 27-10-5 — RI Code / Title 27 / Chapter 27-10 / Section 27-10-5
§ 27-10-5. License.
Status: in_force

(a) Unless denied licensure, persons who have met the requirements of § 27-10-3 shall be issued either a public, company, or independent adjuster license.

(b) A company or independent adjuster may qualify for a license in one or more of the following lines of authority:

(1) Property and casualty;

(2) Workers compensation; or

(3) Crop.

(c) An individual may not hold both a public adjuster and a company or independent adjuster license at the same time.

(d) An adjuster license shall remain in effect unless probated, suspended, revoked, or refused as long as a biennial application for renewal and fee set forth in § 27-10-3(a)(6) is paid and all other requirements for license renewal are met by the due date; otherwise, the license expires.

(e) An adjuster whose license expires may, within twelve (12) months of the renewal date, be reissued an adjuster license upon receipt of the renewal request, as prescribed by the department. However, a penalty in the amount of fifty dollars ($50.00) in addition to the renewal fee shall be required to reissue the expired license.

(f) An adjuster who is unable to comply with license renewal procedures and requirements due to military service, long-term medical disability, or some other extenuating circumstance may request a waiver of same and a waiver of any examination requirement, fine, or other sanction imposed for failure to comply with renewal procedures.

(g) An adjuster shall be subject to chapters 9.1 and 29 of this title.

(h) The adjuster shall inform the department by any means acceptable of any change in resident or business address(es) for the home state or in legal name within thirty (30) days of the change.

(i) In order to assist in the performance of the departments duties, the department may contract with nongovernmental entities, including the National Association of Insurance Commissioners (NAIC), its affiliates or subsidiaries, to perform any ministerial functions, including the collection of fees and data, related to licensing that the insurance commissioner may deem appropriate.
R.I. Gen. Laws § 27-20-39.1 — RI Code / Title 27 / Chapter 27-20 / Section 27-20-39.1
§ 27-20-39.1. Genetic information.
Status: in_force

(a) Except as provided in chapter 37.3 of title 5, insurance administrators, health plans, and providers shall be prohibited from releasing genetic information without prior written authorization of the individual. Written authorization shall be required for each disclosure and include to whom the disclosure is being made. An exception shall exist for those participating in research settings governed by the federal policy for the protection of human research subjects (also known as The Common Rule). Tests conducted purely for research are excluded from the definition, as are tests for somatic (as opposed to heritable) mutations, and testing for forensic purposes.

(b) No individual or group health insurance contract, plan, or policy delivered, issued for delivery, or renewed in this state 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 excluding disability income, long-term care and insurance supplemental policies that only provide coverage for specified diseases or other supplemental policies, shall:

(1) Use genetic information or request for genetic information or the results of genetic information or other genetic information to reject, deny, limit, cancel, refuse to renew, increase the rates of, affect the terms or conditions of, or affect a group or an individuals health insurance policy, contract, or plan;

(2) Request or require genetic information for the purpose of determining whether or not to issue or renew a group or individuals health benefits coverage, to set reimbursement/copay levels, or determine covered benefits and services;

(3) Release the results of genetic information without the prior written authorization of the individual from whom the information was obtained, except in a format by which individual identifiers are removed, encrypted, or encoded so that the identity of the individual is not disclosed. A recipient of information pursuant to this section may use or disclose the information solely to carry out the purpose for which the information was disclosed. Authorization shall be required for each redisclosure. An exception shall exist for participation in research settings governed by the federal policy for the protection of human research subjects (also known as The Common Rule);

(4) Request or require information as to whether an individual has genetic information, or participated in genetic information of any kind, whether for clinical or research purposes.

(c) For the purposes of this section, genetic information is information about genes, gene product, or inherited characteristics that may derive from the individual or a family member.
R.I. Gen. Laws § 27-2-22 — RI Code / Title 27 / Chapter 27-2 / Section 27-2-22
§ 27-2-22. Companies owned or controlled in whole or in part by foreign state or government.
Status: in_force

No license or certificate of authority to transact any kind of insurance business in this state shall be issued, renewed, or continued in effect to any domestic, foreign, or alien insurance company or other insurance entity that is owned or financially controlled in whole or in part by another state of the United States or by a foreign government or by any political subdivision, instrumentality, or agency of either, or that is an agency or instrumentality of any state government or subdivision, unless the company or entity was owned in this way, controlled, or constituted prior to January 1, 1955, and was authorized to do business in this state on or prior to January 1, 1955.
R.I. Gen. Laws § 27-80-2 — RI Code / Title 27 / Chapter 27-80 / Section 27-80-2
§ 27-80-2. Purpose.
Status: in_force

By enacting this chapter, it is the intent of the general assembly to require the complete and proper disclosure, transparency, and accountability relating to any method of payment for life insurance death benefits regulated by the state.
R.I. Gen. Laws § 27-52-5 — RI Code / Title 27 / Chapter 27-52 / Section 27-52-5
§ 27-52-5. Books and records  Reinsurance intermediary brokers.
Status: in_force

(a) For at least ten (10) years after the expiration of each contract of reinsurance transacted by the RB, the RB will keep a complete record for each transaction showing:

(1) The type of contract, limits, underwriting restrictions, classes, or risks and territory;

(2) Period of coverage, including effective and expiration dates, cancellation provisions, and notice required of cancellation;

(3) Reporting and settlement requirements of balances;

(4) Rate used to compute the reinsurance premium;

(5) Names and addresses of assuming reinsurers;

(6) Rates of all reinsurance commissions, including the commissions on any retrocessions handled by the RB;

(7) Related correspondence and memoranda;

(8) Proof of placement;

(9) Details regarding retrocessions handled by the RB including the identity of retrocessionaries and percentage of each contract assumed or ceded;

(10) Financial records including, but not limited to, premium and loss accounts; and

(11) When the RB procures a reinsurance contract on behalf of a licensed ceding insurer:

(i) Directly from any assuming reinsurer, written evidence that the assuming reinsurer has agreed to assume the risk; or

(ii) If placed through a representative of the assuming reinsurer, other than an employee, written evidence that the reinsurer has delegated binding authority to the representative.

(b) The insurer will have access and the right to copy and audit all accounts and records maintained by the RB related to its business in a form usable by the insurer.
R.I. Gen. Laws § 27-46-9 — RI Code / Title 27 / Chapter 27-46 / Section 27-46-9
§ 27-46-9. Restrictions on insurance purchased by purchasing groups.
Status: in_force

(a) A purchasing group may not purchase insurance from a risk retention group that is not chartered in a state or from an insurer not admitted in the state in which the purchasing group is located, unless the purchase is effected through a licensed agent or broker or insurance producer acting pursuant to the surplus lines laws and regulations of that state.

(b) A purchasing group which obtains liability insurance from an insurer not admitted in this state or a risk retention group shall inform each of the members of the group which have a risk resident or located in this state that the risk is not protected by an insurance insolvency guaranty fund in this state, and that the risk retention group or the insurer may not be subject to all insurance laws and regulations of this state.

(c) No purchasing group may purchase insurance providing for a deductible or self-insured retention applicable to the group as a whole; coverage may provide for a deductible or self-insured retention applicable to individual members.

(d) Purchases of insurance by purchasing groups are subject to the same standards regarding aggregate limits which are applicable to all purchases of group insurance.
R.I. Gen. Laws § 27-29-13 — RI Code / Title 27 / Chapter 27-29 / Section 27-29-13
§ 27-29-13. Payment of premium  Cancellation.
Status: in_force

Notwithstanding the provisions of chapter 14.6 of title 19, private passenger motor vehicle insurance policyholders on either six-month (6) or twelve-month (12) policies shall have the option of paying any policy premiums in installment payments; provided that for a twelve-month (12) policy the insurer may require a payment of fifteen percent (15%) of the annual premium at time of issuance with the balance to be paid thereafter in nine (9) subsequent and equal monthly installments thereafter for a six-month (6) policy, the insurer may require a payment of thirty-five percent (35%) of the premium at time of issuance with the balance to be paid in three (3) subsequent and equal monthly installments thereafter. The insurer may levy a service charge of up to five dollars ($5.00) per installment period against those policyholders who choose the installment option. An insurer may levy and collect a maximum fee or charge of ten dollars ($10.00) for any late payment of premium by a policyholder. A late fee may not be imposed unless payment is received more than five (5) business days following the date payment is due. Policyholders shall be entitled to receive no less than thirty (30) days notice before a cancellation of an automobile insurance policy for any reason except nonpayment of premium, in which instance policyholders shall be entitled to receive no less than ten (10) days notice.
R.I. Gen. Laws § 27-20-2 — RI Code / Title 27 / Chapter 27-20 / Section 27-20-2
§ 27-20-2. Organization as charitable corporation  Insurance laws inapplicable.
Status: in_force

Each nonprofit medical service corporation shall be incorporated as a charitable corporation under the provisions of chapter 6 of title 7, and shall be subject to that chapter and to this chapter. The laws of this state relative to insurance companies or to the business of insurance, and acts in amendment or in addition to those laws, shall not apply to any nonprofit medical service corporation unless expressly provided in those laws. Each nonprofit medical service corporation shall be deemed to be an insurer, for the purposes of compliance with chapter 17 of title 44.
R.I. Gen. Laws § 27-60-2 — RI Code / Title 27 / Chapter 27-60 / Section 27-60-2
§ 27-60-2. Definitions.
Status: in_force

For the purpose of this chapter:

(1) Abuse means the occurrence of one or more of the following acts:

(i) Attempting to cause or intentionally, knowingly, or recklessly causing another person, including a minor child, bodily injury, physical harm, severe emotional distress, psychological trauma, rape, sexual assault, or involuntary sexual intercourse;

(ii) Knowingly engaging in a course of conduct or repeatedly committing acts toward another person, including a minor child, including following the person or minor child without proper authority, under circumstances that place the person or minor child in reasonable fear of bodily injury or physical harm;

(iii) Subjecting another person, including a minor child, to false imprisonment; or

(iv) Attempting to cause or intentionally, knowingly, or recklessly causing damage to property so as to intimidate or attempt to control the behavior of another person, including a minor child.

(2) Abuse-related medical condition means a medical condition sustained by a subject of abuse that arises in whole or part out of an act or pattern of abuse.

(3) Abuse status means the fact or perception that a person is, has been, or may be a subject of abuse, irrespective of whether the person has sustained abuse-related medical conditions.

(4) Commissioner means the director of the department of business regulation.

(5) Health benefit plan or plan means a policy, contract, certificate, or agreement offered by a carrier to provide, deliver, arrange for, pay for, or reimburse any of the costs of healthcare services. Health benefit plan includes accident only, credit health, dental, vision, Medicare supplement or long-term care insurance, coverage issued as a supplement to liability insurance, short-term and catastrophic health insurance policies, and a policy that pays on a cost-incurred basis. Health benefit plan does not include workers compensation or similar insurance.

(6) Health carrier means an entity subject to the insurance laws and regulations of this state, or subject to the jurisdiction of the commissioner, that contracts or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of healthcare services, including a sickness and accident insurance company, a health maintenance organization, a nonprofit hospital and health service corporation, or any other entity providing a plan of health insurance, health benefits, or health services.

(7) Insured means a party named on a health benefit plan as the person with legal rights to the benefits provided by the health benefit plan. For group plans, insured includes a person who is a beneficiary covered by a group health benefit plan.

(8) Subject of abuse means a person to whom a family member, or a current or former household member, intimate partner, or caretaker, or a perpetrator of sexual assault, a stalker, or a sex offender has directed an act defined in subsection (1) of this section; who has current or prior injuries, illnesses, or disorders that resulted from abuse; or who seeks, may have sought, or had reason to seek medical or psychological treatment for abuse or protection, court-ordered protection, or shelter from abuse.
R.I. Gen. Laws § 27-29-10 — RI Code / Title 27 / Chapter 27-29 / Section 27-29-10
§ 27-29-10. Provisions of chapter additional to existing law.
Status: in_force

The powers vested in the insurance commissioner by this chapter shall be additional to any other powers to enforce any penalties, fines, or forfeitures authorized by law with respect to the methods, acts, and practices declared to be unfair or deceptive.
R.I. Gen. Laws § 27-49-5.1 — RI Code / Title 27 / Chapter 27-49 / Section 27-49-5.1
§ 27-49-5.1. Insurer disclosure  Qualified immunity.
Status: in_force

(a) An insurer and an agent authorized to act on its behalf, upon written request, may provide to another insurer or insurance industry related organization whose purpose it is to investigate or assist in the prosecution of motor vehicle insurance fraud any and all relevant factually accurate information that the insurer may possess as to any motor vehicle claim or other information that may relate to whether a motor vehicle theft or motor vehicle insurance fraud has occurred.

(b) No insurer, organization, or agent authorized to act under subsection (a) shall be subjected to any civil or criminal liability in any cause of action of any kind for releasing or receiving any relevant factually accurate information pursuant to subsection (a) if it acts in good faith and with due care solely for the purpose of facilitating the discovery and prosecution of the theft or fraud.
R.I. Gen. Laws § 27-72-14 — RI Code / Title 27 / Chapter 27-72 / Section 27-72-14
§ 27-72-14. Fraud prevention and control.
Status: in_force

(a) Fraudulent life settlement acts, interference and participation of convicted felons prohibited. (1) A person shall not commit a fraudulent life settlement act. (2) A person shall not knowingly and intentionally interfere with the enforcement of the provisions of this chapter or investigations of suspected or actual violations of this chapter. (3) A person in the business of life settlements shall not knowingly or intentionally permit any person convicted of a felony involving dishonesty or breach of trust to participate in the business of life settlements.

(b) Fraud warning required. (1) Life settlement contracts and applications for life settlement contracts, regardless of the form of transmission, shall contain the following statement or a substantially similar statement: (1) Any person who knowingly presents false information in an application for insurance or life settlement contract is guilty of a crime and may be subject to fines and confinement in prison. (2) The lack of a statement as required in subsection (b)(1) does not constitute a defense in any prosecution for a fraudulent life settlement act.

(c) Mandatory reporting of fraudulent life settlement acts. (1) Any person engaged in the business of life settlements having knowledge or a reasonable belief that a fraudulent life settlement act is being, will be, or has been committed shall provide to the commissioner the information required by, and in a manner prescribed by, the commissioner. (2) Any other person having knowledge or a reasonable belief that a fraudulent life settlement act is being, will be, or has been committed may provide to the commissioner the information required by, and in a manner prescribed by, the commissioner.

(d) Immunity from liability. (1) No civil liability shall be imposed on and no cause of action shall arise from a persons furnishing information concerning suspected, anticipated, or completed fraudulent life settlement acts or suspected or completed fraudulent insurance acts, if the information is provided to or received from: (i) The commissioner or the commissioners employees, agents, or representatives; (ii) Federal, state or local law enforcement or regulatory officials or their employees, agents, or representatives; (iii) A person involved in the prevention and detection of fraudulent life settlement acts or that persons agents, employees, or representatives; (iv) Any regulatory body or their employees, agents, or representatives, overseeing life insurance, life settlements, securities or investment fraud; (v) The life insurer that issued the life insurance policy covering the life of the insured; or (vi) The licensee and any agents, employees, or representatives. (2) Subsection (d)(1) shall not apply to statements made with actual malice. In an action brought against a person for filing a report or furnishing other information concerning a fraudulent life settlement act or a fraudulent insurance act, the party bringing the action shall plead specifically any allegation that subsection (d)(1) does not apply because the person filing the report or furnishing the information did so with actual malice. (3) A person identified in subsection (d)(1) shall be entitled to an award of attorneys fees and costs if he or she is the prevailing party in a civil cause of action for libel, slander or any other relevant tort arising out of activities in carrying out the provisions of this chapter and the party bringing the action was not substantially justified in doing so. For purposes of this section, a proceeding is substantially justified if it had a reasonable basis in law or fact at the time that it was initiated. (4) This section does not abrogate or modify common law or statutory privileges or immunities enjoyed by a person described in subsection (d)(1).

(e) Confidentiality. (1) The documents and evidence provided pursuant to subsection (d) or obtained by the commissioner in an investigation of suspected or actual fraudulent life settlement acts shall be privileged and confidential and shall not be a public record and shall not be subject to discovery or subpoena in a civil or criminal action. (2) Subsection (e)(1) does not prohibit release by the commissioner of documents and evidence obtained in an investigation of suspected or actual fraudulent life settlement acts: (i) In administrative or judicial proceedings to enforce laws administered by the commissioner; (ii) To federal, state or local law enforcement or regulatory agencies, to an organization established for the purpose of detecting and preventing fraudulent life settlement acts or to the NAIC; or (iii) At the discretion of the commissioner, to a person in the business of life settlements that is aggrieved by a fraudulent life settlement act. (3) Release of documents and evidence under subsection (e)(2) does not abrogate or modify the privilege granted in subsection (e)(1).

(f) Other law enforcement or regulatory authority. This chapter shall not:

(1) Preempt the authority or relieve the duty of other law enforcement or regulatory agencies to investigate, examine, and prosecute suspected violations of law;

(2) Preempt, supersede, or limit any provision of any state securities law or any rule, order, or notice issued thereunder;

(3) Prevent or prohibit a person from voluntarily disclosing information concerning life settlement fraud to a law enforcement or regulatory agency other than the insurance department; or

(4) Limit the powers granted elsewhere by the laws of this state to the commissioner or an insurance fraud unit to investigate and examine possible violations of law and to take appropriate action against wrongdoers.

(g) Life settlement antifraud initiatives. (1) Providers and brokers shall have in place antifraud initiatives reasonably calculated to detect, prosecute, and prevent fraudulent life settlement acts. At the discretion of the commissioner, the commissioner may order, or a licensee may request and the commissioner may grant, such modifications of the following required initiatives as necessary to ensure an effective antifraud program. The modifications may be more or less restrictive than the required initiatives so long as the modifications may reasonably be expected to accomplish the purpose of this section. Antifraud initiatives shall include: (i) Fraud investigators, who may be provider or broker employees or independent contractors; and (ii) An antifraud plan, which shall be submitted to the commissioner. The antifraud plan shall include, but not be limited to: (A) A description of the procedures for detecting and investigating possible fraudulent life settlement acts and procedures for resolving material inconsistencies between medical records and insurance applications; (B) A description of the procedures for reporting possible fraudulent life settlement acts to the commissioner; (C) A description of the plan for antifraud education and training of underwriters and other personnel; and (D) A description or chart outlining the organizational arrangement of the antifraud personnel who are responsible for the investigation and reporting of possible fraudulent life settlement acts and investigating unresolved material inconsistencies between medical records and insurance applications. (2) Antifraud plans submitted to the commissioner shall be privileged and confidential and shall not be a public record and shall not be subject to discovery or subpoena in a civil or criminal action.
R.I. Gen. Laws § 27-9-7.1 — RI Code / Title 27 / Chapter 27-9 / Section 27-9-7.1
§ 27-9-7.1. Premium reduction for completing a motor vehicle accident prevention course.
Status: in_force

(a) Every schedule of rates, rating plan, or rating system for automobile liability and physical damage insurance filed with the commissioner shall provide for a reduction in premium charges for those persons fifty-five (55) years of age and older who successfully complete a motor vehicle accident prevention course approved by the division of motor vehicles. All insurers shall allow a reduction in the premium deemed appropriate by the commissioner to persons successfully completing that course.

(b) Motor vehicle accident prevention courses shall be taught by instructors who may be members of the American Association of Retired Persons, and are certified or approved by the division of motor vehicles. Courses may be approved that provide for a form of instruction, including, but not limited to, online courses, classroom, or driving instruction for a minimum number of hours determined by the division of motor vehicles. Instructors may or may not receive compensation.

(c) Each person who completes an approved course shall be issued a certificate by the course sponsor, provided that person has no chargeable accidents or convictions within a three-year (3) period. Any certificate issued shall be valid for a period of two (2) years from its issuance, provided the holder has had no chargeable accidents or convictions within a three-year (3) period. Any person who desires to renew or extend a certificate shall be required to successfully complete another course.

(d) Nothing provided in this section shall preclude an insurer from increasing the premium or charging an insured a surcharge for motor vehicle accidents and/or motor vehicle convictions during the two-year (2) period for which a certificate was issued.

(e) This section shall not apply to any group automobile insurance policy under which premiums are broadly averaged for the group rather than determined individually.
R.I. Gen. Laws § 27-30-5 — RI Code / Title 27 / Chapter 27-30 / Section 27-30-5
§ 27-30-5. Term of consumer credit insurance.
Status: in_force

(a) Effective date of coverage. (1) For consumer credit insurance made available to and elected by the debtor before or contemporaneous with a credit transaction to which the insurance relates, the term of insurance shall, subject to acceptance by the insurer, commence on the date when the debtor becomes obligated to the creditor, except that, when evidence of individual insurability is required and such evidence is furnished more than thirty (30) days after the date when the debtor becomes obligated to the creditor, the term of the credit insurance may commence on the date on which the insurance company determines the evidence to be satisfactory. (2) For insurance coverage made available to and elected by the debtor on a date subsequent to the date of the consumer credit transaction to which the insurance relates, the insurance shall, subject to acceptance by the insurer, commence on a date not earlier than the date the election is made by the debtor nor later than thirty (30) days following the date on which the insurance company accepts the risk for coverage, according to an objective method such as one related to a particular date within the billing or repayment cycle or a calendar month. (3) Notwithstanding the provisions of subdivisions (a)(1) and (a)(2), when a group policy provides coverage with respect to debts existing on the policy effective date, the insurance relating to the debt shall not commence before the effective date of the group policy. (4) In no event shall a charge for insurance be made to the debtor and retained by the creditor or insurer for any time prior to commencement of the consumer credit insurance to which the charge is related.

(b) Termination date of coverage. (1) The term of any consumer credit insurance shall not extend beyond the termination date specified in the policy. The termination date of insurance may precede, coincide with, or follow the scheduled maturity date of the debt to which it relates, subject to any other requirements and restrictions of this chapter. (2) The term of any consumer credit insurance shall not extend more than fifteen (15) days beyond the scheduled maturity date of the debt except when extended without additional cost to the debtor or except when extended pursuant to a written agreement, signed by the debtor, in connection with a variable interest rate credit transaction or a deferral, renewal, refinancing, or consolidation of debt. (3) If the debt is discharged due to renewal, financing, or consolidation prior to the scheduled termination date of insurance, any insurance in force shall be terminated before any new insurance may be written in connection with the renewed, refinanced, or consolidated debt. (4) In all cases of termination of insurance prior to the scheduled termination of the insurance, an appropriate refund or credit to the debtor shall be made of any unearned insurance charge paid by the debtor for a term of insurance after the date of the termination, except that no refund is required of a charge made for insurance if the insurance is terminated by performance of the insurers obligation with respect to insurance. (5) An insured debtor may terminate consumer credit insurance at any time by providing advance request to the insurer. The individual policy or group certificate may require that the request be in writing or that the debtor surrender the individual policy or group certificate, or both. The debtors right to terminate coverage may also be subject to the terms of the credit transaction contract.
R.I. Gen. Laws § 27-5-29 — RI Code / Title 27 / Chapter 27-5 / Section 27-5-29
§ 27-5-29. Statement on policy as to surplus and reserve funds.
Status: in_force

Every policy issued by a company that has constituted and set apart a guaranty surplus and special reserve fund under §§ 27-5-15  27-5-31, or any prior law of this state, shall have printed on the policy by the company a statement that the policy is issued under and in pursuance of the laws of the state of Rhode Island relating to guaranty surplus and special reserve funds, and every policy shall be deemed to have been issued and received subject to the provisions of this chapter.
R.I. Gen. Laws § 27-41-1 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-1
§ 27-41-1. Short title.
Status: in_force

This chapter may be cited as the Health Maintenance Organization Act.
R.I. Gen. Laws § 27-1-7 — RI Code / Title 27 / Chapter 27-1 / Section 27-1-7
§ 27-1-7. Certificate of deposits.
Status: in_force

Whenever any insurance company has deposited the requisite stocks or other securities in conformity with the laws of the state in which the company is desirous of transacting business, the general treasurer shall furnish the company at its expense a certificate under seal of the deposit for each state that shall require the deposit, which certificate shall embrace the items of security and the amount of each deposited, and shall state that the general treasurer is satisfied that the stocks are of the market value represented, but no stocks or other securities deposited in this manner shall be withdrawn except as provided in § 27-1-6.
R.I. Gen. Laws § 27-74-16 — RI Code / Title 27 / Chapter 27-74 / Section 27-74-16
§ 27-74-16. Regulations.
Status: in_force

The commissioner shall adopt regulations to carry out the provisions of this chapter, including standards for readability of advertisements, marketing materials, brochures, discount medical plan cards, and any other communications by discount medical plan organizations to members and prospective members.
R.I. Gen. Laws § 27-2-30 — RI Code / Title 27 / Chapter 27-2 / Section 27-2-30
§ 27-2-30. Notification of a cybersecurity event.
Status: in_force

(a) Each 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 the insurer reasonably believes that the nonpublic information involved affects two hundred fifty (250) or more consumers residing in this state and that either of the following apply:

(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 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 imposed under § 27-1.3-5 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 § 27-46-15 — RI Code / Title 27 / Chapter 27-46 / Section 27-46-15
§ 27-46-15. Severability.
Status: in_force

If any clause, sentence, paragraph, section, or part of this chapter or the application of this chapter to any person or circumstances shall, for any reason, be adjudged by any court of competent jurisdiction to be invalid, that judgment shall not affect, impair, or invalidate the remainder of this chapter, and the application of the chapter to other persons or circumstances, but shall be confined in its operation to the clause, sentence, paragraph, section, or part of it directly involved in the controversy in which the judgment shall have been rendered and to the person or circumstances involved.
R.I. Gen. Laws § 27-41-27 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-27
§ 27-41-27. Offer of health maintenance organization alternative to employees.
Status: in_force

(a)(1) In accordance with regulations promulgated by the director of the department of business regulation: (i) Each employer that during any calendar quarter employed an average number of employees of not less than twenty-five (25), and (ii) The state and each political subdivision of the state that during any calendar quarter employed an average number of employees of not less than twenty-five (25), shall include in any benefits plan, offered to their employees in the calendar year beginning after that calendar quarter, the option of membership in licensed health maintenance organizations (HMOs) that are qualified under the provisions of § 42-62-9 and that are engaged in the provision of basic health services in health maintenance organization (HMO) service areas in which at least twenty-five (25) of those employees reside.

(2) If any of the employees of an employer or the state or political subdivision of the state described in subsection (a)(1) of this section are represented by a collective bargaining representative or other employee representative designated or selected under the law, the offer of a membership in a licensed health maintenance organization (HMO), required by subsection (a)(1) of this section to be made in a health benefits plan offered to those employees:

(i) Shall be first made to that collective bargaining representative or other employee representative; and

(ii) If that offer is accepted by that representative, it shall then be made to each employee.

(b) If there is more than one licensed and qualified health maintenance organization engaged in the provision of health services in the area in which the employees of an employer reside and if:

(1) One or more of those organizations provides health services through professionals who are employed members of the staff of the organization or through an organized medical group or groups on a contractual basis; and

(2) One or more of those organizations provides those services through an individual practice association or associations; then of the licensed and qualified health maintenance organizations included in a health benefits plan of that employer pursuant to subsection (a) of this section at least one shall be an organization that provides health services as described in subsection (b)(1) of this section and at least one shall be an organization that provides health services as described in subsection (b)(2) of this section.

(c) An employer shall offer the option of membership in additional licensed and qualified health maintenance organizations if the additional licensed and qualified health maintenance organizations demonstrate that their service areas include the residence areas of employees:

(1) Who do not reside in the service area of licensed health maintenance organizations already included in the employers health benefits plans; or

(2) To whom membership in licensed and qualified health maintenance organizations already included in the health benefits plans is not available because those organizations have closed their enrollment of eligible employees of that employer.

(d) An employer is not required to include in the health benefits plan offered to eligible employees the option of membership in the specific licensed and qualified health maintenance organization that initiated the request for inclusion in the health benefits plan; provided, that the employer selects, in a manner consistent with this section, one or more other licensed and qualified health maintenance organizations that may not have made a request but are willing to be included; provided, that these latter health maintenance organizations are of the same type, i.e., the type described in subsection (b)(1) of this section or the type described in subsection (b)(2) of this section, and serve, or will serve at a minimum, the same area in which the employers or public entitys employees reside individually or collectively as the health maintenance organization that submitted the timely request.

(e) No employer shall be required to pay more for health benefits as a result of the application of this section than would otherwise be required by any prevailing collective bargaining agreement or legally enforceable contract for the provision of health benefits between the employer and its employees; provided, that the annual per employee absolute dollar contribution by the employer for any alternative health maintenance organization coverage shall in no event be required by this section to exceed the employers per employee absolute dollar contribution to any other health benefits plan offered by the employer. Each employer that provides payroll deductions as a means of paying employees contributions for health benefits or that provides a health benefits plan, and that is required by subsection (a) to offer his or her employees the option of membership in a licensed and qualified health maintenance organization (HMO), shall, with the consent of an employee who exercises that option, arrange for the employees contribution for that membership to be paid through payroll deductions.
R.I. Gen. Laws § 27-77-2 — RI Code / Title 27 / Chapter 27-77 / Section 27-77-2
§ 27-77-2. Definitions.
Status: in_force

For purposes of this chapter:

(1) Commissioner means the director of the department of business regulation or his or her designee.

(2) Insurance group. For the purpose of conducting an ORSA, the term insurance group means those insurers and affiliates included within an insurance holding company system as defined in chapter 35 of this title.

(3) Insurer. The term insurer 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.

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

(5) Own Risk and Solvency Assessment or ORSA. An Own Risk and Solvency Assessment or ORSA means a confidential internal assessment, appropriate to the nature, scale, and complexity of an insurer or insurance group, conducted by that insurer or insurance group of the material and relevant risks associated with the insurer or insurance groups current business plan, and the sufficiency of capital resources to support those risks.

(6) ORSA guidance manual means the current version of the Own Risk and Solvency Assessment Guidance Manual developed and adopted by the NAIC and as amended from time to time. A change in the ORSA guidance manual shall be effective on January 1 following the calendar year in which the changes have been adopted by the NAIC.

(7) ORSA summary report means a confidential high-level summary of an insurer or insurance groups ORSA.
R.I. Gen. Laws § 27-5-19 — RI Code / Title 27 / Chapter 27-5 / Section 27-5-19
§ 27-5-19. Certification that funds equal capital stock  Subsequent additions.
Status: in_force

Whenever any company notifies the insurance commissioner that it has fulfilled the requirements already expressed in this chapter, and that its guaranty surplus fund and its special reserve fund taken together equal its capital stock, the commissioner shall make an examination of the company and make a certificate of the result and file the certificate in the commissioners office. If the commissioner finds that the combined funds equal the capital stock of the company, after this the company may continue, out of any subsequent profits of its business, to add to those funds; provided, that whenever any addition is made to the special reserve fund, an equal sum shall be carried to the guaranty surplus fund.
R.I. Gen. Laws § 27-19-35 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-35
§ 27-19-35. Diabetes treatment.
Status: in_force

(a) Every individual or group health insurance contract, plan, or policy delivered, issued for delivery, or renewed in this state 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 the following equipment and supplies for the treatment of insulin treated diabetes, non-insulin treated diabetes, and gestational diabetes when medically appropriate and prescribed by a physician: blood glucose monitors and blood glucose monitors for the legally blind, test strips for glucose monitors and/or visual reading, insulin, injection aids, cartridges for the legally blind, syringes, insulin pumps and appurtenances to the pumps, insulin infusion devices, and oral agents for controlling blood sugar and therapeutic/molded shoes for the prevention of amputation. Upon the approval of new or improved diabetes equipment and supplies by the Food and Drug Administration, all policies governed by this chapter shall guarantee coverage of new diabetes equipment and supplies when medically appropriate and prescribed by a physician. The policies shall also include coverage, when medically necessary, for diabetes self-management education to ensure that persons with diabetes are instructed in the self-management and treatment of their diabetes, including information on the nutritional management of diabetes. The coverage for self-management education and education relating to medical nutrition therapy shall be limited to medically necessary visits upon the diagnosis of diabetes, where a physician diagnoses a significant change in the patients symptoms or conditions that necessitates changes in a patients self-management, or where reeducation or refresher training is necessary. This education, when medically necessary and prescribed by a physician, may be provided only by the physician or upon his or her referral by an appropriately licensed and certified healthcare provider and may be conducted in group settings. Coverage for self-management education and education relating to medical nutrition therapy shall also include home visits when medically necessary.

(b) Benefit plans offered by a hospital service corporation may impose copayment or deductibles, or both, for the benefits mandated by this chapter, however, in no instance shall the copayment or deductible amount be greater than the copayment or deductible amount imposed for other supplies, equipment, or physician office visits. 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.
R.I. Gen. Laws § 27-20-43 — RI Code / Title 27 / Chapter 27-20 / Section 27-20-43
§ 27-20-43. FDA approved prescription contraceptive drugs and devices.
Status: in_force

(a) Every individual or group health insurance contract, plan, or policy that provides prescription coverage and is delivered, issued for delivery, or renewed in this state shall provide coverage for FDA approved contraceptive drugs and devices requiring a prescription. Provided, that nothing in this subsection shall be deemed to mandate or require coverage for the prescription drug RU 486.

(b) Notwithstanding any other provision of this section, any medical service corporation may issue to a religious employer an individual or group health insurance contract, plan, or policy that excludes coverage for prescription contraceptive methods that are contrary to the religious employers bona fide religious tenets.

(c) As used in this section, religious employer means an employer that is a church or a qualified church-controlled organization as defined in 26 U.S.C. § 3121.

(d) Every religious employer that invokes the exemption provided under this section shall provide written notice to prospective enrollees prior to enrollment with the plan, listing the contraceptive healthcare services the employer refuses to cover for religious reasons.

(e) Beginning on the first day of each plan year after April 1, 2019, every health insurance issuer offering group or individual health insurance coverage that covers prescription contraception shall not restrict reimbursement for dispensing a covered prescription contraceptive up to three hundred sixty-five (365) days at a time.
R.I. Gen. Laws § 27-72-3 — RI Code / Title 27 / Chapter 27-72 / Section 27-72-3
§ 27-72-3. Licensing requirements.
Status: in_force

(a) No person, wherever located, shall act as a provider or broker with an owner or multiple owners who is a resident of this state without first having obtained a license from the commissioner. If there is more than one owner on a single policy and the owners are residents of different states, the life settlement contract shall be governed by the law of the state in which the owner having the largest percentage ownership resides or, if the owners hold equal ownership, the state of residence of one owner agreed upon in writing by all owners.

(b) Application for a provider or broker license shall be made to the commissioner by the applicant on a form prescribed by the commissioner, and the application shall be accompanied by a fee reasonable in an amount established by the commissioner.

(c) A life insurance producer who has been duly licensed as a resident insurance producer with a life line of authority in this state or his or her home state for at least one year and is licensed as a nonresident producer in this state shall be deemed to meet the licensing requirements of this section and shall be permitted to operate as a broker.

(d) Not later than thirty (30) days from the first day of operating as a broker, the life insurance producer shall notify the commissioner that he or she is acting as a broker on a form prescribed by the commissioner, and shall pay any applicable fee to be determined by the commissioner. Notification shall include an acknowledgement by the life insurance producer that he or she will operate as a broker in accordance with this chapter.

(e) The insurer that issued the policy that is the subject of a life settlement contract shall not be responsible for any act or omission of a broker or provider or purchaser arising out of or in connection with the life settlement transaction, unless the insurer receives compensation for the placement of a life settlement contract from the provider or purchaser or broker in connection with the life settlement contract.

(f) A person licensed as an attorney, certified public accountant or financial planner accredited by a nationally recognized accreditation agency, who is retained to represent the owner, whose compensation is not paid directly or indirectly by the provider or purchaser, may negotiate life settlement contracts on behalf of the owner without having to obtain a license as a broker.

(g) Broker licenses may be renewed on a schedule prescribed by the commissioner and upon payment of the reasonable renewal fee as prescribed by the commissioner. Failure to pay the fee within the terms prescribed shall result in the automatic revocation of the license requiring periodic renewal.

(h) The term of a provider license shall be perpetual; provided, that the provider files the annual report and pays the fee as prescribed by the commissioner. Failure to file the annual report or pay the fees on or before the due date shall result in immediate suspension of the license.

(i) The applicant shall provide such information as the commissioner may require on forms prepared by the commissioner. The commissioner shall have authority, at any time, to require such applicant to fully disclose the identity of its stockholders (except stockholders owning fewer than ten percent (10%) of the shares of an applicant whose shares are publicly traded), partners, officers, and employees, and the commissioner may, in the exercise of the commissioners sole discretion, refuse to issue such a license in the name of any person if not satisfied that any officer, employee, stockholder, or partner thereof who may materially influence the applicants conduct meets the standards set forth in this chapter.

(j) Upon the filing of an application and the payment of the license fee, the commissioner shall make an investigation of each applicant and may issue a license if the commissioner finds that the applicant:

(1) If a provider, has provided a detailed plan of operation;

(2) Is competent and trustworthy and intends to transact its business in good faith;

(3) Has a good business reputation and has had experience, training, or education so as to be qualified in the business for which the license is applied;

(4) If the provider applicant is a legal entity, is formed or organized pursuant to the laws of this state or is a foreign legal entity authorized to transact business in this state, or provides a certificate of good standing from the state of its domicile; and

(5) Has provided to the commissioner an anti-fraud plan that meets the requirements of this chapter and includes:

(i) A description of the procedures for detecting and investigating possible fraudulent acts and procedures for resolving material inconsistencies between medical records and insurance applications;

(ii) A description of the procedures for reporting fraudulent insurance acts to the commissioner;

(iii) A description of the plan for anti-fraud education and training of its underwriters and other personnel; and

(iv) A written description or chart outlining the arrangement of the anti-fraud personnel who are responsible for the investigation and reporting of possible fraudulent insurance acts and investigating unresolved material inconsistencies between medical records and insurance applications.

(k) The commissioner shall not issue any license to any nonresident applicant, unless a written designation of an agent for service of process is filed and maintained with the commissioner or unless the applicant has filed with the commissioner the applicants written irrevocable consent that any action against the applicant may be commenced against the applicant by service of process on the commissioner.

(l) Each licensee shall file with the commissioner on or before the first day of March of each year an annual statement containing such information as the commissioner by rule may prescribe. The department may have this annual statement renewed and analyzed by outside consultant(s) and the total cost of that review shall be borne by, billed directly to, and paid by the provider filing the annual statement.

(m) A provider may not use any person to perform the functions of a broker as defined in this chapter unless the person holds a current, valid license as a broker, and as provided in this section.

(n) A broker may not use any person to perform the functions of a provider as defined in this chapter unless such person holds a current, valid license as a provider, and as provided in this section.

(o) A provider or broker shall provide to the commissioner new or revised information about officers, ten percent (10%) or more stockholders, partners, directors, members, or designated employees within thirty (30) days of the change.

(p) An individual licensed as a broker shall complete, on a biennial basis, fifteen (15) hours of training related to life settlements and life settlement transactions, as required by the commissioner; provided, however, that a life insurance producer who is operating as a broker pursuant to this section shall not be subject to the requirements of this subsection. Any person failing to meet the requirements of this subsection shall be subject to the penalties imposed by the commissioner.
R.I. Gen. Laws § 27-25-21 — RI Code / Title 27 / Chapter 27-25 / Section 27-25-21
§ 27-25-21. Investments.
Status: in_force

A society shall invest its funds only in those investments authorized by the laws of this state for the investment of assets of life insurers and subject to the limitations on the investments. Any foreign or alien society permitted or seeking to do business in this state that invests its funds in accordance with the laws of the state, district, territory, country, or province in which it is incorporated, shall be held to meet the requirements of this section for the investment of funds.
R.I. Gen. Laws § 27-20-48 — RI Code / Title 27 / Chapter 27-20 / Section 27-20-48
§ 27-20-48. Mandatory coverage for certain lyme disease treatments.
Status: in_force

Every individual or group hospital or medical expense insurance policy or individual or group hospital or medical services plan contract delivered, issued for delivery, or renewed in this state on or after January 1, 2004, shall provide coverage for diagnostic testing and long-term antibiotic treatment of chronic lyme disease when determined to be medically necessary and ordered by a physician acting in accordance with chapter 37.5 of title 5 entitled lyme disease diagnosis and treatment after making a thorough evaluation of the patients symptoms, diagnostic test results, and response to treatment. Treatment otherwise eligible for benefits pursuant to this section shall not be denied solely because such treatment may be characterized as unproven, experimental, or investigational in nature.
R.I. Gen. Laws § 27-78-1 — RI Code / Title 27 / Chapter 27-78 / Section 27-78-1
§ 27-78-1. Short title.
Status: in_force

This chapter shall be known and may be cited as the Certificates of Insurance Model Act.
R.I. Gen. Laws § 27-18-81 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-81
§ 27-18-81. Consumer notification.
Status: in_force

Every health insurer or health plan 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 § 27-19-53 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-53
§ 27-19-53. Mandatory coverage for certain lyme disease treatments.
Status: in_force

Every individual or group hospital or medical expense insurance policy or individual or group hospital or medical services plan contract delivered, issued for delivery, or renewed in this state on or after January 1, 2004, shall provide coverage for diagnostic testing and long-term antibiotic treatment of chronic lyme disease when determined to be medically necessary and ordered by a physician acting in accordance with chapter 37.5 of title 5 entitled lyme disease diagnosis and treatment after making a thorough evaluation of the patients symptoms, diagnostic test results, and response to treatment. Treatment otherwise eligible for benefits pursuant to this section shall not be denied solely because the treatment may be characterized as unproven, experimental, or investigational in nature.
R.I. Gen. Laws § 27-76-7 — RI Code / Title 27 / Chapter 27-76 / Section 27-76-7
§ 27-76-7. Use of prior claim experience of insured property.
Status: in_force

No insurer may refuse to insure, cancel, nonrenew, or surcharge an insurance policy covering damages to personal lines residential property based solely upon prior claim experience for property damage claims at the insured property while under the ownership of someone other than the current insured unless the risk from which the claim originated has not been mitigated.
R.I. Gen. Laws § 27-18-2 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-2
§ 27-18-2. Form of policy.
Status: in_force

No policy of accident and sickness insurance shall be delivered or issued for delivery to any person in this state unless:

(1) The entire money and other considerations for it are expressed in the policy;

(2) The time at which the insurance takes effect and terminates is expressed in the policy;

(3) It purports to insure only one person, except that a policy may insure, originally or by subsequent amendment, upon the application of an adult member of a family who shall be deemed the policyholder, any two (2) or more eligible members of that family, including husband, wife, dependent children or any children under a specified age which shall not exceed nineteen (19) years, and any other person dependent upon the policyholder;

(4) The style, arrangement, and overall appearance of the policy give no undue prominence to any portion of the text, and unless every printed portion of the text of the policy and of any endorsements or attached papers is plainly printed in light faced type of a style in general use, the size of which shall be uniform and not less than ten-point with a lower case unspaced alphabet length not less than one hundred and twenty (120) point; the text shall include all printed matter except the name and address of the insurer, name or title of the policy, the brief description if any, and captions and subcaptions;

(5) The exceptions and reductions of indemnity are set forth in the policy and, except those which are set forth in §§ 27-18-3  27-18-10 are printed, at the insurers option, either included with the benefit provision to which they apply, or under an appropriate caption such as EXCEPTIONS, or EXCEPTIONS AND REDUCTIONS; provided, that if an exception or reduction specifically applies only to a particular benefit of the policy, a statement of the exception or reduction shall be included with the benefit provision to which it applies;

(6) Each form, including riders and endorsements, shall be identified by a form number in the lower left-hand corner of the first page of the form; and

(7) It contains no provision purporting to make any portion of the charter, rules, constitution, or bylaws of the insurer a part of the policy unless the portion is set forth in full in the policy, except in the case of the incorporation of, or reference to, a statement of rates or classification of risks, or short rate table filed with the insurance commissioner, referred to in this chapter as the commissioner.
R.I. Gen. Laws § 27-20-54 — RI Code / Title 27 / Chapter 27-20 / Section 27-20-54
§ 27-20-54. Mandatory coverage for scalp hair prosthesis.
Status: in_force

(a) Every individual or group hospital or medical expense insurance policy or individual or group hospital or medical services plan contract delivered, issued for delivery, or renewed in this state on or after January 1, 2007, that provides coverage for any other prosthesis shall provide coverage for expenses for scalp hair prosthesis worn for hair loss suffered as a result of the treatment of any form of cancer or leukemia; provided, however, that the coverage shall be subject to the same limitations and guidelines as other prosthesis, and that coverage shall not exceed an amount of three hundred fifty dollars ($350) per covered member per year, exclusive of any deductible.

(b) 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 § 27-41-47 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-47
§ 27-41-47. Penalties and remedies.
Status: in_force

(a) Any person, firm, corporation, association, or other legal entity who or that shall violate the provisions of § 27-41-46 shall be guilty of a misdemeanor, and upon conviction, shall be fined in an amount of not more than one thousand dollars ($1,000), imprisonment for up to one year, or by both a fine and imprisonment.

(b) In addition to the criminal sanctions set forth in subsection (a) of this section, any person, firm, corporation, association, or other legal entity who or that shall willfully or negligently violate any provision of this chapter shall be subject to a civil penalty, to be assessed by the insurance commissioner, in the maximum amount of five thousand dollars ($5,000) for each violation, and each violation shall constitute a separate and distinct offense under this section.
R.I. Gen. Laws § 27-19-24 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-24
§ 27-19-24. Nonprofit hospital service corporations assessment.
Status: repealed

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

(b) The assessment referred to in subsection (a) of this section shall be calculated in the same manner as set forth in § 27-1-41 [repealed].

(c) The minimum assessment charged shall be the greater of the sum determined by subsection (b) of this section or $ 1,000.
R.I. Gen. Laws § 27-72-2 — RI Code / Title 27 / Chapter 27-72 / Section 27-72-2
§ 27-72-2. Definitions.
Status: in_force

As used in this chapter:

(1) Advertisement means any written, electronic, or printed communication or any communication by means of recorded telephone messages or transmitted on radio, television, the internet or similar communications media, including film strips, motion pictures, and videos, published, disseminated, circulated, or placed before the public, directly or indirectly, for the purpose of creating an interest in or inducing a person to purchase or sell, assign, devise, bequest, or transfer the death benefit or ownership of a life insurance policy or an interest in a life insurance policy pursuant to a life settlement contract.

(2) Broker means a person who, on behalf of an owner and for a fee, commission or other valuable consideration, offers or attempts to negotiate life settlement contracts between an owner and provider. A broker represents only the owner and owes a fiduciary duty to the owner to act according to the owners instructions, and in the best interest of the owner, notwithstanding the manner in which the broker is compensated. A broker does not include an attorney, certified public accountant, or financial planner retained in the type of practice customarily performed in their professional capacity to represent the owner whose compensation is not paid directly or indirectly by the provider or any other person, except the owner.

(3) Business of life settlements means an activity involved in, but not limited to, offering to enter into, soliciting, negotiating, procuring, effectuating, monitoring, or tracking, of life settlement contracts.

(4) Chronically ill means:

(i) Being unable to perform at least two (2) activities of daily living (i.e., eating, toileting, transferring, bathing, dressing, or continence);

(ii) Requiring substantial supervision to protect the individual from threats to health and safety due to severe cognitive impairment; or

(iii) Having a level of disability similar to that described in subsection (4)(i) of this section as determined by the United States Secretary of Health and Human Services.

(5) Commissioner means the director of the department of business regulation or his or her designee.

(6) Federally regulated entity means a national bank, thrift, credit union, or any entity registered or exempt from registration under 15 U.S.C. §80a-1 et seq., 15 U.S.C. §80b-1 et seq., 15 U.S.C. §77a et seq., and 15 U.S.C. §78a et seq., or any affiliate thereof.

(7) Financing entity means an underwriter, placement agent, lender, purchaser of securities, purchaser of a policy or certificate from a provider, credit enhancer, or any entity that has a direct ownership in a policy or certificate that is the subject of a life settlement contract, but:

(i) Whose principal activity related to the transaction is providing funds to effect the life settlement contract or purchase of one or more policies; and

(ii) Who has an agreement in writing with one or more providers to finance the acquisition of life settlement contracts.

Financing entity does not include a non-accredited investor or purchaser.

(8) Financing transaction means a transaction in which a licensed provider obtains financing from a financing entity including, without limitation, any secured or unsecured financing, any securitization transaction, or any securities offering which either is registered or exempt from registration under federal and state securities law.

(9) Fraudulent life settlement act includes:

(i) Acts or omissions committed by any person who, knowingly and with intent to defraud, for the purpose of depriving another of property or for pecuniary gain, commits, or permits its employees or its agents to engage in acts including, but not limited to:

(A) Presenting, causing to be presented, or preparing with knowledge and belief that it will be presented to or by a provider, premium finance lender, broker, insurer, insurance producer, or any other person, false material information, or concealing material information, as part of, in support of, or concerning a fact material to one or more of the following:

(I) An application for the issuance of a life settlement contract or insurance policy;

(II) The underwriting of a life settlement contract or insurance policy;

(III) A claim for payment or benefit pursuant to a life settlement contract or insurance policy;

(IV) Premiums paid on an insurance policy;

(V) Payments and changes in ownership or beneficiary made in accordance with the terms of a life settlement contract or insurance policy;

(VI) The reinstatement or conversion of an insurance policy;

(VII) In the solicitation, offer to enter into, or effectuation of a life settlement contract, or insurance policy;

(VIII) The issuance of written evidence of a life settlement contract or insurance;

(IX) Any application for or the existence of or any payments related to a loan secured directly or indirectly by any interest in a life insurance policy; or

(X) Entering into any practice or plan that involves stranger originated life insurance (STOLI).

(B) Failing to disclose to the insurer where the request for such disclosure has been asked for by the insurer that the prospective insured has undergone a life expectancy evaluation by any person or entity other than the insurer or its authorized representatives in connection with the issuance of the policy.

(C) Employing any device, scheme, or artifice to defraud in the business of life settlements.

(D) In the solicitation, application, or issuance of a life insurance policy, employing any device, scheme, or artifice in violation of state insurable interest laws.

(ii) In the furtherance of a fraud or to prevent the detection of a fraud any person commits or permits its employees or its agents to:

(A) Remove, conceal, alter, destroy, or sequester from the commissioner the assets or records of a licensee or other person engaged in the business of life settlements;

(B) Misrepresent or conceal the financial condition of a licensee, financing entity, insurer, or other person;

(C) Transact the business of life settlements in violation of laws requiring a license, certificate of authority, or other legal authority for the transaction of the business of life settlements;

(D) File with the commissioner or the chief insurance regulatory official of another jurisdiction a document containing false information or otherwise concealing information about a material fact from the commissioner;

(E) Engage in embezzlement, theft, misappropriation, or conversion of monies, funds, premiums, credits, or other property of a provider, insurer, insured, owner, insurance policy owner, or any other person engaged in the business of life settlements or insurance;

(F) Knowingly and with intent to defraud, enter into, broker, or otherwise deal in a life settlement contract, the subject of which is a life insurance policy that was obtained by presenting false information concerning any fact material to the policy or by concealing, for the purpose of misleading another, information concerning any fact material to the policy, where the owner or the owners agent intended to defraud the policys issuer;

(G) Attempt to commit, assist, aid, or abet in the commission of, or conspiracy to commit, the acts or omissions specified in this subsection; or

(H) Misrepresent the state of residence of an owner to be a state or jurisdiction that does not have a law substantially similar to this chapter for the purpose of evading or avoiding the provisions of this chapter.

(10) Insured means the person covered under the policy being considered for sale in a life settlement contract.

(11) Life expectancy means the arithmetic mean of the number of months the insured under the life insurance policy to be settled can be expected to live as determined by a life expectancy company provider, broker, or financing entity considering medical records and appropriate experiential data.

(12) Life insurance producer means any person licensed in this state as a resident or nonresident insurance producer who has received qualification or authority for life insurance coverage or a life line of coverage pursuant to chapter 2.4 of this title.

(13) Life settlement contract means a written agreement entered into between a provider and an owner, establishing the terms under which compensation or any thing of value will be paid, which compensation or thing of value is less than the expected death benefit of the insurance policy or certificate, in return for the owners assignment, transfer, sale, devise, or bequest of the death benefit or any portion of an insurance policy or certificate of insurance for compensation; provided, however, that the minimum value for a life settlement contract shall be greater than a cash surrender value or accelerated death benefit available at the time of an application for a life settlement contract. Life settlement contract also includes the transfer for compensation or value of ownership or beneficial interest in a trust or other entity that owns such policy if the trust or other entity was formed or availed of for the principal purpose of acquiring one or more life insurance contracts, which life insurance contract insures the life of a person residing in this state.

(i) Life settlement contract also includes a premium finance loan made for a policy on or before the date of issuance where:

(A) The loan proceeds are not used solely to pay premiums for the policy and any costs or expenses incurred by the lender or the borrower in connection with the financing; or

(B) The owner receives on the date of the premium finance loan a guarantee of the future life settlement value of the policy; or

(C) The owner agrees on the date of the premium finance loan to sell the policy or any portion of its death benefit on any date following the issuance of the policy.

(ii) Life settlement contract does not include:

(A) A policy loan by a life insurance company pursuant to the terms of the life insurance policy or accelerated death provisions contained in the life insurance policy, whether issued with the original policy or as a rider;

(B) A premium finance loan, as defined herein, or any loan made to an insured, a trust established by an insured, or an entity established by the insured by a bank, federally regulated entity, or other licensed financial institution or any transfer, foreclosure, option to transfer, sale of any interest in collateral of such loan subsequent thereto for the purpose of evading regulation under this chapter;

(C) A collateral assignment of a life insurance policy by an owner;

(D) A loan made by a lender that does not violate chapter 14.6 of title 19, provided such loan is not described in subsection (13)(i) above, and is not otherwise within the definition of a life settlement contract;

(E) An agreement where all the parties:

(I) Are closely related to the insured by blood or law; or

(II) Have a lawful substantial economic interest in the continued life, health, and bodily safety of the person insured, or are trusts established primarily for the benefit of such parties;

(F) Any designation, consent, or agreement by an insured who is an employee of an employer in connection with the purchase by the employer, or trust established by the employer, of life insurance on the life of the employee;

(G) A bona fide business succession planning arrangement:

(I) Between one or more shareholders in a corporation or between a corporation and one or more of its shareholders or one or more trust established by its shareholders;

(II) Between one or more partners in a partnership or between a partnership and one or more of its partners or one or more trust established by its partners; or

(III) Between one or more members in a limited liability company or between a limited liability company and one or more of its members or one or more trust established by its members;

(H) An agreement entered into by a service recipient, or a trust established by the service recipient, and a service provider, or a trust established by the service provider, who performs significant services for the service recipients trade or business; or

(I) Any other contract, transaction, or arrangement from the definition of life settlement contract that the commissioner determines is not of the type intended to be regulated by this chapter.

(14) Net death benefit means the amount of the life insurance policy or certificate to be settled less any outstanding debts or liens.

(15) Owner means the owner of a life insurance policy or a certificate holder under a group policy, with or without a terminal illness, who enters or seeks to enter into a life settlement contract. For the purposes of this article, an owner shall not be limited to an owner of a life insurance policy or a certificate holder under a group policy that insures the life of an individual with a terminal or chronic illness or condition except where specifically addressed. The term owner does not include:

(i) Any provider or other licensee under this chapter;

(ii) A qualified institutional buyer as defined in Rule 144A of the Federal Securities Act of 1933, as amended, 17 C.F.R. § 230.144A;

(iii) A financing entity;

(iv) A special purpose entity; or

(v) A related provider trust.

(16) Patient identifying information means an insureds address, telephone number, facsimile number, electronic mail address, photograph or likeness, employer, employment status, social security number, or any other information that is likely to lead to the identification of the insured.

(17) Person means any natural person or legal entity including, but not limited to, a partnership, limited liability company, association, trust, or corporation.

(18) Policy means an individual or group policy, group certificate, contract, or arrangement of life insurance owned by a resident of this state, regardless of whether delivered or issued for delivery in this state.

(19) Premium finance loan is a loan made primarily for the purposes of making premium payments on a life insurance policy, which loan is secured by an interest in such life insurance policy.

(20) Provider means a person, other than an owner, who enters into or effectuates a life settlement contract with an owner. A provider does not include:

(i) Any bank, savings bank, savings and loan association, credit union;

(ii) A licensed lending institution or creditor or secured party pursuant to a premium finance loan agreement that takes an assignment of a life insurance policy or certificate issued pursuant to a group life insurance policy as collateral for a loan;

(iii) The insurer of a life insurance policy or rider to the extent of providing accelerated death benefits or riders or cash surrender value;

(iv) Any natural person who enters into or effectuates no more than one agreement in a calendar year for the transfer of a life insurance policy or certificate issued pursuant to a group life insurance policy, for compensation or anything of value less than the expected death benefit payable under the policy;

(v) A purchaser;

(vi) Any authorized or eligible insurer that provides stop loss coverage to a provider; purchaser, financing entity, special purpose entity, or related provider trust;

(vii) A financing entity;

(viii) A special purpose entity;

(ix) A related provider trust;

(x) A broker; or

(xi) An accredited investor or qualified institutional buyer as defined, respectively, in Regulation D, Rule 501, 17 C.F.R. § 230.501, or Rule 144A of the Federal Securities Act of 1933, as amended, 17 C.F.R. § 230.144A, who purchases a life settlement policy from a provider.

(21) Purchased policy means a policy or group certificate that has been acquired by a provider pursuant to a life settlement contract.

(22) Purchaser means a person who pays compensation or anything of value as consideration for a beneficial interest in a trust which is vested with, or for the assignment, transfer, or sale of, an ownership or other interest in a life insurance policy or a certificate issued pursuant to a group life insurance policy that has been the subject of a life settlement contract.

(23) Related provider trust means a titling trust or other trust established by a licensed provider or a financing entity for the sole purpose of holding the ownership or beneficial interest in purchased policies in connection with a financing transaction. In order to qualify as a related provider trust, the trust must have a written agreement with the licensed provider under which the licensed provider is responsible for ensuring compliance with all statutory and regulatory requirements and under which the trust agrees to make all records and files relating to life settlement transactions available to the commissioner as if those records and files were maintained directly by the licensed provider.

(24) Settled policy means a life insurance policy or certificate that has been acquired by a provider pursuant to a life settlement contract.

(25) Special purpose entity means a corporation, partnership, trust, limited liability company, or other legal entity formed solely to provide either directly or indirectly access to institutional capital markets:

(i) For a financing entity or provider; or

(ii) In connection with a transaction in which the securities in the special purpose entity are acquired by the owner or by a qualified institutional buyer as defined in Rule 144 promulgated under the Federal Securities Act of 1933, as amended; or

(iii) The securities pay a fixed rate of return commensurate with established asset-backed institutional capital markets.

(26) Stranger-originated life insurance or STOLI is a practice or plan to initiate a life insurance policy for the benefit of a third-party investor who, at the time of policy origination, has no insurable interest in the insured. STOLI practices include, but are not limited to, cases in which life insurance is purchased with resources or guarantees from or through a person, or entity, who, at the time of policy inception, could not lawfully initiate the policy himself, herself, or itself, and where, at the time of inception, there is an arrangement or agreement, whether verbal or written, to directly or indirectly transfer the ownership of the policy and/or the policy benefits to a third party. Trusts that are created to give the appearance of insurable interest, and are used to initiate policies for investors, violate insurable interest laws and the prohibition against wagering on life. STOLI arrangements do not include those practices set forth in this chapter.

(27) Terminally ill means having an illness or sickness that can reasonably be expected to result in death in twenty-four (24) months or less.
R.I. Gen. Laws § 27-19-62 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-62
§ 27-19-62. Prohibition on rescission of coverage.
Status: in_force

(a)(1) Coverage under a health plan subject to the jurisdiction of the commissioner under this chapter with respect to an individual, including a group to which the individual belongs or family coverage in which the individual is included, shall not be rescinded after the individual is covered under the plan, unless:

(i) The individual or a person seeking coverage on behalf of the individual, performs an act, practice, or omission that constitutes fraud; or

(ii) The individual makes an intentional misrepresentation of material fact, as prohibited by the terms of the plan or coverage.

(2) For purposes of subsection (a)(1)(i), a person seeking coverage on behalf of an individual does not include an insurance producer or employee or authorized representative of the health carrier.

(b) At least thirty (30) days advance written notice shall be provided to each health benefit plan enrollee or, for individual health insurance coverage, primary subscriber, who would be affected by the proposed rescission of coverage before coverage under the plan may be rescinded in accordance with subsection (a) regardless of, in the case of group health insurance coverage, whether the rescission applies to the entire group or only to an individual within the group.

(c) For purposes of this section, to rescind means to cancel or to discontinue coverage with retroactive effect for reasons unrelated to timely payment of required premiums or contribution to costs of coverage.

(d) This section applies to grandfathered health plans.
R.I. Gen. Laws § 27-51-3 — RI Code / Title 27 / Chapter 27-51 / Section 27-51-3
§ 27-51-3. Licensure.
Status: in_force

(a) No person, firm, association, or corporation shall act in the capacity of an MGA with respect to risks located in this state for an insurer licensed in this state unless that person, firm, association, or corporation is a licensed producer in this state.

(b) No person, firm, association, or corporation shall act in the capacity of an MGA representing an insurer domiciled in this state with respect to risks located outside this state unless that person, firm, association, or corporation is licensed as a producer in this state. The license may be a nonresident license pursuant to the provisions of this chapter.

(c) The commissioner may require a bond in an amount acceptable to the commissioner for the protection of the insurer.

(d) The commissioner may require the MGA to maintain an errors and omissions policy.
R.I. Gen. Laws § 27-67-2 — RI Code / Title 27 / Chapter 27-67 / Section 27-67-2
§ 27-67-2. Findings.
Status: in_force

The general assembly finds and declares that:

(1) Rhode Island has a proud history of health insurance companies including health insurance corporations, health maintenance organizations, nonprofit hospital service corporations, and nonprofit medical service corporations doing business in this state;

(2) Nationally and regionally, insurance corporations, health maintenance organizations, hospital service corporations, and medical service corporations, are being consolidated or are departing from some state insurance markets. Rhode Island is one of twelve (12) states with three (3) or fewer health insurers active in the group insurance market;

(3) One reason cited for the departure of health insurers from the state of Rhode Island is the size of our population. States with larger populations offer a greater opportunity for competition and profit; and

(4) A regional approach to health insurance that joins Rhode Islands health insurance market with those of the other New England states may expand the opportunities for regional insurers to offer insurance in Rhode Island.
R.I. Gen. Laws § 27-41-35 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-35
§ 27-41-35. Enrollment period in the event of insolvency.
Status: in_force

(a) In the event of an insolvency of a health maintenance organization, upon order of the director, all other carriers that participated in the enrollment process with the insolvent health maintenance organization at a groups last regular enrollment period shall offer the groups enrollees of the insolvent health maintenance organization a thirty-day (30) enrollment period commencing upon the date of insolvency. Each carrier shall offer the enrollees of the insolvent health maintenance organization the same coverage and rates that it had offered to the enrollees of the group at its last regular enrollment period.

(b) If no other carrier had been offered to some groups enrolled in the insolvent health maintenance organization, or if the director determines that the other health benefit plan(s) lack(s) sufficient healthcare delivery resources to ensure that healthcare services will be available and accessible to all of the group enrollees of the insolvent health maintenance organization, then the director shall allocate equitably the insolvent health maintenance organizations group contracts for the groups among all health maintenance organizations that operate within a portion of the insolvent health maintenance organizations service area, taking into consideration the healthcare delivery resources of each health maintenance organization. If the director determines that no health maintenance organization has sufficient resources to ensure that healthcare services will be available and accessible to some groups enrolled in the insolvent health maintenance organization, then the director shall allocate equitably the insolvent health maintenance organizations contracts for the groups among the other carriers as he or she deems appropriate. Each health maintenance organization, or other carrier, to which a group or groups are so allocated, shall offer the group or groups the health maintenance organizations or other carriers existing coverage that is most similar to each groups coverage with the insolvent health maintenance organization at rates determined in accordance with the successor health maintenance organizations or other carriers existing rating methodology.

(c) The director shall also allocate equitably the insolvent health maintenance organizations nongroup enrollees that are unable to obtain other coverage among all health maintenance organizations that operate within a portion of the insolvent health maintenance organizations service area, taking into consideration the healthcare delivery resources of each health maintenance organization. If the director determines that no health maintenance organization has sufficient resources to ensure that healthcare services will be available and accessible to some nongroup enrollees of the insolvent health maintenance organization, then the director shall allocate equitably the insolvent health maintenance organizations contracts for the nongroup enrollees among the other carriers as he or she deems appropriate. Each health maintenance organization or other carrier to which nongroup enrollees are allocated shall offer the nongroup enrollees the health maintenance organizations or other carriers existing coverage for individual or conversion coverage as determined by his or her type of coverage in the insolvent health maintenance organization at rates determined in accordance with the successor health maintenance organizations or other carriers existing rating methodology. Successor health maintenance organizations or other carriers that do not offer direct nongroup enrollment may aggregate all of the allocated nongroup enrollees into one group for rating and coverage purposes.
R.I. Gen. Laws § 27-19-69 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-69
§ 27-19-69. Primary care provider designation requirement.
Status: in_force

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, 2013, shall require that the subscriber and each dependent designate a participating primary care provider and the insurer shall collect the designation from the insured. Designation of a primary care provider shall not be a condition of enrollment and failure to designate a primary care provider shall not constitute grounds for cancellation of coverage. For purposes of this section, primary care provider means the physician, practice, or other medical provider considered by the insured to be his or her usual source of medical care.
R.I. Gen. Laws § 27-46-13 — RI Code / Title 27 / Chapter 27-46 / Section 27-46-13
§ 27-46-13. Binding effect of orders issued in U.S. district court.
Status: in_force

An order issued by any district court of the United States enjoining a risk retention group from soliciting or selling insurance, or operating in any state, or in all states or in any territory or possession of the United States, upon a finding that the group is in hazardous financial or financially impaired condition, shall be enforceable in the courts of the state.
R.I. Gen. Laws § 27-18-54 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-54
§ 27-18-54. 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 otherwise acquires control of a nonprofit hospital service corporation organized under chapter 19 of this title, a nonprofit medical service corporation organized under chapter 20 of this title, 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 policy holders, regardless of whether the 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 § 27-4-22 — RI Code / Title 27 / Chapter 27-4 / Section 27-4-22
§ 27-4-22. Assignment of interest under group life insurance.
Status: in_force

Subject to the terms of the policy relating to assignment of incidents of ownership under the policy, a person whose life is insured under a policy of group life insurance may assign any or all incidents of ownership granted that person under the policy, including but not limited to any right to designate a beneficiary, to have an individual policy issued to him or her, and to pay premiums. Any assignment by the insured shall be valid for the purpose of vesting in the assignee, in accordance with any provisions included in the policy as to the time at which it is to be effective, all of the incident of ownership assigned, but without prejudice to the insurer on account of any payment it may make or individual policy it may issue without notice of the assignment.
R.I. Gen. Laws § 27-35-14 — RI Code / Title 27 / Chapter 27-35 / Section 27-35-14
§ 27-35-14. Severability.
Status: in_force

If any provision of this chapter or its application to any person or circumstance is held invalid, the invalidity shall not affect other provisions or applications of this chapter which can be given effect without the invalid provision or application, and for this purpose the provisions of this chapter are severable.
R.I. Gen. Laws § 27-18-30 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-30
§ 27-18-30. Health insurance contracts  Infertility.
Status: in_force

(a) Any health insurance contract, plan, or policy delivered or issued for delivery or renewed in this state, except contracts 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 insurance contract provides reimbursement for a test or procedure used in the diagnosis or treatment of conditions other than infertility, the 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 a 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 presumably 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) Notwithstanding the provisions of § 27-18-19 or any other provision to the contrary, this section shall apply to blanket or group policies of insurance.

(g) The health insurance contract may limit coverage to a lifetime cap of one hundred thousand dollars ($100,000).
R.I. Gen. Laws § 27-3-38.2 — RI Code / Title 27 / Chapter 27-3 / Section 27-3-38.2
§ 27-3-38.2. Definitions.
Status: in_force

As used in this chapter:

(1) Admitted insurer means an insurer licensed to do an insurance business in this state.

(2) Capital as used in the financial requirements of § 27-3-40, means funds paid in for stock or other evidence of ownership.

(3) Commissioner means the insurance commissioner of Rhode Island or the commissioners designee, deputies, or staff, or the commissioner, director, or superintendent of insurance in any other state.

(4) Eligible surplus lines insurer means a nonadmitted insurer with which a surplus lines licensee may place surplus lines insurance pursuant to § 27-3-38.

(5) Home state means,

(i) With respect to an insured:

(A) The state in which an insured maintains its principal place of business or, in the case of an individual, the individuals principal residence; or

(B) If one hundred percent (100%) of the insured risk is located out of the state referred to in subsection (5)(i), the state to which the greatest percentage of the insureds taxable premium for that insurance contract is allocated.

(ii) Principal place of business means, with respect to determining the home state of the insured:

(A) The state where the insured maintains its headquarters and where the insureds high-level officers direct, control and coordinate the business activities; or

(B) If the insureds high-level officers direct, control, and coordinate the business activities in more than one state, the state in which the greatest percentage of the insureds taxable premium for that insurance contract is allocated; or

(C) If the insured maintains its headquarters or the insureds high-level officers direct, control, and coordinate the business activities outside any state, the state to which the greatest percentage of the insureds taxable premium for that insurance contract is allocated.

(iii) Principal residence means, with respect to determining the home state of the insured, (i) The state where the insured resides for the greatest number of days during a calendar years; or (ii) If the insureds principal residence is located outside any state, the state to which the greatest percentage of the insureds taxable premium for that insurance contract is allocated.

(iv) Affiliated groups. If more than one insured from an affiliated group are named insureds on a single nonadmitted insurance contract, the term home state means the home state, as determined above, of the member of the affiliated group that has the largest percentage of premium attributed to it under such insurance contract.

(v) Group insurance. When the group policyholder pays one hundred percent (100%) of the premium from its own funds, the term home state means the home state, as determined above, of the group policyholder. When the group policyholder does not pay one hundred percent (100%) of the premium from its own funds, the term home state means the home state, as determined above, of the group member.

(6) Insurer means any person, corporation, association, partnership, reciprocal exchange, interinsurer, Lloyds insurer, insurance exchange syndicate, fraternal benefit society, and any other legal entity engaged in the business of insurance.

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

(8) Nonadmitted insurer means an insurer not licensed to do an insurance business in this state.

(9) Person means any natural person or other entity, including, but not limited to, individuals, partnerships, associations, trusts, or corporations.

(10) Surplus as used in the financial requirements of § 27-3-40, means funds over and above liabilities and capital of the company for the protection of policyholders.

(11) Surplus lines insurance means any property and casualty insurance in this state on properties, risks, or exposures, located or to be performed in this state, permitted to be placed through a surplus lines licensee with a nonadmitted insurer eligible to accept such insurance, pursuant to § 27-3-40.

(12) Surplus lines licensee means an individual, firm, or corporation licensed under § 27-3-38 to place insurance on properties, risks, or exposures located or to be performed in this state with nonadmitted insurers eligible to accept such insurance.
R.I. Gen. Laws § 27-4-9 — RI Code / Title 27 / Chapter 27-4 / Section 27-4-9
§ 27-4-9. Preexisting contracts unaffected by policy terms provisions.
Status: in_force

The provisions of §§ 27-4-6  27-4-8 shall not affect any contract existing on April 24, 1931.
R.I. Gen. Laws § 27-41-10 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-10
§ 27-41-10. Information to enrollees.
Status: in_force

Every health maintenance organization shall promptly provide to its enrollees notice of any material change in the operation of the organization that will affect them directly. New enrollees shall receive at least the following information:

(1) The most recent annual statement of financial condition including a balance sheet and summary of receipts and disbursements;

(2) A description of the organizational structure and operation of the health maintenance organization;

(3) A description of services and information as to where and how to secure them; and

(4) A clear and understandable description of the health maintenance organizations method for resolving enrollee complaints.
R.I. Gen. Laws § 27-1-28 — RI Code / Title 27 / Chapter 27-1 / Section 27-1-28
§ 27-1-28. Proxies, consents, and authorizations in respect to any equity security issued by a domestic insurer.
Status: in_force

(a) The commissioner may by regulations prescribe the form, content, and manner of solicitation of any proxy, consent, or authorization in respect of any equity security issued by a domestic insurer, which regulations when and if issued and in force shall substantially conform to those prescribed by the National Association of Insurance Commissioners.

(b) No domestic insurer, or any director, officer, or employee of the insurer or any other person shall solicit or permit the use of their name to solicit, by mail or otherwise, any person to give or to refrain from giving any proxy, consent, or authorization in respect of any equity security issued by the insurer in contravention of any regulations the commissioner may prescribe pursuant to this section.

(c) From and after the date of issuance of any regulations by the commissioner, every proxy, consent, or authorization, and every form of written solicitation, announcement or advertisement to be used to obtain the proxy, consent, or authorization, that is intended to be used in respect of any meeting or procedure of equity security holders of a domestic insurer and is not exempted from the operation of the regulations by its terms shall be filed with the commissioner in the manner and at the times provided by the regulations by the person intending to use the written solicitation, announcement, or advertisement. For the purposes of this section, the term person means an individual, a corporation, a partnership, an association, a joint stock company, a business trust, or an unincorporated organization.

(d) Failure to comply with any regulation of the commissioner made pursuant to this section shall be unlawful and any proxy, consent, or authorization obtained in violation of this section or in contravention of any regulation issued pursuant to this section shall be void. Any domestic insurer or any person legally entitled to vote or to give the persons consent or authorization with respect to the equity security, or the commissioner, may enforce compliance with the regulations of the commissioner made pursuant to this section by appropriate action at law or in equity; provided, that no action shall be brought more than fifteen (15) days after the date of the meeting at which a vote, consent, or authorization was purported to have been recorded.
R.I. Gen. Laws § 27-5-3 — RI Code / Title 27 / Chapter 27-5 / Section 27-5-3
§ 27-5-3. Form of standard policy.
Status: in_force

The form of the standard fire insurance policy of the state of Rhode Island, with permission to substitute for the word company or companies a more accurate descriptive term for the type of insurer, shall be as follows:

Space for insertion of name of company or companies issuing the policy and other matter permitted to be stated at the head of the policy.

Space for listing 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.

In consideration of the provisions and stipulations herein or added hereto and of ............... dollars premium this company, for the term of .............
R.I. Gen. Laws § 27-44-17 — RI Code / Title 27 / Chapter 27-44 / Section 27-44-17
§ 27-44-17. Noncompetitive markets  Nonapplicability of chapter.
Status: in_force

Any market deemed to be a noncompetitive market, and any market described in § 27-44-3, shall have rates established for it pursuant to the standards and procedures as applicable in chapters 6, 7.1, 9, 19, and 20 of this title, and the other sections of law govern the rates of different classes of insurance. Nothing contained in this section shall be construed to limit the applicability of any other relevant section of law.