R.I. Gen. Laws § 27-72-15 — RI Code / Title 27 / Chapter 27-72 / Section 27-72-15
§ 27-72-15. Injunctions  Civil remedies  Cease and desist.
Status: in_force

(a) In addition to the penalties and other enforcement provisions of this chapter, if any person violates this chapter or any rule implementing this chapter, the commissioner may seek an injunction in a court of competent jurisdiction in this state and may apply for temporary and permanent orders that the commissioner determines necessary to restrain the person from further committing the violation.

(b) Any person damaged by the acts of another person in violation of this chapter or any rule or regulation implementing this chapter, may bring a civil action for damages against the person committing the violation in a court of competent jurisdiction.

(c) The commissioner may issue a cease and desist order upon a person who violates any provision of this part, any rule or order adopted by the commissioner, or any written agreement entered into with the commissioner, in accordance with the chapter governing administrative procedures, § 42-35-1 et seq.

(d) When the commissioner finds that such an action presents an immediate danger to the public and requires an immediate final order, the commissioner may issue an emergency cease and desist order reciting with particularity the facts underlying such findings. The emergency cease and desist order is effective immediately upon service of a copy of the order on the respondent and remains effective for ninety (90) days. If the department begins non-emergency cease and desist proceedings under subsection (a), the emergency cease and desist order remains effective, absent an order by a court of competent jurisdiction pursuant to § 42-35-1 et seq. In the event of a willful violation of this chapter, the superior court may award statutory damages in addition to actual damages in an additional amount up to three (3) times the actual damage award. The provisions of this chapter may not be waived by agreement. No choice of law provision may be utilized to prevent the application of this chapter to any settlement in which a party to the settlement is a resident of this state.
R.I. Gen. Laws § 27-9-47 — RI Code / Title 27 / Chapter 27-9 / Section 27-9-47
§ 27-9-47. Hearings on rules and decisions of commissioner.
Status: in_force

Any insurer or rating organization aggrieved by any order or decision of the commissioner or by any rule or regulation adopted and promulgated by the commissioner may within thirty (30) days after notice to the insurer or organization make a written request to the commissioner for a hearing, except that a hearing provided for by §§ 27-9-16  27-9-21 shall be held as provided in those sections. Within twenty (20) days after the receipt of that written request, the commissioner shall hear the party or parties and shall give not less than ten (10) days written notice of the time and place of the hearing. Within fifteen (15) days after the hearing, the commissioner shall affirm, reverse, or modify the commissioners previous action, specifying the commissioners reasons. Pending the hearing and decision the commissioner may suspend or postpone the effective date of the commissioners previous action.
R.I. Gen. Laws § 27-5-31 — RI Code / Title 27 / Chapter 27-5 / Section 27-5-31
§ 27-5-31. Termination of surplus and reserve fund method  Return of special reserve fund.
Status: in_force

Any company that has established a guaranty surplus fund and special reserve fund may, at a regular meeting of its board of directors, or at a special meeting called for that purpose, adopt a resolution declaring its desire and intention to discontinue those funds and to cease to do business under and in pursuance of the provisions of law relating to those funds, and file a certified copy of that resolution with the insurance commissioner. Upon the adoption and filing of that resolution, all rights of the company to withhold a special reserve fund from its general creditors shall be terminated and the company shall discontinue printing upon its policies or renewals the notice provided for in § 27-5-29, and after this the provisions of this chapter so far as they relate to those funds shall cease to apply to the company; provided, that the special reserve fund of the company shall continue at the amount prescribed by the provisions of this chapter at the date of the making and filing of the resolution and the guaranty surplus fund may continue at a like amount, but those funds need not be increased on account of any increase in capital of the company or otherwise after the adoption and filing of the resolution and shall be held and invested as provided in §§ 27-5-15  27-5-31, but only for the purpose of assuring to the holders of policies at the time the resolution is filed with the insurance commissioner any rights and privileges as may inure to them under §§ 27-5-15  27-5-31. At the expiration of five (5) years after the adoption and filing of the resolution by the company, the special reserve fund shall be reduced to an amount equal to the unearned premium upon and all losses incurred and unpaid under any remaining policies that were outstanding at the time of the adoption and filing of the resolution. The excess of the special reserve fund above that amount shall be returned by the insurance commissioner to the company, and when all policies that were outstanding at the time of the adoption and filing of the resolution shall have terminated by expiration or by cancellation, the entire balance of the special reserve fund shall be returned to the company.
R.I. Gen. Laws § 27-60-4 — RI Code / Title 27 / Chapter 27-60 / Section 27-60-4
§ 27-60-4. Unfairly discriminatory acts relating to health benefit plans.
Status: in_force

The following acts are prohibited as unfairly discriminatory:

(1) Denying, refusing to issue, renew, or reissue, canceling or terminating a health benefit plan, or restricting or excluding health benefit plan coverage or adding a premium differential to any health benefit plan on the basis of the applicants or insureds abuse status;

(2) Excluding or limiting coverage for losses or denying a claim incurred by an insured as a result of abuse on the basis of the insureds abuse status;

(3) Terminating group coverage for a subject of abuse because coverage was originally issued in the name of the abuser and the abuser has divorced, separated from, or lost custody of the subject of abuse, or the abusers coverage has terminated voluntarily or involuntarily. Nothing in this subsection prohibits the health carrier from requiring the subject of abuse to pay the full premium for coverage under the health plan or from requiring as a condition of coverage that the subject of abuse reside or work within its service area, if the requirements are applied to all insureds of the health carrier. The health carrier may terminate group coverage after the continuation coverage required by this subsection has been in force for eighteen (18) months, and the health carrier shall offer conversion to an equivalent individual plan providing the conversion plan already exists and is offered to all the insureds of the health carrier. The continuation coverage required by this section shall be satisfied by coverage required under Pub. L. No. 99-272, the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985, provided to a subject of abuse and is not intended to be in addition to coverage provided under COBRA; or

(4) Disclosure or transfer by a person employed by or contracting with a health carrier of any information relating to a persons abuse status, a persons medical condition that the health carrier knows or has reason to know is abuse-related or a persons family, household, social, or employment relationship with a subject of abuse, except to the extent necessary for the direct provision of healthcare services, compliance with abuse reporting laws, or compliance with an order of the commissioner or a court of competent jurisdiction. This subsection shall not preclude a subject of abuse from obtaining his or her own medical records. This subsection shall not be construed to prohibit a health carrier from asking an applicant or insured about a medical condition, even if the condition is abuse-related, or using information obtained for the purpose of acts or practices permitted by this chapter. A subject of abuse may provide evidence of abuse to a health carrier for the limited purpose of facilitating treatment of an abuse-related condition or demonstrating that a medical condition is abuse-related, and this section shall not be construed as authorizing the health carrier to disregard that information.
R.I. Gen. Laws § 27-9-35 — RI Code / Title 27 / Chapter 27-9 / Section 27-9-35
§ 27-9-35. Unlawful joint underwriting or reinsurance practices.
Status: in_force

If, after a hearing, the commissioner finds that any activity or practice of any joint underwriting or reinsurance group, association, or other organization is unfair or unreasonable or inconsistent with the provisions of this chapter, the commissioner may issue a written order specifying in what respects the activity or practice is unfair or unreasonable or inconsistent with the provisions of this chapter, and requiring the discontinuance of the activity or practice.
R.I. Gen. Laws § 27-58-5 — RI Code / Title 27 / Chapter 27-58 / Section 27-58-5
§ 27-58-5. Licensure requirement.
Status: in_force

Any insurance transaction conducted by a financial institution shall be conducted only by a Rhode Island licensed insurance producer representing a Rhode Island authorized insurer or representing a Rhode Island eligible surplus lines insurer.
R.I. Gen. Laws § 27-41-86 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-86
§ 27-41-86. Opioid antagonists.
Status: in_force

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

(b) As used in this section:

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

(c) The coverage mandated by this section shall include generic opioid antagonists prescribed or dispensed via standing order or collaborative-practice agreement intended for use on patients other than the insured. Prior authorization may be required for non-generic forms of opioid antagonists and devices.
R.I. Gen. Laws § 27-41-73 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-73
§ 27-41-73. Licensed ambulance service.
Status: in_force

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

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

(c) This section shall not apply to insurance coverage providing benefits for: (1) Hospital confinement indemnity; (2) Disability income; (3) Accident only; (4) Long-term care; (5) Medicare supplement; (6) Limited benefit health; (7) Specified disease indemnity; (8) Sickness or bodily injury or death by accident or both; and (9) Other limited benefit policies.
R.I. Gen. Laws § 27-41-84 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-84
§ 27-41-84. Orally administered anticancer medication  Cost-sharing requirement.
Status: in_force

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

(b) This section does not apply to insurance coverage providing benefits for: (1) Hospital confinement indemnity; (2) Disability income; (3) Accident only; (4) Long-term care; (5) Medicare supplement; (6) Limited benefit health; (7) Specified disease indemnity; (8) Sickness or bodily injury or death by accident or both; and (9) Other limited benefit policies.
R.I. Gen. Laws § 27-18-15 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-15
§ 27-18-15. Alteration of application.
Status: in_force

No alteration of any written application for the policy shall be made by any person other than the applicant without the applicants written consent, except that insertions may be made by the insurer, for administrative purposes only, in a manner to indicate clearly that the insertions are not to be ascribed to the applicant.
R.I. Gen. Laws § 27-51-8 — RI Code / Title 27 / Chapter 27-51 / Section 27-51-8
§ 27-51-8. Rules and regulations.
Status: in_force

The commissioner of insurance may adopt reasonable rules and regulations for the implementation and administration of the provisions of this chapter.
R.I. Gen. Laws § 27-18-91 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-91
§ 27-18-91. Coverage for treatment of pre-exposure prophylaxis (PrEP) for the prevention of HIV and post-exposure prophylaxis (PEP) to prevent HIV infection.
Status: in_force

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

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

(c) A health insurer shall provide access to at least one pre-exposure (PrEP) drug in each method of administration and at least one of the Centers for Disease Control and Prevention preferred post-exposure (PEP) drug treatment regimen, without any prior authorization or step therapy requirement. There shall be no copayment required, and no deductible shall need to be met, to obtain the prescription covered by the contract, plan, or policy.
R.I. Gen. Laws § 27-33-11 — RI Code / Title 27 / Chapter 27-33 / Section 27-33-11
§ 27-33-11. Rules and regulations.
Status: in_force

The director of business regulation may issue rules, regulations, and orders necessary to carry out the purposes of this chapter. The director is specifically empowered to require that basic property insurance as defined in § 27-33-10 and any other insurance that may be required or suggested by the federal insurance administrator for inclusion be made available under the FAIR plan. Any regulation requiring coverage described in this section that has been promulgated by the insurance commissioner is ratified and confirmed.
R.I. Gen. Laws § 27-71-3 — RI Code / Title 27 / Chapter 27-71 / Section 27-71-3
§ 27-71-3. Definitions.
Status: in_force

As used in this chapter:

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

(2) Complaint means a written or documented oral communication to the commissioner primarily expressing a grievance, meaning an expression of dissatisfaction. For healthcare companies, a grievance is a written complaint submitted by or on behalf of a covered person.

(3) Comprehensive market conduct examination means a review of one or more lines of business of an insurer domiciled in this state that is not conducted for cause. The term includes a review of rating, tier classification, underwriting, policyholder service, claims, marketing and sales, producer licensing, complaint handling practices, or compliance procedures and policies.

(4) Market analysis means a process whereby market conduct surveillance personnel collect and analyze information from filed schedules, surveys, required reports, and other sources in order to develop a baseline and to identify patterns or practices of insurers licensed to do business in this state that deviate significantly from the norm or that may pose a potential risk to the insurance consumer.

(5) Market conduct action means any of the full range of activities that the commissioner may initiate to assess the market and practices of individual insurers, beginning with market analysis and extending to targeted examinations. The commissioners activities to resolve an individual consumer complaint or other reports of a specific instance of misconduct are not market conduct actions for purposes of this chapter.

(6) Market conduct examination means the examination of the insurance operations of an insurer licensed to do business in this state in order to evaluate compliance with the applicable laws and regulations of this state. A market conduct examination may be either a comprehensive examination or a targeted examination. A market conduct examination is separate and distinct from a financial examination of an insurer performed pursuant to the Rhode Island general laws, but may be conducted at the same time.

(7) Market conduct surveillance personnel means those individuals employed or contracted by the commissioner to collect, analyze, review, or act on information on the insurance marketplace that identifies patterns or practices of insurers.

(8) National Association of Insurance Commissioners (NAIC) means the organization of insurance regulators from the fifty (50) states, the District of Columbia, and the four U.S. territories.

(9) NAIC market conduct uniform examination procedures means the set of guidelines developed and adopted by the NAIC designed to be used by market conduct surveillance personnel in conducting an examination.

(10) NAIC market regulation handbook means a handbook, developed and adopted by the NAIC, or successor product, which:

(i) Outlines elements and objectives of market analysis and the process by which states can establish and implement market analysis programs; and

(ii) Sets up guidelines that document established practices to be used by market conduct surveillance personnel in developing and executing an examination.

(11) NAIC standard data request means the set of field names and descriptions developed and adopted by the NAIC for use by market conduct surveillance personnel in an examination.

(12) Qualified contract examiner means a person under contract to the commissioner, who is qualified by education, experience, and, where applicable, professional designations, to perform market conduct actions.

(13) Targeted examination means a focused exam conducted for cause, based on the results of market analysis indicating the need to review either a specific line of business or specific business practices, including but not limited to, underwriting and rating, marketing and sales, complaint handling operations/management, advertising materials, licensing, policyholder services, nonforfeitures, claims handling, or policy forms and filings. A targeted examination may be conducted by desk examination or by an on-site examination:

(i) Desk examination means a targeted examination that is conducted by an examiner at a location other than the insurers premises. A desk examination is usually performed at the department of business regulations offices with the insurer providing requested documents by hard copy, microfiche, discs, or other electronic media, for review; and

(ii) On-site examination means a targeted examination conducted at the insurers home office or the location where the records under review are stored.

(14) Third-party model or product means a model or product provided by an entity separate from and not under direct or indirect corporate control of the insurer using the model or product.
R.I. Gen. Laws § 27-76-9 — RI Code / Title 27 / Chapter 27-76 / Section 27-76-9
§ 27-76-9. Severability.
Status: in_force

If a court holds any section or portion of a section of this chapter or the applicability thereof to any person or circumstance invalid, the remainder of the chapter shall not be affected thereby.
R.I. Gen. Laws § 27-66-20 — RI Code / Title 27 / Chapter 27-66 / Section 27-66-20
§ 27-66-20. General powers and limitations.
Status: in_force

For the purposes of exercising the specific powers granted in this chapter and effectuating the other purposes of this chapter, the foundation:

(1) May be sued and sue;

(2) May have a seal and alter it at will;

(3) May make, amend, and repeal rules relating to the conduct of the business of the foundation;

(4) May enter into contracts relating to the administration of the foundation;

(5) May rent, lease, buy, or sell property in its own name and may construct or repair buildings necessary to provide space for its operations;

(6) May hire personnel, consultants, and experts and set salaries; and

(7) May perform all other functions and exercise all other powers that are necessary, appropriate, or convenient to administer the foundation.
R.I. Gen. Laws § 27-16-1.5 — RI Code / Title 27 / Chapter 27-16 / Section 27-16-1.5
§ 27-16-1.5. Requirements before defensive pleadings.
Status: in_force

(a) Before any unauthorized insurer files or causes to be filed in any pleading in any court action, suit, or proceeding or in any notice, order, pleading, or process in an administrative proceeding before the commissioner instituted against a person or insurer, by service made as provided in § 27-16-1.4, the insurer shall either:

(1) Deposit with the clerk of the court in which the action, suit, or proceeding is pending, or with the commissioner of insurance in administrative proceedings before the commissioner, cash or securities, or file with the clerk or commissioner a bond with good and sufficient sureties, to be approved by the clerk or commissioner in an amount to be fixed by the court or commissioner sufficient to secure the payment of any final judgment which may be rendered in an action or administrative proceeding; or

(2) Procure a certificate of authority to transact the business of insurance in this state. In considering the application of an insurer for a certificate of compliance for the purposes of this subsection, the commissioner need not assert the provisions of § 27-2-17 against an insurer with respect to its application if the commissioner determines that the company would comply with the requirements for the certificate of compliance.

(b) The commissioner of insurance, in any administrative proceeding in which service is made as provided in § 27-16-1.4, may in the commissioners discretion, order any postponement as may be necessary to afford the defendant reasonable opportunity to comply with the provisions of subsection (a) of this section and to defend the action.

(c) Nothing in subsection (a) of this section shall be construed to prevent an unauthorized insurer from filing a motion to quash a writ or to set aside service of it made in the manner provided in § 27-16-1.4, on the ground that the unauthorized insurer has not done any of the acts enumerated in § 27-16-1.2.
R.I. Gen. Laws § 27-41-53 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-53
§ 27-41-53. Genetic testing.
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 health maintenance organization subject to the provisions of this chapter shall:

(1) Use a genetic test or request for genetic test or the results of a genetic test 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 a genetic test 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 a genetic test without the prior written authorization of the individual from whom the test was obtained, except in a format where 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); or

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

(c) For the purposes of this section, genetic testing is the analysis of an individuals DNA, RNA, chromosomes, protein, and certain metabolites in order to detect heritable inheritable disease-related genotypes, mutations, phenotypes, or karyotypes for clinical purposes. Those purposes include predicting risk of disease, identifying carriers, establishing prenatal and clinical diagnosis or prognosis. Prenatal, newborn, and carrier screening, and testing in high-risk families may be included provided there is an approved release by a parent or guardian. Tests for metabolites are covered only when they are undertaken with high probability that an excess or deficiency of the metabolite indicates the presence of heritable mutations in single genes. Genetic testing does not mean routine physical measurement, a routine chemical, blood, or urine analysis or a test for drugs or for HIV infections.
R.I. Gen. Laws § 27-4-2 — RI Code / Title 27 / Chapter 27-4 / Section 27-4-2
§ 27-4-2. Preexisting contracts unaffected by discrimination provisions.
Status: in_force

Sections 27-4-1 and 27-4-4 shall not affect any contracts existing on April 24, 1931.
R.I. Gen. Laws § 27-18-87 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-87
§ 27-18-87. Perinatal doulas.
Status: in_force

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

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

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

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

(1) Hospital confinement indemnity;

(2) Disability income;

(3) Accident only;

(4) Long-term care;

(5) Medicare supplement;

(6) Limited benefit health;

(7) Specified disease indemnity;

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

(9) Other limited benefit policies.
R.I. Gen. Laws § 27-9-24 — RI Code / Title 27 / Chapter 27-9 / Section 27-9-24
§ 27-9-24. Regulation by rating organization of payments by insurers to policyholders or members.
Status: in_force

No rating organization shall adopt any rule the effect of which would be to prohibit or regulate the payment of dividends, savings, or unabsorbed premium deposits allowed or returned by insurers to their policyholders, members, or subscribers.
R.I. Gen. Laws § 27-78-4 — RI Code / Title 27 / Chapter 27-78 / Section 27-78-4
§ 27-78-4. Limitations on use.
Status: in_force

(a) A person may not:

(1) Alter or modify a certificate of insurance after issuance by a producer or insurer;

(2) Prepare, issue, or request or require the issuance of a certificate of insurance that contains any false or misleading information concerning the policy of insurance to which the certificate of insurance makes reference; or

(3) Prepare, issue, or request or require the issuance of a certificate of insurance that purports to affirmatively or negatively alter, amend, or extend the coverage provided by the policy of insurance to which the certificate of insurance makes reference.

(b) A certificate of insurance may not warrant that the policy of insurance referenced in the certificate comply with the insurance or indemnification requirements of a contract and the inclusion of a contract number or description within a certificate of insurance may not be interpreted as doing such.
R.I. Gen. Laws § 27-19-34.1 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-34.1
§ 27-19-34.1. Insurance coverage for mastectomy hospital stays.
Status: repealed

(a) The Rhode Island General Assembly recognizes that breast cancer is a unique illness with both a physical and emotional impact on patients. Every individual or group hospital or medical services plan contract delivered, issued for delivery, as renewed in this state shall provide coverage for a minimum forty-eight-hour (48) time period in a hospital after the surgical procedures known as a mastectomy, and a minimum twenty-four (24) hours after an axillary node dissection. Any decision to shorten these minimum coverages shall be made by the attending physician in consultation with and upon agreement by the patient. If the patient participates in an early discharge, defined as in-patient care following a mastectomy that is less than forty-eight (48) hours and in-patient care following an axillary node dissection that is less than twenty-four (24) hours, coverage shall include a minimum of one home visit conducted by a physician or registered nurse.

(b) Any subscriber who is aggrieved by a denial of benefits to be provided under this section may appeal the denial in accordance with regulations of the department of health, which have been promulgated pursuant to chapter 17.12 of title 23 [repealed]. No policy or plan covered under this chapter shall terminate the services, reduce capitation payment, or otherwise penalize an attending physician or other healthcare provider who orders care consistent with the provisions of this section.

(c) All plans subject to this section shall provide notice to each enrollee:

(1) In the next mass mailing made by the plan to the employee; or

(2) As part of any informational packet sent to the enrollee.
R.I. Gen. Laws § 27-4-24.6 — RI Code / Title 27 / Chapter 27-4 / Section 27-4-24.6
§ 27-4-24.6. Severability.
Status: in_force

If any subsection, subdivision, paragraph, sentence, or clause of this chapter is held invalid or unconstitutional, that decision shall not affect the remaining portions of the section or sections.
R.I. Gen. Laws § 27-69-3 — RI Code / Title 27 / Chapter 27-69 / Section 27-69-3
§ 27-69-3. Deductibles and other cost sharing.
Status: in_force

Notwithstanding anything to the contrary in any mandated benefit law, no mandated benefit law shall be construed to forbid inclusion in any health plan of a provision for any deductible and/or other cost-sharing provisions suitable to qualify a health plan, which may be purchased for use with health savings accounts for a tax preference, as a high deductible health plan or any other similar federal or state tax preference available now or in the future; provided, however, that this section shall not exempt high deductible health plans from any other provision of applicable mandated benefit laws. The commissioner shall retain jurisdiction to approve policies, rates, and forms for all high deductible health plans pursuant to the provisions of this title and title 42.
R.I. Gen. Laws § 27-66-23 — RI Code / Title 27 / Chapter 27-66 / Section 27-66-23
§ 27-66-23. Determination of confidentiality by the department of business regulation.
Status: in_force

The director shall have the power to decide whether any information required by this chapter of an applicant is confidential and/or proprietary. The decisions by the department of business regulation shall be made prior to any public notice of an initial application or any public review of the information.
R.I. Gen. Laws § 27-41-26 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-26
§ 27-41-26. Enrollee liability.
Status: in_force

No enrollee is liable to any provider for charges for covered health services, except for amounts due for copayments, when provided or made available to enrolled participants by a licensed health maintenance organization during a period in which premiums were paid by or on behalf of the enrollee.
R.I. Gen. Laws § 27-29-15 — RI Code / Title 27 / Chapter 27-29 / Section 27-29-15
§ 27-29-15. Severability.
Status: in_force

If any provision of this chapter, or the application of a provision to any person or circumstances shall be held invalid, the remainder of the chapter, and the application of the provision to persons or circumstances other than those as to which it is held invalid, shall not be affected by that invalidity.
R.I. Gen. Laws § 27-41-6 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-6
§ 27-41-6. Governing body.
Status: in_force

(a) The governing body of any health maintenance organization may include providers, other individuals, or both.

(b) The governing body shall establish a mechanism to afford the enrollees an opportunity to participate in matters of policy and operation through the establishment of advisory panels, by the use of advisory referenda on major policy decisions, or through the use of other mechanisms.
R.I. Gen. Laws § 27-34-12.5 — RI Code / Title 27 / Chapter 27-34 / Section 27-34-12.5
§ 27-34-12.5. Prevention of insolvencies.
Status: in_force

To aid in the detection and prevention of insurer insolvencies:

(1) The board of directors may, upon a majority vote, make recommendations to the commissioner on matters generally related to improving or enhancing regulation for solvency.

(2) At the conclusion of any domestic insurer insolvency in which the association was obligated to pay covered claims, the board of directors may, upon a majority vote, prepare a report on the history and causes of the insolvency, based on the information available to the association and submit the report to the commissioner.

(3) Reports and recommendations provided under this section shall not be considered public documents.
R.I. Gen. Laws § 27-34-14 — RI Code / Title 27 / Chapter 27-34 / Section 27-34-14
§ 27-34-14. Tax exemption.
Status: in_force

The association shall be exempt from the payment of all fees and all taxes levied by this state or any of its subdivisions, except taxes levied on real or personal property.
R.I. Gen. Laws § 27-54-2 — RI Code / Title 27 / Chapter 27-54 / Section 27-54-2
§ 27-54-2. Civil penalties.
Status: in_force

In addition to the criminal penalties set forth in § 27-54-1, the attorney general or the director or the directors designee may bring a civil action against any person who engages in conduct constituting an offense under this chapter and, upon proof of that conduct by a preponderance of the evidence, the person shall be subject, for each violation, to a civil penalty not exceeding fifty thousand dollars ($50,000) or the amount of damages caused by that conduct, whichever is greater. If the insurance company is placed in conservation, rehabilitation, or liquidation, the conservator or receiver shall also be entitled to bring a civil action, and the penalty shall be paid to the conservator or receiver for the benefit of the policyholders, claimants, and creditors of the insurer. The imposition of a civil penalty under this section does not preclude any other criminal or civil statutory, common law, or administrative remedy, that is available by law to the state of Rhode Island or any other person.
R.I. Gen. Laws § 27-1-19 — RI Code / Title 27 / Chapter 27-1 / Section 27-1-19
§ 27-1-19. Declaration of forfeiture.
Status: in_force

The court shall, upon hearing of the parties to the complaint, if it sees cause, declare the charter of the corporation forfeited.
R.I. Gen. Laws § 27-5-20 — RI Code / Title 27 / Chapter 27-5 / Section 27-5-20
§ 27-5-20. Investment of guaranty surplus fund  Liability to payment of losses.
Status: in_force

The guaranty surplus fund shall be held and be invested by a state fire insurance company in the same manner as its capital stock and surplus accumulation may be held and be invested, and shall be liable and applicable in the same manner as the capital stock is to the payment generally of the losses of the company.
R.I. Gen. Laws § 27-6-23 — RI Code / Title 27 / Chapter 27-6 / Section 27-6-23
§ 27-6-23. Licensing of rating organizations.
Status: in_force

(a) A corporation, an unincorporated association, a partnership, or an individual, whether located within or outside this state, may make an application to the commissioner for a license as a rating organization for those kinds of insurance, or a subdivision or a class of risk or a part or combination of it as are specified in its application and shall file with the application:

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

(2) A list of its members and subscribers;

(3) The name and address of a resident of this state upon whom notices or orders of the commissioner or process affecting the rating organization may be served; and

(4) A statement of its qualification as a rating organization.

(b) If the commissioner finds that the applicant is competent, trustworthy, and otherwise qualified to act as a rating organization and that its constitution, its articles of agreement or association or certificate of incorporation, and its bylaws, rules, and regulations governing the conduct of its business conform to the requirements of law, the commissioner shall issue a license specifying the kinds of insurance, or a subdivision or a class or a risk or part or combination of it, for which the applicant is authorized to act as a rating organization. Every application shall be granted or denied in whole or in part by the commissioner within sixty (60) days of the date of its filing with the commissioner. Licenses issued pursuant to this section shall remain in effect for three (3) years unless suspended or revoked by the commissioner. The fee for the license shall be three hundred dollars ($300). All in force licenses shall be transitioned into a three-year (3) licensing cycle beginning June 1, 2006, to expire every three (3) years thereafter. License fees may be prorated for the initial renewal period as deemed appropriate by the director.

(c) Licenses issued pursuant to this section may be suspended or revoked by the commissioner, after hearing upon notice, in the event the rating organization ceases to meet the requirements of this section. Every rating organization shall notify the commissioner promptly of every change in:

(1) Its constitution, its articles of agreement or association or its certificate of incorporation, and its bylaws, rules, and regulations governing the conduct of its business;

(2) Its list of members and subscribers; and

(3) The name and address of the resident of this state designated by it upon whom notices or orders of the commissioner or process affecting the rating organization may be served.
R.I. Gen. Laws § 27-6-14 — RI Code / Title 27 / Chapter 27-6 / Section 27-6-14
§ 27-6-14. Rates on specific risks exceeding filed rates.
Status: in_force

Upon the written consent of the insured, stating the insureds reasons, filed with and approved by the commissioner, a rate in excess of that provided by an applicable filing may be used on any specific risk.
R.I. Gen. Laws § 27-19-81 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-81
§ 27-19-81. 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 is 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 as used here are 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 as used here are 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) is 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 § 27-17-1 — RI Code / Title 27 / Chapter 27-17 / Section 27-17-1
§ 27-17-1. Admission of foreign exchanges and interinsurers.
Status: in_force

Any reciprocal exchange or interinsurer formed and doing business under the laws of any state of the United States, other than the state of Rhode Island, for the purpose of transacting any or all of the kinds of insurance that an insurance company may be authorized to transact in this state, other than life or title insurance, may be permitted to transact that business in this state upon complying with the provisions of this chapter.
R.I. Gen. Laws § 27-19-43 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-43
§ 27-19-43. 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 otherwise permissible by law.
R.I. Gen. Laws § 27-77-4 — RI Code / Title 27 / Chapter 27-77 / Section 27-77-4
§ 27-77-4. ORSA requirement.
Status: in_force

Subject to § 27-77-6, an insurer, or the insurance group of which the insurer is a member, shall regularly conduct an ORSA consistent with a process comparable to the ORSA guidance manual. The ORSA shall be conducted no less than annually but also at any time when there are significant changes to the risk profile of the insurer or the insurance group of which the insurer is a member.
R.I. Gen. Laws § 27-41-63 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-63
§ 27-41-63. Hearing aids.
Status: in_force

(a)(1) Every individual or group health insurance contract, or every individual or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state on or after January 1, 2026, shall provide coverage for one thousand seven hundred fifty dollars ($1,750) per individual hearing aid, per ear.

(2) Every group health insurance contract or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state on or after January 1, 2026, shall provide, as an optional rider, additional hearing aid coverage. Provided, the provisions of this paragraph shall not apply to contracts, plans, or group policies subject to the small employer health insurance availability act, chapter 50 of this title.

(b) For the purposes of this section, hearing aid means any nonexperimental, wearable instrument or device designed for the ear and offered for the purpose of aiding or compensating for impaired human hearing, but excluding batteries, cords, and other assistive listening devices, including, but not limited to FM systems.

(c) It shall remain within the sole discretion of the health maintenance organizations as to the provider of hearing aids with which they choose to contract. Reimbursement shall be provided according to the respective principles and policies of the health maintenance organizations. Nothing contained in this section precludes the health maintenance organizations from conducting managed care, medical necessity, or utilization review.
R.I. Gen. Laws § 27-18-9 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-9
§ 27-18-9. Policies of foreign insurers.
Status: in_force

Any policy of a foreign or alien insurer, when delivered or issued for delivery to any person in this state, may contain any provision that is not less favorable to the insured or the beneficiary than the provision of this chapter and that is prescribed or required by the law of the state under which the insurer is organized.
R.I. Gen. Laws § 27-6-11.1 — RI Code / Title 27 / Chapter 27-6 / Section 27-6-11.1
§ 27-6-11.1. Costs.
Status: in_force

For the purpose of determining whether the filing meets the requirements of this chapter, the director may employ staff personnel and outside consultants, including, but not limited to, those authorized pursuant to § 27-9-52. The reasonable costs related to the review of rate filings, including the conduct of the hearing, shall be borne by the rating organizations or insurers making the filing.
R.I. Gen. Laws § 27-30-8 — RI Code / Title 27 / Chapter 27-30 / Section 27-30-8
§ 27-30-8. Premiums and refunds.
Status: in_force

(a) An insurer may revise its schedules of premium rates from time to time, and shall file the revised schedules with the commissioner. No insurer shall issue any consumer credit insurance policy for which the premium rate exceeds that determined by the schedules of the insurer as then on file with the commissioner. The commissioner shall have the authority to promulgate regulations to assure that the premium rates are reasonable in relation to the benefits provided, including the authority to regulate the compensation component of the premium rates. In determining whether the premium rates are reasonable in relation to the benefits provided, the commissioner shall consider and provide for: actual and expected loss experience, general and administrative expenses, loss settlement and adjustment expenses, reasonable creditor compensation, investment income, the manner in which premiums are charged, and other acquisition costs, reserves, taxes, regulatory license fees and fund assessments, reasonable insurer profit and other relevant data, consistent with generally accepted actuarial standards.

(b) Each individual policy or group certificate shall provide for a refund in the event of termination of the insurance prior to the scheduled maturity date of the insurance and upon notice to the insurer from the debtor with the debtors contact information. The refund of an amount paid by the debtor for insurance shall be paid or credited promptly to the person entitled thereto; provided, however, that the commissioner shall prescribe a minimum refund and no refund that would be less than such minimum need be made. Refund formulas that any insurer desires to use must develop refunds that are at least as favorable to the debtor as refunds equal to the premium cost of scheduled benefits subsequent to the date of cancellation or termination, computed at the schedule of premium rates in effect on the date of issue. The formula to be used in computing such refund shall be filed with and approved by the commissioner.

(c) If a creditor requires a debtor to make any payment for consumer credit insurance and an individual policy or group certificate of insurance is not issued, the creditor shall immediately give written notice to the debtor and shall promptly make an appropriate credit to the account or issue a refund.

(d) The amount charged to a debtor for any consumer credit insurance shall not exceed the premiums charged by the insurer, as computed at the time the charge to the debtor is determined.
R.I. Gen. Laws § 27-5-21 — RI Code / Title 27 / Chapter 27-5 / Section 27-5-21
§ 27-5-21. Deposit of special reserve fund.
Status: in_force

The special reserve fund shall be invested according to existing laws relating to investments of capital by fire insurance companies, and shall be deposited as the fund shall accumulate and be invested, with the insurance commissioner of the state, who shall permit the company depositing the fund to change deposits by substituting for those withdrawn others of equal amount and value, and to collect and receive the interest or dividends upon those securities as the interest or dividends may accrue. The fund shall not be regarded as any part of the assets in possession of the company, so as to be or render the company liable for any claim for loss by fire or except as provided in this chapter.
R.I. Gen. Laws § 27-17-4 — RI Code / Title 27 / Chapter 27-17 / Section 27-17-4
§ 27-17-4. Declaration filed by attorney  Requirements for admission.
Status: in_force

The attorney shall file with the insurance commissioner, referred to in this chapter as the commissioner, a declaration verified by the oath of the attorney, or when the attorney is a corporation, by the oath of its president or oaths of its treasurer and secretary setting forth:

(1) The name of the attorney and the name or designation of the exchange under which the contracts are to be issued, which name or designation shall not be so similar to any other name or designation previously adopted by an attorney or by any insurance organization in this state so as to confuse or mislead;

(2) The kind or kinds of insurance to be effected or exchanged;

(3) A copy of the form of policy contract or agreement under or by which the insurance is to be effected or exchanged and forms of application for that insurance;

(4) A certified copy of the power of attorney or other authorization of the attorney under or by which the attorney is to effect or exchange the insurance contracts;

(5) The location of the office or offices from which the contracts or agreements are to be issued;

(6)(i) That, except as to the kinds of insurance specifically mentioned in this subsection (6), applications have been made for insurance upon at least one hundred (100) separate risks, the liability to the exchange for premiums due on the risks shall aggregate not less than six hundred thousand dollars ($600,000), represented by executed contracts or bona fide applications to become concurrently effective, or, in lieu of this amount, the exchange or interinsurer is possessed of a surplus of not less than three hundred thousand dollars ($300,000). The minimum amount of surplus established as a requirement for the writing of other lines of insurance as specified in this section shall be in addition to that required by the provisions of this subsection (6)(i);

(ii) In the case of employers liability or workers compensation insurance, applications shall have been made for indemnity upon at least one hundred (100) separate risks having a total annual premium of not less than two million five hundred thousand dollars ($2,500,000), as represented by executed contracts or bona fide applications to become concurrently effective, or, in lieu of this amount, the exchange or interinsurer is possessed of a surplus of not less than one hundred thousand dollars ($100,000);

(iii) In the case of automobile insurance, applications shall have been made for insurance for at least two hundred (200) separate risks, or for insurance the premiums due the exchange on the risks shall aggregate not less than two hundred thousand dollars ($200,000) represented by executed contracts or bona fide applications to become concurrently effective on any or all classes of automobile insurance effected by the subscribers through the attorney, or, in lieu of this amount, the exchange or interinsurer is possessed of a surplus of not less than one hundred thousand dollars ($100,000);

(iv) The surplus as provided in this subsection (6) shall not be acceptable unless invested in securities of the United States of America, the state of Rhode Island, or any other state of the United States or political subdivision of the state;

(7) That there shall be maintained at the exchange, available for the payment of losses, assets conforming to the requirements of §§ 27-17-7  27-17-12;

(8) A financial statement under oath in the form prescribed by the commissioner;

(9) An instrument authorizing the service of process as provided for in this chapter; and

(10) A certificate from the proper official of the state where the principal office is maintained, that the subscribers and the attorney have complied with all provisions of law and are authorized in that state to transact the classes of business that are sought to be transacted in this state.
R.I. Gen. Laws § 27-73-2 — RI Code / Title 27 / Chapter 27-73 / Section 27-73-2
§ 27-73-2. Program implementation.
Status: in_force

(a) Upon recommendation of the uniform healthcare benefit plan designs or at such other time as specified herein or as specified in §§ 28-9.3-2 and 28-9.4-3, all public school districts and charter schools may implement one or more benefit plan design(s) including, but not limited to, those recommended in accordance with this chapter.

(b) Upon expiration of collective bargaining agreements, recommended benefit plan designs recommended by the board in accordance with this chapter may be specified in future collective bargaining agreements.

(c) Choice of benefit plan designs from those recommended in accordance with § 27-73-4, medical insurance cost sharing, payment for waiving medical insurance, eligibility for receiving benefits, and providing benefits for retirees shall continue to be negotiated pursuant to §§ 28-9-3 and 28-9-4.

(d) Each municipality, district, or charter school, may, at its discretion, contract for and manage benefit plans under this chapter, either directly or indirectly, through municipal, district, or charter arrangements with insurance purchasing collaboratives or joint purchasing groups.
R.I. Gen. Laws § 27-6-51 — RI Code / Title 27 / Chapter 27-6 / Section 27-6-51
§ 27-6-51. Judicial review of orders and decisions.
Status: in_force

(a) Any final order or decision of the commissioner, including any order made after a hearing under the provisions of §§ 27-6-17  27-6-22 or § 27-6-49, shall be subject to review by a petition filed within twenty (20) days after notice of it at the instance of any party in interest in the superior court for the counties of Providence and Bristol, and the matter shall be heard de novo in the superior court and decisions on issues of fact shall be in accordance with the preponderance of the evidence presented there.

(b) The court shall determine whether the order or decision of the commissioner shall be stayed pending review. The court may, in disposing of the issue before it, modify, affirm, or reverse the order or decision of the commissioner in whole or in part.

(c) An appeal may be taken from the decision of the superior court to the supreme court, and that appeal shall follow the course of equity.
R.I. Gen. Laws § 27-52-12 — RI Code / Title 27 / Chapter 27-52 / Section 27-52-12
§ 27-52-12. Rules and regulations.
Status: in_force

The commissioner may adopt reasonable rules and regulations for the implementation and administration of the provisions of this chapter.
R.I. Gen. Laws § 27-9-54 — RI Code / Title 27 / Chapter 27-9 / Section 27-9-54
§ 27-9-54. Rules and regulations  Auto insurance buyers guide.
Status: in_force

(a) The director of the department of business regulation is authorized and empowered to promulgate rules and regulations to compile data regarding automobile insurance premiums. Those rules shall be promulgated in accordance with the Administrative Procedures Act, chapter 35 of title 42.

(b) The director of the department of business regulation shall formulate a plan for the publication of the automobile insurance premiums, including but not limited to, an automobile insurance buyers guide and rate comparison booklet.
R.I. Gen. Laws § 27-19-78 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-78
§ 27-19-78. Health insurance contracts  Copayments exemption for COVID-19 vaccinations.
Status: in_force

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

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

(c) The health insurance commissioner shall promulgate any rules and regulations as the commissioner deems necessary for the efficient administration and enforcement of this section.
R.I. Gen. Laws § 27-9-13 — RI Code / Title 27 / Chapter 27-9 / Section 27-9-13
§ 27-9-13. Approval of rates in excess of those filed.
Status: in_force

Upon the written consent of the insured, stating the insureds reasons, filed with and approved by the commissioner, a rate in excess of that provided by an applicable filing may be used on any specific risk.
R.I. Gen. Laws § 27-33-2 — RI Code / Title 27 / Chapter 27-33 / Section 27-33-2
§ 27-33-2. Participation.
Status: in_force

Each domestic insurer and all insurers licensed to write those classes of insurance listed in §§ 27-8-1 and 27-8-3 in the state, on a direct basis, shall participate in the basic property insurance and placement program established in this state in furtherance of 12 U.S.C. § 1749bbb et seq., commonly known as the FAIR (Fair Access to Insurance Requirements) plan. Failure to comply with this provision may be grounds for revocation, suspension, or nonrenewal of any license.
R.I. Gen. Laws § 27-17-8 — RI Code / Title 27 / Chapter 27-17 / Section 27-17-8
§ 27-17-8. Net premium deposits defined.
Status: in_force

Net premium deposits, as used in this chapter, mean the premium deposits made by subscribers after deduction from them of the amount paid as return premiums upon cancelled contracts and reinsurance in companies or associations licensed to do business in this state.
R.I. Gen. Laws § 27-41-30.1 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-30.1
§ 27-41-30.1. Postpartum hospital stays.
Status: repealed

(a) Every individual or group hospital or medical services plan contract delivered, issued for delivery, or renewed in this state shall provide coverage for a forty-eight-hour (48) time period in a hospital after a vaginal birth, and ninety-six (96) hours after a cesarean section for a mother and her newly born child. Any decision to shorten these minimum coverages shall be made by the attending healthcare provider in consultation with the mother. The decision shall be made in accordance with the standards for guidelines for perinatal care published by the American College of Obstetrics and Gynecology and the American Academy of Pediatrics. The standards shall be relative to early discharge, defined as less than forty-eight (48) hours for a vaginal delivery and ninety-six (96) hours for a cesarean delivery. In the case of early discharge, post-delivery care shall include home visits, parent education, assistance and training in breast or bottle feeding, and the performance of any necessary and appropriate clinical tests or any other tests or services consistent with the guidelines in this subsection.

(b) For the purposes of this section, attending healthcare provider includes the attending obstetrician, pediatrician, family practitioner, general practitioner, or certified nurse midwife attending the mother and newly born child.

(c) Any member who is aggrieved by a denial of benefits to be provided under this section may appeal the denial in accordance with regulations of the department of health that have been promulgated pursuant to chapter 17.12 of title 23 [repealed]. No policy or plan covered under this chapter shall terminate the services, reduce capitation payment, or penalize an attending physician or other healthcare provider who orders care consistent with the provisions of this section.
R.I. Gen. Laws § 27-2-7 — RI Code / Title 27 / Chapter 27-2 / Section 27-2-7
§ 27-2-7. Charter to be filed.
Status: in_force

Every insurance company not incorporated under the authority of this state shall, before making any contract of insurance with any person in this state, deposit with the insurance commissioner a copy of the charter of the company.
R.I. Gen. Laws § 27-6-15 — RI Code / Title 27 / Chapter 27-6 / Section 27-6-15
§ 27-6-15. Compliance with rate filings required.
Status: in_force

No insurer shall make or issue a contract or policy at a rate or premium in excess of filings that are in effect for that insurer as provided in this chapter or in accordance with § 27-6-13 or § 27-6-14. This section shall not apply to contracts or policies for inland marine risks as to which filings are not required.
R.I. Gen. Laws § 27-19-75 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-75
§ 27-19-75. Unfair discrimination prohibited.
Status: repealed

Notwithstanding any provision of any policy of insurance, certificate, or service contract issued in this state, whenever the insurance policy, certificate, or service contract provides for reimbursement for any services that may be legally performed by any person licensed under the provisions of chapters 29, 30, 35 [repealed], and 37 of title 5, reimbursement under the insurance policy, certificate, or service contract shall be based upon a determination of medical necessity and shall not be denied because of race, color, or creed, nor shall any insurer make or permit any unfair discrimination against particular individuals or persons licensed under chapters 29, 30, 35 [repealed], and 37 of title 5.
R.I. Gen. Laws § 27-32-1 — RI Code / Title 27 / Chapter 27-32 / Section 27-32-1
§ 27-32-1. Separate accounts authorized.
Status: in_force

(a) Any domestic life insurance company may establish one or more separate accounts, and may allocate to the account or accounts any amounts paid to it that are to be applied under the terms of an individual or group contract or agreement to provide annuity or life insurance benefits, or under the terms of a funding agreement, which contract or agreement or funding agreement may also provide other benefits incidental thereto, payable in fixed or in variable dollar amounts or in both.

(b) Notwithstanding any other provision of law, any domestic life insurance company that establishes one or more separate accounts as provided in this section may provide to the holders of interests in any separate account voting rights with respect to the management of the separate account and the investment of assets in it, may establish for the separate account a committee, board, or other body, the members of which: (1) May be elected solely by holders having voting rights, and (2) May or may not be affiliated with the life insurance company, and may provide for compliance with any applicable state and federal law in order that contracts assigned to separate accounts may be lawfully sold or offered for sale. If and to the extent provided in the applicable agreement, the assets in a separate account shall not be chargeable with liabilities arising out of any other business of the company.
R.I. Gen. Laws § 27-19-57 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-57
§ 27-19-57. Tobacco cessation programs.
Status: in_force

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

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

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

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

(1) Hospital confinement indemnity;

(2) Disability income;

(3) Accident only;

(4) Long-term care;

(5) Medicare supplement;

(6) Limited benefit health;

(7) Specified disease indemnity;

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

(9) Other limited benefit policies.
R.I. Gen. Laws § 27-82-4 — RI Code / Title 27 / Chapter 27-82 / Section 27-82-4
§ 27-82-4. Exemptions.
Status: in_force

The reporting required by this chapter shall not apply to dental insurance plans issued, delivered, or renewed to a self-insured group or where the carrier is acting as a third-party administrator.
R.I. Gen. Laws § 27-20-56 — RI Code / Title 27 / Chapter 27-20 / Section 27-20-56
§ 27-20-56. Enteral nutrition products.
Status: in_force

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

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

(c) This section shall not apply to insurance coverage providing benefits for: (1) Hospital confinement indemnity; (2) Disability income; (3) Accident only; (4) Long-term care; (5) Medicare supplement; (6) Limited benefit health; (7) Specified disease indemnity; (8) Sickness or bodily injury or death by accident or both; and (9) Other limited benefit policies.
R.I. Gen. Laws § 27-9-16 — RI Code / Title 27 / Chapter 27-9 / Section 27-9-16
§ 27-9-16. Disapproval of filing within waiting period.
Status: in_force

If, within the waiting period or any extension of it as provided in § 27-9-10, the commissioner finds that a filing does not meet the requirements of this chapter, the commissioner shall send to the insurer or rating organization that made the filing written notice of disapproval of the filing specifying in the notice in what respects the commissioner finds the filing fails to meet the requirements of this chapter and stating that the filing shall not become effective.
R.I. Gen. Laws § 27-1-32 — RI Code / Title 27 / Chapter 27-1 / Section 27-1-32
§ 27-1-32. Exempted sales of dealers.
Status: in_force

The provisions of § 27-1-30 shall not apply to any purchase and sale, or sale and purchase, and the provisions of § 27-1-31 shall not apply to any sale, of an equity security of a domestic stock insurance company not then or previously held by a beneficial owner, director, or officer in an investment account by a dealer in the ordinary course of the dealers business, and incident to the establishment or maintenance by the dealer of a primary or secondary market, otherwise than on an exchange referred to in 15 U.S.C. § 78l(d) for the security. The commissioner may, by any rules and regulations that the commissioner deems necessary or appropriate in the public interest, define and prescribe terms and conditions with respect to securities held in an investment account and transaction made in the ordinary course of business and incident to the establishment or maintenance of a primary or secondary market.
R.I. Gen. Laws § 27-29-3 — RI Code / Title 27 / Chapter 27-29 / Section 27-29-3
§ 27-29-3. Prohibited trade practices.
Status: in_force

No person shall engage in this state in any trade practice which is defined in this chapter as, or determined pursuant to this chapter to be, an unfair method of competition or an unfair or deceptive act or practice in the business of insurance.
R.I. Gen. Laws § 27-1-31 — RI Code / Title 27 / Chapter 27-1 / Section 27-1-31
§ 27-1-31. Prohibited sales of securities.
Status: in_force

It shall be unlawful for any beneficial owner, director, or officer, directly or indirectly, to sell any equity security of the company if the person selling the security or the persons principal: (1) does not own the security sold; or (2) if owning the security, does not deliver it against the sale within twenty (20) days thereafter, or does not within five (5) days after the sale deposit it in the mails or other usual channels of transportation. No person shall be deemed to have violated this section if the person proves that notwithstanding the exercise of good faith the person was unable to make the delivery or deposit within time, or that to do this would cause undue inconvenience or expense.
R.I. Gen. Laws § 27-41-14.1 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-14.1
§ 27-41-14.1. Prohibition against restraint on provider  Patient communications.
Status: in_force

No health maintenance organization shall refuse to contract with or compensate for covered services an otherwise eligible healthcare provider solely because the provider has in good faith communicated with one or more of his or her current, former, or prospective patients regarding the provisions, terms, requirements, restrictions, or other treatment options not provided by the health maintenance organization and of the health maintenance organizations products or services, or both, as they relate to the needs of the providers patients. By way of illustration only, and without limiting the protections afforded in this section, the communications within this section may involve hospital stays, emergency room use, and referral to specialists. Any provision contained in any contract between a health maintenance organization and a healthcare provider that violates the provisions of this section shall be null and void, and any attempt by a health maintenance organization to enforce that provision shall subject the health maintenance organization to assessment of a penalty of up to five thousand dollars ($5,000). These penalties shall be enforced by the consumer protection division of the department of the attorney general in the district court.
R.I. Gen. Laws § 27-41-21 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-21
§ 27-41-21. Penalties and enforcement.
Status: in_force

(a) The director of business regulation may, in lieu of the suspension or revocation of a license under § 27-41-17, levy an administrative penalty in an amount not less than five hundred dollars ($500) nor more than fifty thousand dollars ($50,000), if reasonable notice in writing is given of the intent to levy the penalty and the health maintenance organization has a reasonable time in which to remedy the defect in its operations that gave rise to the penalty citation. The director of business regulation may augment this penalty by an amount equal to the sum that the director calculates to be the damages suffered by enrollees or other members of the public.

(b) Any person who violates this chapter shall be guilty of a misdemeanor and may be punished by a fine not to exceed five hundred dollars ($500) or by imprisonment for a period not exceeding one year, or both.

(c)(1) If the director of business regulation or the director of health shall for any reason have cause to believe that any violation of this chapter has occurred or is threatened, the director of business regulation or the director of health may give notice to the health maintenance organization and to their representatives, or other persons who appear to be involved in the suspected violation, to arrange a conference with the alleged violators or their authorized representatives for the purpose of attempting to ascertain the facts relating to the suspected violation, and, in the event it appears that any violation has occurred or is threatened, to arrive at an adequate and effective means of correcting or preventing the violation;

(2) Proceedings under this subsection (c) shall be governed by chapter 35 of title 42.

(d)(1) The director of business regulation may issue an order directing a health maintenance organization or a representative of a health maintenance organization to cease and desist from engaging in any act or practice in violation of the provisions of this chapter;

(2) Within thirty (30) days after service of the order to cease and desist, the respondent may request a hearing on the question of whether acts or practices in violation of this chapter have occurred. Those hearings shall be conducted pursuant to §§ 42-35-9  42-35-13, and judicial review shall be available as provided by §§ 42-35-15 and 42-35-16.

(e) In the case of any violation of the provisions of this chapter, if the director of business regulation elects not to issue a cease and desist order, or in the event of noncompliance with a cease and desist order issued pursuant to subsection (d) of this section, the director of business regulation may institute a proceeding to obtain injunctive relief, or seeking other appropriate relief, in the superior court for the county of Providence.

(f) Notwithstanding any other provisions of this chapter, if a health maintenance organization fails to comply with the net worth, risk-based capital, or any other requirement of this title related to the solvency of the health maintenance organization, the director is authorized to take appropriate action to ensure that the continued operation of the health maintenance organization will not be hazardous to its enrollees or the public.
R.I. Gen. Laws § 27-44-6 — RI Code / Title 27 / Chapter 27-44 / Section 27-44-6
§ 27-44-6. Filing of rates and other rating information.
Status: in_force

(a) Filings as to competitive markets; file and use. In a competitive market, every insurer shall file with the director all rates and supplementary rate information to be used in this state. At the time the rates are filed, the filing shall state the specific model(s) used (catastrophic risk planning), and explain the manner in which each model was used to determine the filed rate. The rates and supplementary rate information shall be filed at least thirty (30) days prior to the proposed effective date. At the end of that time, the rates may be used if no disapproval order or request for supporting information has been issued by the director. If the director finds that an insurers rates require closer review because of an insurers financial condition, or upon any other grounds as the director may consider harmful to the public interest including, but not limited to, excessiveness, inadequacy, or unfair discrimination, the director may request supporting information as needed. If the director requests the further information, the rates may not be made effective until thirty (30) days after the information has been received by the director.

(b) Filings as to noncompetitive markets. Nothing contained in this chapter shall be construed to abrogate or supersede any statute or regulation governing either classes of business identified in § 27-44-3, or deemed noncompetitive pursuant to the provisions of this chapter. Those classes of business and noncompetitive markets shall have rates established pursuant to the standards and procedures applicable under chapters 6, 7.1, 9, 19, and 20 of this title, and chapter 62 of title 42.

(c) Requirement of director. Rates shall be filed in the form and manner prescribed by the director.

(d) Rating organization. Any insurer may discharge its obligation under this section by giving notice to the director that it uses rates and supplementary rate information prepared and filed by a designated rating organization of which it is a member or subscriber. The insurers rates and supplementary rate information shall be those filed by the rating organization, including any amendments, subject to modifications filed by the insurer.

(e) Consent to rate. Upon the written consent of the insured, stating the reasons for consent and filed with the director, a rate in excess of that provided by an otherwise applicable filing may be used on any specific risk. A rate greater than that applicable to the insured under a residual market mechanism may not be used unless approved by the director.

(f) Filings open to inspection. All rates, supplementary rate information, and any supporting information for rates filed under this chapter shall, as soon as filed, be open to public inspection at any reasonable time. Copies may be obtained by any person on request and upon payment of a reasonable charge.
R.I. Gen. Laws § 27-82-2 — RI Code / Title 27 / Chapter 27-82 / Section 27-82-2
§ 27-82-2. Definitions.
Status: in_force

As used in this chapter, the following terms shall mean:

(1) Commissioner or health insurance commissioner shall have the meaning set forth in § 27-18-1.1.

(2) Dental health insurance carrier means a health insurance carrier, as defined in § 27-18-1.1, to the extent that it provides insured dental services benefits coverage, including any entity providing individual or group coverage for dental or oral surgery services or procedures:

(i) Through an individual or group policy of health, accident, and sickness insurance under this title;

(ii) As a nonprofit hospital service corporation organized under chapter 19 of this title;

(iii) As a nonprofit medical service corporation organized under chapter 20 of this title;

(iv) As a nonprofit dental service corporation organized under chapter 20.1 of this title; and/or

(v) As a health maintenance organization organized under chapter 41 of this title.

(3) Dental loss ratio (DLR) means the percentage of dental premium dollars spent on patient care, calculated as follows:

(i) The numerator in the DLR is the incurred claims as defined in this section; and

(ii) The denominator in the DLR is the earned premiums as defined in this section.

(4) Earned premiums means, for any reporting year, the premium received up to the loss measurement ratio date for coverage provided during the reporting year minus federal and state taxes and assessments, and pass through payments made by the dental health insurance carrier as a billing convenience for commissions or fees charged by a broker or consultant retained by the group or individual receiving coverage, and for which the group or individual, as opposed to the dental health insurance carrier, is responsible for payment.

(5) Health insurance carrier shall have the same meaning set forth in § 27-18-1.1.

(6) Incurred claims means, for a reporting year, the claims for which services were provided in the reporting year, including an estimate of unpaid claim reserves and incurred value-based care incentive pool and bonuses, the costs related to improving healthcare quality and access, fraud reduction, charitable contributions made to nonprofit entities to improve access to dental care to the disadvantaged and underserved populations; to encourage and support workforce development as it relates to all components of dental care delivery including dentists, hygienists, and assistants, and costs incurred for dental care management, including utilization review.

(7) Reporting year means a calendar year during which group or individual dental coverage is provided by a policy, contract, or certificate covering dental services.
R.I. Gen. Laws § 27-30-2 — RI Code / Title 27 / Chapter 27-30 / Section 27-30-2
§ 27-30-2. Scope and definitions.
Status: in_force

(a) Citation and scope. (1) This chapter may be cited as Consumer Credit Insurance Act. (2) All consumer credit insurance sold in connection with loans or other credit transactions for personal, family, or household purposes shall be subject to the provisions of this chapter except: (i) Insurance written in connection with a credit transaction that is: (A) Secured by a first mortgage or deed of trust; and (B) Made to finance the purchase of real property or the construction of a dwelling thereon, or to refinance a prior credit transaction made for such a purpose; (ii) Insurance sold as an isolated transaction on the part of the insurer and not related to an agreement or a plan for insuring debtors of the creditor; (iii) Insurance for which no identifiable charge is made to the debtor; and (iv) Insurance on accounts receivable.

(b) Definitions. For the purpose of this chapter:

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

(2) Compensation means commissions, dividends, retrospective rate credits, service fees, expense allowances or reimbursements, gifts, furnishing of equipment, facilities, goods, or services, or any other form of remuneration resulting directly from the sale of consumer credit insurance.

(3) Consumer credit insurance is a general term used in this chapter to refer to any or all credit life insurance, credit accident and health insurance, credit unemployment insurance specifically defined in this chapter.

(4) Credit accident and health insurance means insurance on a debtor to provide indemnity for payments or debt becoming due on a specific loan or other credit transaction while the debtor is disabled as defined in the policy.

(5) Credit life insurance means insurance on a debtor or debtors, pursuant to or in connection with a specific loan or other credit transaction, to provide for satisfaction of a debt, in whole or in part, upon the death of an insured debtor.

(6) Credit transaction means any transaction by the terms of which the repayment of money loaned or loan commitment made, or payment for goods, services, or properties sold or leased, is to be made at a future date or dates.

(7) Credit unemployment insurance means insurance on a debtor to provide indemnity for payments or debt becoming due on a specific loan or other credit transaction while the debtor is involuntarily unemployed as defined in the policy.

(8) Creditor means the lender of money or vendor or lessor of goods, services, property, rights, or privileges, for which payment is arranged through a credit transaction or any successor to the right, title, or interest of any lender, vendor, or lessor, and an affiliate, associate, or subsidiary of any of them or any director, officer, or employee of any of them or any other person in any way associated with any of them.

(9) Debtor means a borrower of money or a purchaser or lessee of goods, services, property, rights, or privileges for which payment is arranged through a credit transaction.

(10) Gross debt means the sum of the remaining payments owed to the creditor by the debtor.

(11) Identifiable charge means a charge for a type of consumer credit insurance that is made to debtors having such insurance and not made to debtors not having such insurance; it includes a charge for insurance that is disclosed in the credit or other instrument furnished to the debtor that sets out the financial elements of the credit transaction and any difference in the finance, interest, service, or other similar charge made to debtors who are in like circumstances except for the insured or non-insured status of the debtor or of the property used as security for the credit transaction.

(12) Net debt means the amount necessary to liquidate the remaining debt in a single lump-sum payment, excluding all unearned interest and other unearned finance charges.

(13) Open-end credit means credit extended by a creditor under an agreement in which:

(i) The creditor reasonably contemplates repeated transactions;

(ii) The creditor imposes a finance charge from time to time on an outstanding unpaid balance; and

(iii) The amount of credit that may be extended to the debtor during the term of the agreement (up to any set limit by the creditor) is generally made available to the extent that any outstanding balance is repaid.
R.I. Gen. Laws § 27-41-89 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-89
§ 27-41-89. 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 § 27-7-1 — RI Code / Title 27 / Chapter 27-7 / Section 27-7-1
§ 27-7-1. Direct liability of insurer to person injured.
Status: in_force

Every policy written insuring against liability for property damage or personal injuries or both, and every policy written indemnifying any person by reason of that liability, other than the payment of compensation under chapters 29  38 of title 28, shall contain provisions to the effect that the insurer shall be directly liable to the injured party and, in the event of that partys death, to the party entitled to sue for that death, to pay that party the amount of damages for which the insured is liable.
R.I. Gen. Laws § 27-44-21 — RI Code / Title 27 / Chapter 27-44 / Section 27-44-21
§ 27-44-21. Judicial review.
Status: in_force

(a) Any order, regulation, or decision of the director made after a hearing shall be subject to judicial review in accordance with the Administrative Procedures Act, chapter 35 of title 42.

(b) Upon the request of any insurer or organization to which the director has directed an order made without a hearing, the director shall grant a hearing within thirty (30) days of the request. Within thirty (30) days after the hearing, the director shall affirm, reverse, or modify the previous action, specifying the reasons for it.
R.I. Gen. Laws § 27-19-21 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-21
§ 27-19-21. Mammograms  Quality assurance standards.
Status: in_force

A mammogram eligible for reimbursement under § 27-19-20 shall be reimbursed only if the facility in which the mammogram has been taken and processed, and the licensed physician interpreting the mammogram, both meet state approved quality assurance standards for taking, processing, and interpreting mammograms. The director of health shall have the authority to promulgate rules and regulations necessary to carry out the provisions of this section.
R.I. Gen. Laws § 27-18-85 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-85
§ 27-18-85. Prohibition on discrimination in organ transplants.
Status: in_force

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

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

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

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

(4) Reduce or limit coverage benefits to a patient for the medical services or other services related to organ transplantation performed pursuant to this section as determined in consultation with the attending physician and patient.
R.I. Gen. Laws § 27-66-10 — RI Code / Title 27 / Chapter 27-66 / Section 27-66-10
§ 27-66-10. Investigation  Notice to attend  Court order to appear  Contempt.
Status: in_force

(a) The director and/or the department of the attorney general may conduct investigations in discharging the duties required under this chapter. For purposes of this investigation, the director or the attorney general may require any person, agent, trustee, fiduciary, consultant, institution, association, or corporation directly related to the proposed conversion to appear at any time and place that the director or the attorney general may designate, then and there under oath to produce for the use of the director or the attorney general any and all documents and other information.

(b) Whenever the director or the attorney general may require the attendance of any person as provided in subsection (a), the director or the attorney general shall issue a notice setting the time and place when the attendance is required and shall cause the notice to be delivered or sent by registered or certified mail to the person at least fourteen (14) days before the date fixed in the notice for the attendance.

(c) If any person receiving notice pursuant to this provision neglects to attend or remain in attendance so long as may be necessary for the purposes for which the notice was issued, or refuses to produce information requested, any justice of the superior court for the county within which the inquiry is carried on or within which the person resides or transacts business, upon application by the director or the attorney general, or any transacting party shall have jurisdiction to hear and consider on an expedited basis the request, and if appropriate and relevant to the consideration of proposed conversion, may issue to the person an order requiring the person to appear before the director or the attorney general there to produce for the use of the director or the attorney general evidence in accordance with the terms of the order of the court, and any failure to obey the order of the superior court may be punished by the court as contempt of court.
R.I. Gen. Laws § 27-25-10 — RI Code / Title 27 / Chapter 27-25 / Section 27-25-10
§ 27-25-10. Organization.
Status: in_force

A domestic society shall be formed as follows:

(1) Seven (7) or more citizens of the United States, a majority of whom are citizens of this state, who desire to form a fraternal benefit society, may make, sign, and acknowledge before some officer competent to take acknowledgment of deeds, articles of incorporation, in which shall be stated:

(i) The proposed corporate name of the society, which shall not so closely resemble the name of any society or insurance company as to be misleading or confusing;

(ii) The purposes for which it is being formed and the mode in which its corporate powers are to be exercised. Those purposes shall not include more liberal powers than are granted by this chapter; and

(iii) The names and residences of the incorporators and the names, residences, and official titles of all the officers, trustees, directors, or other persons who are to have and exercise the general control of the management of the affairs and funds of the society for the first year or until the ensuing election at which all of the officers shall be elected by the supreme governing body, which election shall be held not later than one year from the date of the issuance of the permanent certificate of authority;

(2) The articles of incorporation, duly certified copies of the societys bylaws and rules, copies of all proposed forms of certificates, applications for them, and circulars to be issued by the society and a bond conditioned upon the return to applicants of the advanced payments if the organization is not completed within one year, shall be filed with the commissioner of insurance, who may require any further information the commissioner deems necessary. The bond with sureties approved by the commissioner of insurance shall be in an amount, not less than three hundred thousand dollars ($300,000) nor more than one million five hundred thousand dollars ($1,500,000), as required by the commissioner of insurance. All documents filed are to be in the English language. If the purposes of the society conform to the requirements of this chapter and all of the provisions of the law have been complied with, the commissioner of insurance shall certify, retain, and file the articles of incorporation and furnish the incorporators with a preliminary certificate of authority authorizing the society to solicit members;

(3) No preliminary certificate of authority granted under the provisions of this section shall be valid after one year from its date or after a further period, not exceeding one year, as may be authorized by the commissioner of insurance upon cause shown, unless the five hundred (500) applicants have been secured and the organization has been completed as provided in this section. The articles of incorporation and all other proceedings under the articles shall become null and void in one year from the date of the preliminary certificate of authority, or at the expiration of the extended period, unless the society shall have completed its organization and received a certificate of authority to do business;

(4) Upon receipt of a preliminary certificate of authority from the commissioner of insurance, the society may solicit members for the purpose of completing its organization, shall collect from each applicant the amount of not less than one regular monthly premium in accordance with its table of rates, and shall issue to each applicant a receipt for the amount so collected. No society shall incur any liability other than for the return of the advance premium, nor issue any certificate, nor pay, allow, or offer or promise to pay or allow, any benefit to any person until:

(i) Actual bona fide applications for benefits have been secured on not less than five hundred (500) applicants, and any necessary evidence of insurability has been furnished to and approved by the society;

(ii) At least ten (10) subordinate lodges have been established into which the five hundred (500) applicants have been admitted;

(iii) There has been submitted to the commissioner of insurance, under oath of the president or secretary or corresponding officer of the society, a list of the applicants, giving their names, addresses, date each was admitted, name and number of the subordinate lodge of which each applicant is a member, amount of benefits to be granted and premiums for the benefits; and

(iv) It shall have been shown to the commissioner of insurance, by sworn statement of the treasurer or corresponding officer of the society, that at least five hundred (500) applicants have each paid in cash at least one regular monthly premium as provided in this section, which premiums in the aggregate shall amount to at least one hundred and fifty thousand dollars ($150,000). The advance premiums shall be held in trust during the period of organization and if the society has not qualified for a certificate of authority within one year, the premiums shall be returned to the applicant;

(5) The commissioner of insurance may make any examination and require any further information as the commissioner deems advisable. Upon presentation of satisfactory evidence that the society has complied with all of the provisions of law, the commissioner shall issue to the society a certificate of authority to that effect and that the society is authorized to transact business pursuant to the provisions of this chapter. The certificate of authority shall be prima facie evidence of the existence of the society at the date of the certificate. The commissioner of insurance shall cause a record of the certificate of authority to be made. A certified copy of the record may be given in evidence with like effect as the original certificate of authority; and

(6) Any incorporated society authorized to transact business in this state at the time this chapter becomes effective shall not be required to reincorporate.
R.I. Gen. Laws § 27-6-43 — RI Code / Title 27 / Chapter 27-6 / Section 27-6-43
§ 27-6-43. Cooperation with other states.
Status: in_force

In order to further uniform administration of rate regulatory laws, the commissioner and every insurer and rating organization may exchange information and experience data with insurance supervisory officials, insurers, and rating organizations in other states and may consult with them with respect to ratemaking and the application of rating systems.
R.I. Gen. Laws § 27-67-4 — RI Code / Title 27 / Chapter 27-67 / Section 27-67-4
§ 27-67-4. Establishment of regional health insurance market.
Status: in_force

The health insurance commissioner shall undertake a review of the existing laws and regulations pertaining to the business of health insurance in this state, and in other New England states. On or before March 1, 2009, the health insurance commissioner shall submit a report to the general assembly on what changes would be necessary to the laws and/or regulations of Rhode Island in order to meet the goal of enabling health insurers licensed in other New England states to do business in Rhode Island without a separate application for licensure in Rhode Island. The report shall address the policy implications of implementing the identified changes in law and regulations, and the potential advantages and disadvantages of creating a regional health insurance market.

The report shall further address the extent to which licensure is a barrier to bringing other health insurers into the Rhode Island market. The report shall further address the manner in which licensure can be automatically granted to those insurers licensed in other New England states while still requiring that such insurers otherwise remain bound by the non-licensure related laws and regulations governing the administration of health insurance benefit plans in Rhode Island. The report shall include an analysis of barriers to the creation of a regional health insurance market and a proposed timeline for implementing all changes that would be needed to establish a regional health insurance market.
R.I. Gen. Laws § 27-7-6 — RI Code / Title 27 / Chapter 27-7 / Section 27-7-6
§ 27-7-6. Rental vehicle coverage.
Status: in_force

(a)(1) For liability assumed under a written contract, coverage shall be provided under the property damage liability section of an insureds private passenger automobile insurance policy. Property damage coverage shall extend to a rented motor vehicle, under ten thousand pounds (10,000 lbs.), without regard to negligence for a period not to exceed sixty (60) consecutive days.

(2) Coverage under subsection (a)(1) of this section shall apply to the named insured and driver(s) on the private passenger automobile insurance policy and/or their designee(s), unless the designee driver is specifically excluded from the policy.

(b) Coverage pursuant to subsection (a) shall apply to all collision and comprehensive type losses.

(c) Whenever liability is accepted by an insurance company involving an accident that results in their insureds causing a total loss of the other partys vehicle, the at-fault carrier shall extend coverage for a rental vehicle for not less than an additional seven (7) days after the aggrieved party receives the total loss property damage check.

(d) Coverage shall be provided for loss of use of the rental motor vehicle; provided, that a claim for loss of use of a rental vehicle shall be limited to the reasonable time to repair or replace the rental vehicle, and shall be no less than the daily rental rate set forth in the rental agreement. To establish loss of use, the rental car company shall demonstrate that the rental vehicle sustained damage, regardless of fault, requires repair, and will be out of service for the period of time determined by a Rhode Island licensed auto appraiser or adjuster. In the case of a total loss, loss of use payments shall be made up until the time the vehicle owner receives the property damage payment for the total loss. Coverage for loss of use of a rented motor vehicle shall be provided regardless of fleet utilization.

(e) Whenever a claimants vehicle is damaged in an accident, the at-fault insurance company shall provide at its expense, a rental vehicle that is reasonably comparable in quality to the claimants damaged vehicle, and rental charges to be paid shall be based on the local retail prices reasonably available to consumers at the date and time a claimant rents a vehicle.
R.I. Gen. Laws § 27-80-3 — RI Code / Title 27 / Chapter 27-80 / Section 27-80-3
§ 27-80-3. Definitions.
Status: in_force

As used in this chapter:

(1) Contract means an annuity contract. The term contract shall not include an annuity used to fund an employment-based retirement plan or program where the insurer is not committed by terms of the annuity contract to pay death benefits to the beneficiaries of specific plan participants.

(2) Death master file means the United States Social Security Administrations death master file or any other database or service that is at least as comprehensive as the United States Social Security Administrations death master file for determining that a person has reportedly died.

(3) Death master file match means a search of the death master file that results in a match of the Social Security number or the name and date of birth of an insured, annuity owner, or retained asset account holder.

(4) Policy means any policy or certificate of life insurance that provides a death benefit. The term policy shall not include:

(i) Any policy or certificate of life insurance that provides a death benefit under an employee benefit plan:

(A) Subject to the Employee Retirement Income Security Act of 1974 (Pub. L. No. 93-406), 29 U.S.C. § 1002, as periodically amended; or

(B) Under any federal employee benefit program; or

(ii) Any policy or certificate of life insurance that is used to fund a pre-need funeral contract or pre-arrangement; or

(iii) Any policy or certificate of credit life or accidental death insurance.
R.I. Gen. Laws § 27-6-45 — RI Code / Title 27 / Chapter 27-6 / Section 27-6-45
§ 27-6-45. False or misleading information.
Status: in_force

No person or organization shall willfully withhold information from, or knowingly give false or misleading information to, the commissioner, any statistical agency designated by the commissioner, any rating organization, or any insurer, that will affect the rates or premiums chargeable under this chapter. A violation of this section shall subject the one guilty of that violation to the penalties provided in §§ 27-6-47 and 27-6-48.
R.I. Gen. Laws § 27-9-10 — RI Code / Title 27 / Chapter 27-9 / Section 27-9-10
§ 27-9-10. Waiting period  Effective date of filings.
Status: in_force

Subject to the exception specified in § 27-9-9, each filing shall be on file for a waiting period of thirty (30) days before it becomes effective, which period may be extended by the commissioner for an additional period not to exceed thirty (30) days if the commissioner gives written notice within that waiting period to the insurer or rating organization that made the filing that the commissioner needs that additional time for the consideration of the filing. Upon written application by the insurer or rating organization, 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 it. A filing shall be deemed to meet the requirements of this chapter and to become effective unless disapproved as provided in this chapter by the commissioner within the waiting period or any extension of it; provided, that if the commissioner gives written notice to the insurer or rating organization within the waiting period or any extension that he or she will hold a hearing on the filing, the filing shall not become effective before or until the commissioner issues his or her decision. Upon giving that notice the commissioner shall also give public notice of the hearing by causing a notice to be published in a newspaper of general circulation in the state at least ten (10) days prior to the hearing stating the name of the insurer or rating organization which has made the filing and including a general description of the subject matter and sending a copy of that notice to the consumer protection unit of the department of attorney general. The commissioner shall hold a hearing on major filings. The hearing shall be held and a decision issued by the commissioner as soon as reasonably possible.
R.I. Gen. Laws § 27-71-1 — RI Code / Title 27 / Chapter 27-71 / Section 27-71-1
§ 27-71-1. Short title.
Status: in_force

This chapter shall be known and may be cited as the Market Conduct Surveillance Act.
R.I. Gen. Laws § 27-19-38 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-38
§ 27-19-38. Penalties and remedies.
Status: in_force

(a) Any person, firm, corporation, association, or other legal entity who or that shall violate the provisions of § 27-19-37 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 § 27-9-2 — RI Code / Title 27 / Chapter 27-9 / Section 27-9-2
§ 27-9-2. Applicability.
Status: in_force

This chapter applies to casualty insurance, including fidelity, surety, and guaranty bonds, and to all other forms of motor vehicle insurance, on risks or operations in this state, except:

(1) Reinsurance, other than joint reinsurance to the extent stated in §§ 27-9-34 and 27-9-35;

(2) Accident and health insurance; and

(3) Insurance against loss of or damage to aircraft, or against liability, other than workers compensation and employers liability, arising out of the ownership, maintenance, or use of aircraft.
R.I. Gen. Laws § 27-66-15 — RI Code / Title 27 / Chapter 27-66 / Section 27-66-15
§ 27-66-15. Distribution of proceeds from acquisition  Selection and establishment of an independent foundation.
Status: in_force

(a) In the event of the approval of a conversion involving a not-for-profit corporation, as an acquiree, it may be required that the proceeds from the sale and any endowments, restricted, unrestricted and specific purpose funds may be transferred to a charitable foundation established in this section.

(b) The determination whether the proceeds of the conversion shall be transferred to the foundation established in this section shall be made pursuant to the common law doctrine of cy pres and chapter 4 of title 18.

(c) The board of directors shall consist of an executive director, who shall serve ex-officio, and nine (9) members, all of whom shall be citizens and residents of this state and none of whom shall be members of the general assembly, and three (3) of whom shall be appointed by the governor, three (3) of whom shall be appointed by the speaker of the house, and three (3) of whom shall be appointed by the president of the senate. The board members may include one or more members with experience in matters including financial, legal, business, labor, healthcare delivery, investments, community purpose, grant-making, health insurance and members who represent diverse populations of the affected community and not more than three (3) members of the board may be prior board members of the acquiree.

(d) The members shall be appointed for terms of three (3) years except for the three (3) members originally appointed by each of the appointing authorities; one shall be appointed for a term of one year, one shall be appointed for a term of two (2) years, and one for a term of three (3) years. The board shall annually elect a chairperson from among its members and other officers it deems necessary for the performance of its duties and board members shall not receive compensation.

(e) Control of the distribution of the proceeds of the fund is vested solely in the board provided, the investment responsibility shall be through the Rhode Island Foundation, or similar foundation.

(f) Vacancies occurring on the board may be filled by a majority vote of the remaining board members.
R.I. Gen. Laws § 27-41-17 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-17
§ 27-41-17. Suspension or revocation of license.
Status: in_force

(a) The director may suspend or revoke any license issued to a health maintenance organization under this chapter if the director finds that any of the following conditions exist:

(1) The health maintenance organization is operating significantly in contravention of its basic organizational document, or in a manner contrary to that described in and reasonably inferred from any other information submitted under § 27-41-3, unless amendments to those submissions have been filed with and approved by the director;

(2) The health maintenance organization issues evidence of coverage or uses a schedule of charges for healthcare services that does not comply with the requirements of § 27-41-8;

(3) The health maintenance organization does not provide or arrange for basic healthcare services;

(4) The health maintenance organization is no longer financially responsible and may reasonably be expected to be unable to meet its obligations to enrollees or prospective enrollees;

(5) The health maintenance organization has failed to implement a mechanism affording the enrollees an opportunity to participate in matters of policy and operation under § 27-41-6;

(6) The health maintenance organization has failed to implement the complaint system required by § 27-41-11 in a manner to reasonably resolve valid complaints;

(7) The health maintenance organization, or any person on its behalf, has advertised or merchandised its services in an untrue, misrepresentative, misleading, deceptive, or unfair manner;

(8) The continued operation of the health maintenance organization would be hazardous to its enrollees; or

(9) The health maintenance organization has failed to substantially comply with this chapter.

(b) The director of business regulation shall suspend or revoke any license issued to a health maintenance organization upon certification by the director of health to the director of business regulation that:

(1) The health maintenance organization does not meet the requirements of § 27-41-4(a)(2); or

(2) The health maintenance organization is unable to fulfill its obligations to furnish healthcare services.

(c) A license shall be suspended or revoked only after compliance with the requirements of § 27-41-20.

(d) When the license of a health maintenance organization is suspended, the health maintenance organization shall not, during the period of that suspension, enroll any additional enrollees except newborn children or other newly acquired dependents of existing enrollees, and shall not engage in any advertising or solicitation.

(e) When the license of a health maintenance organization is revoked, the organization shall proceed, immediately following the effective date of the order of revocation, to wind up its affairs, and shall conduct no further business except as may be essential to the orderly conclusion of the affairs of the organization. It shall engage in no further advertising or solicitation. The director of business regulation may, by written order, permit any further operation of the organization that the director may find to be in the best interest of enrollees, to the end that enrollees will be afforded the greatest practical opportunity to obtain continuing healthcare coverage.
R.I. Gen. Laws § 27-30-4 — RI Code / Title 27 / Chapter 27-30 / Section 27-30-4
§ 27-30-4. Amount of consumer credit insurance.
Status: in_force

(a) Credit life insurance. (1) The amount of credit life insurance shall at no time exceed the greater of the actual net debt or the scheduled net debt. (2) If the coverage is written on the actual net debt, then the amount payable at the time of loss may not be less than the actual net debt less any payments more than two (2) months overdue. (3) If the coverage is written on the scheduled net debt, then the amount payable at the time of loss shall be: (i) If the actual net debt is less than or equal to the scheduled net debt, then the scheduled net debt; (ii) If the actual net debt is greater than the scheduled net debt but less than or equal to the scheduled net debt plus two (2) months of payments, the actual net debt; or (iii) If the actual net debt is greater than the scheduled net debt plus two (2) months of payments, then scheduled net debt plus two (2) months of payments. (4) If a premium is assessed to the debtor on a monthly basis and is based on the actual net debt, then the amount payable at the time of loss shall be the actual net debt on the date of death. When such premium is computed on the basis of a balance that does not include accrued past-due interest, then the amount payable at the time of loss shall not be less than the actual net debt less any accrued interest more than two (2) months past due. (5) Notwithstanding the provisions of subdivision (a)(1), insurance on agricultural loan commitments, not exceeding one year in duration, may be written up to the amount of the loan commitment, on a non-decreasing or level term plan. (6) Notwithstanding the provisions of subdivision (a)(1), insurance on educational loan commitments may be written for net unpaid indebtedness plus any unused commitment. (7) Coverage may be written for less than the net debt by the following methods: (i) The amount of insurance may be the lesser of a stated level amount and the amount determined by subdivision (a)(2); (ii) The amount of insurance may be the lesser of a stated level amount and the amount determined by subdivision (a)(3); (iii) The amount of insurance may be a constant percentage of the amount determined by subdivision (a)(2); (iv) The amount of insurance may be a constant percentage of the amount determined by subdivision (a)(3); or (v) In the absence of any preexisting condition exclusions, the amount of insurance payable in the event of death due to natural causes may be limited to the balance as it existed six months (6) prior to the date of death if: (A) There has been one or more increase in the outstanding balance during the six-month (6) period, other than those due to the accrual of interest or late charges; and (B) Evidence of individual insurability has not been required during the six-month (6) period. (8) Other patterns of insurance may be used that are not inconsistent with the rest of this subsection (a).

(b) Credit accident and health insurance and consumer credit unemployment insurance. (1) The total amount of periodic indemnity payable by credit accident and health insurance or credit unemployment insurance in the event of disability or unemployment, as defined in the policy, shall not exceed the aggregate of the periodic scheduled unpaid installments of the gross debt; and the amount of each periodic indemnity payment shall not exceed the original gross debt divided by the number of periodic installments. (2) Notwithstanding the provisions of subdivision (b)(1), for credit accident and health insurance or credit unemployment insurance written in connection with an open-end credit agreement, the amount of insurance shall not exceed the gross debt that would accrue on that amount using the periodic indemnity. Subject to any policy maximum, the periodic indemnity must not be less than the creditors minimum repayment schedule.
R.I. Gen. Laws § 27-20-23.3 — RI Code / Title 27 / Chapter 27-20 / Section 27-20-23.3
§ 27-20-23.3. Patient choice in dispensing of clinician-administered drugs.
Status: in_force

(a) As used in this section,

(1) Clinician-administered drug means an outpatient infused prescription drug other than a vaccine that:

(i) Cannot reasonably be self-administered by the patient to whom the drug is prescribed or by a non-clinician individual assisting the patient with the self-administration; and

(ii) Is typically administered:

(A) By a healthcare professional authorized under the laws of this state to administer the drug, including when acting under a physicians delegation and supervision; and

(B) In a physicians office, hospital outpatient infusion center, or other clinical setting.

(b) A health insurer or a third party acting on its behalf shall not refuse to authorize, approve, or pay a provider for a covered clinician-administered drug that was administered and dispensed by any in-network hospital or clinic; provided that:

(1) The dispensing and administering and any associated authorizations and approvals are consistent with the provider contract and the issuers medical and payment policies provided such policies do not prohibit the procurement, administration, and dispensing by an in-network hospital or clinic; and

(2) The reimbursement to the provider shall be negotiated between the health insurer and provider at a rate equal to payments between the insurer and a preferred pharmacy.

(c) After January 1, 2025, the office of the health insurance commissioner, in consultation with health insurers and providers, shall conduct an analysis of the payment for clinician-administered drugs under this section.

(1) In conducting the analysis, the office of the health insurance commissioner may:

(i) Gather data from providers regarding potentially inaccurate payments; and

(ii) Obtain necessary information from health insurers to understand how reimbursements to providers for clinician-administered drugs are calculated.

(2) The office of the health insurance commissioner shall publish on its website a summary of its analysis, without identifying any health insurers or providers.

(3) The office of the health insurance commissioner may include in its analysis legislative recommendations to improve the reimbursement process for clinician-administered drugs under this section, as necessary. Any recommendations shall include a description of the recommendations potential costs to consumers, health insurers, providers, and the state.

(4) The office of the health insurance commissioner shall provide the general assembly with their analysis no later than February 28, 2026.
R.I. Gen. Laws § 27-74-8 — RI Code / Title 27 / Chapter 27-74 / Section 27-74-8
§ 27-74-8. Charges and fees  Refund requirements  Bundling of services.
Status: in_force

(a) A discount medical plan organization may charge a periodic charge as well as a reasonable one-time processing fee for a discount medical plan.

(b) If a member cancels his or her membership in the discount medical plan organization within the first thirty (30) days after the date of receipt of the written document for the discount medical plan described in § 27-74-11(e), the member shall receive a reimbursement of all periodic charges and the amount of any one-time processing fee that exceeds twenty dollars ($20.00) upon return of the discount medical plan card to the discount medical plan organization.

(c) Cancellation occurs when notice of cancellation is given to the discount medical plan organization. Notice of cancellation is deemed given when delivered by hand or deposited in a mailbox, properly addressed and postage prepaid to the mailing address of the discount medical plan organization or emailed to the email address of the discount medical plan organization.

(d) A discount medical plan organization shall return any periodic charge charged or collected after the member has returned the discount medical plan card or given the discount medical plan organization notice of cancellation.

(e) If the discount medical plan organization cancels a membership for any reason other than nonpayment of charges by the member, the discount medical plan organization shall make a pro rata reimbursement of all periodic charges to the member.

(f) When a marketer or discount medical plan organization sells a discount medical plan in conjunction with any other products, the marketer or discount medical plan organization shall:

(1) Provide the charges for each discount medical plan in writing to the member; or

(2) Reimburse the member for all periodic charges for the discount medical plan and all periodic charges for any other product if the member cancels his or her membership in accordance with this section.

(g) Any discount medical plan organization that is a health carrier that provides a discount medical plan product that is incidental to the insured product is not subject to this section.
R.I. Gen. Laws § 27-5-6.2 — RI Code / Title 27 / Chapter 27-5 / Section 27-5-6.2
§ 27-5-6.2. Escrow accounts for insurance premiums.
Status: in_force

All banks and lending institutions doing business in this state, whether acting under state or federal authority, which include, but are not limited to: (1) A bank, savings bank, or trust company, as defined in title 19, its affiliates or subsidiaries; (2) A bank holding company, as defined in 12 U.S.C. § 1841, its affiliates or subsidiaries; (3) Mortgage companies and mortgage services; and (4) Any other individual, corporation, partnership, or association authorized to take deposits and/or to makes loans of money under the provisions of title 19, that in connection with a loan secured by residential property situated in the state of Rhode Island of four (4) or fewer units and occupied or to be occupied in whole or in part by the mortgagor, require the mortgagor to escrow for hazard insurance premiums, shall pay the annual premium to the insurance company on or before the last to occur of the following dates: (A) Ten (10) days after receipt of the annual insurance premium bill, approved in writing by the mortgagor if required by the bank or lending institution provided the bank or lending institution has notified the mortgagor in writing that the mortgagors approval is required; or (B) Seven (7) days before the effective date of the hazard insurance policy; provided, that no payment shall be required unless the mortgagor has sufficient funds escrowed for payment of the annual premium.
R.I. Gen. Laws § 27-18-50 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-50
§ 27-18-50. Drug coverage.
Status: repealed

(a) Any accident and sickness insurer that utilizes a formulary of medications for which coverage is provided under an individual or group plan master contract shall require any physician or other person authorized by the department of health to prescribe medication to prescribe from the formulary. A physician or other person authorized by the department of health to prescribe medication shall be allowed to prescribe medications previously on, or not on, the accident and sickness insurers formulary if he or she believes that the prescription of the non-formulary medication is medically necessary. An accident and sickness insurer shall be required to provide coverage for a non-formulary medication only when the non-formulary medication meets the accident and sickness insurers medical-exception criteria for the coverage of that medication.

(b) An accident and sickness insurers medical-exception criteria for the coverage of non-formulary medications shall be developed in accordance with § 23-17.13-3(c)(3) [repealed].

(c) Any subscriber who is aggrieved by a denial of benefits to be provided under this section may appeal the denial in accordance with the rules and regulations promulgated by the department of health pursuant to chapter 17.12 of title 23 [repealed].

(d) Prior to removing a prescription drug from its plans formulary or making any change in the preferred or tiered cost-sharing status of a covered prescription drug, an accident and sickness insurer must provide at least thirty (30) days notice to authorized prescribers by established communication methods of policy and program updates and by updating available references on web-based publications. All adversely affected members must be provided at least thirty (30) days notice prior to the date such change becomes effective by a direct notification:

(1) The written or electronic notice must contain the following information:

(i) The name of the affected prescription drug;

(ii) Whether the plan is removing the prescription drug from the formulary, or changing its preferred or tiered cost-sharing status; and

(iii) The means by which subscribers may obtain a coverage determination or medical exception, in the case of drugs that will require prior authorization or are formulary exclusions respectively.

(2) An accident and sickness insurer may immediately remove from its plan formularies covered prescription drugs deemed unsafe by the accident and sickness insurer or the Food and Drug Administration, or removed from the market by their manufacturer, without meeting the requirements of this section.

(e) 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; or (9) Other limited benefit policies.
R.I. Gen. Laws § 27-41-43 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-43
§ 27-41-43. Mastectomy treatment.
Status: in_force

(a) All individual or group health insurance coverage and health benefit plans delivered, issued for delivery, or renewed in this state on or after January 1, 2005, that provide medical and surgical benefits with respect to mastectomy shall provide, in a case of any person covered in the individual market or covered by a group health plan, coverage for:

(1) Reconstruction of the breast on which the mastectomy has been performed;

(2) Surgery and reconstruction of the other breast to produce a symmetrical appearance; and

(3) Prostheses and treatment of physical complications, including lymphademas, at all stages of mastectomy; in a manner determined in consultation with the attending physician, physician assistant as defined in § 5-54-2, or an advance practice registered nurse as defined in § 5-34-3, and the patient. As used in this section, mastectomy means the removal of all or part of a breast. Written notice of the availability of such coverage shall be delivered to the participant upon enrollment and annually thereafter.

(b) Notice. A group health plan, and a health insurance issuer providing health insurance coverage in connection with a group health plan, shall provide notice to each participant and beneficiary under the plan regarding the coverage required by this section in accordance with regulations promulgated by the United States Secretary of Health and Human Services. The notice shall be in writing and prominently positioned in any literature or correspondence made available or distributed by the plan or issuer and shall be transmitted as part of any yearly informational packet sent to the participant or beneficiary.

(c) As used in this section, prosthetic devices means and includes the provision of initial and subsequent prosthetic devices pursuant to an order of the patients physician, physician assistant, advance practice registered nurse, or surgeon.

(d)(1) [Deleted by P.L. 2018, ch. 114, § 4 and P.L. 2018, ch. 204, § 4.]

(2) Nothing in this section shall be construed to prevent a group health plan or a health insurance carrier offering health insurance coverage from negotiating the level and type of reimbursement with a provider for care provided in accordance with this section.

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

(4) Prohibitions. A group health plan and a health insurance carrier offering group or individual health insurance coverage may not:

(i) Deny to a patient eligibility, or continued eligibility, to enroll or renew coverage under the terms of the plan, solely for the purpose of avoiding the requirements of this section; nor

(ii) Penalize or otherwise reduce or limit the reimbursement of an attending provider, or provide incentives (monetary or otherwise) to an attending provider, to induce the provider to provide care to an individual participant or beneficiary in a manner inconsistent with this section.
R.I. Gen. Laws § 27-1-17 — RI Code / Title 27 / Chapter 27-1 / Section 27-1-17
§ 27-1-17. Stay of executions and process against company.
Status: in_force

As long as the injunction is in force against any corporation, all executions and other final process against the corporation for the collection of debts shall be stayed.
R.I. Gen. Laws § 27-66-4 — RI Code / Title 27 / Chapter 27-66 / Section 27-66-4
§ 27-66-4. Definitions.
Status: in_force

For purposes of this chapter:

(1) Acquiree means the person or persons that lose(s) any ownership or control in a health insurance corporation, health maintenance organization, nonprofit hospital service corporation, or nonprofit medical service corporation.

(2) Acquiror means the person or persons who or that gain(s) an ownership or control in a health insurance corporation, health maintenance organization, nonprofit hospital service corporation, or nonprofit medical service corporation.

(3) Conversion means any transfer by a person or persons of an ownership or membership interest or authority in a health insurance corporation, health maintenance organization, nonprofit hospital service corporation, or nonprofit medical service corporation or the assets of these corporations, whether by purchase, merger, consolidation, lease, gift, joint venture, sale, or other disposition that results in a change of ownership or control or possession of twenty percent (20%) or greater of the members or voting rights or interests of the health insurance corporation, health maintenance organization, nonprofit hospital service corporation, or nonprofit medical service corporation or of the assets of the health insurance corporation, health maintenance organization, nonprofit hospital service corporation, or nonprofit medical service corporation or pursuant to which, by virtue of the transfer, a person, together with all persons affiliated with that person, holds or owns, in the aggregate, twenty percent (20%) or greater of the membership or voting rights or interests of the health insurance corporations, health maintenance organization, nonprofit hospital service corporation, or nonprofit medical service corporation or of the assets of the health insurance organization, health maintenance organization, nonprofit hospital service corporation, or nonprofit medical service corporation or the removal, addition, or substitution of a partner that results in a new partner gaining or acquiring a controlling interest in the health insurance organization, health maintenance organization, nonprofit hospital service corporation, or nonprofit medical service corporation or any change in membership that results in a new person gaining or acquiring a controlling vote in the health insurance corporation, health maintenance organization, nonprofit hospital service corporation, or nonprofit medical service corporation.

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

(5) Director means the director of the department of business regulation.

(6) Existing health insurance corporation, health maintenance organization, nonprofit hospital service corporation, or nonprofit medical service corporation means the health insurance corporation, health maintenance organization, nonprofit hospital service corporation, or nonprofit medical service corporation as it exists prior to the acquisition.

(7) For-profit corporation means a legal entity formed for the purpose of transacting business that has as any one of its purposes pecuniary profit.

(8) Health insurance corporation means any insurance company subject to chapter 1 of this title that offers health insurance in Rhode Island except that health insurance corporation shall not include companies whose health insurance policies only cover one or more of the following: disability income, long-term care, legal services, hospital confinement indemnity, specified disease indemnity, sickness or bodily injury by accident, or other limited health benefits.

(9) Mutual insurance company means a corporation in which shares are held exclusively by members to whom profits are distributed as dividends and members are both the insurer and the insured.

(10) New health insurance corporation, health maintenance organization, nonprofit hospital service corporation, or nonprofit medical service corporation means the health insurance corporation, health maintenance organization, nonprofit hospital service corporation, or nonprofit medical service corporation as it exists after the completion of a conversion.

(11) Not-for-profit corporation means a corporation subject to chapter 6 of title 7, including any corporation organized under special provisions of the general laws or under a private act that is declared to be a charitable corporation.

(12) Person means any individual, trust or estate, partnership, joint venture, corporation, whether for profit or not for profit (including associations, mutual insurance companies, joint stock companies, and insurance companies).

(13) Subscriber means those persons or groups of persons who or that shall contract with a health insurance corporation, health maintenance organization, nonprofit hospital service corporation, or nonprofit medical service corporation for health insurance.

(14) Transacting parties means any person or persons who or that seeks either to transfer or acquire ownership or a controlling interest or controlling authority in a health insurance corporation, health maintenance organization, nonprofit hospital service corporation, or nonprofit medical service corporation that would result in a change of ownership, control, or authority of twenty percent (20%) or greater.
R.I. Gen. Laws § 27-35-10.5 — RI Code / Title 27 / Chapter 27-35 / Section 27-35-10.5
§ 27-35-10.5. Recovery.
Status: in_force

(a) If an order for liquidation or rehabilitation of a domestic insurer has been entered, the receiver appointed under the order shall have a right to recover on behalf of the insurer, (i) From any parent corporation or holding company or person or affiliate who otherwise controlled the insurer, the amount of distributions (other than distributions of shares of the same class of stock) paid by the insurer on its capital stock; or (ii) Any payment in the form of a bonus, termination settlement, or extraordinary lump sum salary adjustment made by the insurer or its subsidiary to a director, officer, or employee, where the distribution or payment pursuant to (i) or (ii) is made at any time during the one year preceding the petition for liquidation, conservation, or rehabilitation, as the case may be, subject to the limitations of subsections (b), (c), and (d).

(b) No distribution shall be recoverable if the parent or affiliate shows that when paid the distribution was lawful and reasonable, and that the insurer did not know and could not reasonably have known that the distribution might adversely affect the ability of the insurer to fulfill its contractual obligations.

(c) Any person who was a parent corporation or holding company or a person who otherwise controlled the insurer or affiliate at the time the distributions were paid shall be liable up to the amount of distributions or payments under subsection (a) which the person received. Any person who otherwise controlled the insurer at the time the distributions were declared shall be liable up to the amount of distributions that would have been received if they had been paid immediately. If two (2) or more persons are liable with respect to the same distributions, they shall be jointly and severally liable.

(d) The maximum amount recoverable under this section shall be the amount needed in excess of all other available assets of the impaired or insolvent insurer to pay the contractual obligations of the impaired or insolvent insurer and to reimburse any guaranty funds.

(e) To the extent that any person liable under subsection (c) is insolvent or otherwise fails to pay claims due from it, its parent corporation or holding company or person who otherwise controlled it at the time the distribution was paid, shall be jointly and severally liable for any resulting deficiency in the amount recovered from the parent corporation or holding company or person who otherwise controlled it.
R.I. Gen. Laws § 27-66-24 — RI Code / Title 27 / Chapter 27-66 / Section 27-66-24
§ 27-66-24. Exceptions  Rehabilitation, liquidation, or conservation.
Status: in_force

No proposed conversion shall be subject to this chapter in the event that the health insurance corporation, health maintenance corporation, a nonprofit hospital service corporation, nonprofit medical service corporation, or affiliate or subsidiary of them is subject to an order from the superior court directing the director to rehabilitate, liquidate, or conserve, as provided in §§ 27-19-28, 27-20-24, 27-41-18, or chapter 14.1, 14.2, 14.3, or 14.4 of this title.
R.I. Gen. Laws § 27-60-5 — RI Code / Title 27 / Chapter 27-60 / Section 27-60-5
§ 27-60-5. Justification of adverse insurance decisions.
Status: in_force

A health carrier that takes an action that adversely affects a subject of abuse on the basis of a medical condition that the health carrier knows or has reason to know is abuse-related shall explain the reason for its action to the applicant or insured, in writing, and shall be able to demonstrate that its action, and any applicable plan provision:

(1) Does not have the purpose or effect of treating abuse status as a medical condition or underwriting criterion;

(2) Is not based upon any actual or perceived correlation between a medical condition and abuse;

(3) Is permissible by law and applies in the same manner and to the same extent to all applicants and the insured with a similar medical condition without regard to whether the condition or claim is abuse-related; and

(4) Is based on a determination, made in conformance with sound actuarial principles and supported by reasonable statistical evidence, that there is a correlation between the medical condition and a material increase in insurance risk.
R.I. Gen. Laws § 27-83-6 — RI Code / Title 27 / Chapter 27-83 / Section 27-83-6
§ 27-83-6. Insurance producer training. [Effective January 1, 2026.]
Status: in_force

(a) An insurance producer shall not sell, solicit, or negotiate a pet insurance product until after the producer is appropriately licensed and has completed the required training identified in subsection (c) of this section.

(b) Insurers shall ensure that its producers are trained under subsection (c) of this section and that its producers have been appropriately trained on the coverages and conditions of its pet insurance products.

(c) The training required under this subsection shall include information on the following topics:

(1) Preexisting conditions and waiting periods;

(2) The differences between pet insurance and noninsurance wellness programs;

(3) Hereditary disorders, congenital anomalies or disorders, and chronic conditions and how pet insurance policies interact with those conditions or disorders; and

(4) Rating, underwriting, renewal, and other related administrative topics.

(d) The satisfaction of the training requirements of another state that are substantially similar to the provisions of subsection (c) of this section shall be deemed to satisfy the training requirements in this state.
R.I. Gen. Laws § 27-18-41 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-41
§ 27-18-41. Mammograms and pap smears  Coverage mandated.
Status: in_force

(a)(1) 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 shall provide coverage for mammograms and pap smears, in accordance with guidelines established by the American Cancer Society.

(2) Notwithstanding the provisions of this chapter, every individual or group hospital or medical insurance policy or individual or group hospital or medical services plan contract delivered, issued for delivery, or renewed in this state shall pay for:

(i) Two (2) screening mammograms per year when recommended by a physician for women who have been treated for breast cancer within the last five (5) years or are at high risk of developing breast cancer due to genetic predisposition (BRCA gene mutation or multiple first-degree relatives) or high risk lesion on prior biopsy (lobular carcinoma in situ) or atypical ductal hyperplasia; and

(ii) Any screening deemed medically necessary for proper breast cancer screening in accordance with applicable American College of Radiology guidelines including, but not limited to, magnetic resonance imaging, ultrasound, or molecular breast imaging for any person who has received notice pursuant to § 23-12.9-2 of the existence of dense breast tissue.

(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 § 27-18-42 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-42
§ 27-18-42. Mammograms  Quality assurance standards.
Status: in_force

A mammogram eligible for reimbursement under § 27-18-41 shall be reimbursed only if the facility in which the mammogram has been taken and processed, and the licensed physician interpreting the mammogram, both meet state-approved quality assurance standards for taking, processing, and interpreting mammograms. The director of health shall have the authority to promulgate rules and regulations necessary to carry out the provisions of this section.
R.I. Gen. Laws § 27-25-17 — RI Code / Title 27 / Chapter 27-25 / Section 27-25-17
§ 27-25-17. Beneficiaries.
Status: in_force

(a) The owner of a benefit contract shall have the right at all times to change the beneficiary or beneficiaries in accordance with the laws or rules of the society unless the owner waives this right by specifically requesting, in writing, that the beneficiary designation is irrevocable. A society may, through its laws or rules, limit the scope of beneficiary designations and shall provide that no revocable beneficiary shall have or obtain any vested interest in the proceeds of any certificate until the certificate has become due and payable in conformity with the provisions of the benefit contract.

(b) A society may make provision for the payment of funeral benefits to the extent of the portion of any payment under a certificate as might reasonably appear to be due to any person equitably entitled to payment by reason of having incurred expense occasioned by the burial of the member, provided the portion so paid shall not exceed the sum of two thousand dollars ($2,000).

(c) If, at the death of any person insured under a benefit contract, there is no lawful beneficiary to whom the proceeds shall be payable, the amount of the benefit, except to the extent that funeral benefits may be paid as provided in subsection (b) of this section, shall be payable to the personal representative of the deceased insured, provided that if the owner of the certificate is other than the insured, the proceeds shall be payable to the owner.
R.I. Gen. Laws § 27-20-75 — RI Code / Title 27 / Chapter 27-20 / Section 27-20-75
§ 27-20-75. Perinatal doulas.
Status: in_force

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

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

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

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

(1) Hospital confinement indemnity;

(2) Disability income;

(3) Accident only;

(4) Long-term care;

(5) Medicare supplement;

(6) Limited benefit health;

(7) Specified disease indemnity;

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

(9) Other limited benefit policies.
R.I. Gen. Laws § 27-34-9 — RI Code / Title 27 / Chapter 27-34 / Section 27-34-9
§ 27-34-9. Plan of operation.
Status: in_force

(a) The association shall submit to the commissioner a plan of operation and any amendments to the plan of operation necessary or suitable to assure the fair, reasonable, and equitable administration of the association. The plan of operation and amendments shall become effective upon approval in writing by the commissioner.

(b) If the association fails to submit a suitable plan of operation or suitable amendments to the plan, the commissioner shall, after notice and hearing, adopt and promulgate any reasonable rules necessary or advisable to effectuate the provisions of this chapter. The rules shall continue in force until modified by the commissioner or superseded by a plan or amendments to it submitted by the association and approved by the commissioner.

(c) All member insurers shall comply with the plan of operation.

(d) The plan of operation shall:

(1) Establish the procedures where all of the powers and duties of the fund under § 27-34-8 will be performed;

(2) Establish the procedures for handling the assets of the association;

(3) Require that written procedures be established for the disposition of liquidating dividends or other monies received from the estate of the insolvent insurer;

(4) Require that written procedures be established to designate the amount and method of reimbursing members of the board of directors under § 27-34-7;

(5) Establish procedures by which claims may be filed with the association and establish acceptable forms of proof of covered claims;

(6) Establish regular places and times for meetings of the board of directors;

(7) Require that written procedures be established for records to be kept of all financial transactions of the association, its agents, and the board of directors;

(8) Provide that any member insurer aggrieved by any final action or decision of the association may appeal to the commissioner within thirty (30) days after the action or decision;

(9) Establish the procedures under which selections for the board of directors will be submitted to the commissioner; and

(10) Contain additional provisions necessary or proper for the execution of the powers and duties of the association.

(e) The plan of operation may provide that any or all powers and duties of the association, except those under §§ 27-34-8(a)(3) and 27-34-8(b)(2), are delegated to a corporation, association, similar to the association or other organization which performs or will perform functions similar to those of the association, or its equivalent, in two or more states. The corporation, association, similar to the association or organization shall be reimbursed as a servicing facility would be reimbursed and shall be paid for its performance of any other functions of the association. A delegation under this subsection shall take effect only with the approval of both the board of directors and the commissioner, and may be made only to a corporation, association, or organization which extends protection not substantially less favorable and effective than that provided by this chapter.
R.I. Gen. Laws § 27-60-6 — RI Code / Title 27 / Chapter 27-60 / Section 27-60-6
§ 27-60-6. Insurance protocols for subjects of abuse.
Status: in_force

Health carriers shall develop, file with the commissioner, and adhere to protocols specifying how health carrier employees, contractors, agents, and brokers will pursue an insurance action, including claims investigation and subrogation, that may impact the safety of a subject of abuse involved with that action.
R.I. Gen. Laws § 27-6-30 — RI Code / Title 27 / Chapter 27-6 / Section 27-6-30
§ 27-6-30. Appeals from action of rating organization on changes in filings.
Status: in_force

(a) Any member of or subscriber to a rating organization may appeal to the commissioner from any action or decision of the rating organization in approving or rejecting any proposed change in or addition to the filings of the rating organization, and the commissioner shall, after a hearing held upon not less than ten (10) days written notice to the appellant and to the rating organization, issue an order approving the action or decision of the rating organization or directing it to give further consideration to the proposal and to take action or make a decision upon it within thirty (30) days, or if the appeal is from the action or decision of the rating organization in rejecting a proposed addition to its filings, the commissioner may, in the event the commissioner finds that the action or decision was unreasonable, issue an order directing the rating organization to make an addition to its filings, on behalf of its members and subscribers, in a manner consistent with the commissioners findings, within a reasonable time after the issuance of the order; provided, if the appeal is from the action of the rating organization with regard to a rate on a proposed change in or addition to its filings relating to the character and extent of coverage, the commissioner shall approve the rate applied by the rating organization or the rate suggested by the appellant if either rate is in accordance with this chapter.

(b) The failure of a rating organization to take action or make a decision within thirty (30) days after submission to it of a proposal under this section shall constitute a rejection of that proposal within the meaning of this section.
R.I. Gen. Laws § 27-50-9 — RI Code / Title 27 / Chapter 27-50 / Section 27-50-9
§ 27-50-9. Periodic market evaluation.
Status: in_force

Within three (3) months after March 31, 2002, and every thirty-six (36) months after this, the director shall obtain an independent actuarial study and report. The director shall assess a fee to the health plans to commission the report. The report shall analyze the effectiveness of the chapter in promoting rate stability, product availability, and coverage affordability. The report may contain recommendations for actions to improve the overall effectiveness, efficiency, and fairness of the small group health insurance marketplace. The report shall address whether carriers and producers are fairly actively marketing or issuing health benefit plans to small employers in fulfillment of the purposes of the chapter. The report may contain recommendations for market conduct or other regulatory standards or action.
R.I. Gen. Laws § 27-49-5 — RI Code / Title 27 / Chapter 27-49 / Section 27-49-5
§ 27-49-5. Immunity.
Status: in_force

No insurer, or agent authorized by an insurer to act on its behalf, authorized governmental agency or its respective employees shall be subject to any civil or criminal liability in a cause of action of any kind for releasing or receiving any factually accurate information pursuant to § 27-49-3 or § 27-49-4. Nothing in this chapter is intended to or does in any way or manner abrogate or lessen the common and statutory law, privileges, and immunities of an insurer, agent authorized by an insurer to act on its behalf, or authorized governmental agency or any of their respective employees.
R.I. Gen. Laws § 27-19-10 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-10
§ 27-19-10. Commission plans for solicitors or insurance producers.
Status: in_force

No person shall be engaged to solicit subscribers to any nonprofit hospital service plan upon a commission basis or upon any other basis by which the payment of the compensation or expenses of that person shall be conditioned upon the enrollment of subscribers, unless the method of solicitation and rate of compensation shall have had the prior written approval of the insurance commissioner.
R.I. Gen. Laws § 27-12-3 — RI Code / Title 27 / Chapter 27-12 / Section 27-12-3
§ 27-12-3. Examination of reports  Requiring additional statements.
Status: in_force

(a) The insurance commissioner shall annually examine the statements and returns required to be made by the companies and insurance producers, and if, in the commissioners opinion, any return is obscure, defective, or unsatisfactory the commissioner shall immediately require answers under oath, from the insurance producer or company by whom that obscure, defective, or unsatisfactory return has been made, to any interrogatories as the commissioner may deem necessary or proper to be answered in order to explain that return, and exhibit a full and accurate view of the business and resources of the company represented by the insurance producer.

(b) In the event that the insurance commissioner for any reason does not examine the statements and returns required to be made by insurance companies as stated in subsection (a), the examination shall be deemed to have been made for all purposes upon the following conditions:

(1) The examination has not been conducted for a period of two (2) consecutive calendar years;

(2) The company has filed its financial statements for each of the two (2) years which financial statements have been examined by an independent certified public accountant and shall have been prepared in accordance with generally accepted accounting principles applicable to insurance companies for complete financial statements, including balance sheets and related statements of income, changes in surplus, and changes in financial position for each of the previous three (3) years;

(3) The chief executive officer or the chief financial officer of the company shall affirm that the filed financial statements are complete and accurate; and

(4) The insurance commissioner shall not reject any filing within sixty (60) days of the date of the filing as being incomplete, inaccurate, or requiring further information in order to provide a full and accurate review of the business and resources of the company.
R.I. Gen. Laws § 27-4-26 — RI Code / Title 27 / Chapter 27-4 / Section 27-4-26
§ 27-4-26. Interest upon proceeds of life insurance policies.
Status: in_force

An insurer of a life insurance contract or annuity contract shall pay to the beneficiary or policyholder, respectively, interest on the proceeds at the rate of nine percent (9%) per annum from the date of the death of an insured or annuitant in connection with a death claim on a life insurance policy or annuity contract and from the date of maturity of an endowment contract to the date of payment and the interest shall be added to and be a part of the total sum paid.
R.I. Gen. Laws § 27-6-49 — RI Code / Title 27 / Chapter 27-6 / Section 27-6-49
§ 27-6-49. Hearings on decisions of commissioner.
Status: in_force

Any insurer or rating organization aggrieved by any order or decision of the commissioner or by any rule or regulation adopted and promulgated by the commissioner may within thirty (30) days after notice to the insurer or organization make a written request to the commissioner for a hearing, except that a hearing provided for by §§ 27-6-17  27-6-22 shall be held as provided in those sections. Within twenty (20) days after receipt of that written request, the commissioner shall hear the party or parties and shall give not less than ten (10) days written notice of the time and place of the hearing. Within fifteen (15) days after the hearing, the commissioner shall affirm, reverse, or modify the commissioners previous action, specifying the commissioners reasons. Pending the hearing and decision, the commissioner may suspend or postpone the effective date of the commissioner's previous action.
R.I. Gen. Laws § 27-62-5 — RI Code / Title 27 / Chapter 27-62 / Section 27-62-5
§ 27-62-5. General rules and prohibitions.
Status: in_force

(a) An illustration used in the sale of a life insurance policy shall satisfy the applicable requirements of this chapter, be clearly labeled life insurance illustration and contain the following basic information:

(1) Name of insurer;

(2) Name and business address of producer or insurers authorized representative, if any;

(3) Name, age, and sex of proposed insured, except where a composite illustration is permitted under this chapter;

(4) Underwriting or rating classification upon which the illustration is based;

(5) Generic name of policy, the company product name, if different, and form number;

(6) Initial death benefit; and

(7) Dividend option election or application of non-guaranteed elements, if applicable.

(b) When using an illustration in the sale of a life insurance policy, an insurer or its producers or other authorized representatives shall not:

(1) Represent the policy as anything other than a life insurance policy;

(2) Use or describe non-guaranteed elements in a manner that is misleading or has the capacity or tendency to mislead;

(3) State or imply that the payment or amount of non-guaranteed elements is guaranteed;

(4) Use an illustration that does not comply with the requirements of this chapter;

(5) Use an illustration that at any policy duration depicts policy performance more favorable to the policy owner than that produced by the illustrated scale of the insurer whose policy is being illustrated;

(6) Provide an applicant with an incomplete illustration;

(7) Represent in any way that premium payments will not be required for each year of the policy in order to maintain the illustrated death benefits, unless that is the fact;

(8) Use the term vanish or vanishing premium, or a similar term that implies the policy becomes paid up, to describe a plan for using non-guaranteed elements to pay a portion of future premiums;

(9) Except for policies that can never develop nonforfeiture values, use an illustration that is lapse-supported; or

(10) Use an illustration that is not self-supporting.

(c) If an interest rate used to determine the illustrated non-guaranteed elements is shown, it shall not be greater than the earned interest rate underlying the disciplined current scale.
R.I. Gen. Laws § 27-61-5 — RI Code / Title 27 / Chapter 27-61 / Section 27-61-5
§ 27-61-5. Justification of adverse insurance decisions.
Status: in_force

An insurer of an individual or group policy that takes an underwriting action that adversely affects a subject of abuse on the basis of a medical condition that the insurer knows is abuse-related shall explain the reason for its action to the applicant or insured in writing and shall be able to demonstrate that its action:

(1) Does not treat abuse status as a medical condition;

(2) Is permissible by law and applies in the same manner and to the same extent to all applicants and the insured with a similar medical condition without regard to whether the condition or claim is abuse-related; and

(3) Is based on a determination, made in conformance with sound actuarial principles or related actual or reasonably anticipated experience, that there is a correlation between the medical condition and a material increase in insurance risk.
R.I. Gen. Laws § 27-25-31 — RI Code / Title 27 / Chapter 27-25 / Section 27-25-31
§ 27-25-31. Suspension, revocation, or refusal of license of foreign or alien society.
Status: in_force

(a) When the commissioner of insurance upon investigation finds that a foreign or alien society transacting or applying to transact business in this state: (1) Has exceeded its powers; (2) Has failed to comply with any of the provisions of this chapter; (3) Is not fulfilling its contracts in good faith; or (4) Is conducting its business fraudulently or in a manner hazardous to its members or creditors or the public; the commissioner shall notify the society of the deficiency or deficiencies and state in writing the reasons for his or her dissatisfaction. The commissioner shall at once issue a written notice to the society requiring that the existing deficiency or deficiencies be corrected. After the notice the society shall have a thirty-day (30) period in which to comply with the commissioners request for correction, and, if the society fails to comply, the commissioner shall notify the society of the findings of noncompliance and require the society to show cause on a named date why its license should not be suspended, revoked, or refused. If on that date the society does not present good and sufficient reason why its authority to do business in this state should not be suspended, revoked, or refused, the commissioner may suspend or refuse the license of the society to do business in this state until satisfactory evidence is furnished to the commissioner that the suspension or refusal should be withdrawn or the commissioner may revoke the authority of the society to do business in this state.

(b) Nothing contained in this section shall be taken or construed as preventing the society from continuing in good faith all contracts made in this state during the time the society was legally authorized to transact business in this state.
R.I. Gen. Laws § 27-82-6 — RI Code / Title 27 / Chapter 27-82 / Section 27-82-6
§ 27-82-6. Study report.
Status: in_force

(a) On or before October 1, 2026, the commissioner shall provide the general assembly with an analysis of the reporting information furnished pursuant to § 27-82-3, and recommendations with respect to a minimum dental loss ratio. The report shall also include recommendations with respect to requiring dental health carriers to offer a full range of comprehensive dental benefit plans including, but not limited to, one hundred percent (100%) coverage options.

(b) The commissioner shall make a special annual assessment against each dental health insurance carrier during years 2023, 2024, and 2025 for payment of all reasonable costs and expenditures in connection with the study report and related analysis required by this section, no greater than the combined maximum total of one hundred fifty thousand dollars ($150,000) per year for all carriers. Each annual assessment shall, subject to the foregoing maximum, be deemed as reasonably sufficient reimbursement for any costs and expenditures necessary for the commissioner to fulfill the commissioner's obligations under this section. The sums shall be proportionately assessed by the commissioner against each dental health insurance carrier based on relative annual fully insured membership enrollment, and may be billed whether or not the study report has been completed. The carriers billed for such costs and expenditures shall make payment to the commissioner within sixty (60) days of the date invoiced. Assessments made pursuant to this section may be credited to the normal operating costs of each dental health insurance carrier, and shall be deposited as general revenue.
R.I. Gen. Laws § 27-81-4 — RI Code / Title 27 / Chapter 27-81 / Section 27-81-4
§ 27-81-4. Coverage of telemedicine services.
Status: in_force

(a) Each health insurer that issues individual or group accident and sickness insurance policies for healthcare services and/or provides a healthcare plan for healthcare services shall provide coverage for the cost of such covered healthcare services provided through telemedicine services, as provided in this section.

(b)(1) A health insurer shall not exclude a healthcare service for coverage solely because the healthcare service is provided through telemedicine and is not provided through in-person consultation or contact, so long as such healthcare services are medically necessary and clinically appropriate to be provided through telemedicine services.

(2) All medically necessary and clinically appropriate telemedicine services delivered by in-network primary care providers, registered dietitian nutritionists, and behavioral health providers shall be reimbursed at rates not lower than services delivered by the same provider through in-person methods.

(c) Benefit plans offered by a health insurer shall not impose a deductible, copayment, or coinsurance requirement for a healthcare service delivered through telemedicine in excess of what would normally be charged for the same healthcare service when performed in person.

(d) Prior authorization requirements for medically necessary and clinically appropriate telemedicine services shall not be more stringent than prior authorization requirements for in-person care. No more stringent medical or benefit determination and utilization review requirements shall be imposed on any telemedicine service than is imposed upon the same service when performed in person.

(e) Except for requiring compliance with applicable state and federal laws, regulations, and/or guidance, no health insurer shall impose any specific requirements as to the technologies used to deliver medically necessary and clinically appropriate telemedicine services.

(f) The requirements of this section shall apply to all policies and health plans issued, reissued, or delivered in the state of Rhode Island on and after January 1, 2018.

(g) This chapter shall not apply to: short-term travel, accident-only, limited or specified disease; or individual conversion policies or health plans; nor to policies or health plans designed for issuance to persons eligible for coverage under Title XVIII of the Social Security Act, known as Medicare; or any other similar coverage under state or federal governmental plans.
R.I. Gen. Laws § 27-18-3.3 — RI Code / Title 27 / Chapter 27-18 / Section 27-18-3.3
§ 27-18-3.3. Penalties.
Status: in_force

In addition to any other penalty provided by law, any person, firm, or corporation who violates §§ 27-18-3.1  27-18-3.5, after a hearing held in accordance with the provisions of § 42-35-9 by the department of business regulation, shall be fined civilly not less than one thousand dollars ($1,000) nor more than two thousand five hundred dollars ($2,500).
R.I. Gen. Laws § 27-12-4 — RI Code / Title 27 / Chapter 27-12 / Section 27-12-4
§ 27-12-4. Penalty for refusal to answer interrogatories.
Status: in_force

Every insurance producer who shall refuse or neglect to answer any interrogatories required under § 27-12-3 for the space of thirty (30) days, and continues to act as an insurance producer, shall be liable to the penalty prescribed in § 27-2.4-14.
R.I. Gen. Laws § 27-30-16 — RI Code / Title 27 / Chapter 27-30 / Section 27-30-16
§ 27-30-16. Duties of an insurer.
Status: in_force

Except as otherwise prohibited by law, duties imposed upon an insurer within this chapter may be carried out by a creditor if the creditor is acting as a common law or statutory agent on behalf of the insurer.
R.I. Gen. Laws § 27-1-42 — RI Code / Title 27 / Chapter 27-1 / Section 27-1-42
§ 27-1-42. Maximum amount of single risk.
Status: in_force

No company organized under the laws of this state, other than a life insurance company, shall incur in any one risk a greater hazard than one-tenth ( ) part of its capital and surplus if a stock company or of its net assets if a mutual company. Any risk incurred on or before June 18, 1991, that is not in compliance with the provisions in this section shall not be subject to the established limitations.
R.I. Gen. Laws § 27-25-42 — RI Code / Title 27 / Chapter 27-25 / Section 27-25-42
§ 27-25-42. Severability.
Status: in_force

If any provision of this chapter or the application of a provision to any circumstance is held invalid, the remainder of the chapter or the application of the provision to other circumstances shall not be affected by that invalidity.
R.I. Gen. Laws § 27-29-17.2 — RI Code / Title 27 / Chapter 27-29 / Section 27-29-17.2
§ 27-29-17.2. Notice of nonrenewal.
Status: in_force

(a) An insurer may nonrenew a policy; provided, however, no nonrenewal of any policy of insurance to which this section applies shall be effective unless an insurer shall first give, mail, or deliver to the first-named insured at the address shown on the policy, and to the insurance producer of record, written notice that the insurer will not renew the policy. Such notice shall be given, mailed or delivered at least sixty (60) days before the expiration date. If the notice is given, mailed or delivered less than sixty (60) days before the expiration, coverage shall remain in effect until sixty (60) days after notice is given, mailed or delivered. Earned premium for any period of coverage that extends beyond the expiration date shall be considered pro-rata based upon the previous years rate. For purposes of this section, the transfer of a policyholder between companies within the same insurance group is not a refusal to renew. In addition, changes in deductibles, changes in premium, changes in the amount of insurance, or reductions in policy limits or coverage shall not be deemed to be refusals to renew.

(b) Notice of nonrenewal shall not be required where:

(1) The insurer or a company within the same insurance group has offered to issue a renewal policy; or

(2) The named insured has obtained replacement coverage or has agreed in writing to obtain replacement coverage.
R.I. Gen. Laws § 27-9-41 — RI Code / Title 27 / Chapter 27-9 / Section 27-9-41
§ 27-9-41. 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 § 27-41-51 — RI Code / Title 27 / Chapter 27-41 / Section 27-41-51
§ 27-41-51. Drug coverage.
Status: repealed

(a) Any health maintenance organization that utilizes a formulary of medications for which coverage is provided under an individual or group plan master contract shall require any physician or other person authorized by the department of health to prescribe medication to prescribe from the formulary. A physician or other person authorized by the department of health to prescribe medication shall be allowed to prescribe medications previously on, or not on, the health maintenance organizations formulary if he or she believes that the prescription of non-formulary medication is medically necessary. A health maintenance organization shall be required to provide coverage for a non-formulary medication only when the non-formulary medication meets the health maintenance organizations medical-exception criteria for the coverage of that medication.

(b) A health maintenance organizations medical-exception criteria for the coverage of non-formulary medications shall be developed in accordance with § 23-17.13-3(c)(3) [repealed].

(c) Any subscriber who is aggrieved by a denial of benefits to be provided under this section may appeal the denial in accordance with the rules and regulations promulgated by the department of health pursuant to chapter 17.12 of title 23 [repealed].

(d) Prior to removing a prescription drug from its plans formulary or making any change in the preferred or tiered cost-sharing status of a covered prescription drug, a health maintenance organization must provide at least thirty (30) days notice to authorized prescribers by established communication methods of policy and program updates and by updating available references on web-based publications. All adversely affected members must be provided at least thirty (30) days notice prior to the date such change becomes effective by a direct notification:

(1) The written or electronic notice must contain the following information:

(i) The name of the affected prescription drug;

(ii) Whether the plan is removing the prescription drug from the formulary, or changing its preferred or tiered cost-sharing status; and

(iii) The means by which subscribers may obtain a coverage determination or medical exception, in the case of drugs that will require prior authorization or are formulary exclusions respectively.

(2) A health maintenance organization may immediately remove from its plan formularies covered prescription drugs deemed unsafe by the health maintenance organization or the Food and Drug Administration, or removed from the market by their manufacturer, without meeting the requirements of this section.
R.I. Gen. Laws § 27-19-12 — RI Code / Title 27 / Chapter 27-19 / Section 27-19-12
§ 27-19-12. Corporations deemed public charitable institutions.
Status: in_force

Every nonprofit hospital service corporation is declared to be and shall be deemed to be a charitable corporation and an incorporated public charitable institution.
R.I. Gen. Laws § 27-44-8 — RI Code / Title 27 / Chapter 27-44 / Section 27-44-8
§ 27-44-8. Licensing of rating organizations.
Status: in_force

(a) License required. No rating organization shall provide any service relating to the rates of any insurance subject to this chapter, and no insurer shall utilize the services of the organization for these purposes unless the organization has obtained a license under subsection (c).

(b) Availability of services. No rating organization shall refuse to supply any services for which it is licensed in this state to any insurer authorized to do business in this state and offering to pay the fair and usual compensation for the services.

(c) Licensing. (1) Application. A rating organization applying for a license shall include with its application: (i) A copy of its constitution, charter, articles of organization, agreement, association, or incorporation, and a copy of its bylaws, plan of operation, and any other rules or regulations governing the conduct of its business; (ii) A list of its members and subscribers; (iii) The name and address of one or more residents of this state upon whom notices, process affecting it, or orders of the director may be served; (iv) A statement showing its technical qualifications for acting in the capacity for which it seeks a license; and (v) Any other relevant information and documents that the director may require. (2) Change of circumstances. Every organization that has applied for a license shall notify the director of every material change in the facts or in the documents on which its application was based. Any amendment to a document filed under this section shall be filed with the director not less than thirty (30) days after it becomes effective. (3) Granting of license; fee. If the director finds that the applicant and the natural persons through whom it acts are competent, trustworthy, and technically qualified to provide the services proposed, and that all requirements of the law are met, he or she shall issue a license specifying the authorized activity of the applicant. The fee for the license shall be three hundred dollars ($300). The director shall not issue a license if the proposed activity would tend to create a monopoly or to substantially lessen the competition in any market. (4) Duration. Licenses issued pursuant to this section shall remain in effect for three (3) years unless sooner suspended or revoked. All in force licenses shall be transitioned into a three-year (3) licensing cycle beginning June 1, 2006, to expire every three (3) years thereafter. License fees may be prorated for the initial renewal period as deemed appropriate by the director. The director may, at any time, after a hearing, revoke or suspend the license of a rating organization that does not comply with the requirements and standards of this chapter.
R.I. Gen. Laws § 27-16-2.4 — RI Code / Title 27 / Chapter 27-16 / Section 27-16-2.4
§ 27-16-2.4. Severability.
Status: in_force

If any provision of §§ 27-16-1.1  27-16-2.6 or the application of any of these provisions to any person or circumstances is held invalid, that invalidity shall not affect other provisions or applications of the act which can be given effect without the invalid provision and to this end the provisions are declared to be severable.
R.I. Gen. Laws § 27-25-2 — RI Code / Title 27 / Chapter 27-25 / Section 27-25-2
§ 27-25-2. Lodge system.
Status: in_force

(a) A society is operating on the lodge system if it has a supreme governing body and subordinate lodges into which members are elected, initiated, or admitted in accordance with its laws, rules, and ritual. Subordinate lodges shall be required by the laws of the society to hold regular meetings at least once in each month in furtherance of the purposes of the society.

(b) A society may, at its option, organize and operate lodges for children under the minimum age for adult membership. Membership and initiation in local lodges shall not be required of the children, nor shall they have a voice or vote in the management of the society.
R.I. Gen. Laws § 27-5-13 — RI Code / Title 27 / Chapter 27-5 / Section 27-5-13
§ 27-5-13. Mutual membership not acquired by reinsurance.
Status: in_force

Any mutual company of this or any other state ceding reinsurance to a similar company shall not, unless the contract of reinsurance provides, become a member of the company accepting the reinsurance, or be entitled to any dividend or expiration return of premium or of unabsorbed premium deposit, or be subject to liability to assessment.
R.I. Gen. Laws § 27-17-10 — RI Code / Title 27 / Chapter 27-17 / Section 27-17-10
§ 27-17-10. Claim or loss reserve.
Status: in_force

There shall also be maintained at all times in the hands of the attorney, as a claim or loss reserve, in cash or securities as stated in § 27-17-7, assets sufficient to discharge all liabilities on all outstanding or accrued losses arising under policies issued, which are to be calculated in accordance with the laws of this state relating to similar reserves for companies insuring similar risks.
R.I. Gen. Laws § 27-55-2 — RI Code / Title 27 / Chapter 27-55 / Section 27-55-2
§ 27-55-2. Prescription drug coverage.
Status: in_force

(a) No health insurer issuing a policy that provides coverage for prescription drugs shall exclude coverage of any drug used for the treatment of cancer or disabling or life-threatening chronic disease on the grounds that the drug has not been approved by the FDA for that indication; provided that the drug is recognized for treatment of that indication in one of the standard reference compendia, or in the medical literature. It is the responsibility of the prescribing physician to submit to the insurer documentation supporting the proposed off-label use or uses, if requested by the issuer.

(b) Any coverage of a drug that serves as the primary treatment required by this chapter shall also include medically necessary services associated with the administration of the drug.

(c) No coverage is required under this chapter: (1) For any drug that has not been fully licensed or approved by the FDA; (2) For the use of any drug when the FDA has determined that use to be contraindicated; or (3) For any experimental drug not approved for any indication by the FDA. The provisions of this section apply to drugs used in the treatment for cancer or disabling or life-threatening chronic disease only and nothing in this section is construed to create, impair, alter, limit, modify, enlarge, abrogate, or prohibit reimbursement for medications used in the treatment of any other disease or condition.

(d) Nothing in this section is construed to prevent the application of contractual deductibles or copayment provisions or managed care review.
R.I. Gen. Laws § 27-46-5 — RI Code / Title 27 / Chapter 27-46 / Section 27-46-5
§ 27-46-5. Compulsory associations.
Status: in_force

(a) No risk retention group shall be required or permitted to join or contribute financially to any insurance insolvency fund, or similar mechanism, in this state, nor shall any risk retention group, or its insureds or claimants against its insureds, receive any benefit from any such fund for claims arising under the insurance policies issued by the risk retention group.

(b) When a purchasing group obtains insurance covering its members risks from an insurer not authorized or licensed in this state or a risk retention group, none of these risks, wherever resident or located, shall be covered by an insurance insolvency fund or similar mechanism in this state.

(c) When a purchasing group obtains insurance covering its members risks from a member insurer of the Rhode Island insurance insolvency fund, only those risks as are subject to the insolvency fund shall be covered by the insolvency fund.
R.I. Gen. Laws § 27-33-1 — RI Code / Title 27 / Chapter 27-33 / Section 27-33-1
§ 27-33-1. Purposes.
Status: in_force

The purposes of this chapter are: (1) To make basic property insurance available to qualified applicants who have been unable to secure the insurance in the normal market, and (2) To create a fund to discharge the obligations of the state to the Secretary of the Department of Housing and Urban Development, referred to in this chapter as the secretary, under 12 U.S.C. § 1749bbb-9, referred to in this chapter as the Act, as and when those obligations shall occur, in order that insurers writing property insurance in this state may not for lack of a fund be rendered ineligible for reinsurance as provided under the Act.
R.I. Gen. Laws § 27-5-3.4 — RI Code / Title 27 / Chapter 27-5 / Section 27-5-3.4
§ 27-5-3.4. Cancellation or nonrenewal of standard fire insurance policy.
Status: in_force

(a) A company issuing any policy of insurance that is subject to cancellation or nonrenewal by the company shall effect cancellation or nonrenewal by serving the notice of it provided by the policy. That notice shall be delivered in hand to the named insured, or be left at the named insureds last address as shown by the companys records, or, if its records contain no last address, at the named insureds last business, residence, or other address known to the company, or be forwarded to that address by first class mail and maintain proof of mailing of the notice to the insured by United States Postal Service certificate of mailing in the ordinary course of the insurers business, and this proof of mailing shall be sufficient proof of notice.

(b) If a policy is made payable to a mortgagee or any person other than the named insured, notice shall be given as provided in subsection (a) of this section to the payee and to the named insured.

(c) Policies subject to cancellation by the named insured upon giving notice to the company may be cancelled by serving notice in the manner provided in subsection (a) of this section upon the company or upon its insurance producer who issued the policy.
R.I. Gen. Laws § 27-72-12 — RI Code / Title 27 / Chapter 27-72 / Section 27-72-12
§ 27-72-12. Authority to promulgate regulations  Conflict of laws.
Status: in_force

(a) The commissioner may:

(1) Promulgate regulations implementing this chapter and regulating the activities and relationships of providers, brokers, insurers, and their agents, subject to statutory limitations on administrative rulemaking.

(2) Provide by regulation that the commissioner is authorized and may in his or her discretion recover the reasonable cost of legal services incurred by the department in enforcement actions under this chapter either from the licensee against whom the action is taken or by way of an assessment of all providers licensed pursuant to § 27-72-3(a). The assessment formula shall be set by regulation based upon information provided in the prior years annual statement filed pursuant to § 27-72-3( l ).

(b) Conflict of laws. (1) 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 of ownership resides or, if the owners hold equal ownership, the state of residence of one owner agreed upon in writing by all of the owners. The law of the state of the insured shall govern in the event that equal owners fail to agree in writing upon a state of residence for jurisdictional purposes. (2) A provider from this state who enters into a life settlement contract with an owner who is a resident of another state that has enacted statutes or adopted regulations governing life settlement contracts, shall be governed in the effectuation of that life settlement contract by the statutes and regulations of the owners state of residence. If the state in which the owner is a resident has not enacted statutes or regulations governing life settlement contracts, the provider shall give the owner notice that neither state regulates the transaction upon which he or she is entering. For transactions in those states, however, the provider is to maintain all records required as if the transactions were executed in the state of residence. The forms used in those states need not be approved by the department. (3) If there is a conflict in the laws that apply to an owner and a purchaser in any individual transaction, the laws of the state that apply to the owner shall take precedence and the provider shall comply with those laws.