reglab/housing_qa huggingface dataset:
RI Gen L § 27-20.1-7 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-20.1 - Nonprofit Dental Service Corporations|Section 27-20.1-7 - Investment standards.

§ 27-20.1-7. Investment standards.(a) All nonprofit dental service corporations shall protect the interests of subscribers by promoting company solvency and financial strength through the application of investment standards that facilitate a reasonable balance of the following objectives:(1) To preserve principal;(2) To assure reasonable diversification as to type of investment, issuer and credit quality; and(3) To allow the nonprofit medical service corporation to allocate investments in a manner consistent with principles of prudent investment management to achieve an adequate return so that obligations to subscribers are adequately met and financial strength is sufficient to cover reasonably foreseeable contingencies.(b) All investments, including, but not limited to, those referred to in this chapter, shall be made and held in accordance with the objectives in subsection (a) of this section subject to the limitations set forth in this chapter and in regulations promulgated pursuant to this chapter. Investments not conforming to this chapter and any regulations promulgated pursuant to this chapter are not considered admitted assets.History of Section.P.L. 1959, ch. 183, § 1; P.L. 1999, ch. 45, § 3.
RI Gen L § 27-20.1-8 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-20.1 - Nonprofit Dental Service Corporations|Section 27-20.1-8 - Corporation deemed public charitable institution.

§ 27-20.1-8. Corporation deemed public charitable institution.Every nonprofit dental service corporation is declared to be, and shall be deemed to be, a charitable institution and shall be subject to the provisions of chapter 6 of title 7, except as otherwise expressly provided in this chapter, and to this chapter.History of Section.P.L. 1959, ch. 183, § 1.
RI Gen L § 27-20.1-9 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-20.1 - Nonprofit Dental Service Corporations|Section 27-20.1-9 - Adoption of chapter by hospital service corporation.

§ 27-20.1-9. Adoption of chapter by hospital service corporation.Any nonprofit hospital service corporation organized pursuant to the provisions of chapter 19 of this title, which first obtains authorization to do so by the Rhode Island State Dental Society as evidenced by the affidavit of the president and secretary of the society, may amend its articles of association to adopt the provisions of this chapter, and upon the adoption the corporation shall have and exercise all of the powers and be subject to all of the duties and responsibilities of a nonprofit dental service corporation to the same extent as though it had been incorporated as a nonprofit dental service corporation.History of Section.P.L. 1959, ch. 183, § 1.
RI Gen L § 27-20.1-10 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-20.1 - Nonprofit Dental Service Corporations|Section 27-20.1-10 - Nonprofit dental service corporation assessment.

§ 27-20.1-10. Nonprofit dental service corporation assessment.(a) Notwithstanding any other provisions of law, each domestic nonprofit dental service corporation shall be charged an assessment to partially support the activities of the division of insurance in the department of business regulation.(b) The minimum assessment charged shall be one thousand dollars ($1,000).History of Section.P.L. 1990, ch. 65, art. 29, § 4; P.L. 1993, ch. 180, § 18; P.L. 2002, ch. 292, § 133.
RI Gen L § 27-20.1-11 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-20.1 - Nonprofit Dental Service Corporations|Section 27-20.1-11 - Rehabilitation, liquidation, or conservation.

§ 27-20.1-11. Rehabilitation, liquidation, or conservation.(a) Any rehabilitation, liquidations, administrative supervision or conservation of a nonprofit dental service corporation organized under this chapter shall be conducted under the supervision of the director of business regulation pursuant to chapters 14.1, 14.2, and 14.3 of this title. The director of business regulation may apply for an order from the superior court directing the director of business regulation to rehabilitate, liquidate, or conserve a nonprofit dental service corporation upon any one or more of the following grounds:(1) That the nonprofit dental service corporation is insolvent; for the purposes of this section, the term "insolvent" means the inability of the nonprofit dental service corporation to meet its debts and financial obligations as they become due;(2) That the nonprofit dental service corporation fails or refuses to comply with a lawful order of the director of business regulation reasonably designed to correct unsound business policies or practices which, if uncorrected, could reasonably lead to insolvency as defined in subdivision (1) of this subsection; or(3) That the nonprofit dental service corporation's financial condition is such as to render its further transaction of business hazardous to the public or its subscribers or members.(b) A claim by a health care provider shall not be asserted against any subscriber or member of the nonprofit dental service corporation in the event of the rehabilitation, liquidation, conservation, or administrative supervision of the nonprofit dental service corporation.History of Section.P.L. 1993, ch. 180, § 19.
RI Gen L § 27-20.1-12 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-20.1 - Nonprofit Dental Service Corporations|Section 27-20.1-12 - Holding company systems.

§ 27-20.1-12. Holding company systems.All of the provisions of chapter 35 of this title apply to corporations organized or licensed pursuant to this chapter. Any approval granted by the director pursuant to chapter 35 of this title do not supersede any other approval under Rhode Island law relative to mergers or other acquisitions of nonprofit dental service corporations in their capacity as Rhode Island charitable nonprofit corporations.History of Section.P.L. 1993, ch. 180, § 19; P.L. 1998, ch. 90, § 3; P.L. 2000, ch. 178, § 5; P.L. 2000, ch. 200, § 15; P.L. 2000, ch. 229, § 15.
RI Gen L § 27-20.1-12.1 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-20.1 - Nonprofit Dental Service Corporations|Section 27-20.1-12.1 - No derogation of attorney general.

§ 27-20.1-12.1. No derogation of attorney general.No provision of this chapter shall derogate from the common law or statutory authority of the attorney general nor shall any provision be construed as a limitation on the common law or statutory authority of the attorney general, including the authority to investigate at any time charitable assets for the purpose of determining and ascertaining whether they are being administered in accordance with law and with the terms and purposes of the charity.History of Section.P.L. 1998, ch. 90, § 8.
RI Gen L § 27-20.1-13 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-20.1 - Nonprofit Dental Service Corporations|Section 27-20.1-13 - Regulations.

§ 27-20.1-13. Regulations.The director of the department of business regulation may adopt reasonable rules and regulations for the implementation and administration of the provisions of this chapter.History of Section.P.L. 1993, ch. 180, § 19.
RI Gen L § 27-20.1-14 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-20.1 - Nonprofit Dental Service Corporations|Section 27-20.1-14 - Reserves.

§ 27-20.1-14. Reserves.Any corporation organized under this title shall maintain total reserves for dental services, separate and distinct from reserves for other health services, in a dollar amount sufficient to pay claims for dental services and operating expenses for not less than one month. Those reserves shall be computed as of each March 31, June 30, September 30 and December 31, and a report setting forth the computation shall be submitted to the director of the department of business regulation together with the corporation's Rhode Island quarterly or annual statement to the insurance commissioner of the state of Rhode Island.History of Section.P.L. 1995, ch. 264, § 1.
RI Gen L § 27-20.1-15 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-20.1 - Nonprofit Dental Service Corporations|Section 27-20.1-15 - Drug coverage.

§ 27-20.1-15. Drug coverage.(a) Any nonprofit dental-service corporation 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 nonprofit dental-service corporation's formulary if he or she believes that the prescription of the non-formulary medication is medically necessary. A nonprofit dental-service corporation shall be required to provide coverage for a non-formulary medication only when the non-formulary medication meets the nonprofit dental-service corporation's medical-exception criteria for the coverage of that medication.(b) A nonprofit dental-service corporation'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 nonprofit dental-service corporation 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:(i) The written or electronic notice must contain the following information:(A) The name of the affected prescription drug;(B) Whether the plan is removing the prescription drug from the formulary, or changing its preferred or tiered, cost-sharing status; and(C) 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.(ii) A nonprofit dental-service corporation may immediately remove from its plan formularies covered prescription drugs deemed unsafe by the nonprofit dental-service corporation or the Food and Drug Administration, or removed from the market by their manufacturer, without meeting the requirements of this section.History of Section.P.L. 1998, ch. 290, § 4; P.L. 2016, ch. 541, § 4; P.L. 2017, ch. 274, § 4; P.L. 2017, ch. 361, § 4.
RI Gen L § 27-20.1-16 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-20.1 - Nonprofit Dental Service Corporations|Section 27-20.1-16 - Magnetic resonance imaging - Quality assurance standards.

§ 27-20.1-16. Magnetic resonance imaging — Quality assurance standards.A magnetic resonance imaging examination eligible for reimbursement by a nonprofit dental services corporation licensed pursuant to this chapter shall be reimbursed only if the provider at which the examination has been conducted and processed, and the licensed physician interpreting the results of the magnetic resonance imaging examination, both meet state approved quality assurance standards for taking, processing, and interpreting magnetic resonance imaging examinations. The director of health has the authority to promulgate rules and regulations necessary to carry out the provisions of this section. The rules and regulations are based upon the most current standards of the American College of Radiology, and approved by the director.History of Section.P.L. 1999, ch. 169, § 5.
RI Gen L § 27-20.1-17 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-20.1 - Nonprofit Dental Service Corporations|Section 27-20.1-17 - Termination of children's benefits.

§ 27-20.1-17. Termination of children's benefits.(a) Every individual or group health insurance contract, plan, or policy delivered, issued for delivery, or renewed in this state which provides medical coverage that includes coverage for physician services in a physician's office, and every policy which provides major medical or similar comprehensive type coverage, except for supplemental policies which only provide coverage for specified diseases and other supplemental policies, shall include a provision that policyholders shall receive no less than thirty (30) days notice from the nonprofit dental service corporation that a child covered as a dependent by the policyholder is about to lose his or her coverage as a result of reaching the maximum age for a dependent child and that the child will only continue to be covered upon documentation being provided of current college enrollment, or that the child may purchase a conversion policy if he or she is not a college student.(b) Nothing in this section prohibits a nonprofit dental service corporation from requiring a policyholder to annually provide proof of a child's current college enrollment in order to maintain the child's coverage. Provided, nothing in this section requires coverage inconsistent with the membership criteria in effect under the policyholder's health benefits coverage.History of Section.P.L. 2000, ch. 214, § 4; P.L. 2002, ch. 292, § 40.
RI Gen L § 27-20.1-18 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-20.1 - Nonprofit Dental Service Corporations|Section 27-20.1-18 - Dental insurance assignment of benefits.

§ 27-20.1-18. Dental insurance assignment of benefits.Every entity providing nonprofit dental service plan as defined in this chapter shall allow, as a provision in a group or individual policy, contract or health benefit plan for coverage of dental services, any person insured by such entity to direct, in writing, that benefits from a health benefit plan, policy or contract, be paid directly to a dental care provider who has not contracted with the entity to provide dental services to persons covered by the entity but otherwise meets the credentialing criteria of the entity and has not previously been terminated by such entity as a participating provider. If written direction to pay is executed and written notice of the direction to pay is provided to such entity, the insuring entity shall pay the benefits directly to the dental care provider. Any efforts to modify the amount of benefits paid directly to the dental care provider under this section may include a reduction in benefits paid of no more than five percent (5%) less than the benefits paid to participating dentists. The entity paying the dentist, pursuant to a direction to pay duly executed by the subscriber, shall have the right to review the records of the dentist receiving such payment that relate exclusively to that particular subscriber/patient to determine that the service in question was rendered.History of Section.P.L. 2004, ch. 268, § 4; P.L. 2004, ch. 386, § 4.
RI Gen L § 27-20.1-19 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-20.1 - Nonprofit Dental Service Corporations|Section 27-20.1-19 - Post-payment audits.

§ 27-20.1-19. Post-payment audits.(a) Except as otherwise provided herein, any review, audit, or investigation by a nonprofit dental service corporation of a healthcare provider's claims which results in the recoupment or set-off of funds previously paid to the healthcare provider in respect to such claims shall be completed no later than eighteen (18) months after the completed claims were initially paid. This section shall not restrict any review, audit, or investigation regarding claims that are submitted fraudulently, are known, or should have been known, by the healthcare provider to be a pattern of inappropriate billing according to the standards for provider billing of their respective medical or dental specialty, are related to coordination of benefits, or are subject to any federal law or regulation that permits claims review beyond the period provided herein.(b) No healthcare provider shall seek reimbursement from a payer for underpayment of a claim later than eighteen (18) months from the date the first payment on the claim was made, except if the claim is the subject of an appeal properly submitted pursuant to the payer's claims appeal policies or the claim is subject to continual claims submission.(c) For the purposes of this section, "healthcare provider" means an individual clinician, either in practice independently or in a group, who provides healthcare services, and otherwise referred to as a non-institutional provider.History of Section.P.L. 2006, ch. 86, § 4; P.L. 2006, ch. 97, § 4; P.L. 2017, ch. 368, § 5; P.L. 2017, ch. 375, § 5.
RI Gen L § 27-20.1-20 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-20.1 - Nonprofit Dental Service Corporations|Section 27-20.1-20 - Plan change notices.

§ 27-20.1-20. Plan change notices.Every entity providing a nonprofit dental service plan as defined in this chapter shall notify all dentists providing services under a group or individual policy, contract or health benefit plan for coverage of dental services, in writing, of any changes to its rules and regulations, guidelines, policies or procedures concerning coverage of or payment for dental services. Said notice of changes in terms shall be communicated to the participating dentists by the dental plan in electronic mail format or, in addition, beginning January 1, 2012, and upon the written request of the dentist, received by the nonprofit dental service plan on or before December 31, 2011, by U.S. mail, showing the changes in redline format and shall be provided to the participating dentists no later than fifteen (15) days before the effective date of said changes.History of Section.P.L. 2011, ch. 236, § 1; P.L. 2011, ch. 255, § 1.
RI Gen L § 27-20.1-21 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-20.1 - Nonprofit Dental Service Corporations|Section 27-20.1-21 - Discretionary clauses.

§ 27-20.1-21. Discretionary clauses.(a) No new or existing policy or certificate may contain any provision:(1) Purporting to reserve sole discretion to the insurance company to determine eligibility for benefits or interpret the terms of a policy or certificate; or(2) Specifying or affecting a standard of review upon which a court may review denial of a claim or any other decision made by an insurance company with respect to a policyholder or certificate holder.(b) Any such clause or language included in a contract, policy or certificate issued to or covering a resident of this state that is contrary to or inconsistent with the provisions of this section is void and unenforceable.(c) Nothing in this section prohibits an insurer from including a provision in a contract that informs an insured that as part of its routine operations the insurer applies the terms of its contracts for making decisions, including making determinations regarding eligibility, receipt of benefits and claims, or explaining policies, procedures, and processes, so long as the provision could not give rise to a deferential standard of review by any reviewing court.History of Section.P.L. 2013, ch. 85, § 5; P.L. 2013, ch. 94, § 5.
RI Gen L § 27-20.1-22 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-20.1 - Nonprofit Dental Service Corporations|Section 27-20.1-22 - Consumer notification.

§ 27-20.1-22. Consumer notification.Every nonprofit dental service corporation providing dental benefits to subscribers shall include on the identification card provided to its subscribers on the front of the cards the following language when the underlying plan contains a non-duplication of benefits clause: "NO DUPLICATION OF BENEFITS".History of Section.P.L. 2013, ch. 452, § 4; P.L. 2013, ch. 479, § 4.
RI Gen L § 27-20.2-1 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-20.2 - Nonprofit Optometric Service Corporations|Section 27-20.2-1 - Definitions.

§ 27-20.2-1. Definitions.As used in this chapter:(1) "Nonprofit optometric service corporation" means any corporation organized pursuant to this chapter for the purpose of establishing, maintaining, and operating a nonprofit optometric service plan;(2) "Nonprofit optometric service plan" means a plan by which specified optometric service is provided to subscribers to the plan by a nonprofit optometric service corporation;(3) "Optometric service" means the professional services rendered by persons duly licensed under the laws of this state to practice optometry or the expense indemnity for the services, appliances, supplies, and care as may be specified in any nonprofit optometric service plan. Optometric service shall not be construed to include hospital services; and(4) "Subscribers" means those persons or groups of persons who contract with a nonprofit optometric service corporation for optometric service pursuant to a nonprofit optometric service plan.History of Section.P.L. 1960, ch. 69, § 1.
RI Gen L § 27-20.2-2 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-20.2 - Nonprofit Optometric Service Corporations|Section 27-20.2-2 - Organization.

§ 27-20.2-2. Organization.(a) Five (5) or more optometrists duly licensed to practice under the laws of this state who are members of the Rhode Island Optometric Association and who first obtain authorization to do so by the Rhode Island Optometric Association, as evidenced by an affidavit of the president and secretary of the association, may associate themselves by written articles of association for the incorporation of a nonprofit optometric service corporation under the provisions of chapter 6 of title 7.(b) The laws of this state relative to insurance companies or to the business of insurance, and acts in amendment of or in addition to them, shall not apply to any nonprofit optometric service corporation unless expressly so provided in the laws.(c) A majority of the directors of a nonprofit optometric service corporation, other than a corporation organized pursuant to the provisions of chapter 19 of this title, must at all times be optometrists duly licensed to practice under the laws of this state.History of Section.P.L. 1960, ch. 69, § 1.
RI Gen L § 27-20.2-3 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-20.2 - Nonprofit Optometric Service Corporations|Section 27-20.2-3 - Contracts.

§ 27-20.2-3. Contracts.(a) Each nonprofit optometric service corporation may contract with its subscribers for an optometric service under any nonprofit optometric service plan adopted by the corporation.(b) The rates charged by the nonprofit optometric service corporation to its subscribers shall be consistent with the proper conduct of its business and the interests of the public, and shall at all times be subject to the approval of the director of business regulation.(c) Nothing contained in this chapter or in any nonprofit optometric service plan shall affect the ordinary professional relationship between the person rendering optometric services under the plan and the subscriber to whom the services are rendered; and no action based upon or arising out of the relationship or relating to optometric services rendered pursuant to a nonprofit optometric service plan shall be maintained against the nonprofit optometric service corporation operating the plan.History of Section.P.L. 1960, ch. 69, § 1.