reglab/housing_qa huggingface dataset:
RI Gen L § 42-157-2 (2021)
2021 Rhode Island General Laws|Title 42 - State Affairs and Government|Chapter 42-157 - Rhode Island Health Benefit Exchange|Section 42-157-2 - Definitions.

§ 42-157-2. Definitions.As used in this section, the following words and terms shall have the following meanings, unless the context indicates another or different meaning or intent:(1) "Director" means the director of the department of administration.(2) "Federal act" means the Federal Patient Protection and Affordable Care Act (Public Law 111-148), as amended by the Federal Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), and any amendments to, or regulations or guidance issued under, those acts.(3) "Health plan" and "qualified health plan" have the same meanings as those terms are defined in § 1301 of the Federal Act.(4) "Insurer" means every medical service corporation, hospital service corporation, accident and sickness insurer, dental service corporation, and health maintenance organization licensed under title 27, or as defined in § 42-62-4.(5) "Secretary" means the secretary of the Federal Department of Health and Human Services.(6) "Qualified dental plan" means a dental plan as described in § 1311(d)(2)(B)(ii) of the Federal Act [42 U.S.C. § 18031].(7) "Qualified individuals" and "qualified employers" shall have the same meaning as defined in federal law.History of Section.P.L. 2015, ch. 141, art. 18, § 2.
RI Gen L § 42-157-3 (2021)
2021 Rhode Island General Laws|Title 42 - State Affairs and Government|Chapter 42-157 - Rhode Island Health Benefit Exchange|Section 42-157-3 - General requirements.

§ 42-157-3. General requirements.(a) The exchange shall make qualified health plans available to qualified individuals and qualified employers. The exchange shall not make available any health benefit plan that has not been certified by the exchange as a qualified health plan in accordance with federal law.(b) The exchange shall allow an insurer to offer a plan that provides limited scope dental benefits meeting the requirements of § 9832(c)(2)(A) of the Internal Revenue Code of 1986 through the exchange, either separately or in conjunction with a qualified health plan, if the plan provides pediatric dental benefits meeting the requirements of § 1302(b)(1)(J) of the Federal Act [42 U.S.C. § 18022].(c) Any health plan that delivers a benefit plan on the exchange that covers abortion services, as defined in 45 C.F.R. § 156.280(d)(1), shall comply with segregation of funding requirements, as well as an annual assurance statement to the Office of the Health Insurance Commissioner, in accordance with 45 C.F.R. §§ 156.680(e)(3) and (5).(d) At least one plan variation for individual market plan designs offered on the exchange at each level of coverage, as defined by section 1302(d)(1) of the federal act [42 U.S.C. § 18022], at which the carrier is offering a plan or plans, shall exclude coverage for abortion services as defined in 45 C.F.R. § 156.280(d)(1). If the health plan proposes different rates for such plan variations, each listed plan design shall include the associated rate. Except for Religious Employers (as defined in Section 6033(a)(3)(A)(i) of the Internal Revenue Code), employers selecting a plan under this religious exemption subsection may not designate it as the single plan for employees, but shall offer their employees full-choice of small employer plans on the exchange, using the employer-selected plan as the base plan for coverage. The employer is not responsible for payment that exceeds that designated for the employer-selected plan.(e) Health plans that offer a plan variation that excludes coverage for abortion services as defined in 45 C.F.R. § 156.280(d)(l) for a religious exemption variation in the small group market shall treat such a plan as a separate plan offering with a corresponding rate.(f) An employer who elects a religious exemption variation shall provide written notice to prospective enrollees prior to enrollment that the plan excludes coverage for abortion services as defined in 45 C.F.R. § 156.280(d)(1). The carrier must include notice that the plan excludes coverage for abortion services as part of the Summary of Benefits and Coverage required by 42 U.S.C. § 300gg-15.History of Section.P.L. 2015, ch. 141, art. 18, § 2.
RI Gen L § 42-157-4 (2021)
2021 Rhode Island General Laws|Title 42 - State Affairs and Government|Chapter 42-157 - Rhode Island Health Benefit Exchange|Section 42-157-4 - Financing.

§ 42-157-4. Financing.(a) The department is authorized to assess insurers offering qualified health plans and qualified dental plans. To support the functions of the exchange, insurers offering qualified health plans and qualified dental plans must remit an assessment to the exchange each month, in a timeframe and manner established by the exchange, equal to three and one-half percent (3.5%) of the monthly premium charged by the insurer for each policy under the plan where enrollment is through the exchange. Revenues from the assessment shall be deposited in a restricted-receipt account for the sole use of the exchange and shall be exempt from the indirect cost-recovery provisions of § 35-4-27.(b) The general assembly may appropriate general revenue to support the annual budget for the exchange in lieu of or to supplement revenues raised from the assessment under subsection (a) of this section.(c) If the director determines that the level of resources obtained pursuant to subsection (a) will be in excess of the budget for the exchange, the department shall provide a report to the governor, the speaker of the house, and the senate president identifying the surplus and detailing how the assessment established pursuant to subsection (a) may be offset in a future year to reconcile with impacted insurers and how any future supplemental or annual budget submission to the general assembly may be revised accordingly.History of Section.P.L. 2015, ch. 141, art. 18, § 2; P.L. 2019, ch. 88, art. 11, § 2.
RI Gen L § 42-157-5 (2021)
2021 Rhode Island General Laws|Title 42 - State Affairs and Government|Chapter 42-157 - Rhode Island Health Benefit Exchange|Section 42-157-5 - Regional purchasing, efficiencies, and innovation.

§ 42-157-5. Regional purchasing, efficiencies, and innovation.To take advantage of economies of scale and to lower costs, the exchange is hereby authorized to pursue opportunities to jointly negotiate, procure or otherwise purchase exchange services with or partner with another state or multiple states and to pursue a Federal Affordable Care Act 1332 Waiver.History of Section.P.L. 2015, ch. 141, art. 18, § 2.
RI Gen L § 42-157-5.1 (2021)
2021 Rhode Island General Laws|Title 42 - State Affairs and Government|Chapter 42-157 - Rhode Island Health Benefit Exchange|Section 42-157-5.1 - Small business health options program (SHOP) innovation waiver.

§ 42-157-5.1. Small business health options program (SHOP) innovation waiver.(a) As small business owners and sole proprietors are the life blood of this state's economy, a recent change in the Federal Affordable Care Act effective on January 1, 2016, has caused irreparable harm to the economic well-being of small business owners and sole proprietors by requiring them to secure health insurance coverage on the individual market as opposed to securing health insurance coverage on the small group market.(b) In an effort to reduce and/or eliminate the irreparable economic harm, the director of the department of administration, with assistance from the commissioner of health insurance, shall seek a waiver under Section 1332 of the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, as amended by the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152, for the purpose of allowing businesses classified as self-employed and sole proprietors to purchase insurance in the small group market through the health source RI for employers SHOP program and not be forced into the individual market.History of Section.P.L. 2018, ch. 124, § 1; P.L. 2018, ch. 194, § 1.
RI Gen L § 42-157-6 (2021)
2021 Rhode Island General Laws|Title 42 - State Affairs and Government|Chapter 42-157 - Rhode Island Health Benefit Exchange|Section 42-157-6 - Audit.

§ 42-157-6. Audit.(a) Annually, the exchange shall cause to have a financial and/or performance audit of its functions and operations performed in compliance with the generally accepted governmental auditing standards and conducted by the state office of internal audit or a certified public accounting firm qualified in performance audits.(b) If the audit is not directly performed by the state office of internal audit, the selection of the auditor and the scope of the audit shall be subject to the approval of the state office of internal audit.(c) The results of the audit shall be made public upon completion, posted on the department's website and otherwise made available for public inspection.History of Section.P.L. 2015, ch. 141, art. 18, § 2.
RI Gen L § 42-157-7 (2021)
2021 Rhode Island General Laws|Title 42 - State Affairs and Government|Chapter 42-157 - Rhode Island Health Benefit Exchange|Section 42-157-7 - Exchange advisory board.

§ 42-157-7. Exchange advisory board.The exchange shall maintain an advisory board which shall be appointed by the director. The director shall consider the expertise of the members of the board and make appointments so that the board's composition reflects a range and diversity of skills, backgrounds and stakeholder perspectives.History of Section.P.L. 2015, ch. 141, art. 18, § 2.
RI Gen L § 42-157-8 (2021)
2021 Rhode Island General Laws|Title 42 - State Affairs and Government|Chapter 42-157 - Rhode Island Health Benefit Exchange|Section 42-157-8 - Reporting.

§ 42-157-8. Reporting.HealthSource RI shall provide a monthly report to the chairpersons of the house finance committee and the senate finance committee by the fifteenth day of each month beginning in July 2015. The report shall include, but not be limited to, the following information: actual enrollment data by market and insurer, total new and renewed customers, number of paid customers, actual average premium costs by market and insurer, number of enrollees receiving financial assistance as defined in the Federal Act, as well as the number of inbound calls and the number of walk-ins received. The data on inbound calls shall be segregated by type of call.History of Section.P.L. 2015, ch. 141, art. 18, § 2.
RI Gen L § 42-157-9 (2021)
2021 Rhode Island General Laws|Title 42 - State Affairs and Government|Chapter 42-157 - Rhode Island Health Benefit Exchange|Section 42-157-9 - Relation to other laws.

§ 42-157-9. Relation to other laws.Nothing in this chapter, and no action taken by the exchange pursuant to this chapter. shall be construed to preempt or supersede the authority of the health insurance commissioner to regulate the business of insurance within this state, the director of the department of health to oversee the licensure of healthcare providers, the certification of health plans under chapter 17.13 of title 23, or the licensure of utilization review agents wider chapter 17.13 of title 23, or the director of the department of human services to oversee the provision of medical assistance under chapter 8 of title 40. In addition to the provisions of this chapter, all insurers offering qualified health plans or qualified dental plans in this state shall comply fully with all applicable health insurance laws and regulations of this state.History of Section.P.L. 2015, ch. 141, art. 18, § 2.
RI Gen L § 42-157-10 (2021)
2021 Rhode Island General Laws|Title 42 - State Affairs and Government|Chapter 42-157 - Rhode Island Health Benefit Exchange|Section 42-157-10 - Severability.

§ 42-157-10. Severability.The provisions of this chapter are severable, and if any provision hereof shall be held invalid in any circumstances, any invalidity shall not affect any other provisions or circumstances. This chapter shall be construed in all respects so as to meet any constitutional requirements. In carrying out the purposes and provisions of this chapter, all steps shall be taken which are necessary to meet constitutional requirements.History of Section.P.L. 2015, ch. 141, art. 18, § 2.
RI Gen L § 42-157-11 (2021)
2021 Rhode Island General Laws|Title 42 - State Affairs and Government|Chapter 42-157 - Rhode Island Health Benefit Exchange|Section 42-157-11 - Exemptions from the shared responsibility payment penalty.

§ 42-157-11. Exemptions from the shared responsibility payment penalty.(a) Establishment of program. The exchange shall establish a program for determining whether to grant a certification that an individual is entitled to an exemption from the shared responsibility payment penalty set forth in § 44-30-101(c) by reason of religious conscience or hardship.(b) Eligibility determinations. The exchange shall make determinations as to whether to grant a certification described in subsection (a) of this section. The exchange shall notify the individual and the tax administrator for the Rhode Island department of revenue of the determination in a time and manner as the exchange, in consultation with the tax administrator, shall prescribe. In notifying the tax administrator, the exchange shall adhere to the data privacy and data security standards adopted in accordance with 45 C.F.R. 155.260. The exchange shall only be required to notify the tax administrator to the extent that the exchange determines the disclosure is permitted under 45 C.F.R. 155.260.(c) Appeals. Any person aggrieved by the exchange's determination of eligibility for an exemption under this section has the right to an appeal in accordance with the procedures contained within chapter 35 of this title.History of Section.P.L. 2019, ch. 88, art. 11, § 3.
RI Gen L § 42-157-12 (2021)
2021 Rhode Island General Laws|Title 42 - State Affairs and Government|Chapter 42-157 - Rhode Island Health Benefit Exchange|Section 42-157-12 - Special enrollment period for qualified individuals assessed a shared responsibility payment penalty.

§ 42-157-12. Special enrollment period for qualified individuals assessed a shared responsibility payment penalty.(a) Definitions. The following definition shall apply for purposes of this section:(1) "Special enrollment period" means a period during which a qualified individual who is assessed a penalty in accordance with § 44-30-101 may enroll in a qualified health plan through the exchange outside of the annual open enrollment period.(b) In the case of a qualified individual who is assessed a shared responsibility payment in accordance with § 44-30-101 and who is not enrolled in a qualified health plan, the exchange must provide a special enrollment period consistent with this section and the Federal Patient Protection and Affordable Care Act (Public Law 111-148), as amended by the Federal Care and Reconciliation Act of 2010 (Public Law 111-152), and any amendments to, or regulations or guidance issued under, those acts.(c) Effective date. The exchange must ensure that coverage is effective for a qualified individual who is eligible for a special enrollment period under this section on the first day of the month after the qualified individual completes enrollment in a qualified health plan through the exchange.(d) Availability and length of special enrollment period. A qualified individual has sixty (60) days from the date he or she is assessed a penalty in accordance with § 44-30-101 to complete enrollment in a qualified health plan through the exchange. The date of assessment shall be determined in accordance with § 44-30-82.History of Section.P.L. 2019, ch. 88, art. 11, § 3.
RI Gen L § 42-157-13 (2021)
2021 Rhode Island General Laws|Title 42 - State Affairs and Government|Chapter 42-157 - Rhode Island Health Benefit Exchange|Section 42-157-13 - Outreach to Rhode Island residents and individuals assessed a shared responsibility payment penalty.

§ 42-157-13. Outreach to Rhode Island residents and individuals assessed a shared responsibility payment penalty. Outreach. The exchange, in consultation with the office of the health insurance commissioner and the division of taxation, is authorized to engage in coordinated outreach efforts to educate Rhode Island residents about the importance of health insurance coverage; their responsibilities to maintain minimum essential coverage as defined in § 44-30-101; the penalties for failure to maintain coverage; and information on the services available through the exchange.History of Section.P.L. 2019, ch. 88, art. 11, § 3.
RI Gen L § 42-157-14 (2021)
2021 Rhode Island General Laws|Title 42 - State Affairs and Government|Chapter 42-157 - Rhode Island Health Benefit Exchange|Section 42-157-14 - Regulatory authority.

§ 42-157-14. Regulatory authority.The exchange may promulgate regulations as necessary to carry out the purposes of this chapter.History of Section.P.L. 2019, ch. 88, art. 11, § 3.
RI Gen L § 42-157.1-1 (2021)
2021 Rhode Island General Laws|Title 42 - State Affairs and Government|Chapter 42-157.1 - Rhode Island Market Stability and Reinsurance Act|Section 42-157.1-1 - Short title and purpose.

§ 42-157.1-1. Short title and purpose.(a) This chapter shall be known and may be cited as the "Rhode Island Market Stability and Reinsurance Act."(b) The purpose of this chapter is to authorize the director to create the Rhode Island reinsurance program to stabilize health insurance rates and premiums in the individual market and provide greater financial certainty to consumers of health insurance in this state.(c) [Deleted by P.L. 2019, ch. 88, art. 11, § 4].(d) No general revenue funding shall be used for reinsurance payments.History of Section.P.L. 2018, ch. 220, § 1; P.L. 2018, ch. 278, § 1; P.L. 2019, ch. 88, art. 11, § 4.
RI Gen L § 42-157.1-2 (2021)
2021 Rhode Island General Laws|Title 42 - State Affairs and Government|Chapter 42-157.1 - Rhode Island Market Stability and Reinsurance Act|Section 42-157.1-2 - Definitions.

§ 42-157.1-2. Definitions.As used in this chapter:(1) "Director" means the director of the Rhode Island health benefits exchange.(2) "Exchange" means the Rhode Island health benefits exchange established within the department of administration by § 42-157-1.(3) "Health insurance carrier" or "carrier" has the same meaning as it does in § 27-18.5-2.(4) "Health insurance coverage" has the same meaning as it does in § 27-18.5-2.(5) "Individual market" has the same meaning as it does in § 27-18.5-2.(6) "Office of the health insurance commissioner" means the entity established by § 42-14.5-1 within the department of business regulation.(7) "Program" means the Rhode Island reinsurance program established by § 42-157.1-3.(8) "Program fund" or "fund" means the fund established by § 42-157.1-5.(9) "State" means the state of Rhode Island.History of Section.P.L. 2018, ch. 220, § 1; P.L. 2018, ch. 278, § 1.
RI Gen L § 42-157.1-3 (2021)
2021 Rhode Island General Laws|Title 42 - State Affairs and Government|Chapter 42-157.1 - Rhode Island Market Stability and Reinsurance Act|Section 42-157.1-3 - Establishment of the Rhode Island reinsurance program.

§ 42-157.1-3. Establishment of the Rhode Island reinsurance program.(a) The director is authorized to establish and implement a state-based reinsurance program, to be known as the Rhode Island reinsurance program:(1) To provide reinsurance to carriers that offer health insurance coverage on the individual market in the state;(2) That meets the requirements of a waiver approved under 42 U.S.C. § 18052; and(3) That is consistent with state and federal law.(b) The program is intended to mitigate the impact of high-risk individuals on health insurance rates offered in the individual insurance market on and off of the exchange.(c) The director is authorized to establish reinsurance payment parameters for calendar year 2020 and each subsequent calendar year that include:(1) An attachment point;(2) A coinsurance rate; and(3) A coinsurance cap.(d) Carriers must provide the exchange and the office of the health insurance commissioner with data the director prescribes by rules and regulations as necessary to determine reinsurance payments in a time and manner determined by the director.(e) The director may alter the parameters established in accordance with subsections (c) and (d) of this section as necessary to secure federal approval for a waiver submitted in accordance with § 42-157.1-6.History of Section.P.L. 2018, ch. 220, § 1; P.L. 2018, ch. 278, § 1.
RI Gen L § 42-157.1-4 (2021)
2021 Rhode Island General Laws|Title 42 - State Affairs and Government|Chapter 42-157.1 - Rhode Island Market Stability and Reinsurance Act|Section 42-157.1-4 - Powers of the director.

§ 42-157.1-4. Powers of the director.The director may:(1) Contract with the federal government or another unit of government to ensure coordination of the program;(2) Apply for any available federal funding for the program;(3) Undertake, directly or through contracts with other persons or entities, studies or demonstration programs to develop awareness of the benefits of this chapter; and(4) Formulate general policy and adopt rules and regulations that are reasonably necessary to administer this chapter, including regulations establishing a reinsurance program to mitigate the impact of high-risk individuals on health insurance rates.History of Section.P.L. 2018, ch. 220, § 1; P.L. 2018, ch. 278, § 1.
RI Gen L § 42-157.1-5 (2021)
2021 Rhode Island General Laws|Title 42 - State Affairs and Government|Chapter 42-157.1 - Rhode Island Market Stability and Reinsurance Act|Section 42-157.1-5 - Establishment of program fund.

§ 42-157.1-5. Establishment of program fund.(a) The health insurance market integrity fund is hereby established to provide funding for the operation and administration of the program in carrying out the purposes of the program under this chapter.(b) The director is authorized to administer the fund.(c) The fund shall consist of:(1) Any pass-through funds received from the federal government under a waiver approved under 42 U.S.C. § 18052;(2) Any funds designated by the federal government to provide reinsurance to carriers that offer individual health benefit plans in the state;(3) Any funds designated by the state to provide reinsurance to carriers that offer individual health benefit plans in the state; and(4) Any other money from any other source accepted for the benefit of the fund.(d) [Deleted by P.L. 2019, ch. 88, art. 11, § 4].(e) No general revenue funding shall be used for reinsurance payments.(f) A restricted-receipt account shall be established for the fund which may be used for the purposes set forth in this section and shall be exempt from the indirect cost recovery provisions of § 35-4-27.(g) Monies in the fund shall be used to provide reinsurance to health insurance carriers as set forth in this chapter and its implementing regulations, and to support the personnel costs, operating costs, and capital expenditures of the exchange and the division of taxation that are necessary to carry out the provisions of this chapter, §§ 44-30-101 through 44-30-102, and §§ 42-157-11 through 42-157-14.(h) Any excess monies remaining in the fund, not including any monies received from the federal government pursuant to subsection (c)(1) or (c)(2) of this section and after making the payments required by subsection (g) of this section, may be used for preventative healthcare programs for vulnerable populations in consultation with the executive office of health and human services.History of Section.P.L. 2018, ch. 220, § 1; P.L. 2018, ch. 278, § 1; P.L. 2019, ch. 88, art. 11, § 4.
RI Gen L § 42-157.1-6 (2021)
2021 Rhode Island General Laws|Title 42 - State Affairs and Government|Chapter 42-157.1 - Rhode Island Market Stability and Reinsurance Act|Section 42-157.1-6 - State innovation waiver.

§ 42-157.1-6. State innovation waiver.In accordance with § 42-157-5, the director may apply to the United States Secretary of Health and Human Services under 42 U.S.C. § 18052 for a state innovation waiver to implement the program and seek federal pass-through funding for calendar years beginning January 1, 2020, and future years, to maximize federal funding.History of Section.P.L. 2018, ch. 220, § 1; P.L. 2018, ch. 278, § 1.