reglab/housing_qa huggingface dataset:
RI Gen L § 27-18.6-4 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.6 - Large Group Health Insurance Coverage|Section 27-18.6-4 - Discrimination prohibited.

§ 27-18.6-4. Discrimination prohibited.(a) (1) Notwithstanding any of the provisions of this title to the contrary, a group health plan and a health insurance carrier offering group health insurance in connection with a group health plan may not establish rules for eligibility (including continued eligibility) of any individual to enroll under the terms of the plan based on health status-related factors in relation to the individual or dependent of the individual.(2) Rules for eligibility to enroll under a plan include rules defining any applicable waiting periods for enrollment.(b) Subsection (a) of this section shall not be construed:(1) To require a group health plan or group health insurance coverage to provide particular benefits other than those provided under the terms of the plan or coverage; or(2) To prevent a plan or coverage from establishing limitations on the amount, level, extent, or nature of the benefits or coverage for similarly situated individuals enrolled in the coverage.(c) (1) A group health plan and a health insurance carrier offering health insurance coverage in connection with a group health plan may not require any individual (as a condition of enrollment or continued enrollment under the plan) to pay a premium or contribution which is greater than the premium or contribution for a similarly situated individual enrolled in the plan on the basis of any health status-related factor in relation to the individual or to an individual enrolled under the plan as dependent of the individual.(2) Nothing contained within this subsection shall be construed to:(i) Restrict the amount that an employer may be charged for coverage under a group health plan; or(ii) Prevent a group health plan and a health insurance carrier offering group health insurance coverage from establishing premium discounts or rebates or modifying applicable copayments or deductibles in return for adherence to programs of health promotion and disease prevention.History of Section.P.L. 2000, ch. 200, § 4; P.L. 2000, ch. 229, § 4.
RI Gen L § 27-18.6-7 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.6 - Large Group Health Insurance Coverage|Section 27-18.6-7 - Collective bargaining agreements.

§ 27-18.6-7. Collective bargaining agreements.(a) Notwithstanding anything contained in this chapter to the contrary, except as provided in § 27-18.6-3(n), in the case of a group health plan maintained pursuant to one or more collective bargaining agreements between employee representatives and one or more employers ratified before July 13, 2000, this chapter does not apply to plan years beginning before the later of:(1) The date on which the last of the collective bargaining agreements relating to the plan terminates (determined without regard to any extension of the collective bargaining agreement agreed to after July 13, 2000); or(2) July 1, 1997.(b) For purposes of subdivision (a)(1) of this section, any plan amendment made pursuant to a collective bargaining agreement relating to the plan which amends the plan solely to conform to any requirement of this chapter shall not be treated as a termination of the collective bargaining agreement.History of Section.P.L. 2000, ch. 200, § 4; P.L. 2000, ch. 229, § 4; P.L. 2002, ch. 292, § 36.
RI Gen L § 27-18.6-8 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.6 - Large Group Health Insurance Coverage|Section 27-18.6-8 - Enforcement - Limitation on actions.

§ 27-18.6-8. Enforcement — Limitation on actions.The director has the power to enforce the provisions of this chapter in accordance with § 42-14-16 and all other applicable state law.History of Section.P.L. 2000, ch. 200, § 4; P.L. 2000, ch. 229, § 4.
RI Gen L § 27-18.6-9 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.6 - Large Group Health Insurance Coverage|Section 27-18.6-9 - Rules and regulations.

§ 27-18.6-9. Rules and regulations.The director may promulgate rules and regulations necessary to effectuate the purposes of this chapter.History of Section.P.L. 2000, ch. 200, § 4; P.L. 2000, ch. 229, § 4.
RI Gen L § 27-18.6-10 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.6 - Large Group Health Insurance Coverage|Section 27-18.6-10 - Severability.

§ 27-18.6-10. Severability.If any provision of this chapter or the application of any provision to any person or circumstances is for any reason held invalid, the remainder of the chapter and the application of that provision to other persons or circumstances shall not be affected by that invalidity.History of Section.P.L. 2000, ch. 200, § 4; P.L. 2000, ch. 229, § 4.
RI Gen L § 27-18.6-11 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.6 - Large Group Health Insurance Coverage|Section 27-18.6-11 - Health insurance plan payment and expense reporting.

§ 27-18.6-11. Health insurance plan payment and expense reporting.A health insurance carrier: (1) providing proposed rate, premium, fee, or other prospective cost information in connection with an offering of health insurance coverage to a large group or large employer setting forth claims cost as an element of cost; or (2) providing information to a large group or large employer (as so defined) regarding claims paid, shall be required to distinguish, set forth and itemize as separate and distinct elements of cost: (i) sums actually payable (or paid) to health care providers; and (ii) sums actually (or proposed to be) retained or paid by the carrier for administration, including, but not limited to, sums relating to claim services, managed care fees, network access fees, and contributions to reserves.History of Section.P.L. 2004, ch. 196, § 1; P.L. 2004, ch. 361, § 1.
RI Gen L § 27-18.6-12 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.6 - Large Group Health Insurance Coverage|Section 27-18.6-12 - Health plan loss information.

§ 27-18.6-12. Health plan loss information.(a) To ensure maximum competition in the purchase of group health insurance, all employers with at least one hundred (100) employees enrolled in their group health plan shall be entitled to receive their health plan loss information upon request and without charge. No contract between any health insurance carrier, third-party administrator, employer group, or pool of employers shall abridge this right in any manner. For purposes of this section, "health plan loss information" shall mean: (1) aggregate total cost figures for four (4) separate categories of medical claims covered by the employer's group health plan: physician, hospital, prescription drug, and miscellaneous; and (2) that were incurred for the twelve (12) month period paid through the fourteen (14) months which end within the sixty (60) day period prior to the date of the request. "Health plan loss information" shall not include any information: (1) pertaining to specific medical diagnoses, treatments or drugs; or (2) that identifies or reasonably could lead to the identity of any individuals covered under the group health plan; or (3) that is defined as protected or confidential health information under state or federal laws.(b) Upon written request from any employer with one hundred (100) or more employees enrolled in its group health plan, every health insurance carrier shall provide that employer's health plan loss information within thirty (30) calendar days of receipt of the request. An employer shall not be entitled by this section to more than two (2) health plan loss information requests in any twelve (12) month period, however, nothing shall prohibit a carrier from fulfilling more frequent requests on a mutually agreed upon basis.(c) If an employer requests health plan loss information from an insurance agent or other authorized representative, the agent or authorized representative shall transmit the request to the health insurance carrier within four (4) working days.History of Section.P.L. 2004, ch. 406, § 1; P.L. 2004, ch. 502, § 1.
RI Gen L § 27-18.7-1 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.7 - Extended Medical Leave|Section 27-18.7-1 - Medical benefits for employees on extended medical leave.

§ 27-18.7-1. Medical benefits for employees on extended medical leave.Whenever an employee who has been employed on a full-time basis by an employer for at least three (3) months and who is an insured member of a group hospital, surgical, or medical insurance plan is placed on extended medical leave by the employer, the employee may remain on the group hospital, surgical, or medical insurance plan and the benefits of the plan may be continued for no more than eighteen (18) months from the date the employee was placed on extended medical leave.History of Section.P.L. 2010, ch. 180, § 1; P.L. 2010, ch. 187, § 1.
RI Gen L § 27-18.7-2 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.7 - Extended Medical Leave|Section 27-18.7-2 - Costs of the plan.

§ 27-18.7-2. Costs of the plan.An employer may continue to contribute to the cost of the plan benefits for an employee on extended medical leave or may require an employee on extended medical leave to pay up to one hundred percent (100%) of the cost of the plan benefits.History of Section.P.L. 2010, ch. 180, § 1; P.L. 2010, ch. 187, § 1.
RI Gen L § 27-18.7-3 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.7 - Extended Medical Leave|Section 27-18.7-3 - Eligibility for medical benefits while on extended medical leave.

§ 27-18.7-3. Eligibility for medical benefits while on extended medical leave.(a) An employee shall be considered eligible for continuing coverage under the group hospital, surgical, or medical insurance plan as an employee on extended medical leave if an employer provides to the group hospital, surgical, or medical insurance plan a written statement that explains that, due to medical reasons pertaining to the employee or a member of the employee's family (parent, child, step-child, spouse, sibling or a person for whom the employee serves as a legal guardian), the employee can no longer work full-time, the employee and the employer anticipate that the employee will someday return to full-time employment, and the employer has placed the employee on extended medical leave.(b) Nothing in this statute shall be construed to give an insurance company, a health maintenance organization or a nonprofit hospital and medical service corporation the ability to determine whether an employee is eligible for extended medical leave. The determination of whether an employee is eligible for extended medical leave rests solely with, and in the discretion of, the employer. Nothing in this statute shall be construed to require an employer to offer extended medical leave to its full-time employees.History of Section.P.L. 2010, ch. 180, § 1; P.L. 2010, ch. 187, § 1.
RI Gen L § 27-18.7-4 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.7 - Extended Medical Leave|Section 27-18.7-4 - Transition to extended medical benefits.

§ 27-18.7-4. Transition to extended medical benefits.Once an employee on extended medical leave has remained on a group hospital, surgical, or medical insurance plan for eighteen (18) months and is no longer eligible to participate in that plan, the employee shall be eligible for extended medical benefits under chapter 19.1 of title 27 as if the employee were involuntarily terminated from employment the day he or she is no longer eligible to participate in the plan as an employee on extended medical leave.History of Section.P.L. 2010, ch. 180, § 1; P.L. 2010, ch. 187, § 1.
RI Gen L § 27-18.8-1 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.8 - Health Care Accessibility and Quality Assurance Act|Section 27-18.8-1 - Purpose.

§ 27-18.8-1. Purpose.The legislature declares that:(1) It is in the best interest of the public that those individuals and healthcare entities involved with the delivery of health plan coverage in our state meet the standards of this chapter to ensure accessibility and quality for the state's patients; and(2) Nothing in this legislation is intended to prohibit a healthcare entity from forming limited networks of providers; and(3) It is a vital state function to establish these standards for the conduct of healthcare entities in Rhode Island and for public health well-being; and(4) Nothing in this chapter is intended to prohibit or discourage the health insurance commissioner from consulting or collaborating with the department of health, or any other state or federal agency, to the extent the commissioner in his or her discretion determines such consultation and/or collaboration is necessary and/or appropriate for the administration and enforcement of this chapter.History of Section.P.L. 2017, ch. 302, art. 5, § 4.
RI Gen L § 27-18.8-4 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.8 - Health Care Accessibility and Quality Assurance Act|Section 27-18.8-4 - Contracts with providers for dental services.

§ 27-18.8-4. Contracts with providers for dental services.No contract between a dental plan of a healthcare entity and a dentist for the provision of services to beneficiaries may require that a dentist provide services to its patients at a fee set by the healthcare entity unless said services are covered services under the applicable subscriber agreement. "Covered services," as used herein, means services reimbursable under the applicable beneficiary agreement, subject to such contractual limitations on beneficiary benefits as may apply, including, for example, deductibles, waiting period, or frequency limitations.History of Section.P.L. 2017, ch. 302, art. 5, § 4.
RI Gen L § 27-18.8-5 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.8 - Health Care Accessibility and Quality Assurance Act|Section 27-18.8-5 - Contracts with providers for optometric services.

§ 27-18.8-5. Contracts with providers for optometric services.(a) No contract between an eye care provider and a healthcare entity or vision plan may require that an eye care provider provide services or materials to its beneficiaries at a fee set by the insurer or vision plan, unless the insurer or vision plan compensates the eye care provider for the provision of such services or materials to the beneficiary. Reimbursement paid by the insurer or vision plan for covered services and materials shall not provide nominal reimbursement in order to claim that services and materials are covered services.(b) (1) "Services" means services and materials for which reimbursement from the vision plan is provided for by a beneficiary's plan contract, or for which a reimbursement would be available but for the application of the beneficiary's contractual limitations of deductibles, copayments, or coinsurance.(2) "Materials" means and includes, but is not limited to: lenses, devices containing lenses, prisms, lens treatments and coatings, contact lenses, orthoptics, vision training, and prosthetic devices to correct, relieve, or treat defects or abnormal conditions of the human eye or its adnexa.(3) "Eye care provider" means an optometrist, optician, or ophthalmologist.History of Section.P.L. 2017, ch. 302, art. 5, § 4.
RI Gen L § 27-18.8-6 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.8 - Health Care Accessibility and Quality Assurance Act|Section 27-18.8-6 - Reporting requirements.

§ 27-18.8-6. Reporting requirements.The office shall establish reporting requirements to determine if healthcare entities and/or network plans are in compliance with the provisions of this chapter and applicable regulations as well as in compliance with applicable federal law.History of Section.P.L. 2017, ch. 302, art. 5, § 4.
RI Gen L § 27-18.8-7 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.8 - Health Care Accessibility and Quality Assurance Act|Section 27-18.8-7 - Rules and regulations.

§ 27-18.8-7. Rules and regulations.The health insurance commissioner may promulgate such rules and regulations as are necessary and proper to effectuate the purpose and for the efficient administration and enforcement of this chapter.History of Section.P.L. 2017, ch. 302, art. 5, § 4.
RI Gen L § 27-18.8-8 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.8 - Health Care Accessibility and Quality Assurance Act|Section 27-18.8-8 - Denial, suspension, or revocation of certificate - Penalties.

§ 27-18.8-8. Denial, suspension, or revocation of certificate — Penalties.Adopted pursuant to this chapter;(a) The office may deny a certificate or certification upon review of the application if, upon review of the application, it finds that the applicant proposing to establish a network plan does not meet the standards required by this chapter or by any regulations promulgated pursuant to this chapter.(b) The office may revoke or suspend a certificate or certification and/or impose monetary penalties not less than one hundred dollars ($100) and not to exceed fifty thousand dollars ($50,000) per violation and/or impose an order requiring a monetary restitution or disgorgement payment in an amount determined by the commissioner to reasonably reflect the amount of damages caused or monies improperly obtained in any case in which:(1) The network plan and/or healthcare entity fails to comply with the requirements of this chapter or of regulations;(2) The network plan and/or healthcare entity fails to comply with the criteria used by it in its application for a certificate or certification; or(3) The network plan and/or healthcare entity refuses to permit or fails to reasonably cooperate with an examination by the commissioner to determine compliance with the requirements of this chapter and regulations promulgated pursuant to the authority granted to the commissioner in this chapter. These determinations may involve consideration of any written grievances filed with the office against the network plan or healthcare entity by patients or providers.(c) Any applicant for certification or certificate holder aggrieved by an order or a decision of the commissioner made under this chapter without a hearing may, within thirty (30) days after notice of the order or decision, make a written request to the office for a hearing on the order or decision pursuant to § 42-35-15.(d) The procedure governing hearings authorized by this section shall be in accordance with §§ 42-35-9 through 42-35-13 as stipulated in § 42-35-14(a). A full and complete record shall be kept of all proceedings, and all testimony shall be recorded but need not be transcribed unless the decision is appealed pursuant to § 42-35-15. A copy or copies of the transcript may be obtained by any interested party upon payment of the cost of preparing the copy or copies. Witnesses may be subpoenaed by either party.History of Section.P.L. 2017, ch. 302, art. 5, § 4.
RI Gen L § 27-18.8-9 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.8 - Health Care Accessibility and Quality Assurance Act|Section 27-18.8-9 - Penalties and enforcement.

§ 27-18.8-9. Penalties and enforcement.For the purposes of this chapter, in addition to the provisions of § 27-18.8-8, a healthcare entity or any person or entity conducting any activities requiring certification under this chapter shall be subject to the penalty and enforcement provisions of this title and chapters 14 and 14.5 of title 42 and the regulations promulgated thereunder in the same manner as a licensee or any person or entity conducting any activities requiring licensure or certification under this title.History of Section.P.L. 2017, ch. 302, art. 5, § 4.
RI Gen L § 27-18.8-10 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.8 - Health Care Accessibility and Quality Assurance Act|Section 27-18.8-10 - Severability.

§ 27-18.8-10. Severability.If any section, clause, or provision of this chapter shall be held either unconstitutional or ineffective in whole or in part, to the extent that it is not unconstitutional or ineffective, it shall be valid and effective and no other section, clause or provision shall on account thereof be termed invalid or ineffective.History of Section.P.L. 2017, ch. 302, art. 5, § 4.
RI Gen L § 27-18.9-1 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.9 - Benefit Determination and Utilization Review Act|Section 27-18.9-1 - Purpose of chapter.

§ 27-18.9-1. Purpose of chapter.(a) The purpose of this chapter is to:(1) Promote the delivery of quality health care in a cost-effective manner;(2) Foster greater coordination between healthcare providers, patients, healthcare entities, health benefit plans and utilization-review entities to ensure public health well-being;(3) Protect beneficiaries, businesses, and providers by ensuring that review agents are qualified to perform review activities and to make informed decisions on the medical necessity and appropriateness of medical care;(4) Ensure that review agents maintain the confidentiality of medical records in accordance with applicable state and federal laws; and(5) Interface and maintain compliance with federal benefit determination and adverse benefit determination requirements.(b) Nothing in this chapter is intended to prohibit or discourage the health insurance commissioner from consulting or collaborating with the department of health, or any other state or federal agency, to the extent the commissioner in his or her discretion determines such consultation and/or collaboration is necessary and/or appropriate for the administration and enforcement of this chapter.History of Section.P.L. 2017, ch. 302, art. 5, § 5.