reglab/housing_qa huggingface dataset:
RI Gen L § 27-18.2-6 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.2 - Medicare Supplement Insurance Policies|Section 27-18.2-6 - Disclosure standards.

§ 27-18.2-6. Disclosure standards.(a) In order to provide for full and fair disclosure in the sale of Medicare supplement policies, no Medicare supplement policy or certificate shall be delivered in this state unless an outline of coverage is delivered to the applicant at the time application is made.(b) The director shall prescribe the format and content of the outline of coverage required by subsection (a) of this section. For the purposes of this section, "format" means style, arrangements, and overall appearance, including such items as the size, color, and prominence of type and arrangement of text and captions. The outline of coverage shall include:(1) A description of the principal benefits and coverage provided in the policy;(2) A statement of the renewal provisions, including any reservation by the issuer of a right to change premiums, and a disclosure of the existence of any automatic renewal premium increase based on the policyholder's age; and(3) A statement that the outline of coverage is a summary of the policy issued or applied for and that the policy should be consulted to determine governing contractual provisions.(c) The director may prescribe by regulation a standard form and the contents of an informational brochure for persons eligible for Medicare, which is intended to improve the buyer's ability to select the most appropriate coverage and improve the buyer's understanding of Medicare. Except in the case of direct response insurance policies, the director may require by regulation that the information brochure be provided to any prospective insureds eligible for Medicare concurrently with delivery of the outline of coverage. With respect to direct response insurance policies, the director may require by regulation that the prescribed brochure be provided upon request to any prospective insureds eligible for Medicare, but in no event later than the time of policy delivery.(d) The director may adopt regulations for captions or notice requirements, determined to be in the public interest and designed to inform prospective insured that particular insurance coverage is not Medicare supplement coverage, for all accident and sickness insurance policies sold to persons eligible for Medicare other than:(1) Medicare supplement policies; or(2) Disability income policies.(e) The director may adopt reasonable regulations to govern the full and fair disclosure of the information in connection with the replacement of accident and sickness policies, subscriber contracts or certificates by persons eligible for Medicare.History of Section.P.L. 1988, ch. 631, § 2; P.L. 1989, ch. 428, § 1; P.L. 1992, ch. 445, § 4; P.L. 1993, ch. 180, § 12. P.L. 1996, ch. 190, § 1.
RI Gen L § 27-18.2-7 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.2 - Medicare Supplement Insurance Policies|Section 27-18.2-7 - Notice of free examination.

§ 27-18.2-7. Notice of free examination.Medicare supplement policies or certificates shall have a notice prominently printed on the first page of the policy or certificate or attached to it stating in substance that the applicant shall have the right to return the policy or certificate within thirty (30) days of its delivery and to have the premium refunded if, after examination of the policy or certificate, the applicant is not satisfied for any reason. Any refund made pursuant to this section shall be paid in a timely manner directly to the applicant by the insurer.History of Section.P.L. 1989, ch. 428, § 1.
RI Gen L § 27-18.2-8 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.2 - Medicare Supplement Insurance Policies|Section 27-18.2-8 - Filing requirements for advertising.

§ 27-18.2-8. Filing requirements for advertising.Every issuer of Medicare supplement insurance policies or certificates in this state shall provide a copy of any Medicare supplement advertisement intended for use in this state whether through written, radio, or television medium to the director for review or approval by the director to the extent it may be required under state law.History of Section.P.L. 1989, ch. 428, § 1; P.L. 1992, ch. 445, § 4.
RI Gen L § 27-18.2-9 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.2 - Medicare Supplement Insurance Policies|Section 27-18.2-9 - Administrative procedures.

§ 27-18.2-9. Administrative procedures.Regulations adopted pursuant to this chapter shall be subject to the provisions of chapter 35 of title 42.History of Section.P.L. 1989, ch. 428, § 1; P.L. 1992, ch. 445, § 4.
RI Gen L § 27-18.2-10 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.2 - Medicare Supplement Insurance Policies|Section 27-18.2-10 - Enforcement and penalties.

§ 27-18.2-10. Enforcement and penalties.Whenever the director has cause to believe that a violation of this chapter or the regulations promulgated pursuant to this chapter has occurred, the director may, in accordance with the requirements of the Administrative Procedures Act, chapter 35 of title 42, revoke or suspend a license, levy an administrative penalty in an amount not less than five hundred dollars ($500) nor more than fifty thousand dollars ($50,000), order the violator to cease marketing any Medicare supplement policy or certificate in the state, require the violator to take any actions necessary to comply with the provisions of law, or any combination of these.History of Section.P.L. 1989, ch. 428, § 1.
RI Gen L § 27-18.2-11 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.2 - Medicare Supplement Insurance Policies|Section 27-18.2-11 - Severability.

§ 27-18.2-11. Severability.If any provision of this chapter or the application of any provision to any person or circumstances is for any reason held to be 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. 1989, ch. 428, § 1.
RI Gen L § 27-18.3-1 - 27-18.3-13 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.3 - Low Cost Health Insurance for the Uninsured|Section 27-18.3-1 - 27-18.3-13 - Repealed.

§ 27-18.3-1 — 27-18.3-13. Repealed.
RI Gen L § 27-18.4-1 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.4 - Health Insurance - Coordination with Federal Medicaid Program|Section 27-18.4-1 - Definitions.

§ 27-18.4-1. Definitions.(a) "Insurer" means any health insurer (including a group health plan, as defined in § 607(1) of the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1167(1)), a health maintenance organization as defined in § 27-41-2, a qualified health maintenance organization as referred to in § 42-62-9, a non-profit hospital service corporation as defined in § 27-19-1, a non-profit medical service corporation as defined in § 27-20-1, a non-profit dental service corporation as defined in § 27-20.1-1, a non-profit optometric service corporation as defined in § 27-20.2-1, self insured plans, pharmacy benefit managers (PBM), and other parties that are by statute, contract, or agreement, legally responsible for payment of a claim for a health care item of service doing business in the state, a domestic insurance company subject to chapter 1 of this title, and a foreign insurance company subject to chapter 2 of this title.(b) "Medical assistance" and "Medicaid" mean medical assistance provided in whole or in part by the department of human services pursuant to chapter 5.1, 8, 8.4 of title 40 or 12.3 of title 42 and/or title XIX or XXI of the federal Social Security Act, as amended, 42 U.S.C. § 1396 et seq. and 42 U.S.C. § 1397aa et seq., respectively.History of Section.P.L. 1994, ch. 237, § 2; P.L. 2002, ch. 65, art. 35, § 2; P.L. 2007, ch. 73, art. 18, § 5.
RI Gen L § 27-18.4-2 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.4 - Health Insurance - Coordination with Federal Medicaid Program|Section 27-18.4-2 - Coordination of benefits with Medical Assistance - Acquired rights to payments.

§ 27-18.4-2. Coordination of benefits with Medical Assistance — Acquired rights to payments.(a) An insurer is prohibited from considering the availability or eligibility for medical assistance in this or any other state when considering eligibility for coverage or making payments under its plan for eligible enrollees, subscribers, policyholders or certificate holders.(b) To the extent that payment for covered expenses has been made under the state Medicaid program for health care items or services furnished to an individual in any case where a third party, including an insurer, has a legal liability to make payments, the department of human services is considered to have acquired the rights of the individual to payment by any other party, including an insurer, for those health care items or services. These rights are further defined and are enforceable in accordance with §§ 40-6-9 and 40-6-9.1.History of Section.P.L. 1994, ch. 237, § 2; P.L. 2002, ch. 65, art. 35, § 2.
RI Gen L § 27-18.4-3 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.4 - Health Insurance - Coordination with Federal Medicaid Program|Section 27-18.4-3 - Nondiscrimination in enrollment - Claims submission.

§ 27-18.4-3. Nondiscrimination in enrollment — Claims submission.(a) An insurer shall not deny enrollment of a child under any health plan of the child's parent on the grounds that:(1) The child was born out of wedlock;(2) The child is not claimed as a dependent on the parent's federal tax return; or(3) The child does not reside with the parent or in the insurer's service area.(b) Where a child has health coverage through an insurer of a noncustodial parent the insurer shall:(1) Provide any information to the custodial parent as may be necessary for the child to obtain benefits through that coverage;(2) Permit the custodial parent (or the provider, with the custodial parent's approval) to submit claims for covered services without the approval of the noncustodial parent; and(3) Make payments on claims submitted in accordance with subsection (b)(2) of this section directly to the custodial parent, the provider or the department of human services.(c) Where a parent is required by a court or administrative order to provide health coverage for a child, and the parent is eligible for family health coverage, the insurer is required:(1) To permit the parent to enroll, under the family coverage, a child who is eligible for the coverage without regard to any enrollment season restrictions;(2) If the parent is enrolled but fails to make application to obtain coverage for the child, to enroll the child under family coverage upon application of the child's other parent, or the department of human services which administers the Medicaid program and the child support enforcement program under 42 U.S.C. § 651 et seq.; and(3) Not to disenroll (or eliminate coverage of) the child unless the insurer is provided satisfactory written evidence that:(i) The court or administrative order is no longer in effect; or(ii) The child is or will be enrolled in comparable health coverage through another insurer that will take effect not later than the effective date of disenrollment.(d) An insurer may not impose requirements on the department of human services, which has been assigned the rights of an individual eligible for medical assistance pursuant to § 40-6-9 and covered for health benefits from the insurer, that are different from requirements applicable to an agent or assignee of any other covered individual.History of Section.P.L. 1994, ch. 237, § 2.
RI Gen L § 27-18.4-4 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.4 - Health Insurance - Coordination with Federal Medicaid Program|Section 27-18.4-4 - Employer obligations.

§ 27-18.4-4. Employer obligations.Where a parent is required by a court or administrative order to provide health coverage, which is available through an employer doing business in this state, the employer is required:(1) To permit the parent to enroll under family coverage any child who is eligible for coverage without regard to any enrollment season restrictions;(2) If the parent is enrolled but fails to make application to obtain coverage of the child, to enroll the child under family coverage upon application by the child's other parent, or by the department of human services acting as the state Medicaid and/or child support enforcement program;(3) Not to disenroll (or eliminate coverage of) this child unless the employer is provided satisfactory written evidence that:(i) The court order is no longer in effect;(ii) The child is or will be enrolled in comparable coverage which will take effect no later than the effective date of disenrollment; or(iii) The employer has eliminated family health coverage for all of its employees.(4) To withhold from the employee's compensation the employee's share (if any) of premiums for health coverage and to pay this amount to the insurer.History of Section.P.L. 1994, ch. 237, § 2.
RI Gen L § 27-18.4-5 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.4 - Health Insurance - Coordination with Federal Medicaid Program|Section 27-18.4-5 - Rules and regulations.

§ 27-18.4-5. Rules and regulations.The director of business regulation may promulgate any rules and regulations as he or she shall deem necessary for the efficient administration of this chapter.History of Section.P.L. 1994, ch. 237, § 2.
RI Gen L § 27-18.4-6 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.4 - Health Insurance - Coordination with Federal Medicaid Program|Section 27-18.4-6 - Severability.

§ 27-18.4-6. Severability.If any provision of the chapter, or the application of a provision to any person or circumstances, is 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.History of Section.P.L. 1994, ch. 237, § 2.
RI Gen L § 27-18.5-1 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.5 - Individual Health Insurance Coverage|Section 27-18.5-1 - Purpose.

§ 27-18.5-1. Purpose.The purpose of this chapter is, among other things, to insure compliance of all policies, contracts, certificates, and agreements of individual health insurance coverage offered or delivered in this state with the Health Insurance Portability and Accountability Act of 1996 (P.L. 104-191).History of Section.P.L. 2000, ch. 200, § 4; P.L. 2000, ch. 229, § 4; P.L. 2006, ch. 273, § 2; P.L. 2006, ch. 297, § 2.
RI Gen L § 27-18.5-5 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.5 - Individual Health Insurance Coverage|Section 27-18.5-5 - Enforcement - Limitation on actions.

§ 27-18.5-5. 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 laws.History of Section.P.L. 2000, ch. 200, § 4; P.L. 2000, ch. 229, § 4.
RI Gen L § 27-18.5-6 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.5 - Individual Health Insurance Coverage|Section 27-18.5-6 - Rules and regulations.

§ 27-18.5-6. 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 § 27-18.5-7 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.5 - Individual Health Insurance Coverage|Section 27-18.5-7 - Severability.

§ 27-18.5-7. 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 the invalidity.History of Section.P.L. 2000, ch. 200, § 4; P.L. 2000, ch. 229, § 4.
RI Gen L § 27-18.5-8 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.5 - Individual Health Insurance Coverage|Section 27-18.5-8 - Wellness health benefit plan.

§ 27-18.5-8. Wellness health benefit plan.All carriers that offer health insurance in the individual market shall actively market and offer the wellness health direct benefit plan to eligible individuals. The wellness health direct benefit plan shall be determined by regulation promulgated by the office of the health insurance commissioner (OHIC). The OHIC shall develop the criteria for the direct wellness health benefit plan, including, but not limited to, benefit levels, cost sharing levels, exclusions and limitations in accordance with the following:(1) Form and utilize an advisory committee in accordance with subsection 27-50-10(5).(2) Set a target for the average annualized individual premium rate for the direct wellness health benefit plan to be less than ten percent (10%) of the average annual statewide wage, dependent upon the availability of reinsurance funds, as reported by the Rhode Island department of labor and training, in their report entitled "Quarterly Census of Rhode Island Employment and Wages." In the event that this report is no longer available, or the OHIC determines that it is no longer appropriate for the determination of maximum annualized premium, an alternative method shall be adopted in regulation by the OHIC. The maximum annualized individual premium rate shall be determined no later than August 1st of each year, to be applied to the subsequent calendar year premiums rates.(3) Ensure that the direct wellness health benefit plan creates appropriate incentives for employers, providers, health plans and consumers to, among other things:(i) Focus on primary care, prevention and wellness;(ii) Actively manage the chronically ill population;(iii) Use the least cost, most appropriate setting; and(iv) Use evidence based, quality care.(4) The plan shall be made available in accordance with title 27, chapter 18.5 as required by regulation on or before May 1, 2007.History of Section.P.L. 2006, ch. 258, § 5; P.L. 2006, ch. 296, § 5; P.L. 2008, ch. 475, § 82.
RI Gen L § 27-18.5-9 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.5 - Individual Health Insurance Coverage|Section 27-18.5-9 - Affordable health plan reinsurance program for individuals.

§ 27-18.5-9. Affordable health plan reinsurance program for individuals.(a) The commissioner shall allocate funds from the affordable health plan reinsurance fund for the affordable health reinsurance program.(b) The affordable health reinsurance program for individuals shall only be available to high-risk individuals as defined in § 27-18.5-2, and who purchase the direct wellness health benefit plan pursuant to the provisions of this section. Eligibility shall be determined based on state and federal income tax filings.(c) The affordable health plan reinsurance shall be in the form of a carrier cost-sharing arrangement, which encourages carriers to offer a discounted premium rate to participating individuals, and whereby the reinsurance fund subsidizes the carriers' losses within a prescribed corridor of risk as determined by regulation.(d) The specific structure of the reinsurance arrangement shall be defined by regulations promulgated by the commissioner.(e) The commissioner shall determine total eligible enrollment under qualifying individual health insurance contracts by dividing the funds available for distribution from the reinsurance fund by the estimated per member annual cost of claims reimbursement from the reinsurance fund.(f) The commissioner shall suspend the enrollment of new individuals under qualifying individual health insurance contracts if the director determines that the total enrollment reported under such contracts is projected to exceed the total eligible enrollment, thereby resulting in anticipated annual expenditures from the reinsurance fund in excess of ninety-five percent (95%) of the total funds available for distribution from the fund.(g) The commissioner shall provide the health maintenance organization, health insurers and health plans with notification of any enrollment suspensions as soon as practicable after receipt of all enrollment data.(h) The premiums of qualifying individual health insurance contracts must be no more than ninety percent (90%) of the actuarially-determined and commissioner approved premium for this health plan without the reinsurance program assistance.(i) The commissioner shall prepare periodic public reports in order to facilitate evaluation and ensure orderly operation of the funds, including, but not limited to, an annual report of the affairs and operations of the fund, containing an accounting of the administrative expenses charged to the fund. Such reports shall be delivered to the co-chairs of the joint legislative committee on health care oversight by March 1st of each year.History of Section.P.L. 2006, ch. 273, § 4; P.L. 2006, ch. 297, § 4.
RI Gen L § 27-18.5-10 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.5 - Individual Health Insurance Coverage|Section 27-18.5-10 - Prohibition on preexisting condition exclusions.

§ 27-18.5-10. Prohibition on preexisting condition exclusions.(a) A health insurance policy, subscriber contract, or health plan offered, issued, issued for delivery, or issued to cover a resident of this state by a health insurance company licensed pursuant to this title and/or chapter:(1) Shall not limit or exclude coverage for an individual under the age of nineteen (19) by imposing a preexisting condition exclusion on that individual.(2) For plan or policy years beginning on or after January 1, 2014, shall not limit or exclude coverage for any individual by imposing a preexisting condition exclusion on that individual.(b) As used in this section:(1) "Preexisting condition exclusion" means a limitation or exclusion of benefits, including a denial of coverage, based on the fact that the condition (whether physical or mental) was present before the effective date of coverage, or if the coverage is denied, the date of denial, under a health benefit plan whether or not any medical advice, diagnosis, care or treatment was recommended or received before the effective date of coverage.(2) "Preexisting condition exclusion" means any limitation or exclusion of benefits, including a denial of coverage, applicable to an individual as a result of information relating to an individual's health status before the individual's effective date of coverage, or if the coverage is denied, the date of denial, under the health benefit plan, such as a condition (whether physical or mental) identified as a result of a pre-enrollment questionnaire or physical examination given to the individual, or review of medical records relating to the pre-enrollment period.(c) This section shall not apply to grandfathered health plans providing individual health insurance coverage.(d) This section shall not apply to insurance coverage providing benefits for: (1) Hospital confinement indemnity; (2) Disability income; (3) Accident only; (4) Long-term care; (5) Medicare supplement; (6) Limited benefit health; (7) Specified disease indemnity; (8) Sickness or bodily injury or death by accident or both; and (9) Other limited benefit policies.History of Section.P.L. 2012, ch. 256, § 4; P.L. 2012, ch. 262, § 4.
RI Gen L § 27-18.6-1 (2021)
2021 Rhode Island General Laws|Title 27 - Insurance|Chapter 27-18.6 - Large Group Health Insurance Coverage|Section 27-18.6-1 - Purpose.

§ 27-18.6-1. Purpose.The purpose of this chapter is to insure compliance of all policies, contracts, certificates, and agreements of group health insurance coverage offered or delivered in this state with the Health Insurance Portability and Accountability Act of 1996 (P.L. 104-191).History of Section.P.L. 2000, ch. 200, § 4; P.L. 2000, ch. 229, § 4; P.L. 2002, ch. 292, § 36.