reglab/statecodes huggingface dataset:
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29 - Unfair Competition and Practices › Section 27-29-6. - Cease and desist orders and modifications of those orders.

§ 27-29-6. Cease and desist orders and modifications of those orders.
(a)
If after a hearing the insurance commissioner shall determine that the method of competition or the act or practice in question is unfair and that the person complained of has engaged in a method of competition, act, or practice in violation of this chapter, the commissioner shall reduce his or her findings to writing and shall issue and cause to be served upon the person charged with the violation an order requiring the person to cease and desist from engaging in the method of competition, act, or practice. The commissioner may, at the commissioner’s discretion, order: (1) Payment of a monetary penalty of not more than five thousand dollars ($5,000) for each violation, but not to exceed an aggregate penalty of one hundred thousand dollars ($100,000), unless the violation was committed flagrantly in a conscious disregard of this chapter, in which case the penalty shall not be more than twenty-five thousand dollars ($25,000) for each violation not to exceed an aggregate penalty of two hundred fifty thousand dollars ($250,000); or (2) Suspension or revocation of the insurer’s license if the insurer knew or reasonably should have known that it was in violation of this chapter.
(b)
Until the expiration of the time allowed under § 27-29-7(a) for filing a petition for review, if no petition has been duly filed within that time, the insurance commissioner may at any time upon the notice and in the manner the commissioner shall deem proper, modify or set aside in whole or in part any order issued by the commissioner under this section.
(c)
After the expiration of the time allowed for filing a petition for review, if no petition has been duly filed within that time, the insurance commissioner may at any time, after notice and opportunity for hearing, reopen and alter, modify, or set aside, in whole or in part, any order issued by the commissioner under this section whenever in his or her opinion conditions of fact or of law have changed as to require that action or if the public interest shall require.
History of Section.
P.L. 1958, ch. 53, § 6; P.L. 1993, ch. 180, § 24.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29 - Unfair Competition and Practices › Section 27-29-9. - Penalty.

§ 27-29-9. Penalty.
(a)
Any person who violates a cease and desist order of the insurance commissioner under § 27-29-6 after it has become final, and while the order is in effect, shall, upon proof of the violation to the satisfaction of the court, forfeit and pay to the state a sum not to exceed twenty-five thousand dollars ($25,000), which may be recovered in a civil action, except that, if the violation is found to be willful, the amount of the penalty shall be a sum not to exceed two hundred fifty thousand dollars ($250,000).
(b)
Any person who violates a cease and desist order of the insurance commissioner under § 27-29-6 after it has become final, and while the order is in effect, may after notice and hearing and upon order of the commissioner, be subject at the discretion of the commissioner to suspension or revocation of the insurer’s license.
History of Section.
P.L. 1958, ch. 53, § 9; P.L. 1993, ch. 180, § 24.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29 - Unfair Competition and Practices › Section 27-29-10. - Provisions of chapter additional to existing law.

§ 27-29-10. Provisions of chapter additional to existing law.
The powers vested in the insurance commissioner by this chapter shall be additional to any other powers to enforce any penalties, fines, or forfeitures authorized by law with respect to the methods, acts, and practices declared to be unfair or deceptive.
History of Section.
P.L. 1958, ch. 53, § 10.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29 - Unfair Competition and Practices › Section 27-29-11. - Immunity from prosecution.

§ 27-29-11. Immunity from prosecution.
If any person shall ask to be excused from attending and testifying or from producing any books, papers, records, correspondence, or other documents at any hearing on the ground that the testimony or evidence required may tend to incriminate or subject the person to a penalty or forfeiture, and shall notwithstanding be directed to give the testimony or produce the evidence, the person shall nonetheless comply with the direction, but shall not after this be prosecuted or subjected to any penalty or forfeiture on account of any transaction, matter, or thing concerning on which the person may testify or produce evidence, and no testimony given or evidence produced shall be received against the person upon any criminal action, investigation, or proceeding. However, no person testifying shall be exempt from prosecution or punishment for any perjury committed while testifying and the testimony or evidence given or produced shall be admissible against the person upon any criminal action, investigation, or proceeding concerning that perjury, nor shall the person be exempt from the refusal, revocation, or suspension of any license, permission, or authority conferred, or to be conferred, pursuant to the insurance law of this state. Any person may execute, acknowledge, and file in the office of the commissioner a statement expressly waiving this immunity or privilege in respect to any transaction, matter, or thing specified in the statement and thereupon the testimony of the person or the evidence in relation to the transaction, matter, or thing may be received or produced before any judge or justice, court, tribunal, grand jury, or otherwise, and if received or produced the person shall not be entitled to any immunity or privilege on account of any testimony the person may give or evidence produced.
History of Section.
P.L. 1993, ch. 180, § 25; G.L. 1956, § 27-29-12; P.L. 2002, ch. 292, § 59.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29 - Unfair Competition and Practices › Section 27-29-12. - Regulations.

§ 27-29-12. Regulations.
The commissioner of insurance may adopt reasonable rules and regulations for the implementation and administration of this chapter.
History of Section.
P.L. 1993, ch. 180, § 25; G.L. 1956, § 27-29-13.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29 - Unfair Competition and Practices › Section 27-29-13. - Payment of premium — Cancellation.

§ 27-29-13. Payment of premium — Cancellation.
Notwithstanding the provisions of chapter 14.6 of title 19, private passenger motor vehicle insurance policyholders on either six-month (6) or twelve-month (12) policies shall have the option of paying any policy premiums in installment payments; provided that for a twelve-month (12) policy the insurer may require a payment of fifteen percent (15%) of the annual premium at time of issuance with the balance to be paid thereafter in nine (9) subsequent and equal monthly installments thereafter for a six-month (6) policy, the insurer may require a payment of thirty-five percent (35%) of the premium at time of issuance with the balance to be paid in three (3) subsequent and equal monthly installments thereafter. The insurer may levy a service charge of up to five dollars ($5.00) per installment period against those policyholders who choose the installment option. An insurer may levy and collect a maximum fee or charge of ten dollars ($10.00) for any late payment of premium by a policyholder. A late fee may not be imposed unless payment is received more than five (5) business days following the date payment is due. Policyholders shall be entitled to receive no less than thirty (30) days’ notice before a cancellation of an automobile insurance policy for any reason except nonpayment of premium, in which instance policyholders shall be entitled to receive no less than ten (10) days’ notice.
History of Section.
P.L. 1994, ch. 115, § 1; P.L. 1994, ch. 261, § 1; G.L. 1956, § 27-29-14; P.L. 2003, ch. 315, § 1; P.L. 2003, ch. 334, § 1; P.L. 2023, ch. 395, art. 1, § 7, effective December 31, 2023.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29 - Unfair Competition and Practices › Section 27-29-13.1. - Late payment of premium.

§ 27-29-13.1. Late payment of premium.
An insurer may levy and collect a maximum fee or charge of ten dollars ($10.00) for any late payment of premium by a policyholder for any property, casualty, fire and marine or liability policy of insurance. A late fee may not be imposed unless payment is received more than five (5) business days following the date payment is due.
History of Section.
P.L. 2005, ch. 69, § 1; P.L. 2005, ch. 79, § 1.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29 - Unfair Competition and Practices › Section 27-29-13.2. - Cancellation provisions for return of unearned premium.

§ 27-29-13.2. Cancellation provisions for return of unearned premium.
Every insurance policy issued and approved for use in Rhode Island shall provide clear language on the method of calculation of the unearned premium portion, if any, to be returned to the insured if the policy is canceled. Insurance policies shall not state “refer to manuals” to determine the amount of unearned premium to be returned. For all cancellations, the actual percentage retained by the insurer shall be discernible in the policy cancellation provisions. If a policy is canceled using a short-rate table, the insurer shall provide the short-rate table within the cancellation provisions of the insurance policy so that an insured can make an informed decision when cancelling a policy midterm. If a policy premium is fully earned or minimum earned on issuance of the policy, the quote and policy provisions shall clearly state that fact. Insurers shall not impose cancellation fees when insurance policies are canceled using short-rate tables.
History of Section.
P.L. 2005, ch. 69, § 1; P.L. 2005, ch. 79, § 1; P.L. 2009, ch. 303, § 6; P.L. 2009, ch. 304, § 6; P.L. 2016, ch. 376, § 5; P.L. 2016, ch. 392, § 5.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29 - Unfair Competition and Practices › Section 27-29-13.3. - Fraud warning.

§ 27-29-13.3. Fraud warning.
Notwithstanding any similar requirements in title 28, every claim form and application for insurance, regardless of the form of transmission, shall contain the following statement or a substantially similar statement; provided, that this section shall not apply to any claim form for health insurance that is on a form promulgated by the Centers for Medicare & Medicaid Services, or in electronic format pursuant to 45 C.F.R. Part 162. “Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison.”
History of Section.
P.L. 2009, ch. 303, § 7; P.L. 2009, ch. 304, § 7.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29 - Unfair Competition and Practices › Section 27-29-14. - Confidentiality of insurance information.

§ 27-29-14. Confidentiality of insurance information.
No insurance company, authorized or licensed to do business in the state of Rhode Island, that obtains insurance information through any residual market (mechanism), including, but not limited to, the assigned risk plans Joint Underwriting Association, including, but not limited to, the name of the insured, the policy expiration date, the amount of insurance coverage, the policy number, the name of the insurance company or the amount of the insurance premium, shall without the permission of the producer of record use that information for marketing or soliciting so as to eliminate the participation of the producer of record and shall be prohibited from selling or transferring that information to any third party for those purposes, without the consent of the producer of record; provided, that nothing contained in this section shall be deemed to prohibit an insurance company from offering voluntary market coverage as provided for in the rules of any automobile insurance residual market mechanism or to prohibit a workers’ compensation insurance company from sharing the name of the insured with a nonprofit medical service corporation or a nonprofit hospital service corporation.
History of Section.
P.L. 1996, ch. 405, § 1; G.L. 1956, § 27-29-15.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29 - Unfair Competition and Practices › Section 27-29-15. - Severability.

§ 27-29-15. Severability.
If any provision of this chapter, or the application of a provision to any person or circumstances shall be held invalid, the remainder of the chapter, and the application of the provision to persons or circumstances other than those as to which it is held invalid, shall not be affected by that invalidity.
History of Section.
P.L. 1958, ch. 53, § 11; G.L. 1956, § 27-29-11.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29 - Unfair Competition and Practices › Section 27-29-17. - Application.

§ 27-29-17. Application.
Sections 27-29-17 — 27-29-17.4 shall apply to commercial property insurance policies, commercial liability insurance policies, commercial package policies, commercial excess or umbrella policies, and commercial auto policies. These sections shall not apply to reinsurance, aviation insurance, workers’ compensation and employer’s liability insurance, multistate location risks, or policies subject to retrospective rating plans.
History of Section.
P.L. 2003, ch. 231, § 1; P.L. 2003, ch. 251, § 1; P.L. 2011, ch. 103, § 1; P.L. 2011, ch. 153, § 1.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29 - Unfair Competition and Practices › Section 27-29-17.1. - Definitions.

§ 27-29-17.1. Definitions.
For the purpose of §§ 27-29-17 — 27-29-17.4:
(1)
“Commissioner” means the commissioner of insurance.
(2)
“Expiration date” means the date upon which coverage under a policy ends. It also means, for a policy written for a term longer than one year or with no fixed expiration date, each annual anniversary date of such policy.
(3)
“Nonrenewal” means termination of a policy at its expiration date.
(4)
“Renewal” or “to renew” means the issuance of or the offer by an insurer to issue a policy succeeding a policy previously issued and delivered by the same insurer or an insurer within the same group of insurers, or the issuance of a certificate or notice extending the term of an existing policy for a specified period beyond its expiration date.
History of Section.
P.L. 2003, ch. 231, § 1; P.L. 2003, ch. 251, § 1; P.L. 2008, ch. 475, § 88.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29 - Unfair Competition and Practices › Section 27-29-17.2. - Notice of nonrenewal.

§ 27-29-17.2. Notice of nonrenewal.
(a)
An insurer may nonrenew a policy; provided, however, no nonrenewal of any policy of insurance to which this section applies shall be effective unless an insurer shall first give, mail, or deliver to the first-named insured at the address shown on the policy, and to the insurance producer of record, written notice that the insurer will not renew the policy. Such notice shall be given, mailed or delivered at least sixty (60) days before the expiration date. If the notice is given, mailed or delivered less than sixty (60) days before the expiration, coverage shall remain in effect until sixty (60) days after notice is given, mailed or delivered. Earned premium for any period of coverage that extends beyond the expiration date shall be considered pro-rata based upon the previous year’s rate. For purposes of this section, the transfer of a policyholder between companies within the same insurance group is not a refusal to renew. In addition, changes in deductibles, changes in premium, changes in the amount of insurance, or reductions in policy limits or coverage shall not be deemed to be refusals to renew.
(b)
Notice of nonrenewal shall not be required where:
(1)
The insurer or a company within the same insurance group has offered to issue a renewal policy; or
(2)
The named insured has obtained replacement coverage or has agreed in writing to obtain replacement coverage.
History of Section.
P.L. 2003, ch. 231, § 1; P.L. 2003, ch. 251, § 1.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29 - Unfair Competition and Practices › Section 27-29-17.3. - Notice of premium or coverage changes.

§ 27-29-17.3. Notice of premium or coverage changes.
(a)
An insurer shall provide to the first-named insured at the mailing address shown on the policy, and to the insurance producer of record, written notice of any premium increase in excess of ten percent (10%) and shall also provide the exact renewal premium, at least sixty (60) days prior to the expiration date of the policy unless the premium increase is the result of an audit or the increase is the result of an increase in exposure at the request of the insured. Not less than sixty (60) days’ written notice, as provided herein, shall be required for any coverage elimination, reduction, diminution, or increased deductible not at the request of the insured and in this case the notice shall itemize and describe the coverage changes and shall be separate from the renewal policy. If the insurer fails to provide such notice, the coverage provided to the named insured shall remain in effect until notice is provided or until the effective date of replacement coverage obtained by the named insured, whichever occurs first. For the purposes of this section, notice is considered given sixty (60) days following the date of giving of the notice. If the named insured elects not to renew, any earned premium for the period of extension of the terminated policy shall be calculated pro-rata at the lower of the current or previous year’s rate. If the insured accepts the renewal, the premium increase, if any, and other changes shall be effective the day following the prior policy’s expiration or anniversary date.
(b)
This section shall not apply to changes based upon the altered nature or extent of the risk insured.
(c)
For the purposes of this section, notice to the insurance producer of record shall not apply to an insurance producer of record who:
(1)
Is an employee of the insurer; or
(2)
Is a non-employee exclusive agent of the insurer; provided, however, notice, as required by this section, shall in all applicable cases, be provided to the named insured.
History of Section.
P.L. 2003, ch. 231, § 1; P.L. 2003, ch. 251, § 1; P.L. 2011, ch. 103, § 1; P.L. 2011, ch. 153, § 1.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29 - Unfair Competition and Practices › Section 27-29-17.4. - Proof of notice.

§ 27-29-17.4. Proof of notice.
(a)
A company issuing any policy of insurance subject to nonrenewal, a premium increase, a change in deductible, reduction in limits, or changes in coverage shall effect the same by serving the notice of it as provided by the policy. The notice shall be delivered in hand to the named insured, or be left at his or her last address as shown by the company’s records, or, if its records contain no last address, at his or her last business, residence, or other address known to the company. A company may alternatively forward notice to that address by first-class mail and maintain proof of mailing of the notice to the insured by the United States Postal Service certificate of mailing in the ordinary course of the insurer’s business, and this proof of mailing shall be sufficient proof of notice.
(b)
If a policy is made payable to a mortgagee or any person other than the named insured, notice shall be given as provided in subsection (a) of this section to the payee and to the named insured.
(c)
The insurance producer of record who insured the policy shall also be given notice of any nonrenewal or any premium increase, a change in deductible, or a change in coverage, in the same manner as provided in subsection (a) of this section.
History of Section.
P.L. 2003, ch. 231, § 1; P.L. 2003, ch. 251, § 1.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29 - Unfair Competition and Practices › Section 27-29-17.5. - Insured’s right to loss information.

§ 27-29-17.5. Insured’s right to loss information.
(a)
Upon request by the first-named insured or that insured’s authorized agent or broker, the insurer shall provide the following loss information, for the period of time coverage has been provided by the insurer or for five (5) years, whichever is less, within fourteen (14) days of such request:
(1)
Information on closed claims, including date and descriptions of occurrence, and payments; and
(2)
Information on open claims, including date and description of occurrence, and amounts of any payments and loss reserves.
(b)
Nothing in this section shall affect the confidentiality requirements pursuant to chapter 37.3 of title 5 and to insurance regulations 99 (privacy of consumer financial information) and 100 (privacy of consumer health information) as promulgated by the department of business regulation.
(c)
This section shall not apply to life, accident, health, personal automobile, homeowner’s, dwelling and boat, personal recreational vehicles, personal excess liability, personal umbrella, or reinsurance policies.
(d)
Notwithstanding any other provision of this section, loss reserve information for claims subject to a documented coverage dispute between the insurer and the insured need not be provided to the first named insured or such insured’s authorized agent or broker.
History of Section.
P.L. 2011, ch. 103, § 2; P.L. 2011, ch. 153, § 2; P.L. 2012, ch. 191, § 1; P.L. 2012, ch. 198, § 1.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29.1 - Pharmacy Freedom of Choice — Fair Competition and Practices › Section 27-29.1-1. - Definitions.

§ 27-29.1-1. Definitions.
For purposes of this chapter, the following terms shall mean:
(1)
“Director” shall mean the director of the department of business regulation.
(2)
“Eligible bidder” shall mean a retail pharmacy, community pharmacy, or pharmacy department registered pursuant to chapter 19.1 of title 5, irrespective of corporate structure or number of locations at which it conducts business, located within the geographical service area of a carrier and willing to bid for participation in a restricted pharmacy network contract.
(3)
“Insured” shall mean any person who is entitled to have pharmacy services paid by an insurer pursuant to a policy, certificate, contract, or agreement of insurance or coverage.
(4)
“Insurer” shall mean an insurance carrier as defined in chapters 18, 19, 20, and 41 of this title.
(5)
“Nonrestricted pharmacy network” shall mean a network that permits any pharmacy to participate on substantially uniform terms and conditions established by an insurer or pharmacy benefits manager.
(6)
“Pharmacy benefits manager” shall mean any person or entity who or that is not licensed in Rhode Island as an insurer and that develops or manages pharmacy benefits, pharmacy network contracts, or the pharmacy benefit bid process.
(7)
“Restricted pharmacy network” shall mean an arrangement for the provision of pharmaceutical drug services to insureds that under the terms of an insurer’s policy, certificate, contract, or agreement of insurance or coverage requires an insured or creates a financial incentive for an insured to obtain prescription drug services from one or more participating pharmacies that have entered into a specific contractual relationship with the carrier.
History of Section.
P.L. 2004, ch. 363, § 2; P.L. 2004, ch. 368, § 2; P.L. 2004, ch. 602, § 2; P.L. 2008, ch. 475, § 89; P.L. 2023, ch. 395, art. 1, § 8, effective December 31, 2023.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29.1 - Pharmacy Freedom of Choice — Fair Competition and Practices › Section 27-29.1-2. - Requirement for availability and accessibility of pharmacy services.

§ 27-29.1-2. Requirement for availability and accessibility of pharmacy services.
In accordance with § 23-17.13-3 [repealed], an insurer must demonstrate to the director of health the willingness and potential ability to ensure that pharmacy services will be provided in a manner to ensure both availability and accessibility of adequate personnel and facilities and in a manner enhancing availability, accessibility, and continuity of service.
History of Section.
P.L. 2004, ch. 363, § 2; P.L. 2004, ch. 368, § 2; P.L. 2004, ch. 602, § 2.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29.1 - Pharmacy Freedom of Choice — Fair Competition and Practices › Section 27-29.1-3. - Fair competition — Requirements for carriers offering pharmacy networks.

§ 27-29.1-3. Fair competition — Requirements for carriers offering pharmacy networks.
(a)
An insurer that offers insureds a restricted pharmacy network shall, in soliciting, arranging, competitively bidding, contracting for, and operating that network, comply with the following requirements for the purpose of promoting fair and competitive bidding, regardless of when the restricted pharmacy network was established:
(1)
Conduct and complete an open bidding process before March 1, 2005, and at least once every three (3) years thereafter;
(2)
Provide notice to eligible bidders of the insurer’s intent to solicit bids for participation in a restricted pharmacy network;
(3)
Inform eligible bidders of the date such bids will be solicited;
(4)
Provide eligible bidders with information on an identical, equal, and uniform basis, including, but not limited to, bid procedure information, financial and utilization information needed to make an informed competitive bid, criteria to be used in awarding a restricted pharmacy network contract, and proposed contractual requirements for the restricted pharmacy network;
(5)
Provide eligible bidders with at least thirty (30) days to prepare and submit bids between the bid solicitation date and the bid submission deadline;
(6)
Open all bids:
(i)
At a previously specified time, which shall not be more than thirty (30) days after the bid submission deadline; and
(ii)
In a public manner, provided, that certain information contained in the bids may be held as confidential from public review consistent with regulations promulgated by the director regarding the disclosure of proprietary data or information submitted by any bidders; and
(7)
Select a successful bidder using solely the criteria provided to eligible bidders pursuant to subsection (a)(4), applied in a uniform manner.
(b)
An insurer shall neither exclude nor favor any individual pharmacy, or group or class of pharmacies, in the design of a competitive bid involving restricted or nonrestricted pharmacy networks in compliance with the requirements of this section. An entity and its affiliates that assists an insurer in the development of the bid, design, bid specifications or the bid process, or assists in the review or evaluation of said bids, shall be prohibited from bidding on such a contract.
History of Section.
P.L. 2004, ch. 363, § 2; P.L. 2004, ch. 368, § 2; P.L. 2004, ch. 602, § 2.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29.1 - Pharmacy Freedom of Choice — Fair Competition and Practices › Section 27-29.1-4. - Mandate to offer a nonrestricted pharmacy network.

§ 27-29.1-4. Mandate to offer a nonrestricted pharmacy network.
Every healthcare insurer that delivers or issues for delivery or renews in this state a contract, plan, or policy that provides coverage for pharmaceuticals delivered on an outpatient basis through a restricted pharmacy network shall:
(1)
Also offer insurance purchasers an optional benefit plan that includes a nonrestricted pharmacy network; and
(2)
Subject to a determination by the U.S. Department of Health and Human Services’ Centers for Medicare & Medicaid Services on the consistency of this subsection with Medicare law and related regulations, offer only nonrestricted pharmacy networks in any Medicare Supplement or Medicare+Choice Plans.
History of Section.
P.L. 2004, ch. 363, § 2; P.L. 2004, ch. 368, § 2; P.L. 2004, ch. 602, § 2.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29.1 - Pharmacy Freedom of Choice — Fair Competition and Practices › Section 27-29.1-5. - Participation of independent community pharmacies.

§ 27-29.1-5. Participation of independent community pharmacies.
(a)
Any pharmacies licensed in the state of Rhode Island that are not owned or controlled, directly or indirectly, by an entity that owns pharmacies licensed in two (2) or more jurisdictions other than Rhode Island, which are not participating in an insurer’s restricted pharmacy network contract shall nevertheless have the right to provide prescription drug services to the insurer’s insureds and be paid by the insurer as if the pharmacy were participating in the insurer’s restricted pharmacy network, provided that the non-network independent pharmacies agree:
(1)
To accept as the insurer’s payments in full the price required of pharmacies in the insurer’s restricted pharmacy network;
(2)
To bill to the insured up to and not in excess of any copayment, coinsurance, deductible, other amount required of an insured by the insurer, or for other uncovered services;
(3)
To be reimbursed on the same methodological basis, including, but not limited to, capitation or other risk-sharing methodology, as required of pharmacies, in the insurer’s restricted pharmacy network;
(4)
To participate in the insurer’s utilization review and quality assurance programs, including utilization and drug management reports as required of pharmacies in the carrier’s restricted pharmacy network;
(5)
To provide computerized online eligibility determinations and claims submissions as required of pharmacies in the insurer’s restricted pharmacy network;
(6)
To participate in the insurer’s satisfaction surveys and complaint resolution programs for its insureds;
(7)
To protect the insurer’s proprietary information and an insured’s confidentiality and privacy;
(8)
To abide by the insurer’s performance standards with respect to waiting times, fill rates, and inventory management, including formulary restrictions;
(9)
To comply with the insurer’s claims audit provisions; and
(10)
To certify, using audit results or accountant statements, the fiscal soundness of the non-network pharmacy.
(b)
An insurer may waive any of the aforementioned agreements in arranging for the provision of pharmaceutical drug benefits to insureds through a non-network pharmacy. An insurer shall not impose any agreements, terms, or conditions on any non-network independent community pharmacy, or on any association of pharmacies, that are more restrictive than those required of pharmacies in the insurer’s restricted pharmacy network. The failure of a non-network pharmacy to abide by the aforementioned agreements may, at the option of the insurer, serve as the basis for cancellation of the non-network pharmacy’s participation.
History of Section.
P.L. 2004, ch. 363, § 2; P.L. 2004, ch. 368, § 2; P.L. 2004, ch. 602, § 2; P.L. 2008, ch. 475, § 89.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29.1 - Pharmacy Freedom of Choice — Fair Competition and Practices › Section 27-29.1-6. - Applicability and allowances.

§ 27-29.1-6. Applicability and allowances.
(a)
Nothing in this chapter shall preclude an insurer from entering into an agreement to allow non-network providers, other than independent community pharmacies, the ability to participate with the insurer’s plans under terms and conditions set forth by the insurer.
(b)
The provisions of this chapter shall not apply to arrangements for the provision of pharmaceutical drug benefits to insureds between an insurer or a pharmacy benefits manager, and a mail order pharmacy, or a hospital-based pharmacy that is not a retail pharmacy.
(c)
Nothing in this chapter shall be construed to require the provision of pharmacy benefits to insureds through a restricted pharmacy network nor any other arrangement for the provision of prescription drug benefits.
History of Section.
P.L. 2004, ch. 363, § 2; P.L. 2004, ch. 368, § 2; P.L. 2004, ch. 602, § 2; P.L. 2023, ch. 395, art. 1, § 8, effective December 31, 2023.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29.1 - Pharmacy Freedom of Choice — Fair Competition and Practices › Section 27-29.1-7. - Regulation of pharmacy benefits managers.

§ 27-29.1-7. Regulation of pharmacy benefits managers.
Pharmacy benefits managers shall be included within the definition of third-party administrator under chapter 20.7 of this title and shall be regulated as such. The annual report filed by third-party administrators with the department of business regulation shall include: contractual language that provides a complete description of the financial arrangements between the third-party administrator and each of the insurers covering benefit contracts delivered in Rhode Island; and if the third-party administrator is owned by or affiliated with another entity or entities, it shall include an organization chart and brief description that shows the relationships among all affiliates within a holding company or otherwise affiliated. The reporting shall be in a format required by the director and filed with the department as a public record as defined and regulated under chapter 2 of title 38.
History of Section.
P.L. 2004, ch. 363, § 2; P.L. 2004, ch. 368, § 2; P.L. 2004, ch. 602, § 2.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29.1 - Pharmacy Freedom of Choice — Fair Competition and Practices › Section 27-29.1-8. - Enforcement.

§ 27-29.1-8. Enforcement.
The department of business regulation shall have authority to enforce the provisions of §§ 27-29.1-3 — 27-29.1-7, subject to the provisions of chapter 35 of title 42.
History of Section.
P.L. 2004, ch. 363, § 2; P.L. 2004, ch. 368, § 2; P.L. 2004, ch. 602, § 2.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29.1 - Pharmacy Freedom of Choice — Fair Competition and Practices › Section 27-29.1-9. - Severability.

§ 27-29.1-9. Severability.
If any provision of §§ 27-29.1-1 — 27-29.1-8, or the application of those sections to any person or circumstances is held invalid, the invalidity shall not affect other provisions or applications of §§ 27-29.1-1 — 27-29.1-8 which can be given effect without the invalid provision or application; to this end the provisions of §§ 27-29.1-1 — 27-29.1-8 are declared to be severable.
History of Section.
P.L. 2004, ch. 363, § 2; P.L. 2004, ch. 368, § 2; P.L. 2004, ch. 602, § 2.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29.1 - Pharmacy Freedom of Choice — Fair Competition and Practices › Section 27-29.1-10. - Costs of enforcement.

§ 27-29.1-10. Costs of enforcement.
The total cost of the enforcement of §§ 27-29.1-3 and 27-29.1-8 shall be borne by the pharmacy benefits manager(s) and/or the insurer(s) against whom the complaint is made on an equal basis and shall include the following expenses:
(1)
One hundred fifty percent (150%) of the total salaries and benefits paid to the personnel of the department of business regulation engaged in the enforcement less any salary reimbursement;
(2)
All reasonable technology costs related to the enforcement process. Technology costs shall include the actual cost of software and hardware utilized in the enforcement process and the cost of training personnel in the proper use of the software or hardware;
(3)
All necessary and reasonable education and training costs incurred by the state to maintain the proficiency and competence of the enforcing personnel. All these costs shall be incurred in accordance with the appropriate state of Rhode Island regulations, guidelines, and procedures.
History of Section.
P.L. 2004, ch. 363, § 2; P.L. 2004, ch. 368, § 2; P.L. 2004, ch. 602, § 2.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29.1 - Pharmacy Freedom of Choice — Fair Competition and Practices › Section 27-29.1-11. - Evaluation report.

§ 27-29.1-11. Evaluation report.
The health insurance commissioner, pursuant to § 42-14.5-1, shall evaluate the impact of nonrestricted pharmacy networks on health insurance costs in Rhode Island and shall submit a report of findings to the joint legislative committee on health care oversight on or before May 1, 2005.
History of Section.
P.L. 2004, ch. 363, § 2; P.L. 2004, ch. 368, § 2; P.L. 2004, ch. 602, § 2.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29.2 - Freedom of Choice for Orthotic or Prosthetic Services › Section 27-29.2-1. - Legislative findings — Freedom of choice.

§ 27-29.2-1. Legislative findings — Freedom of choice.
The general assembly hereby finds that all patients who are in need of an orthosis or prosthesis in the state of Rhode Island shall have the freedom of choice to select any orthotist or prosthetist licensed by the state to practice orthotics or prosthetics.
History of Section.
P.L. 2006, ch. 200, § 1; P.L. 2006, ch. 205, § 1.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29.2 - Freedom of Choice for Orthotic or Prosthetic Services › Section 27-29.2-3. - Exclusion.

§ 27-29.2-3. Exclusion.
This chapter shall not apply to the policies and procedures of the Veterans’ Affairs Medical Center of Rhode Island or Veterans’ Affairs Medical Center Prosthetics and Orthotics Clinics.
History of Section.
P.L. 2006, ch. 200, § 1; P.L. 2006, ch. 205, § 1.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-29.2 - Freedom of Choice for Orthotic or Prosthetic Services › Section 27-29.2-4. - Application.

§ 27-29.2-4. Application.
This chapter shall apply to every individual or group health insurance contract, plan, or policy delivered, issued for delivery, or renewed in this state on or after July 1, 2007, that provides medical coverage that includes coverage for physician services in a physician’s office and every policy that provides major medical or similar comprehensive-type coverage; provided, however, this chapter 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. 2006, ch. 200, § 1; P.L. 2006, ch. 205, § 1.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-30 - Consumer Credit Insurance › Section 27-30-1. - Purpose.

§ 27-30-1. Purpose.
The purpose of this chapter is to promote the public welfare by regulating consumer credit insurance. Nothing in this chapter is intended to prohibit or discourage reasonable competition. The provisions of this chapter shall be liberally construed.
History of Section.
P.L. 1959, ch. 91, § 1; P.L. 2009, ch. 292, § 2; P.L. 2009, ch. 293, § 2.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-30 - Consumer Credit Insurance › Section 27-30-3. - Types of consumer credit insurance.

§ 27-30-3. Types of consumer credit insurance.
The types of consumer credit insurance defined in § 27-30-2 may each be written separately or in combination with other types of consumer credit insurance on an individual policy or group policy basis. The commissioner may by regulation prohibit or limit any combination.
History of Section.
P.L. 1959, ch. 91, § 3; P.L. 1972, ch. 148, § 2; P.L. 2009, ch. 292, § 2; P.L. 2009, ch. 293, § 2.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-30 - Consumer Credit Insurance › Section 27-30-8. - Premiums and refunds.

§ 27-30-8. Premiums and refunds.
(a)
An insurer may revise its schedules of premium rates from time to time, and shall file the revised schedules with the commissioner. No insurer shall issue any consumer credit insurance policy for which the premium rate exceeds that determined by the schedules of the insurer as then on file with the commissioner. The commissioner shall have the authority to promulgate regulations to assure that the premium rates are reasonable in relation to the benefits provided, including the authority to regulate the compensation component of the premium rates. In determining whether the premium rates are reasonable in relation to the benefits provided, the commissioner shall consider and provide for: actual and expected loss experience, general and administrative expenses, loss settlement and adjustment expenses, reasonable creditor compensation, investment income, the manner in which premiums are charged, and other acquisition costs, reserves, taxes, regulatory license fees and fund assessments, reasonable insurer profit and other relevant data, consistent with generally accepted actuarial standards.
(b)
Each individual policy or group certificate shall provide for a refund in the event of termination of the insurance prior to the scheduled maturity date of the insurance and upon notice to the insurer from the debtor with the debtor’s contact information. The refund of an amount paid by the debtor for insurance shall be paid or credited promptly to the person entitled thereto; provided, however, that the commissioner shall prescribe a minimum refund and no refund that would be less than such minimum need be made. Refund formulas that any insurer desires to use must develop refunds that are at least as favorable to the debtor as refunds equal to the premium cost of scheduled benefits subsequent to the date of cancellation or termination, computed at the schedule of premium rates in effect on the date of issue. The formula to be used in computing such refund shall be filed with and approved by the commissioner.
(c)
If a creditor requires a debtor to make any payment for consumer credit insurance and an individual policy or group certificate of insurance is not issued, the creditor shall immediately give written notice to the debtor and shall promptly make an appropriate credit to the account or issue a refund.
(d)
The amount charged to a debtor for any consumer credit insurance shall not exceed the premiums charged by the insurer, as computed at the time the charge to the debtor is determined.
History of Section.
P.L. 1959, ch. 91, § 8; P.L. 2009, ch. 292, § 3; P.L. 2009, ch. 293, § 3.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-30 - Consumer Credit Insurance › Section 27-30-9. - Issuance of policies.

§ 27-30-9. Issuance of policies.
All policies of consumer credit insurance shall be delivered or issued for delivery in this state only by an insurer authorized to engage in the business of insurance thereto, and shall be issued only through holders of licenses or authorizations issued by the commissioner.
History of Section.
P.L. 1959, ch. 91, § 9; P.L. 2009, ch. 292, § 3; P.L. 2009, ch. 293, § 3.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-30 - Consumer Credit Insurance › Section 27-30-10. - Claims.

§ 27-30-10. Claims.
(a)
All claims shall be promptly reported to the insurer or its designated claim representative, and the insurer shall maintain adequate claim files. All claims shall be settled as soon as possible and in accordance with the terms of the insurance contract.
(b)
All claims shall be paid either by draft drawn upon the insurer, by electronic funds transfer, or by check of the insurer to the order of the claimant to whom payment of the claim is due pursuant to the policy provisions, or upon direction of the claimant to one specified.
(c)
No plan or arrangement shall be used by which any person, firm, or corporation other than the insurer or its designated claim representative shall be authorized to settle or adjust claims. The creditor shall not be designated as claim representative for the insurer in adjusting claims; provided, that a group policyholder may, by arrangement with the group insurer, draw drafts, checks, or electronic transfers in payment of claims due to the group policyholder subject to audit and review by the insurer.
(d)
All claims for consumer credit insurance shall be subject to all applicable chapters of this title and title 42, including chapter 9.1 of this title.
History of Section.
P.L. 1959, ch. 91, § 10; P.L. 2009, ch. 292, § 3; P.L. 2009, ch. 293, § 3.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-30 - Consumer Credit Insurance › Section 27-30-11. - Existing insurance — Choice of insurer.

§ 27-30-11. Existing insurance — Choice of insurer.
When consumer credit insurance is required as additional security for any indebtedness, the debtor shall, upon request to the creditor, have the option of furnishing the required amount of insurance through existing policies of insurance owned or controlled by the debtor or procuring and furnishing the required coverage through any insurer authorized to transact an insurance business within this state.
History of Section.
P.L. 1959, ch. 91, § 11; P.L. 2009, ch. 292, § 3; P.L. 2009, ch. 293, § 3; P.L. 2010, ch. 239, § 3.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-30 - Consumer Credit Insurance › Section 27-30-12. - Enforcement.

§ 27-30-12. Enforcement.
The commissioner may, after notice and hearing, issue rules and regulations as the commissioner deems appropriate for the supervision of this chapter. Whenever the commissioner finds that there has been a violation of this chapter or any rules or regulations issued pursuant to it, after written notice of the violation and hearing given to the insurer or other person authorized or licensed by the commissioner, he or she shall set forth the details of the findings together with an order for compliance by a specified date. The order shall be binding on the insurer and other persons authorized or licensed by the commissioner on the specified date unless sooner withdrawn by the commissioner or a stay from the order has been ordered by a court of competent jurisdiction. The commissioner may set forth by regulation prima facie reasonable premium rates, together with corresponding safe-harbor benefit provisions, which premium rates shall be conclusively presumed reasonable in relation to the benefits provided when used for policies containing such benefit provisions.
History of Section.
P.L. 1959, ch. 91, § 12; P.L. 2009, ch. 292, § 4; P.L. 2009, ch. 293, § 4.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-30 - Consumer Credit Insurance › Section 27-30-13. - Judicial review.

§ 27-30-13. Judicial review.
Any party to the proceeding affected by any order of the commissioner shall be entitled to judicial review pursuant to chapter 35 of title 42.
History of Section.
P.L. 1959, ch. 91, § 13; P.L. 2009, ch. 292, § 4; P.L. 2009, ch. 293, § 4.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-30 - Consumer Credit Insurance › Section 27-30-14. - Penalties.

§ 27-30-14. Penalties.
The commissioner, in his or her discretion, may revoke or suspend the license or certificate of authority or proscribe whatever additional penalty is warranted pursuant to § 42-14-16 for any violation of this chapter. The order for penalties shall provide for notice and hearing, and shall be subject to judicial review as provided in § 42-35-15.
History of Section.
P.L. 1959, ch. 91, § 14; P.L. 2009, ch. 292, § 4; P.L. 2009, ch. 293, § 4.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-30 - Consumer Credit Insurance › Section 27-30-15. - Severability.

§ 27-30-15. Severability.
If any provision of this chapter, or the application of the provision to any person or circumstances, shall be held invalid, the remainder of the chapter, and the application of the provision to any person or circumstances other than those as to which it is held invalid, shall not be affected by that invalidity.
History of Section.
P.L. 1959, ch. 91, § 15.
2023 Rhode Island General Laws › Title 27 - Insurance › Chapter 27-30 - Consumer Credit Insurance › Section 27-30-16. - Duties of an insurer.

§ 27-30-16. Duties of an insurer.
Except as otherwise prohibited by law, duties imposed upon an insurer within this chapter may be carried out by a creditor if the creditor is acting as a common law or statutory agent on behalf of the insurer.
History of Section.
P.L. 1959, ch. 91, § 16; P.L. 2009, ch. 292, § 4; P.L. 2009, ch. 293, § 4.