§ 27-18-2.1. Uniform explanation of benefits and coverage.
(a) A health insurance carrier shall provide a summary of benefits and coverage explanation
and definitions to policyholders and others required by, and at the times and in the
format required by, the federal regulations adopted under section 2715 [42 U.S.C. § 300gg-15] of the Public Health Service Act, as amended by the federal Affordable Care Act.
The forms required by this section shall be made available to the commissioner on
request. Nothing in this section shall be construed to limit the authority of the
commissioner under existing state law.
(b)<
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§ 27-18-2.1. Uniform explanation of benefits and coverage.
(a) A health insurance carrier shall provide a summary of benefits and coverage explanation
and definitions to policyholders and others required by, and at the times and in the
format required by, the federal regulations adopted under section 2715 [42 U.S.C. § 300gg-15] of the Public Health Service Act, as amended by the federal Affordable Care Act.
The forms required by this section shall be made available to the commissioner on
request. Nothing in this section shall be construed to limit the authority of the
commissioner under existing state law.
(b) The provisions of this section shall apply to grandfathered health plans. 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.
(c) If the commissioner of the office of the health insurance commissioner determines
that the corresponding provision of the federal Patient Protection and Affordable
Care Act has been declared invalid by a final judgment of the federal judicial branch
or has been repealed by an act of Congress, on the date of the commissioner's determination
this section shall have its effectiveness suspended indefinitely, and the commissioner
shall take no action to enforce this section. Nothing in this section shall be construed
to limit the authority of the commissioner under existing state law.
Notes
Legislative Intent.
P.L. 2012, ch. 256, § 1, and P.L. 2012, ch. 262, § 1, provide: "Purpose and Intent. It is the purpose of this act to amend Rhode Island
statutes so as to be consistent with health insurance consumer protections enacted
in federal law. This act is intended to establish health insurance rules, standards,
and policies pursuant to, and in furtherance of, the health insurance standards established
in the federal Patient Protection and Affordable Care Act of 2010, as amended by the
federal Health Care and Education Reconciliation Act of 2010.�