§ 27-19-5. Contracts with subscribers, hospitals, and other eligible entities.
(a) Each nonprofit hospital service corporation may contract with its subscribers and
with any eligible hospital for hospital service to be rendered by the contracting
hospital to the subscribers and as to the nature and extent of those services. Each
corporation may also contract with any of the following: (1) Any hospital or medical
service corporation incorporated in this or another state for the joint administration
of their business and may enter into reciprocal arrangements with those corporations
for the mutual benefit of the subscribers of each; (2) Corporations paying or organized
for payment of medical, dental, optometric, or legal benefits, for the administration
of their business including, without limiting the generality of the foregoing, corporations
organized under chapters 20, 20.1, 20.2, and 20.3 of this title; (3) The federal government,
the state, county, city, town, or other quasi-municipal corporations or their agencies;
and (4) Employers, associations, and other third parties for the administration and
underwriting of stop-loss or catastrophe insurance, for fully and partially self-insured
health benefit plans sponsored by such employers, associations, and third parties.
(b) Services for which coverage or benefits may be provided to subscribers by any of the
corporations referred to in subsection (a)(2) of this section may also be provided
for or underwritten by each nonprofit hospital service corporation.
(c) No contract between a nonprofit hospital service corporation and a dentist for the
provisions of services to patients may require that the dentist indemnify or hold
harmless the nonprofit hospital service corporation for any expenses and liabilities,
including without limitation, judgments, settlements, attorneys' fees, court costs,
and any associated charges, incurred in connection with any claim or action brought
against the nonprofit hospital service corporation based on the nonprofit hospital
service corporation's management decision, or utilization review provisions for any
patient.
(d) The rates proposed to be charged by any corporation organized under this chapter for
stop-loss or catastrophe insurance shall be filed by the corporation at the office
of the health insurance commissioner. The health insurance commissioner shall review
such rates to determine if they are actuarially sound and may hold a public hearing
on such rates upon not less than ten (10) days' written notice prior to the hearing.
The health insurance commissioner, upon the hearing, may administer oaths, examine
and cross-examine witnesses, receive oral and documentary evidence, and shall have
the power to subpoena witnesses, compel their attendance, and require the production
of books, papers, records, correspondence, or other documents that he or she deems
relevant. The director shall issue a decision as soon as is reasonably possible following
the completion of the hearing. The decision may approve, disapprove, or modify the
rates proposed to be charged by the applicant.