2014 -- S 2704

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2014

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A N   A C T

RELATING TO STATE AFFAIRS AND GOVERNMENT - CATASTROPHIC HEALTH

INSURANCE PLAN ACT

     

     Introduced By: Senators Nesselbush, Archambault, Miller, and Satchell

     Date Introduced: March 05, 2014

     Referred To: Senate Health & Human Services

     (Attorney General)

It is enacted by the General Assembly as follows:

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     SECTION 1. Section 42-62-13 of the General Laws in Chapter 42-62 entitled

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"Catastrophic Health Insurance Plan Act" is hereby amended to read as follows:

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     42-62-13. Rates charged. -- (a) The rates proposed to be charged or a rating formula

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proposed to be used by any insurer or health maintenance organization under this section subject

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to title 27 of the general laws to employers, the state or any political subdivision of the state, or

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individuals, shall be filed by the insurer or health maintenance organization at the office of the

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director of business regulation health insurance commissioner. The applicant shall provide a copy

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of the filing on all rates and/or rating formulas proposed for health insurance coverage offered in

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the individual market as defined in § 27-18.5-2 to the insurance advocacy unit of the attorney

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general's office simultaneously with the filing at the office of the health insurance commissioner.

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This section does not apply to any entity subject to section 27-19-1 et seq., and/or section 27-20-1

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et seq. The rates proposed to be charged by those entities shall be governed by the provisions of

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section 27-19-1 et seq., and/or section 27-20-1 et seq. Within sixty (60) days after receipt of the

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application, the director commissioner, or the director's commissioner's designee, shall hold a

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public hearing pursuant to § 42-35-1 et seq. for all rate filings for individuals as defined in § 27-

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18.5-2 and may hold a hearing pursuant to § 42-35-1 et seq. upon not less than ten (10) days'

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written notice prior to the hearings for other rate filings. The notice shall be published by the

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commissioner in a newspaper or newspapers having aggregate general circulation throughout the

 

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state at least ten (10) days prior to the hearing and shall contain a description of the rates

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proposed to be charged, and a copy of the notice shall be sent to the applicant and to the

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consumer protection insurance advocacy unit of the department of attorney general. In addition,

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the applicant shall provide by mail, at least ten (10) days prior to the hearing, notice of the

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proposed rate increase for health insurance coverage offered in the individual market as defined

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in § 27-18.5-2 to all subscribers subject to the proposed rate increase. At any hearing held under

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this section, the applicant shall be required to establish that the rates proposed to be charged or

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the rating formula proposed to be used are consistent with the proper conduct of its business and

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with the interest of the public. Any documents presented in support of a filing of proposed rates

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under this section shall be made available for public examination at any time and place that the

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director commissioner may deem reasonable. The director commissioner, or the director's

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commissioner's designee, upon that hearing may administer oaths, examine and cross-examine

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witnesses, receive oral and documentary evidence, and shall have the power to subpoena

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witnesses, compel their attendance and require the production of all books, papers, records,

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correspondence, or other documents which he or she deems relevant. Any designee who shall

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conduct a hearing pursuant to this section shall report his or her findings in writing to the director

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commissioner within eighty (80) days of the filing with a recommendation for approval,

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disapproval, or modification of the rates proposed to be charged by the applicant. The

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recommended decision shall become part of the record. The director commissioner shall make

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and issue a decision not later than ten (10) days following the issuance of the recommended

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decision or, if the director commissioner hears the application without the appointment of a

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designee, as soon as is reasonably possible following the completion of the hearing on the

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proposed rate change. The decision may approve, disapprove, or modify the rates proposed to be

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charged by the applicant. Insurers requesting changes in rates shall underwrite the reasonable

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expenses of the department of business regulation office of the health insurance commissioner in

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connection with the hearing, including any costs related to advertisements, stenographic

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reporting, and expert witnesses fees. Notwithstanding any other provisions of law, the filing of

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proposed rates or a rating formula and the holding and conduct of any hearings in connection with

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these proposed rates or rating formula shall be pursuant to this section.

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      (b) Whenever the term "designee" is used in this section, it shall mean a person who is

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impartial, a member in good standing of the Rhode Island bar and a person who is sufficiently

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acquainted with the rules of evidence as used in the superior court of the state so as to enable that

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person to conduct a hearing as designee of the director commissioner. The reasonable per diem

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cost of the designee as appointed by the director commissioner shall be paid by the insurers

 

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requesting changes in the rates.

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     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO STATE AFFAIRS AND GOVERNMENT - CATASTROPHIC HEALTH

INSURANCE PLAN ACT

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     This act would require a public hearing for all insurers or health maintenance

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organizations who propose rates for health insurance coverage in the individual market.

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     This act would take effect upon passage.

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