Chapter 540
2004 -- S 2283
SUBSTITUTE A AS AMENDED
Enacted 07/09/04
A N A C T
RELATING
TO STATE AFFAIRS AND GOVERNMENT -- CATASTROPHIC HEALTH INSURANCE PLAN ACT
Introduced
By: Senators Tassoni, Polisena, Roberts, and Perry
Date Introduced:
February 05, 2004
It
is enacted by the General Assembly as follows:
SECTION
1. Section 42-62-13 of the General Laws in Chapter 42-62 entitled
"Catastrophic
Health Insurance Plan Act" is hereby amended to read as follows:
42-62-13.
Rates charged. -- (a) The rates proposed to be charged or a rating
formula
proposed
to be used by any insurer or health maintenance organization under this
section to
employers,
the state or any political subdivision of the state, or individuals, shall be
filed by the
insurer
or health maintenance organization at the office of the director of
business regulation. A
copy
of the filing shall be provided simultaneously to the Insurance Advocacy Unit
in the
department
of the attorney general. Within sixty (60) days after receipt of the application,
the
director,
or the director's designee, shall hold a hearing upon not less than ten (10)
days' written
notice
whenever a proposed rate exceeds the consumer price index (CPI) for medical
care for the
prior
calendar year in which the proposed rate increase is filed. If the proposed
rate increase is
less
than the increase in the consumer price index (CPI) for medical care for the
prior calendar
year
in which the proposed rate is filed, the director may hold a hearing upon
not less than ten
(10)
days' written notice prior to the hearings. These provisions shall not apply
to products
offered
in the small group or large group market. The notice shall contain a description
of the
rates
proposed to be charged and a copy of the notice shall be sent to the applicant
and to the
consumer
protection unit of the department of attorney general. The notice shall also
be published
by
the department in a newspaper or newspapers having aggregate general
circulation throughout
the
state at least ten (10) days prior to the hearing. In addition, whenever the
proposed rate
increase
exceed the consumer price index (CPI) for medical care for the prior calendar
year in
which
the rate increase is filed, the department shall require the applicant to
notify by mail, at
least
ten (10) days prior to the hearing, notice the proposed rate increase to all
subscribers subject
to
the proposed rate increase. At any hearing held under this section, the applicant shall
be
required
to establish that the rates proposed to be charged or the rating formula
proposed to be
used
are consistent with the proper conduct of its business and with the interest of
the public. Any
documents
presented in support of a filing of proposed rates under this section shall be
made
available
for public examination at any time and place that the director may deem
reasonable. The
director,
or the director's designee, upon that 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 all books, papers,
records,
correspondence,
or other documents which he or she deems relevant. Any designee who shall
conduct
a hearing pursuant to this section shall report his or her findings in writing
to the director
within
eighty (80) days of the filing with a recommendation for approval, disapproval,
or
modification
of the rates proposed to be charged by the applicant. The recommended decision
shall
become part of the record. The director shall make and issue a decision not
later than ten
(10)
days following the issuance of the recommended decision or, if the director
hears the
application
without the appointment of a designee, as soon as is reasonably possible
following the
completion
of the hearing on the proposed rate change. The decision may approve,
disapprove, or
modify
the rates proposed to be charged by the applicant. Insurers requesting changes
in rates
shall
underwrite the reasonable expenses of the department of business regulation in
connection
with
the hearing, including any costs related to advertisements, stenographic
reporting, and expert
witnesses
fees. Notwithstanding any other provisions of law, the filing of proposed rates
or a
rating
formula and the holding and conduct of any hearings in connection with these
proposed
rates
or rating formula shall be pursuant to this section.
(b) Whenever the term "designee" is used in this section, it shall
mean a person who is
impartial,
a member in good standing of the Rhode Island bar and a person who is
sufficiently
acquainted
with the rules of evidence as used in the superior court of the state so as to
enable that
person
to conduct a hearing as designee of the director. The reasonable per diem cost
of the
designee
as appointed by the director shall be paid by the insurers requesting changes
in the rates.
SECTION
2. This act shall take effect upon passage.
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LC01712/SUB
A
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