Chapter
04-585
2004 -- H 7806 SUBSTITUTE A AS AMENDED
Enacted 07/31/04
A N A C T
RELATING TO STATE AFFAIRS AND
GOVERNMENT
Introduced By:
Representatives E Coderre, Lowe, Moura, and Kilmartin
Date
Introduced: February 12, 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 exceeds 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 of 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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LC01862/SUB A
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