Chapter
182
2006 -- S 2943 SUBSTITUTE A
Enacted 06/29/06
A N A C T
RELATING
TO INSURANCE - NONPROFIT HOSPITAL SERVICE CORPORATIONS
Introduced
By: Senator Daniel P. Connors
Date
Introduced: March 15, 2006
It is enacted by the General Assembly as
follows:
SECTION 1. Sections 27-19-2.1 and 27-19-5 of the
General Laws in Chapter 27-19
entitled "Nonprofit Hospital Service
Corporations" are is hereby amended to
read as follows:
27-19-2.1.
Investments and holdings in certain corporations authorized. -- (a)
Each
nonprofit hospital service corporation shall
have, in addition to all other powers granted under
this chapter and the laws of this state, the
power to invest in or cause to be organized and
established one or more corporations, all or any
portion of the issued and outstanding capital
stock of which shall be subscribed for or held
by the nonprofit hospital service corporation.
(b) As used in
this section, "corporation" means any organization incorporated under
the
provisions of the law of this or another state
for one or more of the following purposes:
(1) To establish,
maintain, and operate hospital service and health insurance plans;
(2) To develop,
establish, purchase, maintain, perform, sell, and lease in connection with
carrying out its corporate purpose: (i) data
processing and computer software programs, systems,
and techniques; (ii) data processing,
bookkeeping, statistical, or software services; or (iii) other
administrative and related services; or
(3) To exercise
the powers set forth in section 27-19-5 or to carry out and fulfill any of
the purposes of a hospital service corporation
incorporated under this chapter.
(c) Any
limitation on investments or holdings contained in section 27-19-11 or section
27-19-5.3 or any other law shall not apply with respect
to investments or holdings under this
section; provided, that the value of any
investment shall not exceed twenty percent (20%) of the
assets of the hospital service corporation.
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 which
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.
SECTION 2. Chapter
27-19 of the General Laws entitled "Nonprofit Hospital Service
Corporations" is hereby amended by adding
thereto the following section:
27-19-5.3.
Additional powers. -- Notwithstanding any other law or section of
this
chapter which may be inconsistent with this
section, each nonprofit hospital service corporation
may, through a subsidiary, develop, underwrite and/or
offer for sale life insurance, disability
insurance, long-term care insurance, employee
assistance programs and/or other health related
programs; provided, however, prior to
underwriting risk under policies of insurance listed above,
the nonprofit hospital service corporation must
first demonstrate that underwriting such risk is
consistent with the statutory mission of the
nonprofit hospital service corporation and obtain prior
written approval from the health insurance
commissioner. Each nonprofit hospital service
corporation may also directly, or by contracting
with another entity, develop and/or offer for sale
the policies or programs described in this
section. However, the nonprofit hospital service
corporation shall not directly underwrite any
risk under a policy of insurance described in this
section.
SECTION 3. This
act shall take effect upon passage.
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LC02773/SUB
A
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