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| ARTICLE 11 |
RELATING TO HEALTHCARE MARKET STABILITY
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| SECTION 1. Section 27-18.5-2 of the General Laws in Chapter 27-18.5 entitled |
| "Individual Health Insurance Coverage" is hereby amended to read as follows: |
| 27-18.5-2. Definitions. |
| The following words and phrases as used in this chapter have the following meanings |
| unless a different meaning is required by the context: |
| (1) "Bona fide association" means, with respect to health insurance coverage offered in this |
| state, an association which that: |
| (i) Has been actively in existence for at least five (5) years; |
| (ii) Has been formed and maintained in good faith for purposes other than obtaining |
| insurance; |
| (iii) Does not condition membership in the association on any health status-related factor |
| relating to an individual (including an employee of an employer or a dependent of an employee); |
| (iv) Makes health insurance coverage offered through the association available to all |
| members regardless of any health status-related factor relating to the members (or individuals |
| eligible for coverage through a member); |
| (v) Does not make health insurance coverage offered through the association available |
| other than in connection with a member of the association; |
| (vi) Is composed of persons having a common interest or calling; |
| (vii) Has a constitution and bylaws; and |
| (viii) Meets any additional requirements that the director may prescribe by regulation; |
| (2) "COBRA continuation provision" means any of the following: |
| (i) Section 4980(B) of the Internal Revenue Code of 1986, 26 U.S.C. § 4980B, other than |
| subsection (f)(1) of that section insofar as it relates to pediatric vaccines; |
| (ii) Part 6 of subtitle B of Title I of the Employee Retirement Income Security Act of 1974, |
| 29 U.S.C. § 1161 et seq., other than Section 609 of that act, 29 U.S.C. § 1169; or |
| (iii) Title XXII of the United States Public Health Service Act, 42 U.S.C. § 300bb-1 et seq.; |
| (3)(4) "Creditable coverage" has the same meaning as defined in the United States Public |
| Health Service Act, Section 2701(c), 42 U.S.C. § 300gg(c), as added by P.L. 104-191; |
| (4)(5) "Director" means the director of the department of business regulation; |
| (5)(6) "Eligible individual" means an individual: |
| (i) For whom, as of the date on which the individual seeks coverage under this chapter, the |
| aggregate of the periods of creditable coverage is eighteen (18) or more months and whose most |
| recent prior creditable coverage was under a group health plan, a governmental plan established or |
| maintained for its employees by the government of the United States or by any of its agencies or |
| instrumentalities, or church plan (as defined by the Employee Retirement Income Security Act of |
| 1974, 29 U.S.C. § 1001 et seq.); |
| (ii) Who is not eligible for coverage under a group health plan, part A or part B of title |
| XVIII of the Social Security Act, 42 U.S.C. § 1395c et seq. or 42 U.S.C. § 1395j et seq., or any |
| state plan under title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq. (or any successor |
| program), and does not have other health insurance coverage; |
| (iii) With respect to whom the most recent coverage within the coverage period was not |
| terminated based on a factor described in § 27-18.5-4(b) (relating to nonpayment of premiums or |
| fraud); |
| (iv) If the individual had been offered the option of continuation coverage under a COBRA |
| continuation provision, or under chapter 19.1 of this title or under a similar state program of this |
| state or any other state, who elected the coverage; and |
| (v) Who, if the individual elected COBRA continuation coverage, has exhausted the |
| continuation coverage under the provision or program; |
| (6)(7) "Group health plan" means an employee welfare benefit plan as defined in section |
| 3(1) of the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1002(1), to the extent |
| that the plan provides medical care and including items and services paid for as medical care to |
| employees or their dependents as defined under the terms of the plan directly or through insurance, |
| reimbursement or otherwise; |
| (7)(8) "Health insurance carrier" or "carrier" means any entity subject to the insurance laws |
| and regulations of this state, or subject to the jurisdiction of the director, that contracts or offers to |
| contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care |
| services, including, without limitation, an insurance company offering accident and sickness |
| insurance, a health maintenance organization, a nonprofit hospital, medical or dental service |
| corporation, or any other entity providing a plan of health insurance or health benefits by which |
| health care services are paid or financed for an eligible individual or his or her dependents by such |
| entity on the basis of a periodic premium, paid directly or through an association, trust, or other |
| intermediary, and issued, renewed, or delivered within or without Rhode Island to cover a natural |
| person who is a resident of this state, including a certificate issued to a natural person which that |
| evidences coverage under a policy or contract issued to a trust or association; |
| (8)(i)(9)(i) "Health insurance coverage" means a policy, contract, certificate, or agreement |
| offered by a health insurance carrier to provide, deliver, arrange for, pay for, or reimburse any of |
| the costs of health care healthcare services. Health insurance coverage includes short-term limited- |
| duration policies and any policy that pays on a cost-incurred basis, except as otherwise specifically |
| exempted by subsections (ii), (iii), (iv), or (v)(8) 9(ii), (iii), (iv), or (v) of this section. |
| (ii) "Health insurance coverage" does not include one or more, or any combination of, the |
| following: |
| (A) Coverage only for accident, or disability income insurance, or any combination of |
| those; |
| (B) Coverage issued as a supplement to liability insurance; |
| (C) Liability insurance, including general liability insurance and automobile liability |
| insurance; |
| (D) Workers' compensation or similar insurance; |
| (E) Automobile medical payment insurance; |
| (F) Credit-only insurance; |
| (G) Coverage for on-site medical clinics; and |
| (H) Other similar insurance coverage, specified in federal regulations issued pursuant to |
| P.L. 104-191, under which benefits for medical care are secondary or incidental to other insurance |
| benefits; and; |
| (I) Short term limited duration insurance; |
| (iii) "Health insurance coverage" does not include the following benefits if they are |
| provided under a separate policy, certificate, or contract of insurance or are not an integral part of |
| the coverage: |
| (A) Limited scope dental or vision benefits; |
| (B) Benefits for long-term care, nursing home care, home health care, community-based |
| care, or any combination of these; |
| (C) Any other similar, limited benefits that are specified in federal regulation issued |
| pursuant to P.L. 104-191; |
| (iv) "Health insurance coverage" does not include the following benefits if the benefits are |
| provided under a separate policy, certificate, or contract of insurance, there is no coordination |
| between the provision of the benefits and any exclusion of benefits under any group health plan |
| maintained by the same plan sponsor, and the benefits are paid with respect to an event without |
| regard to whether benefits are provided with respect to the event under any group health plan |
| maintained by the same plan sponsor: |
| (A) Coverage only for a specified disease or illness; or |
| (B) Hospital indemnity or other fixed indemnity insurance; and |
| (v) "Health insurance coverage" does not include the following if it is offered as a separate |
| policy, certificate, or contract of insurance: |
| (A) Medicare supplemental health insurance as defined under section 1882(g)(1) of the |
| Social Security Act, 42 U.S.C. § 1395ss(g)(1); |
| (B) Coverage supplemental to the coverage provided under 10 U.S.C. § 1071 et seq.; and |
| (C) Similar supplemental coverage provided to coverage under a group health plan; |
| (9)(10) "Health status-related factor" means any of the following factors: |
| (i) Health status; |
| (ii) Medical condition, including both physical and mental illnesses; |
| (iii) Claims experience; |
| (iv) Receipt of health care; |
| (v) Medical history; |
| (vi) Genetic information; |
| (vii) Evidence of insurability, including conditions arising out of acts of domestic violence; |
| and |
| (viii) Disability; |
| (10)(12) "Individual market" means the market for health insurance coverage offered to |
| individuals other than in connection with a group health plan; |
| (11)(13) "Network plan" means health insurance coverage offered by a health insurance |
| carrier under which the financing and delivery of medical care, including items and services paid |
| for as medical care, are provided, in whole or in part, through a defined set of providers under |
| contract with the carrier; |
| (12)(14) "Preexisting condition" means, with respect to health insurance coverage, a |
| condition (whether physical or mental), regardless of the cause of the condition, that was present |
| before the date of enrollment for the coverage, for which medical advice, diagnosis, care, or |
| treatment was recommended or received within the six-(6) month (6) period ending on the |
| enrollment date. Genetic information shall not be treated as a preexisting condition in the absence |
| of a diagnosis of the condition related to that information; and |
| (13)(11) "High-risk individuals" means those individuals who do not pass medical |
| underwriting standards, due to high health care healthcare needs or risks; |
| (14)(15) "Wellness health benefit plan" means that health benefit plan offered in the |
| individual market pursuant to § 27-18.5-8; and |
| (15)(3) "Commissioner" means the health insurance commissioner. |
| SECTION 2. Section 42-157-4 of the General Laws in Chapter 42-157 titled “Rhode Island |
| Health Benefit Exchange” is hereby amended to read as follows: |
| 42-157-4. Financing. |
| (a) The department is authorized to assess insurers offering qualified health plans and |
| qualified dental plans. To support the functions of the exchange, insurers offering qualified health |
| plans and qualified dental plans must remit an assessment to the exchange each month, in a |
| timeframe and manner established by the exchange, equal to three and one-half percent (3.5%) of |
| the monthly premium charged by the insurer for each policy under the plan where enrollment is |
| through the exchange. The revenue raised in accordance with this subsection shall not exceed the |
| revenue able to be raised through the federal government assessment and shall be established in |
| accordance and conformity with the federal government assessment upon those insurers offering |
| products on the Federal Health Benefit exchange. Revenues from the assessment shall be deposited |
| in a restricted-receipt account for the sole use of the exchange and shall be exempt from the indirect |
| cost-recovery provisions of § 35-4-27 of the general laws. |
| (b) The general assembly may appropriate general revenue to support the annual budget |
| for the exchange in lieu of or to supplement revenues raised from the assessment under § 42-157- |
| 4(a) subsection (a) of this section. |
| (c) If the director determines that the level of resources obtained pursuant to § 42-157-4(a) |
| subsection (a) will be in excess of the budget for the exchange, the department shall provide a |
| report to the governor, the speaker of the house, and the senate president identifying the surplus |
| and detailing how the assessment established pursuant to § 42-157-4(a) subsection (a) may be |
| offset in a future year to reconcile with impacted insurers and how any future supplemental or |
| annual budget submission to the general assembly may be revised accordingly. |
| SECTION 3. Chapter 42-157 of the General Laws entitled "Rhode Island Health Benefit |
| Exchange" is hereby amended by adding thereto the following section: |
| 42-157-11. Exemptions from the shared responsibility payment penalty. |
| (a) Establishment of program. The exchange shall establish a program for determining |
| whether to grant a certification that an individual is entitled to an exemption from the Shared |
| Responsibility Payment Penalty shared responsibility payment penalty set forth in section § 44- |
| 30-101(c) of the general laws by reason of religious conscience or hardship. |
| (b) Eligibility determinations. The exchange shall make determinations as to whether to |
| grant a certification described in subsection (a) of this section. The exchange shall notify the |
| individual and the tax administrator for the Rhode Island Department of Revenue department of |
| revenue of any such the determination in such a time and manner as the exchange, in consultation |
| with the tax administrator, shall prescribe. In notifying the tax administrator, the exchange shall |
| adhere to the data privacy and data security standards adopted in accordance with 45 C.F.R. |
| 155.260. The exchange shall only be required to notify the tax administrator to the extent that the |
| exchange determines such the disclosure is permitted under 45 C.F.R. 155.260. |
| (c) Appeals. Any person aggrieved by the exchange’s determination of eligibility for an |
| exemption under this section has the right to an appeal in accordance with the procedures contained |
| within chapter 35 of this title 42. |
| 42-157-12. Special enrollment period for qualified individuals assessed a shared |
| responsibility payment penalty. |
| (a) Definitions. The following definition shall apply for purposes of this section: |
| (1) “Special enrollment period” means a period during which a qualified individual who is |
| assessed a penalty in accordance with section § 44-30-101 may enroll in a qualified health plan |
| through the exchange outside of the annual open enrollment period. |
| (b) In the case of a qualified individual who is assessed a shared responsibility payment in |
| accordance with section § 44-30-101 of the general laws and who is not enrolled in a qualified |
| health plan, the exchange must provide a special enrollment period consistent with this section and |
| the Federal Patient Protection and Affordable Care Act (Public Law 111-148), as amended by the |
| Federal Care and Reconciliation Act of 2010 (Public Law 111-152), and any amendments to, or |
| regulations or guidance issued under, those acts. |
| (c) Effective Date. The exchange must ensure that coverage is effective for a qualified |
| individual who is eligible for a special enrollment period under this section on the first day of the |
| month after the qualified individual completes enrollment in a qualified health plan through the |
| exchange. |
| (d) Availability and length of special enrollment period. A qualified individual has sixty |
| (60) days from the date he or she is assessed a penalty in accordance with section § 44-30-101 of |
| the general laws to complete enrollment in a qualified health plan through the exchange. The date |
| of assessment shall be determined in accordance with section § 44-30-82 of the general laws. |
| 42-157-13. Outreach to Rhode Island residents and individuals assessed a shared |
| responsibility payment penalty. |
| Outreach. The exchange, in consultation with the Office of the Health Insurance |
| Commissioner office of the health insurance commissioner and the Division of Taxation division |
| of taxation, is authorized to engage in coordinated outreach efforts to educate Rhode Island |
| residents about the importance of health insurance coverage,; their responsibilities to maintain |
| minimum essential coverage as defined in section § 44-30-101 of the general laws,; the penalties |
| for failure to maintain such coverage,; and information on the services available through the |
| exchange. |
| 42-157-14. Regulatory authority. |
| (a) Regulatory Authority. The exchange may promulgate regulations as necessary to carry |
| out the purposes of this chapter. |
| SECTION 4. Sections 42-157.1-1 and 42-157.1-5 of the General Laws in Chapter 42-157.1 |
| entitled "Rhode Island Market Stability and Reinsurance Act" are hereby amended to read as |
| follows: |
| 42-157.1-1. Short title and purpose. |
| (a) This chapter shall be known and may be cited as the "Rhode Island Market Stability |
| and Reinsurance Act." |
| (b) The purpose of this chapter is to authorize the director to create the Rhode Island |
| reinsurance program to stabilize health insurance rates and premiums in the individual market and |
| provide greater financial certainty to consumers of health insurance in this state. |
| (c) Nothing in this chapter shall be construed as obligating the state to appropriate funds or |
| make payments to carriers. |
| (c) (d) No general revenue funding shall be used for reinsurance payments. |
| 42-157.1-5. Establishment of program fund. |
| (a) A fund shall be The Health Insurance Market Integrity Fund health insurance market |
| integrity fund is hereby established to provide funding for the operation and administration of the |
| program in carrying out the purposes of the program under this chapter. |
| (b) The director is authorized to administer the fund. |
| (c) The fund shall consist of: |
| (1) Any pass-through funds received from the federal government under a waiver approved |
| under 42 U.S.C. § 18052; |
| (2) Any funds designated by the federal government to provide reinsurance to carriers that |
| offer individual health benefit plans in the state; |
| (3) Any funds designated by the state to provide reinsurance to carriers that offer individual |
| health benefit plans in the state; and |
| (4) Any other money from any other source accepted for the benefit of the fund. |
| (d) Nothing in this chapter shall be construed as obligating the state to appropriate funds |
| or make payments to carriers. |
| (d) (e) No general revenue funding shall be used for reinsurance payments. |
| (e) (f) A restricted-receipt account shall be established for the fund which may be used for |
| the purposes set forth in this section and shall be exempt from the indirect cost recovery provisions |
| of section § 35-4-27 of the general laws. |
| (f) (g) Monies in the fund shall be used to provide reinsurance to health insurance carriers |
| as set forth in this chapter and its implementing regulations, and to support the personnel costs, |
| operating costs, and capital expenditures of the exchange and the division of taxation that are |
| necessary to carry out the provisions of this chapter, sections §§ 44-30-101 through 44-30-102, and |
| sections §§ 42-157-11 through 42-157-14 of the general laws. |
| (g) (h) Any excess monies remaining in the fund, not including any monies received from |
| the federal government pursuant to paragraphs (1) or (2) subsection (c)(1) or (c)(2) of this section |
| and after making the payments required by subsection (f) (g) of this section, may be used for |
| preventative health care programs for vulnerable populations in consultation with the executive |
| office of health and human services. |
| 42-157.1-7. Program contingent on federal waiver and appropriation of state funding |
| Program contingent on federal waiver. |
| If the state innovation waiver request in § 42-157.1-6 is not approved, the director shall not |
| implement the program or provide reinsurance payments to eligible carriers. |
| SECTION 5. Chapter 44-30 of the General Laws entitled “Personal Income Tax” is hereby |
| amended by adding thereto the following sections: |
| 44-30-101. Requirements concerning qualifying health insurance coverage. |
| (a) Definitions. For purposes of this section: |
| (1) “Applicable individual” has the same meaning as set forth in 26 U.S.C. § 5000A(d). |
| (2) “Minimum essential coverage” has the same meaning as set forth in 26 U.S. C. § |
| 5000A(f). |
| (3) “Shared Responsibility Payment Penalty responsibility payment penalty” means the |
| penalty imposed pursuant to subsection (c) of this section. |
| (4) “Taxpayer” means any resident individual, as defined in section § 44-30-5 of the |
| general laws. |
| (b) Requirement to maintain minimum essential coverage. Every applicable individual |
| must maintain minimum essential coverage for each month beginning after December 31, 2019. |
| (c) Shared Responsibility Payment Penalty responsibility payment penalty imposed for |
| failing to maintain minimum essential coverage. As of January 1, 2020, every applicable individual |
| required to file a personal income tax return pursuant to section § 44-30-51 of the general laws, |
| shall indicate on the return, in a manner to be prescribed by the tax administrator, whether and for |
| what period of time during the relevant tax year the individual and his or her spouse and dependents |
| who are applicable individuals were covered by minimum essential coverage. If a return submitted |
| pursuant to this subsection fails to indicate that such coverage was in force or indicates that any |
| applicable individuals did not have such coverage in force, a Shared Responsibility Payment |
| Penalty shared responsibility payment penalty shall hereby be assessed as a tax on the return. |
| (d) Shared Responsibility Payment Penalty responsibility payment penalty calculation. |
| Except as provided in subsection (e), the Shared Responsibility Payment Penalty shared |
| responsibility payment penalty imposed shall be equal to a taxpayer’s federal shared |
| responsibility payment for the taxable year under section 5000A of the Internal Revenue Code of |
| 1986, as amended, and as in effect on the 15th day of December 2017. |
| (e) Exceptions. |
| (1) Penalty cap. The amount of the Shared Responsibility Payment Penalty shared |
| responsibility payment penalty imposed under this section shall be determined, if applicable, |
| using the statewide average premium for bronze-level plans offered through the Rhode Island |
| health benefits exchange rather than the national average premium for bronze-level plans. |
| (2) Hardship exemption determinations. Determinations as to hardship exemptions shall |
| be made by the exchange under section § 42-157-11 of the general laws. |
| (3) Religious conscience exemption determinations. Determinations as to religious |
| conscience exemptions shall be made by the exchange under section § 42-157-11 of the general |
| laws. |
| (4) Taxpayers with gross income below state filing threshold. No penalty shall be imposed |
| under this section with respect to any applicable individual for any month during a calendar year if |
| the taxpayer’s household income for the taxable year as described in section 1412(b)(1)(B) of the |
| Patient Protection and Affordable Care Act is less than the amount of gross income requiring the |
| taxpayer to file a return as set forth in section § 44-30-51 of the general laws. |
| (5) Out of State Residents state residents. No penalty shall be imposed by this section |
| with respect to any applicable individual for any month during which the individual is a bona fide |
| resident of another state. |
| (f) Health Insurance Market Integrity Fund insurance market integrity fund. The tax |
| administrator is authorized to withhold from any state tax refund due to the taxpayer an amount |
| equal to the calculated Shared Responsibility Payment Penalty shared responsibility payment |
| penalty and shall place such those amounts in the Health Insurance Market Integrity Fund health |
| insurance market integrity fund created pursuant to section § 42-157.1-5 of the general laws. |
| (g) Deficiency. If, upon examination of a taxpayer’s return, the tax administrator |
| determines there is a deficiency because any refund due to the taxpayer is insufficient to satisfy the |
| Shared Responsibility Penalty shared responsibility penalty or because there was no refund due, |
| the tax administrator may notify the taxpayer of such the deficiency in accordance with section § |
| 44-30-81 and interest shall accrue on such the deficiency as set forth in section § 44-30-84. All |
| monies collected on said the deficiency shall be placed in the Health Insurance Market Integrity |
| Fund health insurance market integrity fund created pursuant to section § 42-157.1-5 of the |
| general laws. |
| (h) Application of Federal federal law. The Shared Responsibility Payment Penalty shared |
| responsibility payment penalty shall be assessed and collected as set forth in this chapter and, |
| where applicable, consistent with regulations promulgated by the federal government, the |
| exchange, and/or the tax administrator. Any federal regulation implementing section 5000A of the |
| Internal Revenue Code of 1986, as amended, and in effect on the 15th day of December 2017, shall |
| apply as though incorporated into the Rhode Island Code of Regulations code of regulations. |
| Federal guidance interpreting these federal regulations shall similarly apply. Except as provided |
| in subsections (j) and (k) of this section, all references to federal law shall be construed as |
| references to federal law as in effect on December 15, 2017, including applicable regulations and |
| administrative guidance that were in effect as of that date. |
| (i) Unavailability of Federal federal premium tax credits. For any taxable year in which |
| federal premium tax credits available pursuant to 26 U.S.C. section 36B become unavailable due |
| to the federal government repealing that section or failing to fund the premium tax credits, the |
| Shared Responsibility Payment Penalty shared responsibility payment penalty under this section |
| shall not be enforced. |
| (j) Imposition of Federal federal shared responsibility payment. For any taxable year in |
| which a federal penalty under section 5000A of the Internal Revenue Code of 1986 is imposed on |
| a taxpayer in an amount comparable to the Shared Responsibility Payment Penalty shared |
| responsibility payment penalty assessed under this section, the state penalty shall not be enforced. |
| (k) Agency Coordination coordination. Where applicable, the tax administrator shall |
| implement this section in consultation with the office of the health insurance commissioner, the |
| office of management and budget, the executive office of health and human services, and the Rhode |
| Island health benefits exchange. |
| 44-30-102. Reporting Requirement for Applicable Entities providing Minimum |
| Essential Coverage minimum essential coverage. |
| (a) Findings. |
| (1) Ensuring the health of insurance markets is a responsibility reserved for states under |
| the McCarran-Ferguson Act and other federal law. |
| (2) There is substantial evidence that being uninsured causes health problems and |
| unnecessary deaths. |
| (3) The Shared Responsibility Payment Penalty shared responsibility payment penalty |
| imposed by subsection § 44-30-101(c) of the general laws is necessary to protect the health and |
| welfare of the state’s residents. |
| (4) The reporting requirement provided for in this section is necessary for the successful |
| implementation of the Shared Responsibility Payment Penalty shared responsibility payment |
| penalty imposed by subsection § 44-30-101(c) of the general laws. This requirement provides the |
| only widespread source of third-party reporting to help taxpayers and the tax administrator verify |
| whether an applicable individual maintains minimum essential coverage. There is compelling |
| evidence that third-party reporting is crucial for ensuring compliance with tax provisions. |
| (5) The Shared Responsibility Payment Penalty shared responsibility payment penalty |
| imposed by subsection § 44-30-101(c) of the general laws, and therefore the reporting requirement |
| in this section, is necessary to ensure a stable and well-functioning health insurance market. There |
| is compelling evidence that, without an effective Shared Responsibility Payment Penalty shared |
| responsibility payment penalty in place for those who go without coverage, there would be |
| substantial instability in health insurance markets, including higher prices and the possibility of |
| areas without any insurance available. |
| (6) The Shared Responsibility Payment Penalty shared responsibility payment penalty |
| imposed by subsection § 44-30-101(c) of the general laws, and therefore the reporting requirement |
| in this section, is also necessary to foster economic stability and growth in the state. |
| (7) The reporting requirement in this section has been narrowly tailored to support |
| compliance with the Shared Responsibility Payment Penalty shared responsibility payment |
| penalty imposed by subsection § 44-30-101(c) of the general laws, while imposing only an |
| incidental burden on reporting entities. In particular, the information that must be reported is |
| limited to the information that must already be reported under a similar federal reporting |
| requirement under section 6055 of the Internal Revenue Code of 1986. In addition, this section |
| provides that its reporting requirement may be satisfied by providing the same information that is |
| currently reported under such federal requirement. |
| (b) Definitions. For purposes of this section: |
| (1) “Applicable entity” means: |
| (i) An employer or other sponsor of an employment-based health plan that offers |
| employment-based minimum essential coverage to any resident of Rhode Island. |
| (ii) The Rhode Island Medicaid single state agency providing Medicaid or Children’s |
| Health Insurance Program (CHIP) coverage. |
| (iii) Carriers licensed or otherwise authorized by the Rhode Island office of the health |
| insurance commissioner to offer health coverage providing coverage that is not described in |
| subparagraphs (i) or (ii) subsection (b)(1)(i) or (b)(1)(ii) of this section. |
| (2) “Minimum essential coverage” has the meaning given such the term by section § 44- |
| 30-101(a)(2) of the general laws. |
| (c) For purposes of administering the Shared Responsibility Payment Penalty shared |
| responsibility payment penalty to individuals who do not maintain minimum essential coverage |
| under subsection § 44-30-101(b) of the general laws, every applicable entity that provides |
| minimum essential coverage to an individual during a calendar year shall, at such time as the tax |
| administrator may prescribe, file a form in a manner prescribed by the tax administrator. |
| (d) Form and manner of return. |
| (1) A return, in such the form as the tax administrator may prescribe, contains the following |
| information: |
| (i) the The name, address, and Taxpayer Identification Number (TIN) TIN of the |
| primary insured and the name and TIN of each other individual obtaining coverage under the |
| policy; |
| (ii) the The dates during which such the individual was covered under minimum essential |
| coverage during the calendar year,; and |
| (iii) such Such other information as the tax administrator may require. |
| (2) Sufficiency of information submitted for federal reporting. Notwithstanding the |
| requirements of paragraph (1) subsection (d)(1) of this section, a return shall not fail to be a return |
| described in this section if it includes the information contained in a return described in section |
| 6055 of the Internal Revenue Code of 1986, as that section is in effect and interpreted on the 15th |
| day of December 2017. |
| (e) Statements to be furnished to individuals with respect to whom information is reported. |
| (1) Any applicable entity providing a return under the requirements of this section shall |
| also provide to each individual whose name is included in such the return a written statement |
| containing the name, address, and contact information of the person required to provide the return |
| to the tax administrator and the information included in the return with respect to the individuals |
| listed thereupon. Such The written statement must be provided on or before January 31 of the year |
| following the calendar year for which the return was required to be made or by such a date as may |
| be determined by the tax administrator. |
| (2) Sufficiency of federal statement. Notwithstanding the requirements of paragraph (1) |
| subsection (e)(1), the requirements of this subsection (e) may be satisfied by a written statement |
| provided to an individual under section 6055 of the Internal Revenue Code of 1986, as that section |
| is in effect and interpreted on the 15th day of December 2017. |
| (f) Reporting responsibility. |
| (1) Coverage provided by governmental units. In the case of coverage provided by an |
| applicable entity that is any governmental unit or any agency or instrumentality thereof, the officer |
| or employee who enters into the agreement to provide such the coverage (or the person |
| appropriately designated for purposes of this section) shall be responsible for the returns and |
| statements required by this section. |
| (2) Delegation. An applicable entity may contract with third-party service providers, |
| including insurance carriers, to provide the returns and statements required by this section. |
| SECTION 6. Section 2 of this article shall take effect January 1, 2020. The remainder of |
| this article shall take effect upon passage. |