2024 -- S 2726

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LC004759

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2024

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A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

     Introduced By: Senators Bissaillon, DiMario, Lauria, LaMountain, Pearson, Miller, and
Euer

     Date Introduced: March 05, 2024

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Section 27-18-54 of the General Laws in Chapter 27-18 entitled "Accident

and Sickness Insurance Policies" is hereby amended to read as follows:

     27-18-54. Health insurance rates.

     No insurance company organized as a stock or mutual corporation which merges or

consolidates with, acquires ownership or control or possession of twenty percent (20%) or greater

of the operating assets of, or otherwise acquires control of a non-profit hospital service corporation

organized under chapter 19 of this title, a non-profit medical service corporation organized under

chapter 20 of this title or a health maintenance organization organized under chapter 41 of this title

may: (1) file with any state agency for review or approval any proposed rate to be used by the

company in the state, or (2) charge to any party in the state any rate or premium, which takes into

account or reflects in any manner the value of any contribution, distribution or allocation the

company expends or incurs in establishing or funding a charitable foundation organized to maintain

or account for the assets of a non-profit hospital service corporation, non-profit medical service

corporation or health maintenance organization, or (3) pay a rate that is less than the approved

Medicaid rate set by the executive office of health and human services. For any rate that is to be

charged to policy holders, regardless of whether the rate is subject to approval by a state agency

under this or another chapter, the company shall at least thirty (30) days before implementing the

rate submit under oath to the commissioner of insurance an accounting that documents the cost

structure on which the rate is based and demonstrates the company’s compliance with this section.

     SECTION 2. Section 27-19-30.1 of the General Laws in Chapter 27-19 entitled "Nonprofit

Hospital Service Corporations" is hereby amended to read as follows:

     27-19-30.1. Health insurance rates.

     No insurance company organized as a stock or mutual corporation that merges or

consolidates with, acquires ownership or control or possession of twenty percent (20%) or greater

of the operating assets of, or otherwise acquires control of a nonprofit hospital service corporation

organized under this chapter, a nonprofit medical service corporation organized under chapter 20

of this title, or a health maintenance organization organized under chapter 41 of this title, may: (1)

File with any state agency for review or approval any proposed rate to be used by the company in

the state, or (2) Charge to any party in the state any rate or premium that takes into account or

reflects in any manner the value of any contribution, distribution, or allocation the company

expends or incurs in establishing or funding a charitable foundation organized to maintain or

otherwise account for the assets of a nonprofit hospital service corporation, nonprofit medical

service corporation, or health maintenance organization, or (3) pay a rate that is less than the

approved Medicaid rate set by the executive office of health and human services. For any rate that

is to be charged to policyholders, regardless of whether the rate is subject to approval by a state

agency under this or another chapter, the company shall at least thirty (30) days before

implementing the rate submit under oath to the commissioner of insurance an accounting that

documents the cost structure on which the rate is based and demonstrates the company’s

compliance with this section.

     SECTION 3. Section 27-20-25.2 of the General Laws in Chapter 27-20 entitled "Nonprofit

Medical Service Corporations" is hereby amended to read as follows:

     27-20-25.2. Health insurance rates.

     No insurance company organized as a stock or mutual corporation that merges or

consolidates with; acquires ownership or control or possession of twenty percent (20%) or greater

of the operating assets of; or acquires control of a nonprofit hospital service corporation organized

under chapter 19 of this title, a nonprofit medical service corporation organized under this chapter,

or a health maintenance organization organized under chapter 41 of this title may: (1) File with any

state agency for review or approval any proposed rate to be used by the company in the state, or

(2) Charge to any party in the state any rate or premium, that takes into account or reflects in any

manner the value of any contribution, distribution, or allocation the company expends or incurs in

establishing or funding a charitable foundation organized to maintain or account for the assets of a

nonprofit hospital service corporation, nonprofit medical service corporation, or health

maintenance organization, or (3) pay a rate that is less than the approved Medicaid rate set by the

LC004759 - Page 2 of 4

executive office of health and human services. For any rate that is to be charged to policyholders,

regardless of whether this rate is subject to approval by a state agency under this or another chapter,

the company shall at least thirty (30) days before implementing the rate submit under oath to the

commissioner of insurance an accounting that documents the cost structure on which the rate is

based and demonstrates the company’s compliance with this section.

     SECTION 4. Section 27-41-27.2 of the General Laws in Chapter 27-41 entitled "Health

Maintenance Organizations" is hereby amended to read as follows:

     27-41-27.2. Health insurance rates.

     No insurance company organized as a stock or mutual corporation that merges or

consolidates with, acquires ownership or control or possession of twenty percent (20%) or greater

of the operating assets of, or acquires control of a nonprofit hospital service corporation organized

under chapter 19 of this title, a nonprofit medical service corporation organized under chapter 20

of this title, or a health maintenance organization organized under chapter 41 of this title: (1) May

file with any state agency for review or approval any proposed rate to be used by the company in

the state, or (2) May charge to any party in the state any rate or premium, that takes into account or

reflects in any manner the value of any contribution, distribution, or allocation the company

expends or incurs in establishing or funding a charitable foundation organized to maintain or

account for the assets of a nonprofit hospital service corporation, nonprofit medical service

corporation, or health maintenance organization, or (3) pay a rate that is less than the approved

Medicaid rate set by the executive office of health and human services. For any rate that is to be

charged to policyholders, regardless of whether this rate is subject to approval by a state agency

under this or another chapter, the company shall at least thirty (30) days before implementing the

rate submit under oath to the commissioner of insurance an accounting that documents the cost

structure on which the rate is based and demonstrates the company’s compliance with this section.

     SECTION 5. This act shall take effect on January 1, 2025.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

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     This act would prohibit insurance companies from paying a rate that is less than the

approved Medicaid rate set by the executive office of health and human services.

     This act would take effect on January 1, 2025.

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LC004759

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