Rhode Island General Laws 27-18.6-11. Health insurance plan payment and expense reporting
A health insurance carrier: (1) providing proposed rate, premium, fee, or other prospective cost information in connection with an offering of health insurance coverage to a large group or large employer setting forth claims cost as an element of cost; or (2) providing information to a large group or large employer (as so defined) regarding claims paid, shall be required to distinguish, set forth and itemize as separate and distinct elements of cost: (i) sums actually payable (or paid) to health care providers; and (ii) sums actually (or proposed to be) retained or paid by the carrier for administration, including, but not limited to, sums relating to claim services, managed care fees, network access fees, and contributions to reserves.
History of Section.
P.L. 2004, ch. 196, § 1; P.L. 2004, ch. 361, § 1.
Terms Used In Rhode Island General Laws 27-18.6-11
- 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, health benefits, or health services;
(15)(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 services. See Rhode Island General Laws 27-18.6-2
- Employer: has the meaning given that term under section 3(5) of the Employee Retirement Income Security Act of 1974, 29 U. See Rhode Island General Laws 27-18.6-2