(a)  Subject to subsection (b), every insurer required to make a contribution shall, on or before the last day of July, October, January and April of each year, make a return to the secretary together with payment of the quarterly healthcare services funding contribution for the preceding three (3) month period.

Terms Used In Rhode Island General Laws 42-7.4-4

  • Healthcare services funding contribution: means per capita amount each contributing insurer must contribute to support the programs funded by the method established under this section, with respect to each contribution enrollee; provided, however, that, with respect to an insurer that is a Medicaid managed care organization offering managed Medicaid, the healthcare funding services contribution for any contribution enrollee whose healthcare services are paid or reimbursed under Title XIX of the Social Security Act (Medicaid) shall not include the children's health services funding requirement described in §?42-12-29. See Rhode Island General Laws 42-7.4-2
  • Insurer: means all persons offering, administering, and/or insuring healthcare services, including, but not limited to:

    (A)  Policies of accident and sickness insurance, as defined by chapter 18 of Title 27:

    (B)  Nonprofit hospital or medical-service plans, as defined by chapters 19 and 20 of title 27;

    (C)  Any person whose primary function is to provide diagnostic, therapeutic, or preventive services to a defined population on the basis of a periodic premium;

    (D)  All domestic, foreign, or alien insurance companies, mutual associations, and organizations;

    (E)  Health maintenance organizations, as defined by chapter 41 of Title 27;

    (F)  All persons providing health benefits coverage on a self-insurance basis;

    (G)  All third-party administrators described in chapter 20. See Rhode Island General Laws 42-7.4-2

  • Secretary: means the secretary of health and human services. See Rhode Island General Laws 42-7.4-2

(b)(1)  Upon request of the director of the department of health, the secretary shall develop a process whereby an insurer required to make the contribution may be directed to make estimated payments for the portion of the liability arising under § 42-7.4-3 and the secretary shall make that pre-paid amount available to the department of health, as requested.

(2)  Unless requested to make an estimated payment as described in subsection (b)(1) above, any insurer required to make the contribution that can substantiate that the insurer’s contribution liability would average less than twenty-five thousand dollars ($25,000) per month may file returns and remit payment annually on or before the last day of June each year; provided, however, that the insurer shall be required to make quarterly payments if the secretary determines that:

(i)  The insurer has become delinquent in either the filing of the return or the payment of the healthcare services funding contribution due thereon; or

(ii)  The liability of the insurer exceeds seventy-five thousand dollars ($75,000) in healthcare services funding contribution per quarter for any two (2) subsequent quarters.

(c)  All returns shall be signed by the insurer required to make the contribution, or by its authorized representative, subject to the pains and penalties of perjury.

(d)  If a return shows an overpayment of the contribution due, the secretary shall refund or credit the overpayment to the insurer required to make the contribution, or the insurer may deduct the overpayment from the next quarterly or annual return.

(e)  The secretary, for good cause shown, may extend the time within which an insurer is required to file a return, and if the return is filed during the period of extension no penalty or late filing charge may be imposed for failure to file the return at the time required by this section, but the insurer shall be liable for interest as prescribed in this section. Failure to file the return during the period for the extension shall void the extension.

History of Section.
P.L. 2014, ch. 145, art. 16, § 4.