§ 27-18-1 “Policy of accident and sickness insurance” construed
§ 27-18-1.1 Definitions
§ 27-18-2 Form of policy
§ 27-18-2.1 Uniform explanation of benefits and coverage
§ 27-18-3 Required provisions
§ 27-18-3.1 Alternative coverage by employer
§ 27-18-3.2 Rules and regulations
§ 27-18-3.3 Penalties
§ 27-18-3.4 Judicial review
§ 27-18-3.5 Non-applicability
§ 27-18-4 Optional provisions
§ 27-18-5 Inapplicable or inconsistent provisions
§ 27-18-6 Sequence of provisions
§ 27-18-7 Third party ownership
§ 27-18-8 Filing of accident and sickness insurance policy forms
§ 27-18-8.1 Waiting period — Effective date of filings
§ 27-18-8.2 Notice of disapproval
§ 27-18-8.3 Withdrawal of approval
§ 27-18-8.4 Rules as to filing
§ 27-18-9 Policies of foreign insurers
§ 27-18-10 Compliance by domestic insurer with laws of other states
§ 27-18-11 Application of provisions to policy issued to nonresident
§ 27-18-12 Less favorable provisions prohibited
§ 27-18-13 Effect of policies inconsistent with chapter
§ 27-18-14 Copies of applications
§ 27-18-15 Alteration of application
§ 27-18-16 False statements in application
§ 27-18-17 Acts not constituting waiver of insurer’s defenses
§ 27-18-18 Acceptance of premiums after effective period of policy
§ 27-18-19 Insurance exempt from chapter
§ 27-18-20 Penalties for violations
§ 27-18-21 Appeals from commissioner
§ 27-18-22 Effect on other law
§ 27-18-23 Severability
§ 27-18-24 Immunity of benefits from process
§ 27-18-25 Unfair discrimination prohibited
§ 27-18-25. v2 Unfair discrimination prohibited
§ 27-18-26 Physical examinations by insurance company
§ 27-18-27 Adoptive children
§ 27-18-28 Health insurance contracts — Abortion
§ 27-18-29 Changing coverage
§ 27-18-30 Health insurance contracts — Infertility
§ 27-18-31 Insurance coverage for services of licensed midwives
§ 27-18-32 Discontinuance of coverage — Chronic disabilities
§ 27-18-33 Drug coverage
§ 27-18-33.1 Insurance coverage for post-partum hospital stays
§ 27-18-33.2 Pharmacy benefit manager requirements with respect to multi-source generic pricing updates to pharmacies
§ 27-18-34 Health insurance contracts — Certified registered nurse practitioners and psychiatric and mental health nurse clinical specialists
§ 27-18-35 Certified counselors in mental health and therapists in marriage and family practice
§ 27-18-38 Diabetes treatment
§ 27-18-39 Mastectomy treatment
§ 27-18-40 Insurance coverage for mastectomy hospital stays
§ 27-18-41 Mammograms and pap smears — Coverage mandated
§ 27-18-42 Mammograms — Quality assurance standards
§ 27-18-43 Pap smears — Quality assurance standards
§ 27-18-44 Primary and preventive obstetric and gynecological care
§ 27-18-45 Whistleblowers protection
§ 27-18-46 Penalties and remedies
§ 27-18-47 Additional relief and damages — Reinstatement
§ 27-18-48 Third party reimbursement for services of certain health care workers
§ 27-18-48.1 Third party reimbursement for services of registered nurse first assistants
§ 27-18-49 Human leukocyte antigen testing
§ 27-18-50 Drug coverage
§ 27-18-50.1 Medication synchronization
§ 27-18-51 Restricted annual rate payments prohibited
§ 27-18-52 Genetic testing
§ 27-18-52.1 Genetic information
§ 27-18-53 Magnetic resonance imaging — Quality assurance standards
§ 27-18-54 Health insurance rates
§ 27-18-55 Acupuncture services
§ 27-18-56 Prohibition against dentists being required to indemnify provider
§ 27-18-57 F.D.A. approved prescription contraceptive drugs and devices
§ 27-18-58 Prostate and colorectal examinations — Coverage mandated
§ 27-18-59 Eligibility for children’s benefits
§ 27-18-60 Hearing aids
§ 27-18-61 Prompt processing of claims
§ 27-18-62 Mandatory coverage for certain lyme disease treatments
§ 27-18-63 Dental insurance assignment of benefits
§ 27-18-64 Coverage for early intervention services
§ 27-18-65 Post-payment audits
§ 27-18-66 Tobacco cessation programs
§ 27-18-67 Reimbursement for orthotic and prosthetic services
§ 27-18-68 Mandatory coverage for scalp hair prosthesis
§ 27-18-69 Licensed ambulance service
§ 27-18-70 Enteral nutrition products
§ 27-18-71 Prohibition on preexisting condition exclusions
§ 27-18-72 Prohibition on rescission of coverage
§ 27-18-73 Prohibition on annual and lifetime limits
§ 27-18-74 Coverage for individuals participating in approved clinical trials
§ 27-18-75 Medical loss ratio reporting and rebates
§ 27-18-76 Emergency services
§ 27-18-77 Internal and external appeal of adverse benefit determinations
§ 27-18-78 Primary care provider designation requirement
§ 27-18-79 Discretionary clauses
§ 27-18-80 Orally administered anticancer medication — Cost-sharing requirement
§ 27-18-81 Consumer notification
§ 27-18-82 Opioid antagonists
§ 27-18-83 Health care provider credentialing

Terms Used In Rhode Island General Laws > Chapter 27-18

  • Affordable Care Act: means the federal Patient Protection and Affordable Care Act of 2010, as amended by the federal Health Care and Education Reconciliation Act of 2010, and federal regulations adopted thereunder. See Rhode Island General Laws 27-18-1.1.
  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • Annuity: A periodic (usually annual) payment of a fixed sum of money for either the life of the recipient or for a fixed number of years. A series of payments under a contract from an insurance company, a trust company, or an individual. Annuity payments are made at regular intervals over a period of more than one full year.
  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • Attachment: A procedure by which a person's property is seized to pay judgments levied by the court.
  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • Continuance: Putting off of a hearing ot trial until a later time.
  • Contract: A legal written agreement that becomes binding when signed.
  • Conviction: A judgement of guilt against a criminal defendant.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • covered benefits: means coverage or benefits for the diagnosis, cure, mitigation, treatment, or prevention of disease, or amounts paid for the purpose of affecting any structure or function of the body including coverage or benefits for transportation primarily for and essential thereto, and including medical services as defined in R. See Rhode Island General Laws 27-18-1.1.
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Dependent: A person dependent for support upon another.
  • Donor: The person who makes a gift.
  • Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. Source: U.S. Courts
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Felony: A crime carrying a penalty of more than a year in prison.
  • Fraud: Intentional deception resulting in injury to another.
  • Garnishment: Generally, garnishment is a court proceeding in which a creditor asks a court to order a third party who owes money to the debtor or otherwise holds assets belonging to the debtor to turn over to the creditor any of the debtor
  • Grace period: The number of days you'll have to pay your bill for purchases in full without triggering a finance charge. Source: Federal Reserve
  • Grandfathered health plan: means any group health plan or health insurance coverage subject to 42 U. See Rhode Island General Laws 27-18-1.1.
  • Group health insurance coverage: means , in connection with a group health plan, health insurance coverage offered in connection with such plan. See Rhode Island General Laws 27-18-1.1.
  • Group health plan: means an employee welfare benefit plan, as defined in 29 U. See Rhode Island General Laws 27-18-1.1.
  • Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
  • health benefit plan: means health insurance coverage and a group health plan, including coverage provided through an association plan if it covers Rhode Island residents. See Rhode Island General Laws 27-18-1.1.
  • Health care facility: means an institution providing health care services or a health care setting, including, but not limited to, hospitals and other licensed inpatient centers, ambulatory surgical or treatment centers, skilled nursing centers, residential treatment centers, diagnostic, laboratory and imaging centers, and rehabilitation and other therapeutic health settings. See Rhode Island General Laws 27-18-1.1.
  • Health care professional: means a physician or other health care practitioner licensed, accredited or certified to perform specified health care services consistent with state law. See Rhode Island General Laws 27-18-1.1.
  • Health care services: means services for the diagnosis, prevention, treatment, cure or relief of a health condition, illness, injury or disease. See Rhode Island General Laws 27-18-1.1.
  • Health insurance carrier: means a person, firm, corporation or other entity subject to the jurisdiction of the commissioner under this chapter. See Rhode Island General Laws 27-18-1.1.
  • health insurance commissioner: means that individual appointed pursuant to § 42-14. See Rhode Island General Laws 27-18-1.1.
  • in writing: include printing, engraving, lithographing, and photo-lithographing, and all other representations of words in letters of the usual form. See Rhode Island General Laws 43-3-16.
  • insured: as used in this chapter , shall not be construed as preventing a person other than the insured with a proper insurable interest from making application for and owning a policy covering the insured or from being entitled under the policy to any indemnities, benefits, and rights provided in the policy. See Rhode Island General Laws 27-18-7.
  • Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • Misdemeanor: Usually a petty offense, a less serious crime than a felony, punishable by less than a year of confinement.
  • oath: includes affirmation; the word "sworn" includes affirmed; and the word "engaged" includes either sworn or affirmed. See Rhode Island General Laws 43-3-11.
  • Office of the health insurance commissioner: means the agency established under § 42-14. See Rhode Island General Laws 27-18-1.1.
  • Oversight: Committee review of the activities of a Federal agency or program.
  • Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
  • person: extends to and includes co-partnerships and bodies corporate and politic. See Rhode Island General Laws 43-3-6.
  • Policy of accident and sickness insurance: as used in this chapter , includes any policy or contract covering against loss resulting from sickness or from bodily injury or death by accident, or both. See Rhode Island General Laws 27-18-1.
  • provider: means a health care professional or a health care facility. See Rhode Island General Laws 27-18-1.1.
  • Remainder: An interest in property that takes effect in the future at a specified time or after the occurrence of some event, such as the death of a life tenant.
  • Rescission: means a cancellation or discontinuance of coverage that has retroactive effect for reasons unrelated to timely payment of required premiums or contribution to costs of coverage. See Rhode Island General Laws 27-18-1.1.
  • Statute: A law passed by a legislature.
  • Statute of limitations: A law that sets the time within which parties must take action to enforce their rights.
  • Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
  • United States: include the several states and the territories of the United States. See Rhode Island General Laws 43-3-8.