§ 27-20.7-1 Short title
§ 27-20.7-2 Definitions
§ 27-20.7-3 Written agreement
§ 27-20.7-4 Payments to administrator
§ 27-20.7-5 Maintenance of records
§ 27-20.7-6 Approval of advertising
§ 27-20.7-7 Responsibilities of the insurer
§ 27-20.7-8 Premium collection and payment of claims
§ 27-20.7-9 Compensation to the administrator
§ 27-20.7-10 Notice and disclosure of charges and fees
§ 27-20.7-11 Delivery of materials
§ 27-20.7-12 Certificate of authority required
§ 27-20.7-13 Waiver of application for certification
§ 27-20.7-14 Annual report and filing fee
§ 27-20.7-15 Grounds for suspension or revocation of certificate of authority
§ 27-20.7-16 Unauthorized third party administrator business

Terms Used In Rhode Island General Laws > Chapter 27-20.7 - Third Party Health Insurance Administrators

  • Administrator: means a person who directly or indirectly solicits or effects coverage of, underwrites, collects charges or premiums from, or adjusts or settles claims on residents of this state, or residents of another state from offices in this state, in connection with life or health insurance coverage or annuities, except any of the following:

    (i)  An employer on behalf of its employees or the employees of one or more subsidiaries or affiliated corporations of the employer;

    (ii)  A union on behalf of its members;

    (iii)  An insurer which is authorized to transact insurance in this state with respect to a policy lawfully issued and delivered in and pursuant to the laws of this state or another state;

    (iv)  A producer licensed to sell life or health insurance in this state, whose activities are limited exclusively to the sale of insurance;

    (v)  A creditor on behalf of its debtors with respect to insurance covering a debt between the creditor and its debtors;

    (vi)  A trust and its trustees, agents and employees acting pursuant to the trust established in conformity with 29 U. See Rhode Island General Laws 27-20.7-2

  • affiliated: means an entity or person who directly or indirectly through one or more intermediaries controls or is controlled by, or is under common control with, a specified entity or person. See Rhode Island General Laws 27-20.7-2
  • Commissioner: means the commissioner of insurance. See Rhode Island General Laws 27-20.7-2
  • 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.
  • Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
  • 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.
  • Fiduciary: A trustee, executor, or administrator.
  • Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
  • 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
  • insurance coverage: means any coverage offered or provided by an insurer. See Rhode Island General Laws 27-20.7-2
  • Insurer: includes all persons, firms or corporations offering and/or insuring health services on a prepaid basis, including, but not limited to, policies of accident and sickness insurance as defined by chapter 18 of this title, nonprofit hospital or medical service plans as defined by chapters 19 and 20 of this title, or any other entity whose primary function is to provide diagnostic, therapeutic or preventive services to a defined population on the basis of a periodic premium. See Rhode Island General Laws 27-20.7-2
  • 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.
  • Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
  • Nolo contendere: No contest-has the same effect as a plea of guilty, as far as the criminal sentence is concerned, but may not be considered as an admission of guilt for any other purpose.
  • Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
  • 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: may be construed to extend to and include co-partnerships and bodies corporate and politic. See Rhode Island General Laws 43-3-6
  • Plea: In a criminal case, the defendant's statement pleading "guilty" or "not guilty" in answer to the charges, a declaration made in open court.
  • Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
  • Statute: A law passed by a legislature.
  • Subpoena: A command to a witness to appear and give testimony.
  • Testify: Answer questions in court.
  • underwriting: means , but is not limited to, the acceptance of employer or individual applications for coverage of individuals in accordance with the written rules of the insurer; the overall planning and coordinating of an insurance program; and the ability to procure bonds and excess insurance. See Rhode Island General Laws 27-20.7-2