2014 -- H 7538

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2014

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A N   A C T

RELATING TO STATE AFFAIRS AND GOVERNMENT - CATASTROPHIC HEALTH

INSURANCE PLAN ACT

     Introduced By: Representatives Messier, Williams, Martin, Serpa, and Ferri

     Date Introduced: February 26, 2014

     Referred To: House Corporations

     (Attorney General)

It is enacted by the General Assembly as follows:

     SECTION 1. Section 42-62-13 of the General Laws in Chapter 42-62 entitled

"Catastrophic Health Insurance Plan Act" is hereby amended to read as follows:

     42-62-13. Rates charged. -- (a) The rates proposed to be charged or a rating formula

proposed to be used by any insurer or health maintenance organization under this section subject

to title 27 of the general laws to employers, the state or any political subdivision of the state, or

individuals, shall be filed by the insurer or health maintenance organization at the office of the

director of business regulation health insurance commissioner. The applicant shall provide a copy

of the filing on all rates and/or rating formulas proposed for health insurance coverage offered in

the individual market as defined in § 27-18.5-2 to the insurance advocacy unit of the attorney

general's office simultaneously with the filing at the office of the health insurance commissioner.

This section does not apply to any entity subject to section 27-19-1 et seq., and/or section 27-20-1

et seq. The rates proposed to be charged by those entities shall be governed by the provisions of

section 27-19-1 et seq., and/or section 27-20-1 et seq. Within sixty (60) days after receipt of the

application, the director commissioner, or the director's commissioner's designee, shall hold a

public hearing pursuant to § 42-35-1 et seq. for all rate filings for individuals as defined in § 27-

18.5-2 and may hold a hearing pursuant to § 42-35-1 et seq. upon not less than ten (10) days'

written notice prior to the hearings for other rate filings. The notice shall be published by the

commissioner in a newspaper or newspapers having aggregate general circulation throughout the

state at least ten (10) days prior to the hearing and shall contain a description of the rates

proposed to be charged, and a copy of the notice shall be sent to the applicant and to the

consumer protection insurance advocacy unit of the department of attorney general. In addition,

the applicant shall provide by mail, at least ten (10) days prior to the hearing, notice of the

proposed rate increase for health insurance coverage offered in the individual market as defined

in § 27-18.5-2 to all subscribers subject to the proposed rate increase. At any hearing held under

this section, the applicant shall be required to establish that the rates proposed to be charged or

the rating formula proposed to be used are consistent with the proper conduct of its business and

with the interest of the public. Any documents presented in support of a filing of proposed rates

under this section shall be made available for public examination at any time and place that the

director commissioner may deem reasonable. The director commissioner, or the director's

commissioner's designee, upon that hearing may administer oaths, examine and cross-examine

witnesses, receive oral and documentary evidence, and shall have the power to subpoena

witnesses, compel their attendance and require the production of all books, papers, records,

correspondence, or other documents which he or she deems relevant. Any designee who shall

conduct a hearing pursuant to this section shall report his or her findings in writing to the director

commissioner within eighty (80) days of the filing with a recommendation for approval,

disapproval, or modification of the rates proposed to be charged by the applicant. The

recommended decision shall become part of the record. The director commissioner shall make

and issue a decision not later than ten (10) days following the issuance of the recommended

decision or, if the director commissioner hears the application without the appointment of a

designee, as soon as is reasonably possible following the completion of the hearing on the

proposed rate change. The decision may approve, disapprove, or modify the rates proposed to be

charged by the applicant. Insurers requesting changes in rates shall underwrite the reasonable

expenses of the department of business regulation office of the health insurance commissioner in

connection with the hearing, including any costs related to advertisements, stenographic

reporting, and expert witnesses fees. Notwithstanding any other provisions of law, the filing of

proposed rates or a rating formula and the holding and conduct of any hearings in connection with

these proposed rates or rating formula shall be pursuant to this section.

      (b) Whenever the term "designee" is used in this section, it shall mean a person who is

impartial, a member in good standing of the Rhode Island bar and a person who is sufficiently

acquainted with the rules of evidence as used in the superior court of the state so as to enable that

person to conduct a hearing as designee of the director commissioner. The reasonable per diem

cost of the designee as appointed by the director commissioner shall be paid by the insurers

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requesting changes in the rates.

     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO STATE AFFAIRS AND GOVERNMENT - CATASTROPHIC HEALTH

INSURANCE PLAN ACT

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     This act would require a public hearing for all insurers or health maintenance

organizations who propose rates for health insurance coverage in the individual market.

     This act would take effect upon passage.

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