2014 -- S 2748

========

LC004198

========

     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2014

____________

A N   A C T

RELATING TO INSURANCE - ACCIDENT AND SICKNESS INSURANCE POLICIES

     Introduced By: Senators Archambault, Lombardi, DiPalma, Ottiano, and Hodgson

     Date Introduced: March 06, 2014

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Chapter 27-18 of the General Laws entitled "Accident and Sickness

Insurance Policies" is hereby amended by adding thereto the following section:

     27-18-82. Plan change notice. – Every entity providing a policy of accident and sickness

insurance as defined in this chapter shall notify:

     (1)(i) All plan purchasers purchasing services for employees under a group or individual

policy contract or health benefit plan for coverage of accident and sickness insurance, in writing,

of any changes to its rules and regulations, guidelines, policies, or procedures concerning

coverage of or payment for services.

     (ii) Said notice of changes in terms shall be communicated to all plan purchasers

purchasing services for employees in writing by the plan showing the changes in redline format

and shall be provided to the participating plan purchasers no later than fifteen (15) days before the

effective date of said changes.

     (iii) The notice shall demonstrate how these changes in coverage will impact the cost of

the plan, including demonstrable cost savings to the plan purchasers.

     (2)(i) All covered members under a group or individual policy contract or health benefit

plan for coverage of accident and sickness insurance, in writing, of any changes to its rules and

regulations, guidelines, policies, or procedures concerning coverage of or payment for services.

     (ii) Said notice of changes in terms shall be communicated to the covered members in

writing by the plan showing the changes in redline format and shall be provided to the covered

members no later than fifteen (15) days before the effective date of said changes.

     SECTION 2. Chapter 27-18.5 of the General Laws entitled "Individual Health Insurance

Coverage" is hereby amended by adding thereto the following section:

     27-18.5-11. Plan change notice. – Every entity providing a policy of individual health

insurance coverage as defined in this chapter shall notify:

     (1)(i) All plan purchasers purchasing services for employees under a group or individual

policy contract or health benefit plan for individual health insurance coverage, in writing, of any

changes to its rules and regulations, guidelines, policies, or procedures concerning coverage of or

payment for services.

     (ii) Said notice of changes in terms shall be communicated to all plan purchasers

purchasing services for employees in writing by the plan showing the changes in redline format

and shall be provided to the participating plan purchasers no later than fifteen (15) days before the

effective date of said changes.

     (iii) The notice shall demonstrate how these changes in coverage will impact the cost of

the plan, including demonstrable cost savings to the plan purchasers.

     (2)(i) All covered members under a group or individual policy contract or health benefit

plan for individual health insurance coverage, in writing, of any changes to its rules and

regulations, guidelines, policies, or procedures concerning coverage of or payment for services.

     (ii) Said notice of changes in terms shall be communicated to the covered members in

writing by the plan showing the changes in redline format and shall be provided to the covered

members no later than fifteen (15) days before the effective date of said changes.

     SECTION 3. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service

Corporations" is hereby amended by adding thereto the following section:

     27-19-73. Plan change notice. – Every entity providing a policy of insurance under this

chapter shall notify:

     (1)(i) All plan purchasers purchasing services for employees under a group or individual

policy contract or health benefit plan, in writing, of any changes to its rules and regulations,

guidelines, policies, or procedures concerning coverage of or payment for services.

     (ii) Said notice of changes in terms shall be communicated to all plan purchasers

purchasing services for employees in writing by the plan showing the changes in redline format

and shall be provided to the participating plan purchasers no later than fifteen (15) days before the

effective date of said changes.

     (iii) The notice shall demonstrate how these changes in coverage will impact the cost of

the plan, including demonstrable cost savings to the plan purchasers.

LC004198 - Page 2 of 4

     (2)(i) All covered members under a group or individual policy contract or health benefit

plan, in writing, of any changes to its rules and regulations, guidelines, policies, or procedures

concerning coverage of or payment for services.

     (ii) Said notice of changes in terms shall be communicated to the covered members in

writing by the plan showing the changes in redline format and shall be provided to the covered

members no later than fifteen (15) days before the effective date of said changes.

     SECTION 4. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service

Corporations" is hereby amended by adding thereto the following section:

     27-20-69. Plan change notice. – Every entity providing a policy of insurance under this

chapter shall notify:

     (1)(i) All plan purchasers purchasing services for employees under a group or individual

policy contract or health benefit plan, in writing, of any changes to its rules and regulations,

guidelines, policies, or procedures concerning coverage of or payment for services.

     (ii) Said notice of changes in terms shall be communicated to all plan purchasers

purchasing services for employees in writing by the plan showing the changes in redline format

and shall be provided to the participating plan purchasers no later than fifteen (15) days before the

effective date of said changes.

     (iii) The notice shall demonstrate how these changes in coverage will impact the cost of

the plan, including demonstrable cost savings to the plan purchasers.

     (2)(i) All covered members under a group or individual policy contract or health benefit

plan, in writing, of any changes to its rules and regulations, guidelines, policies, or procedures

concerning coverage of or payment for services.

     (ii) Said notice of changes in terms shall be communicated to the covered members in

writing by the plan showing the changes in redline format and shall be provided to the covered

members no later than fifteen (15) days before the effective date of said changes.

     SECTION 5. Chapter 27-41 of the General Laws entitled "Health Maintenance

Organizations" is hereby amended by adding thereto the following section:

     27-41-86. Plan change notice. -- Every entity providing a policy of insurance under this

chapter shall notify:

     (1)(i) All plan purchasers purchasing services for employees under a group or individual

policy contract or health benefit plan, in writing, of any changes to its rules and regulations,

guidelines, policies, or procedures concerning coverage of or payment for services.

     (ii) Said notice of changes in terms shall be communicated to all plan purchasers

purchasing services for employees in writing by the plan showing the changes in redline format

LC004198 - Page 3 of 4

and shall be provided to the participating plan purchasers no later than fifteen (15) days before the

effective date of said changes.

     (iii) The notice shall demonstrate how these changes in coverage will impact the cost of

the plan, including demonstrable cost savings to the plan purchasers.

     (2)(i) All covered members under a group or individual policy contract or health benefit

plan, in writing, of any changes to its rules and regulations, guidelines, policies, or procedures

concerning coverage of or payment for services.

     (ii) Said notice of changes in terms shall be communicated to the covered members in

writing by the plan showing the changes in redline format and shall be provided to the covered

members no later than fifteen (15) days before the effective date of said changes.

     SECTION 6. This act shall take effect upon passage.

========

LC004198

========

LC004198 - Page 4 of 4

EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE - ACCIDENT AND SICKNESS INSURANCE POLICIES

***

     This act would require insurance providers to provide notice of changes relating to

coverage to plan purchasers and covered members.

     This act would take effect upon passage.

========

LC004198

========

LC004198 - Page 5 of 4