2018 -- S 2787

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LC005355

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2018

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A N   A C T

RELATING TO INSURANCE - HEALTH CARE INSURERS - COORDINATION OF

BENEFITS

     

     Introduced By: Senators Nesselbush, Metts, Jabour, Miller, and Felag

     Date Introduced: April 05, 2018

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

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     SECTION 1. Chapter 27-20.6 of the General Laws entitled "Health Care Insurers -

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Coordination of Benefits" is hereby amended by adding thereto the following section:

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     27-20.6-4.1. Primary insurer determination.

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     (a) Each insurer prior to arbitration pursuant to § 27-20-5, shall have a coordination of

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benefits process in place to determine which insurer is the primary insurer in the event that a

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subscriber is covered by more than one insurer. When a subscriber is covered by more than one

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insurer, the insurers shall determine which plan is the primary insurer within thirty (30) days of

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receipt of the claim. If there exists a dispute between insurers regarding which health plan is the

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primary insurer that is not resolved within thirty (30) days, the dispute shall be submitted to the

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director of the department of business regulation for review, and the director shall make a

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determination within thirty (30) days of receipt of the dispute. Once the director makes a

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determination as to which insurer is the primary insurer, said primary insurer shall have thirty

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(30) days to pay all pending claims or utilize the arbitration process pursuant to § 27-20-5.

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     (b) The director of the department of business regulation shall promulgate rules and

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regulations which may be necessary to carry out the provisions of this section.

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     SECTION 2. This act shall take effect upon passage.

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LC005355

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE - HEALTH CARE INSURERS - COORDINATION OF

BENEFITS

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     This act would authorize the director of the department of business regulation to

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determine the primary insurer when a subscriber is covered by more than one insurer for the

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purposes of the coordination of benefits between health care insurers.

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     This act would take effect upon passage.

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