Chapter 121

2005 -- S 0778 SUBSTITUTE A

Enacted 07/01/05

A N A C T

RELATING TO INSURANCE -- NONPROFIT HOSPITAL SERVICE CORPORATIONS

Introduced By: Senators Roberts, and Pichardo

Date Introduced: February 17, 2005

It is enacted by the General Assembly as follows:

     SECTION 1. Section 27-19-5 of the General Laws in Chapter 27-19 entitled "Nonprofit

Hospital Service Corporations" is hereby amended to read as follows:

27-19-5. Contracts with subscribers, hospitals, and other eligible entities. -- (a) Each

nonprofit hospital service corporation may contract with its subscribers and with any eligible

hospital for hospital service to be rendered by the contracting hospital to the subscribers and as to

the nature and extent of those services. Each corporation may also contract with any of the

following: (1) any hospital or medical service corporation incorporated in this or another state for

the joint administration of their business and may enter into reciprocal arrangements with those

corporations for the mutual benefit of the subscribers of each; (2) corporations paying or

organized for payment of medical, dental, optometric, or legal benefits, for the administration of

their business including, without limiting the generality of the foregoing, corporations organized

under chapters 20, 20.1, 20.2, and 20.3 of this title; and (3) the federal government, the state,

county, city, town, or other quasi-municipal corporations or their agencies. ; and (4) employers,

associations, and other third-parties for the administration and underwriting of stop loss or

catastrophe insurance, for fully and partially self-insured health benefit plans sponsored by such

employers, associations and third parties.

     (b) Services for which coverage or benefits may be provided to subscribers by any of the

corporations referred to in subsection (a)(2) of this section may also be provided for or

underwritten by each nonprofit hospital service corporation.

      (c) No contract between a nonprofit hospital service corporation and a dentist for the

provisions of services to patients may require that the dentist indemnify or hold harmless the

nonprofit hospital service corporation for any expenses and liabilities, including without

limitation, judgments, settlements, attorneys' fees, court costs, and any associated charges,

incurred in connection with any claim or action brought against the nonprofit hospital service

corporation based on the nonprofit hospital service corporation's management decision, or

utilization review provisions for any patient.

(d) The rates proposed to be charged by any corporation organized under this chapter for

stop-loss or catastrophe insurance shall be filed by the corporation at the office of the health

insurance commissioner. The health insurance commissioner shall review such rates to determine

if they are actuarially sound and may hold a public hearing on such rates upon not less than ten

(10) days written notice prior to the hearing. The health insurance commissioner, upon the

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 books, papers, records, correspondence, or other documents which

he or she deems relevant. The director shall issue a decision as soon as is reasonably possible

following the completion of the hearing. The decision may approve, disapprove, or modify the

rates proposed to be charged by the applicant.

SECTION 2. This act shall take effect upon passage.     

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LC01956/SUB A

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