Section 216-RICR-10-10-5.3 - General Provisions5.3.1ApplicabilityUnless specifically exempted pursuant to § 5.3.2 of this Part, this Part applies to all Insurers, as defined in § 5.2(A)(16) of this Part.
5.3.2ExemptionsA. The requirements of this Part shall not apply to:1. An Insurer that on January 1 of a reporting year has less than three thousand (3,000) enrolled or covered Members; or2. Insurance coverage providing benefits for:a. Hospital confinement indemnity;f. Limited benefit health insurance as defined by R.I. Gen. Laws § 27-50-3(x); g. Specified disease indemnity;h. Sickness or bodily injury or death by accident or both; ori. Other limited benefit policies, including but not limited to those exempt from the application of R.I. Gen. Laws § 27-50-3 pursuant to subsection (t)(2) through (4) of that statute.5.3.3Optional ConsentA. A covered Insurer must permit enrolled or covered Members to "opt out" of having any information or health care claims relating to them submitted to the RIAPCD. 1. The State will contract with a commercial vendor to operate a secure online portal to administer members' opt-out requests. The online portal will be available twenty-four (24) hours a day, except for scheduled maintenance time, and will allow members to opt-out, opt back in, and check the status of their opt-out request.2. The State will also offer a toll-free telephone number that members can call to opt-out over the phone.3. Each covered Insurer shall notify all existing or new members of the option to opt-out via the secure portal or the toll-free telephone number, prior to submitting any of the members' data to the RIAPCD. Each member must be notified of the opt-out provision at least once during their membership duration.4. The method of notifying members of the opt-out provision will be at the discretion of each covered Insurer. Insurers may follow existing business practices to provide this notification.216 R.I. Code R. 216-RICR-10-10-5.3
Amended Effective 12/6/2021