230 R.I. Code R. 230-RICR-20-30-10.11

Current through December 3, 2024
Section 230-RICR-20-30-10.11 - Status of Carriers as Small Employer Carriers
A. Filing required. Each carrier providing health benefit plans in this state shall make a filing with the health insurance commissioner indicating whether the carrier intends to operate as a small employer carrier in this state under the terms of this regulation. There is no application form nor requirement for approval. A letter stating the carrier's intention to operate in Rhode Island as a small employer carrier is sufficient. If a carrier has already made such a filing with either the commissioner or the predecessor to the OHIC, the Department of Business Regulation, the carrier need not make a new filing.
B. Prohibition on providing coverage. Subject to § 10.11(C) of this Part, a carrier shall not offer health benefit plans to small employers, or continue to provide coverage under health benefit plans previously issued to small employers in this state, unless the filing provided pursuant to § 10.11(A) of this Part indicates that the carrier intends to operate as a small employer carrier in this state.
C. Exceptions. If the filing made pursuant § 10.11(A) of this Part indicates that a carrier does not intend to operate as a small employer carrier in this state, the carrier may continue to provide coverage under health benefit plans previously issued to small employers in this state only if the carrier complies with the following provisions:
1. the carrier complies with the requirements of the Act with respect to each of the health benefit plans previously issued to a small employer by the carrier;
2. the carrier provides coverage to each new entrant to a health benefit plan previously issued to a small employer by the carrier; and
3. the carrier complies with the requirements of R.I. Gen. Laws § 27-50-15 and §§ 10.9 and 10.12 of the Part as they apply to small employers whose coverage has been terminated by the carrier and to individuals and small employers whose coverage has been limited or restricted by the carrier.
4. For the purpose of § 10.11(C)(2) of this Part, the provisions of the Act and this regulation shall apply to the coverage issued to new entrants.
D. Five-year prohibition exclusion from market. If the filing made pursuant to § 10.11(A) of this Part indicates that a carrier does not intend to operate as a small employer carrier in this state, the carrier shall be precluded from operating as a small employer carrier in this state, except as provided for in § 10.11(C) of this Part, for a period of five years from the date of the filing. Upon a written request from a carrier, the commissioner may reduce said period provided for in the previous sentence if the commissioner finds that permitting the carrier to operate as a small employer carrier would be in the best interests of the small employers and their employees in the state.

230 R.I. Code R. 230-RICR-20-30-10.11