230 R.I. Code R. 230-RICR-20-30-5.3

Current through December 3, 2024
Section 230-RICR-20-30-5.3 - Definitions
A. As used in this regulation:
1. "Policy" or "policy form" means all health insurance forms required to be submitted to OHIC for approval. These forms include, but are not limited to, certificates of coverage, subscriber agreements, endorsements and modifications to contracts, policies, benefits booklets, and summary plan descriptions.
2. "Carrier" or "insurer" or "health insurance carrier" means any entity subject to the insurance laws and regulations of this state, or subject to the jurisdiction of the health insurance commissioner, that contracts or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services, including, without limitation, an insurance company offering accident and sickness insurance, health insurer, dental insurer, nonprofit hospital service corporation, nonprofit medical service corporation, nonprofit dental service corporation, nonprofit optometric service corporation, association, fraternal benefit society, health maintenance organization or similar entity subject to the provisions of R.I. Gen. Laws Title 27, or any other entity providing a plan of health insurance or health benefits by which health care services are paid or financed for an eligible individual or his or her dependents by such entity on the basis of a periodic premium, paid directly or through an association, trust, or other intermediary, and is either issued, renewed, or delivered within Rhode Island, including a certificate issued that evidences coverage under a policy or contract issued to a trust or association.
3. "Health insurance" means any policy, contract, certificate, or agreement offered by a health insurance carrier to provide, deliver, arrange for, pay for or reimburse any of the costs of health care services. It also includes "health insurance coverage," as defined in R.I. Gen Laws §§ 27-18.5-2 and 27-18.6-2; "health benefit plan," as defined in R.I. Gen Laws § 27-50-3; and a "medical supplement policy," as defined in R.I. Gen Laws §27 - 18.2-1 or coverage similar to a Medicare supplement policy that is issued to an employer to cover retirees.

230 R.I. Code R. 230-RICR-20-30-5.3