Senate Bill #2934 (2018)
AN ACT RELATING TO STATE AFFAIRS AND GOVERNMENT -- HEALTH CARE--HEALTH INSURANCE
Establishes the Rhode Island reinsurance program and restricted receipt account, from federal funding, administered by the director of the Rhode Island health benefits exchange, to mitigate the impact of high-risk individuals on health insurance rates.
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2018-05-29: Introduced, referred to Senate Health and Human Services
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2018-05-29: Scheduled for hearing and/or consideration (05/31/2018)
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2018-05-31: Committee recommends passage
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2018-06-05: Placed on Senate Calendar (06/07/2018)
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2018-06-07: Senate read and passed
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2018-06-08: Referred to House Finance
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2018-06-22: Committee recommends passage of Sub A
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2018-06-22: Placed on House Calendar (06/22/2018)
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2018-06-22: Scheduled for consideration (06/22/2018)
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2018-06-22: House passed Sub A
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2018-06-23: Placed on Senate Calendar (06/23/2018)
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2018-06-23: Senate passed Sub A in concurrence
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2018-07-02: Signed by Governor
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2018-07-02: Transmitted to Governor
Changes since original draft
2018 – S 2934- 2018 – S 2934 SUBSTITUTE A
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LC005817- LC005817/SUB A
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S T A T E O F R H O D E I S L A N D IN GENERAL ASSEMBLY JANUARY SESSION, A.D. 2018- S T A T E O F R H O D E I S L A N D
- IN GENERAL ASSEMBLY
- JANUARY SESSION, A.D. 2018
- ____________
- A N A C T
RELATING TO STATE AFFAIRS AND GOVERNMENT – HEALTH CARE–HEALTH INSURANCE Introduced By: Senator Joshua Miller Date Introduced: May 29, 2018 Referred To: Senate Health & Human Services- RELATING TO STATE AFFAIRS AND GOVERNMENT – HEALTH CARE–HEALTH
- INSURANCE
- Introduced By: Senator Joshua Miller
- Date Introduced: May 29, 2018
- Referred To: Senate Health & Human Services
- It is enacted by the General Assembly as follows:
SECTION 1. Title 42 of the General Laws entitled "STATE AFFAIRS AND GOVERNMENT" is hereby amended by adding thereto the following chapter: CHAPTER 157.1 RHODE ISLAND MARKET STABILITY AND REINSURANCE ACT 42-157.1-1. Short title and purpose. (a) This chapter shall be known and may be cited as the "Rhode Island Market Stability and Reinsurance Act." (b) The purpose of this chapter is to authorize the director to create the Rhode Island reinsurance program to stabilize health insurance rates and premiums in the individual market and provide greater financial certainty to consumers of health insurance in this state. (c) Nothing in this chapter shall be construed as obligating the state to appropriate funds or make payments to carriers. 42-157.1-2. Definitions. As used in this chapter: (1) "Director" means the director of the Rhode Island health benefits exchange. (2) "Exchange" means the Rhode Island health benefits exchange established within the department of administration by § 42-157-1. (3) "Health insurance carrier" or "carrier" has the same meaning as it does in § 27-18.5-2.- SECTION 1. Title 42 of the General Laws entitled "STATE AFFAIRS AND GOVERNMENT" is hereby amended by adding thereto the following chapter:
- CHAPTER 157.1
- RHODE ISLAND MARKET STABILITY AND REINSURANCE ACT
- 42-157.1-1. Short title and purpose.
- (a) This chapter shall be known and may be cited as the "Rhode Island Market Stability and Reinsurance Act."
- (b) The purpose of this chapter is to authorize the director to create the Rhode Island reinsurance program to stabilize health insurance rates and premiums in the individual market and provide greater financial certainty to consumers of health insurance in this state.
- (c) Nothing in this chapter shall be construed as obligating the state to appropriate funds or make payments to carriers.
- 42-157.1-2. Definitions.
- As used in this chapter:
- (1) "Director" means the director of the Rhode Island health benefits exchange.
- (2) "Exchange" means the Rhode Island health benefits exchange established within the department of administration by § 42-157-1.
- (3) "Health insurance carrier" or "carrier" has the same meaning as it does in § 27-18.5-2.
- (4) "Health insurance coverage" has the same meaning as it does in § 27-18.5-2.
- (5) "Individual market" has the same meaning as it does in §27-18.5-2.
- (6) "Office of the health insurance commissioner" means the entity established by § 42- 14.5-1 within the department of business regulation.
- (7) "Program" means the Rhode Island reinsurance program established by § 42-157.1-3.
- (8) "Program fund" or "fund" means the fund established by § 42-157.1-5.
- (9) "State" means the state of Rhode Island.
- 42-157.1-3. Establishment of the Rhode Island reinsurance program.
- (a) The director is authorized to establish and implement a state-based reinsurance program, to be known as the Rhode Island reinsurance program:
- (1) To provide reinsurance to carriers that offer health insurance coverage on the individual market in the state;
- (2) That meets the requirements of a waiver approved under 42 U.S.C. § 18052; and
- (3) That is consistent with state and federal law.
- (b) The program is intended to mitigate the impact of high-risk individuals on health insurance rates offered in the individual insurance market on and off of the exchange.
- (c) The director is authorized to establish reinsurance payment parameters for calendar year 2020 and each subsequent calendar year that include:
- (1) An attachment point;
- (2) A coinsurance rate; and
- (3) A coinsurance cap.
- (d) Carriers must provide the exchange and the office of the health insurance commissioner with data the director prescribes by rules and regulations as necessary to determine reinsurance payments in a time and manner determined by the director.
- (e) The director may alter the parameters established in accordance with §§ 42-157.1-3(c) and 42-157.1-3 (d) as necessary to secure federal approval for a waiver submitted in accordance with § 42-157.1-6.
- 42-157.1-4. Powers of the director.
- (a) The director may:
- (1) Contract with the federal government or another unit of government to ensure coordination of the program;
- (2) Apply for any available federal funding for the program;
- (3) Undertake, directly or through contracts with other persons or entities, studies or demonstration programs to develop awareness of the benefits of this chapter; and
- (4) Formulate general policy and adopt rules and regulations that are reasonably necessary to administer this chapter, including regulations establishing a reinsurance program to mitigate the impact of high-risk individuals on health insurance rates.
- 42-157.1-5. Establishment of program fund.
- (a) A fund shall be established to provide funding for the operation and administration of the program in carrying out the purposes of the program under this chapter.
- (b) The director is authorized to administer the fund.
(c) The general assembly may appropriate general revenue to support the annual budget for the program. (d) The fund shall consist of:- (c) The fund shall consist of:
- (1) Any pass-through funds received from the federal government under a waiver approved under 42 U.S.C. § 18052;
- (2) Any funds designated by the federal government to provide reinsurance to carriers that offer individual health benefit plans in the state;
- (3) Any funds designated by the state to provide reinsurance to carriers that offer individual health benefit plans in the state; and
- (4) Any other money from any other source accepted for the benefit of the fund.
(e) A restricted receipt account shall be established for the fund which may be used for the establishment and operation of the program and shall be exempt from the indirect cost recovery provisions of § 35-4-27. (f) Nothing in this chapter shall be construed as obligating the state to appropriate funds or make payments to carriers.- (d) Nothing in this chapter shall be construed as obligating the state to appropriate funds or make payments to carriers.
- 42-157.1-6. State innovation waiver.
- In accordance with § 42-157-5, the director may apply to the United States Secretary of Health and Human Services under 42 U.S.C. § 18052, for a state innovation waiver to implement the program and seek federal pass-through funding for calendar years beginning January 1, 2020, and future years, to maximize federal funding.
- 42-157.1-7. Program contingent on federal waiver and appropriation of state funding.
(a) The state shall not implement the program or provide reinsurance payments to eligible carriers, without a dedicated appropriation of state funding. (b) If the state innovation waiver request in § 42-157.1-6 is not approved, the director shall not implement the program or provide reinsurance payments to eligible carriers. SECTION 2. Section 35-4-27 of the General Laws in Chapter 35-4 entitled "State Funds" is hereby amended to read as follows: 35-4-27. Indirect cost recoveries on restricted receipt accounts. Indirect cost recoveries of ten percent (10%) of cash receipts shall be transferred from all restricted-receipt accounts, to be recorded as general revenues in the general fund. However, there shall be no transfer from cash receipts with restrictions received exclusively: (1) From contributions from non-profit charitable organizations; (2) From the assessment of indirect cost- recovery rates on federal grant funds; or (3) Through transfers from state agencies to the department of administration for the payment of debt service. These indirect cost recoveries shall be applied to all accounts, unless prohibited by federal law or regulation, court order, or court settlement. The following restricted receipt accounts shall not be subject to the provisions of this section: Executive Office of Health and Human Services Organ Transplant Fund HIV Care Grant Drug Rebates Department of Human Services Veterans' home – Restricted account Veterans' home – Resident benefits Pharmaceutical Rebates Account Demand Side Management Grants Veteran's Cemetery Memorial Fund Donations – New Veterans' Home Construction Department of Health Pandemic medications and equipment account Miscellaneous Donations/Grants from Non-Profits State Loan Repayment Match Department of Behavioral Healthcare, Developmental Disabilities and Hospitals Eleanor Slater non-Medicaid third-party payor account Hospital Medicare Part D Receipts RICLAS Group Home Operations Commission on the Deaf and Hard of Hearing Emergency and public communication access account Department of Environmental Management National heritage revolving fund Environmental response fund II Underground storage tanks registration fees Rhode Island Historical Preservation and Heritage Commission Historic preservation revolving loan fund Historic Preservation loan fund – Interest revenue Department of Public Safety Forfeited property – Retained Forfeitures – Federal Forfeited property – Gambling Donation – Polygraph and Law Enforcement Training Rhode Island State Firefighter's League Training Account Fire Academy Training Fees Account Attorney General Forfeiture of property Federal forfeitures Attorney General multi-state account Forfeited property – Gambling Department of Administration OER Reconciliation Funding RI Health Benefits Exchange RI Health Benefits Exchange – Rhode Island Reinsurance Program Fund Information Technology Investment Fund Restore and replacement – Insurance coverage Convention Center Authority rental payments Investment Receipts – TANS OPEB System Restricted Receipt Account Car Rental Tax/Surcharge-Warwick Share Executive Office of Commerce Housing Resources Commission Restricted Account Department of Revenue DMV Modernization Project Jobs Tax Credit Redemption Fund Legislature Audit of federal assisted programs Department of Children, Youth and Families Children's Trust Accounts – SSI Military Staff RI Military Family Relief Fund RI National Guard Counterdrug Program Treasury Admin. Expenses – State Retirement System Retirement – Treasury Investment Options Defined Contribution – Administration - RR Violent Crimes Compensation – Refunds Treasury Research Fellowship Business Regulation Banking Division Reimbursement Account Office of the Health Insurance Commissioner Reimbursement Account Securities Division Reimbursement Account Commercial Licensing and Racing and Athletics Division Reimbursement Account Insurance Division Reimbursement Account Historic Preservation Tax Credit Account Judiciary Arbitration Fund Restricted Receipt Account Third-Party Grants RI Judiciary Technology Surcharge Account Department of Elementary and Secondary Education Statewide Student Transportation Services Account School for the Deaf Fee-for-Service Account Davies Career and Technical School Local Education Aid Account Davies – National School Breakfast & Lunch Program Office of the Postsecondary Commissioner Westerly Higher Education and Industry Center Department of Labor and Training Job Development Fund SECTION 3. This act shall take effect upon passage. ======== LC005817 ======== EXPLANATION BY THE LEGISLATIVE COUNCIL OF- If the state innovation waiver request in § 42-157.1-6 is not approved, the director shall not implement the program or provide reinsurance payments to eligible carriers.
- SECTION 2. This act shall take effect upon passage.
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- LC005817/SUB A
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- EXPLANATION
- BY THE LEGISLATIVE COUNCIL
- OF
- A N A C T
- RELATING TO STATE AFFAIRS AND GOVERNMENT – HEALTH CARE–HEALTH
INSURANCE- INSURANCE
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This act would establish the Rhode Island reinsurance program that will provide reinsurance to insurance carriers that offer health insurance coverage on the individual market, to mitigate the impact of high-risk individuals on health insurance rates. The director of the Rhode Island health benefits exchange would be authorized to establish payment parameters for this program. A restricted receipt fund consisting of federal funds would be designated to provide reinsurance to carriers that offer individual health benefit plans that are established and administered by the director. This act would take effect upon passage. ======== LC005817 ========- This act would establish the Rhode Island reinsurance program that will provide reinsurance to insurance carriers that offer health insurance coverage on the individual market, to mitigate the impact of high-risk individuals on health insurance rates. The director of the Rhode Island health benefits exchange would be authorized to establish payment parameters for this program.
- This act would take effect upon passage. ======== LC005817/SUB A ========
Votes
NOTE: Electronic voting records are unofficial and may not be accurate. For an official vote tally, check the
House or Senate Journal from the day of the vote.
June 07, 2018 at 4:55pm
Yeas: 35 /
Nays: 0 /
Not voting: 2 /
Recused: 0
June 22, 2018 at 9:35pm
Yeas: 70 /
Nays: 0 /
Not voting: 5 /
Recused: 0
Floor vote for Passage
In Concurrence
June 23, 2018 at 9:23pm
Yeas: 26 /
Nays: 0 /
Not voting: 11 /
Recused: 0