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R.I. Gen. Laws § 27-20.7-7

Responsibilities of the insurer

Known as the The Third-Party Health Insurance Administrators Act

The act spans §§ 27-20.7-1 to 27-20.7-9 (16 sections).

P.L. 2001, ch. 83, § 1; P.L. 2001, ch. 242, § 1; P.L. 2024, ch. 318, § 4, effective June 25, 2024; P.L. 2024, ch. 319, § 4, effective June 25, 2024.

(a) If an insurer utilizes the services of an administrator, the insurer shall be responsible for determining the benefits, premium rates, underwriting criteria, and claims payment procedures applicable to the coverage and for securing reinsurance, if any. The rules pertaining to these matters must be provided, in writing, by the insurer to the administrator. The responsibilities of the administrator as to any of these matters shall be set forth in the written agreement between the administrator and the insurer.

(b) It is the sole responsibility of the insurer to provide for competent administration of its programs.

(c) In cases where an administrator administers benefits for more than one hundred (100) certificate holders on behalf of an insurer, the insurer shall, at least semi-annually, conduct a review of the operations of the administrator.

Official source: Rhode Island General Assembly. Reproduced from public-domain Rhode Island statutes; confirm against the official source for the current text. Not legal advice.