R.I. Gen. Laws § 27-50-3

(1) “Actuarial certification” means a written statement signed by a member of the American Academy of Actuaries or other individual acceptable to the director that a small employer carrier is in compliance with the provisions of § 27-50-5, based upon the person’s examination and including a review of the appropriate records and the actuarial assumptions and methods used by the small employer carrier in establishing premium rates for applicable health benefit plans.

(2) “Adjusted community rating” means a method used to develop a carrier’s premium which spreads financial risk across the carrier’s entire small group population in accordance with the requirements in § 27-50-5.

(3) “Affiliate” or “affiliated” means any entity or person who directly or indirectly through one or more intermediaries controls or is controlled by, or is under common control with, a specified entity or person.

(4) “Affiliation period” means a period of time that must expire before health insurance coverage provided by a carrier becomes effective, and during which the carrier is not required to provide benefits.

(5) “Bona fide association” means, with respect to health benefit plans offered in this state, an association which: Has been actively in existence for at least five (5) years;

(6) Has been formed and maintained in good faith for purposes other than obtaining insurance;

(7) Does not condition membership in the association on any health-status related factor relating to an individual (including an employee of an employer or a dependent of an employee);

(8) Makes health insurance coverage offered through the association available to all members regardless of any health status-related factor relating to those members (or individuals eligible for coverage through a member);

(9) Does not make health insurance coverage offered through the association available other than in connection with a member of the association;

(10) Is composed of persons having a common interest or calling;

(11) Has a constitution and bylaws; and

(12) Meets any additional requirements that the director may prescribe by regulation.

(13) “Carrier” or “small employer carrier” means all entities licensed, or required to be licensed, in this state that offer health benefit plans covering eligible employees of one or more small employers pursuant to this chapter. For the purposes of this chapter, carrier includes an insurance company, a nonprofit hospital or medical service corporation, a fraternal benefit society, a health maintenance organization as defined in chapter 41 of this title or as defined in chapter 62 of title 42, or any other entity subject to state insurance regulation that provides medical care as defined in subsection (y) that is paid or financed for a small employer by such entity on the basis of a periodic premium, paid directly or through an association, trust, or other intermediary, and issued, renewed, or delivered within or without Rhode Island to a small employer pursuant to the laws of this or any other jurisdiction, including a certificate issued to an eligible employee which evidences coverage under a policy or contract issued to a trust or association.

(14) “Church plan” has the meaning given this term under § 3(33) of the Employee Retirement Income Security Act of 1974 [29 U.S.C. § 1002(33)].

(16) A group health plan; (ii) A health benefit plan; (iii) Part A or part B of Title XVIII of the Social Security Act, 42 U.S.C. § 1395c et seq., or 42 U.S.C. § 1395j et seq., (Medicare); (iv) Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq., (Medicaid), other than coverage consisting solely of benefits under 42 U.S.C. § 1396s (the program for distribution of pediatric vaccines); (v) 10 U.S.C. § 1071 et seq., (medical and dental care for members and certain former members of the uniformed services, and for their dependents) (Civilian Health and Medical Program of the Uniformed Services) (CHAMPUS). For purposes of 10 U.S.C. § 1071 et seq., “uniformed services” means the armed forces and the commissioned corps of the National Oceanic and Atmospheric Administration and of the Public Health Service; (vi) A medical care program of the Indian Health Service or of a tribal organization; (vii) A state health benefits risk pool; (viii) A health plan offered under 5 U.S.C. § 8901 et seq., (Federal Employees Health Benefits Program (FEHBP)); (ix) A public health plan, which for purposes of this chapter, means a plan established or maintained by a state, county, or other political subdivision of a state that provides health insurance coverage to individuals enrolled in the plan; or (x) A health benefit plan under § 5(e) of the Peace Corps Act (22 U.S.C. § 2504(e)). (2) A period of creditable coverage shall not be counted, with respect to enrollment of an individual under a group health plan, if, after the period and before the enrollment date, the individual experiences a significant break in coverage.

(17) “Dependent” means a spouse, child under the age twenty-six (26) years, and an unmarried child of any age who is financially dependent upon, the parent and is medically determined to have a physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than twelve (12) months.

(18) “Director” means the director of the department of business regulation.