In 2004, the Rhode Island General Assembly passed legislation establishing the Office of the Health Insurance Commissioner (OHIC).
Prior to 2004, the Department of Business Regulation (DBR) was responsible for oversight of all types of coverage, including health, life, and automobile insurances. The DBR now provides infrastructure and expert staff to the OHIC.
The OHIC is the first state agency dedicated solely to health insurance oversight. Moreover, the Rhode Island legislature expanded the traditional role for insurance regulation beyond consumer protections and insurer solvency. Such a role, laid out in the OHIC Purposes Statute must balance traditional regulation with policy development.In its full statutory form, the OHIC Purposes Statute states, “…the Commissioner shall discharge the powers and duties of the OHIC to:
- Guard the solvency of health insurers;
- Protect the interests of consumers;
- Encourage fair treatment of health care providers;
- Encourage policies and developments that improve the quality and efficiency of health care service delivery and outcomes; and
- View the health care system as a comprehensive entity and encourage and direct insurers towards policies that advance the welfare of the public through overall efficiency, improved health care quality, and appropriate access.
In everyday use this can be condensed as “ensuring solvency, protecting consumers, engaging providers and improving the system”.The full text of the OHIC enabling law, including the Purposes Statute (external link)