Frequently Asked Questions (FAQ)
"What would be the effect of the Federal Health Reform for consumers?" (Kaiser Health News- external link)
The OHIC can resolve issues with commercial insurers within our jurisdiction on behalf of medical service providers and consumers. Before filing a complaint with the Office, please read the following FAQ. If your issue is not addressed here, please go to our complaints page.
Q: I am a looking for more affordable Health Insurance for my Rhode Island small business. I am self - employed. What are my options?
A: Employers Options
Q: If I lay off an employee what are my obligations as the employer regarding continuation of benefits.
A: Rhode Island Law 27-19.1-1, this is RI 's mini COBRA Law the Extended Medical Benefits statute, or "Mini COBRA" (external link). allows a laid off employee to continue their health benefits at the same group rate they are currently receiving the employee will be required to pay the full group premium rate. If your group plan consists of 50 members or less, the employee is responsible for paying the monthly premium directly to the insurance carrier. If your group consists of greater than 50 members, the employee is responsible for paying the monthly premium to the employer directly, or to the insurance carrier if your workplace ceases to exist. Employer Based Health Insurance
Q: As a small employer my annual premium rates have gone up. What can I do about this?
A: All Rhode Island small group insurers are required to provide you and your broker with a breakdown of your premium increase. Your broker is paid to help you understand your health insurance options. Have your broker explain to you what they are. In addition, see the OHIC website for what this Office is doing to control premium increases. RI Law 27-50-3 Small Group Availability Act." (external link).
Q: Can I get a special premium rate through a chamber of commerce?
A: No, All Small Businesses in Rhode Island are subject to Rhode Island Law 27-50-3 in which they have specific rating factor’s that apply equally to all small businesses and eliminate special treatment.
Q: I heard that insurers have to cover infertility treatments, hearing aids, cranial prosthetics, my dependants, but my employer says it is not covered. Is this legal?
A: Some health insurance coverage is exempt from state laws mandating coverage for specific benefits such as infertility treatment or hearing aids (“benefit mandates”).
If you are working for an employer who is:
a) “self-insured” - Many companies with 500 or more employees are self insured and as such, are not required to abide by some state insurance laws, including benefit mandates (there are a few federal mandates that are required under federal law such as mental Illness).
Questions regarding “self-insured” plans please contact Kevin Murphy at the US Dept. of Labor Employee Benefits Security Administration 617-565-9622 or e-mail www.dol.gov/ebsa.
b) Many companies with headquarters outside Rhode Island follow the laws in the state where they are headquartered. An employee should discuss this with their human resource department, or health care administrator.
FEDERAL ECONOMIC STIMULAS
The Federal Economic Stimulus Package subsidises the purchase of COBRA for certain people
COBRA Subsidy OHIC Update
COBRA FAQs 2009
CMS Helpful Information State COBRA ARRA
COBRA Expansion and Subsidy Update
Spreadsheet 2009 COBRA Subsidy Calculation Template