The Office of the Health Insurance Commissioner takes a leadership role in state healthcare reform. OHIC works with stakeholders on policies aimed to help make sure the health care system is meeting Rhode Island's needs. OHIC gathers input from a range of stakeholders to ensure that proposed system reforms are practical, relevant, and fair. More information on the PCMH definition and provider reporting requirements.
The Office of the Health Insurance Commissioner ensures that insurance companies selling policies in the state follow Rhode Island and federal law. OHIC issues recommendations, orders, and/or penalties to protect Rhode Islanders in the case where state or federal law is not followed. OHIC also creates new regulations and updates current regulations as needed.
Consumer protection is at the core of all of the work of the Office of the Health Insurance Commissioner. OHIC is here to help consumers understand the healthcare system, and to protect Rhode Island consumers by making sure federal and state laws are followed.
The Office of the Health Insurance Commissioner acts to make sure that health insurance companies don't use their market power to raise premiums too much or too fast. Rhode Island law requires insurers to submit any changes to their rates to OHIC. Every year, OHIC reviews the rates for small and large group, direct pay (individual market), and dental plans. OHIC researches the health insurance market, and asks the public for input to decide if the proposed rate increases are appropriate. OHIC also works with its actuaries to determine the financial and actuarial soundness of the proposed rate increases. Through this process, OHIC makes sure that insurers have enough funds to stay in business and pay all their customers' health expenses.