Regulation and Monitoring

Developing Regulations

Beyond simply enforcing Rhode Island law in individual cases, OHIC adds substance to the law by creating its own market regulations. Based on legislation passed by Rhode Island's legislature, these regulations provide more detail on each law's interpretation and implementation. When the legislature simply gives the commissioner authority to oversee a particular aspect of the health insurance market, regulations create clear, consistent standards for both OHIC and insurers to follow. And when a loophole or vague provision in a state law allows insurers to avoid particular requirements, OHIC can sometimes create or amend a regulation to fill in the gaps. These regulations then become a legally binding part of Rhode Island's regulatory system.

From requiring insurers to cover nicotine patches, to setting standards for the readability of health insurance forms, OHIC's regulations have a far-reaching impact on Rhode Island's consumers. Working on a larger scale, OHIC has also created regulations to enforce the Small Employer Health Insurance Availability Act and to set minimum standards for Medicare supplement insurance.

To keep the commissioner's office from becoming too powerful, however, the state sets limits on OHIC's authority. All regulations must arise from specific clauses of Rhode Island law, and the public has an opportunity to provide input before a regulation is adopted. To see how new regulations are created, please view the documents below.

The Process of Developing Regulations

To ensure transparency, OHIC releases all regulations and publicizes every stage of the regulation development process. The process begins when the health insurance commissioner writes a proposal for a regulation or an amendment to a regulation that's already on the books. OHIC then releases a letter announcing the proposed changes and inviting the public to comment. This letter may be referred to as a solicitation of public comment, a hearing notice, or simply a notice. When proposing an amendment, OHIC may also release a “redlined” version of the regulation with all potential changes marked.

Once the public has provided its input, OHIC continues the process by releasing a list of public comments. In its concise explanatory statement of the regulation, OHIC reiterates the intent of the new regulation or amendment and may also respond directly the concerns raised by the public. Finally, after making any changes to the proposal that he or she feels to be necessary, the commissioner signs the final regulation and it essentially becomes law.

Updates to Regulations

The State of Rhode Island is reorganizing regulations to a uniform code system. This chart will be updated as the regulations are reformatted. Questions or inquiries regarding this matter may be submitted to: ohic.healthinsinq@ri.gov.

Regulations
Chapter/Sub Chapter Part New Citation Form
20 - Insurance/ 30 - Health Insurance 4 - Powers and Duties of the Office of the Health Insurance Commissioner 230-RICR-20-30-4 n/a
20 - Insurance/ 30 - Health Insurance 5 - Standards for Readability of Health Insurance Forms 230-RICR-20-30-5 n/a
20 - Insurance/ 30 - Health Insurance 7 - Medicare Supplement Insurance Minimum Standards 230-RICR-20-50-7 OHIC Bulletin 2018-1
20 - Insurance/ 30 - Health Insurance 8 - Advertisements of Medicare Supplement Insurance 230-RICR-20-30-8 Guidelines
20 - Insurance/ 30 - Health Insurance 11 - Multiple Employer Welfare Arrangements 230-RICR-20-30-11

n/a

20 - Insurance/ 30 - Health Insurance 12 - Tobacco Cessation Treatment Coverage 230-RICR-20-30-12 n/a
20 - Insurance/ 30 - Health Insurance 13 - Discount Medical Plan Organizations 230-RICR-20-30-13 Application

Regulations 1, 4 and 10

Effective July 27, 2018 the following regulations have been repealed:

Regulation 1 - Adoption of Existing Administrative and Health Insurance Related Regulations of the Department of Business Regulation

Regulation 4 - Declaratory Rulings and Petitions

Regulation 10 - Cafeteria Plans

Regulation 11 Small Employer Health Insurance Availability Regulation

This regulation is adopted to implement the provisions of Title 27, Chapter 50, the "Small Employer Health Insurance Availability Act" (the "Act") and replaces Regulation 82 of the Department of Business Regulation ("DBR Regulation 82"), which had been adopted by OHIC.

Regulation 11 Small Employer Health Insurance Availability

Concise Explanatory Statement Amendment Regulation 11 #1

Concise Explanatory Statement Amendment Regulation 11 #2

Concise Explanatory Statement Regulation 11

Red-Lined Amendment to Regulation 11-2011

Public Comments on Regulation 11-2011

Solicitation of Public Comment on Regulation 11-2011

Bulletin 2008-3 Small Group Annual filing

Bulletins

Bulletins do not have the force and effect of law but are designed to place interested persons on notice of interpretations of statutes that are under the jurisdiction of the Office.

2018-3 Affordability Standards CPI for 2019

2018-2 Carrier Notices: Renewal and Discontinuance of Plans in the Individual and Small Group Markets

2018-1 Forms for compliance with Medicare Supplement Insurance Minimum Standards Regulation

2017-2 Affordability Standards CPI for 2018

2017-1 Carrier Notices Renewal and Discontinuance of Plans in the Individual and Small Group Markets

2016-1 2017 CPI-Urban (Affordability Standards)

2015-3 Guidence on Prohibited Discrimination on the Basis of Gender Identity or Expression

2015-2 CPI Urban Affordability Standards

2015-1 CPI Urban Affordability Standards

2013-2 Bulletin Health Care Claims Data

2013-5 Bulletin Group Rating and Underwriting Unfair Discrimination REVISED June 19th, 2015

2013-1 Price Transparency Bulletin

2010-5 Scam Health Insurance Companies Placed in Liquidation

2011-1 Weather related event or disaster

2010-4 Beware of Health Insurance Scams

2010-3 Health Ins Policy Forms with Readability Certification

2010-2 Student Health Benefit Plans

2010-1 Smoking Cessation Treatments

2009-1 Cafeteria Plan Mandate

2008-6 Exemption From Annual Prompt Processing Report

2008-5 Discount plans CONSUMER ALERT

2008-3 Small Group Annual filing

2007-2 SERFF electronic form filing

2007-1 Wellness Health benefit Plan - Process

2006-5 as a clarification to Coverage of Dependent Children

2006-4 prompt processing and pharmacy claim

2006-3 Prompt Processing Regulation

2006-2 OHIC Purposes Statute

2006-1 Mandates Standards for Deductible