Section 27-20.1-17. – Termination of children’s benefits.
§ 27-20.1-17. Termination of children’s benefits. (a) Every individual or group health insurance contract, plan, or policy delivered, issued for delivery, or renewed in this state which provides medical coverage that includes coverage for physician services in a physician’s office, and every policy which provides major medical or similar comprehensive type coverage, except for supplemental […]
Section 27-20.1-18. – Dental insurance assignment of benefits.
§ 27-20.1-18. Dental insurance assignment of benefits. Every entity providing nonprofit dental service plan as defined in this chapter shall allow, as a provision in a group or individual policy, contract or health benefit plan for coverage of dental services, any person insured by such entity to direct, in writing, that benefits from a health […]
Section 27-20.1-19. – Post-payment audits.
§ 27-20.1-19. Post-payment audits. (a) Except as otherwise provided herein, any review, audit, or investigation by a nonprofit dental service corporation of a healthcare provider’s claims which results in the recoupment or set-off of funds previously paid to the healthcare provider in respect to such claims shall be completed no later than eighteen (18) months […]
Section 27-20.1-20. – Plan change notices.
§ 27-20.1-20. Plan change notices. Every entity providing a nonprofit dental service plan as defined in this chapter shall notify all dentists providing services under a group or individual policy, contract or health benefit plan for coverage of dental services, in writing, of any changes to its rules and regulations, guidelines, policies or procedures concerning […]
Section 27-20.1-21. – Discretionary clauses.
§ 27-20.1-21. Discretionary clauses. (a) No new or existing policy or certificate may contain any provision: (1) Purporting to reserve sole discretion to the insurance company to determine eligibility for benefits or interpret the terms of a policy or certificate; or (2) Specifying or affecting a standard of review upon which a court may review […]
Section 27-20.1-22. – Consumer notification.
§ 27-20.1-22. Consumer notification. Every nonprofit dental service corporation providing dental benefits to subscribers shall include on the identification card provided to its subscribers on the front of the cards the following language when the underlying plan contains a non-duplication of benefits clause: “NO DUPLICATION OF BENEFITS”. History of Section.P.L. 2013, ch. 452, § 4; […]
Section 27-20.1-16. – Magnetic resonance imaging — Quality assurance standards.
§ 27-20.1-16. Magnetic resonance imaging — Quality assurance standards. A magnetic resonance imaging examination eligible for reimbursement by a nonprofit dental services corporation licensed pursuant to this chapter shall be reimbursed only if the provider at which the examination has been conducted and processed, and the licensed physician interpreting the results of the magnetic resonance […]
Section 27-20.1-9. – Adoption of chapter by hospital service corporation.
§ 27-20.1-9. Adoption of chapter by hospital service corporation. Any nonprofit hospital service corporation organized pursuant to the provisions of chapter 19 of this title, which first obtains authorization to do so by the Rhode Island State Dental Society as evidenced by the affidavit of the president and secretary of the society, may amend its […]
Section 27-20.1-10. – Nonprofit dental service corporation assessment.
§ 27-20.1-10. Nonprofit dental service corporation assessment. (a) Notwithstanding any other provisions of law, each domestic nonprofit dental service corporation shall be charged an assessment to partially support the activities of the division of insurance in the department of business regulation. (b) The minimum assessment charged shall be one thousand dollars ($1,000). History of Section.P.L. […]
Section 27-20.1-11. – Rehabilitation, liquidation, or conservation.
§ 27-20.1-11. Rehabilitation, liquidation, or conservation. (a) Any rehabilitation, liquidations, administrative supervision or conservation of a nonprofit dental service corporation organized under this chapter shall be conducted under the supervision of the director of business regulation pursuant to chapters 14.1, 14.2, and 14.3 of this title. The director of business regulation may apply for an […]