§ 27-60-4 - Unfairly discriminatory acts relating to health benefit plans. - Rhode Island Statutes

SECTION 27-60-4

   § 27-60-4  Unfairly discriminatory actsrelating to health benefit plans. – The following acts are prohibited as unfairly discriminatory:

   (1) Denying, refusing to issue, renew or reissue, cancelingor terminating a health benefit plan, or restricting or excluding healthbenefit plan coverage or adding a premium differential to any health benefitplan on the basis of the applicant's or insured's abuse status;

   (2) Excluding or limiting coverage for losses or denying aclaim incurred by an insured as a result of abuse on the basis of the insured'sabuse status;

   (3) Terminating group coverage for a subject of abuse becausecoverage was originally issued in the name of the abuser and the abuser hasdivorced, separated from, or lost custody of the subject of abuse, or theabuser's coverage has terminated voluntarily or involuntarily. Nothing in thissubsection prohibits the health carrier from requiring the subject of abuse topay the full premium for coverage under the health plan or from requiring as acondition of coverage that the subject of abuse reside or work within itsservice area, if the requirements are applied to all insured of the healthcarrier. The health carrier may terminate group coverage after the continuationcoverage required by this subsection has been in force for eighteen (18)months, and the health carrier shall offer conversion to an equivalentindividual plan providing the conversion plan already exists and is offered toall the insured of the health carrier. The continuation coverage required bythis section shall be satisfied by coverage required under P.L. 99-272, theConsolidated Omnibus Budget Reconciliation Act (COBRA) of 1985, provided to asubject of abuse and is not intended to be in addition to coverage providedunder COBRA; or

   (4) Disclosure or transfer by a person employed by orcontracting with a health carrier of any information relating to a person'sabuse status, a person's medical condition which the health carrier knows orhas reason to know is abuse-related or a person's family, household, social oremployment relationship with a subject of abuse, except to the extent necessaryfor the direct provision of health care services, compliance with abusereporting laws or compliance with an order of the commissioner or a court ofcompetent jurisdiction. This subsection shall not preclude a subject of abusefrom obtaining his or her own medical records. This subsection shall not beconstrued to prohibit a health carrier from asking an applicant or insuredabout a medical condition, even if the condition is abuse-related, or usinginformation obtained for the purpose of acts or practices permitted by thischapter. A subject of abuse may provide evidence of abuse to a health carrierfor the limited purpose of facilitating treatment of an abuse-related conditionor demonstrating that a medical condition is abuse-related, and this sectionshall not be construed as authorizing the health carrier to disregard thatinformation.