Summary of 2017 Legislative Changes Relating to Health Insurance Coverage

On Aug. 3, 2017, the Rhode Island (RI) Division of Insurance published Insurance Bulletin Number 2017-2. The bulletin summarizes the changes made by the RI legislature during 2017. Outlined below are the legislative changes described in the bulletin relating to health insurance coverage — including those previously covered in Compliance Corner.

The first change relates to domestic partnerships. Chapter 197, enacted on July 18, 2017, amends RI’s definition of a domestic partnership. Under the new law, “domestic partnership” means two people who are in an exclusive, intimate and committed relationship with each other and who certify by affidavit that their relationship meets certain qualifications. To be qualified, both persons must be at least 18 years of age, mentally competent, and not married to someone else. In addition, the two persons must not be related by blood to a degree that would prohibit marriage in the state of RI. The persons must reside together for at least one year prior to their certification. Lastly, the two must be financially interdependent as evidenced by two of the following: (1) domestic partnership agreement or relationship contract; (2) a joint mortgage or joint ownership of a primary residence; (3) a designation as a beneficiary in the other person’s will, retirement contract or life insurance policy; or (4) any combination of joint ownership of a motor vehicle, joint checking account, joint credit account or joint lease.

As it relates to insurance, Chapter 197 prohibits insurance companies from any distinction or discrimination against individuals in a domestic partner relationship regarding fees for policies issued or renewed in RI. The law applies to all policies issued or renewed on or after Jan. 1, 2018.

The second change is Chapter 274, which relates to prescription drug formularies. Chapter 274, enacted on July 21, 2017, amends RI law to specify that carriers must notify policy holders (employers) at least 30 days in advance when formulary changes remove a covered prescription drug or reclassify the drug’s preferred or tier cost sharing status. The new law takes effect for policies issued or renewed on or after July 21, 2017.

The third change relates to chiropractic coverage. Chapter 165, enacted on July 10, 2017, adds a requirement to utilize a medical necessity standard for provider payment, and – more importantly for employers – requires insurance reimbursement for medically necessary evidence-based chiropractic and osteopathic non-opioid treatments for pain. That would include medically necessary chiropractic care and osteopathic manipulative treatment performed by a licensed provider. The new law is effective for policies issued or renewed on or after April 1, 2018.

The fourth relates to coverage for standard fertility preservation services. Chapter 150 and 132, both enacted on July 5, 2017, mandate insurance coverage for medically necessary expenses for standard fertility preservation services when a medical treatment may – directly or indirectly – cause iatrogenic infertility. For this purpose, “iatrogenic infertility” means an impairment of fertility because of surgery, radiation, chemotherapy or other medical treatment that affects the reproductive organs or processes.

The bulletin and new laws do not contain any new employer compliance obligations. But RI employers will want to be aware of the changes to the insurance laws in RI should employees have questions regarding health insurance coverage.

Insurance Bulletin Number 2017-2 »
Chapter 197 »
Chapter 274 »
Chapter 165 »
Chapter 150 »
Chapter 132 »