The bill amends sections of the General Laws to eliminate annual and lifetime limits on essential health benefits provided by health insurance carriers and health benefit plans. It allows for restricted annual limits on essential health benefits for plan or policy years beginning before January 1, 2014, with specified minimums for the years leading up to 2014. After January 1, 2014, no annual limits are permitted on essential health benefits, except for certain health savings arrangements and non-essential benefits that comply with federal or state regulations. Lifetime limits on the dollar value of essential health benefits are prohibited for any individual, but carriers may impose lifetime limits on non-essential benefits as allowed by law. The bill applies to all health insurance carriers and plans, including grandfathered health plans, but exempts certain types of insurance coverage. It also removes language that would suspend the effectiveness of this section if certain federal provisions were invalidated or repealed.

The bill includes both insertions and deletions in its text. It inserts new section titles to clarify the purpose of the sections and specifies that the provisions related to lifetime and annual limits apply to all health insurance carriers providing coverage under individual or group health plans, including grandfathered plans. The bill deletes a subsection that would suspend the effectiveness of the section if the corresponding provision of the federal Patient Protection and Affordable Care Act is declared invalid or repealed. Instead, it requires the commissioner to report to the general assembly if any provision of the federal act relating to essential health benefits or annual and lifetime limits is repealed or invalidated, describing the impact and making recommendations for the Rhode Island insurance market. The act takes effect upon passage and repeals the authority of the health insurance commissioner to enforce any act of Congress or a federal court decision that invalidates or repeals the prohibition of annual and lifetime limits on health insurance as it pertains to Rhode Island.

Statutes affected:
7091  SUB A: 27-18-73, 27-19-63, 27-20-59, 27-41-76, 42-14.5-3.1
7091: 27-18-73, 27-19-63, 27-20-59, 27-41-76