Rhode Island General Laws
Chapter 27-18 - Accident and Sickness Insurance Policies
Section 27-18-2. - Form of policy.

§ 27-18-2. Form of policy.
No policy of accident and sickness insurance shall be delivered or issued for delivery to any person in this state unless:
(1) The entire money and other considerations for it are expressed in the policy;
(2) The time at which the insurance takes effect and terminates is expressed in the policy;
(3) It purports to insure only one person, except that a policy may insure, originally or by subsequent amendment, upon the application of an adult member of a family who shall be deemed the policyholder, any two (2) or more eligible members of that family, including husband, wife, dependent children or any children under a specified age which shall not exceed nineteen (19) years, and any other person dependent upon the policyholder;
(4) The style, arrangement, and overall appearance of the policy give no undue prominence to any portion of the text, and unless every printed portion of the text of the policy and of any endorsements or attached papers is plainly printed in light faced type of a style in general use, the size of which shall be uniform and not less than ten-point with a lower case unspaced alphabet length not less than one hundred and twenty (120) point; the “text” shall include all printed matter except the name and address of the insurer, name or title of the policy, the brief description if any, and captions and subcaptions;
(5) The exceptions and reductions of indemnity are set forth in the policy and, except those which are set forth in §§ 27-18-3 — 27-18-10 are printed, at the insurer’s option, either included with the benefit provision to which they apply, or under an appropriate caption such as “EXCEPTIONS,” or “EXCEPTIONS AND REDUCTIONS”; provided, that if an exception or reduction specifically applies only to a particular benefit of the policy, a statement of the exception or reduction shall be included with the benefit provision to which it applies;
(6) Each form, including riders and endorsements, shall be identified by a form number in the lower left-hand corner of the first page of the form; and
(7) It contains no provision purporting to make any portion of the charter, rules, constitution, or bylaws of the insurer a part of the policy unless the portion is set forth in full in the policy, except in the case of the incorporation of, or reference to, a statement of rates or classification of risks, or short rate table filed with the insurance commissioner, referred to in this chapter as “the commissioner.”
History of Section.P.L. 1956, ch. 3808, § 2; G.L. 1956, § 27-18-2.

Structure Rhode Island General Laws

Rhode Island General Laws

Title 27 - Insurance

Chapter 27-18 - Accident and Sickness Insurance Policies

Section 27-18-1. - “Policy of accident and sickness insurance” construed.

Section 27-18-1.1. - Definitions.

Section 27-18-2. - Form of policy.

Section 27-18-2.1. - Uniform explanation of benefits and coverage.

Section 27-18-3. - Required provisions.

Section 27-18-3.1. - Alternative coverage by employer.

Section 27-18-3.2. - Rules and regulations.

Section 27-18-3.3. - Penalties.

Section 27-18-3.4. - Judicial review.

Section 27-18-3.5. - Non-applicability.

Section 27-18-4. - Optional provisions.

Section 27-18-5. - Inapplicable or inconsistent provisions.

Section 27-18-6. - Sequence of provisions.

Section 27-18-7. - Third party ownership.

Section 27-18-8. - Filing of accident and sickness insurance policy forms.

Section 27-18-8.1. - Waiting period — Effective date of filings.

Section 27-18-8.2. - Notice of disapproval.

Section 27-18-8.3. - Withdrawal of approval.

Section 27-18-8.4. - Rules as to filing.

Section 27-18-9. - Policies of foreign insurers.

Section 27-18-10. - Compliance by domestic insurer with laws of other states.

Section 27-18-11. - Application of provisions to policy issued to nonresident.

Section 27-18-12. - Less favorable provisions prohibited.

Section 27-18-13. - Effect of policies inconsistent with chapter.

Section 27-18-14. - Copies of applications.

Section 27-18-15. - Alteration of application.

Section 27-18-16. - False statements in application.

Section 27-18-17. - Acts not constituting waiver of insurer’s defenses.

Section 27-18-18. - Acceptance of premiums after effective period of policy.

Section 27-18-19. - Insurance exempt from chapter.

Section 27-18-20. - Penalties for violations.

Section 27-18-21. - Appeals from commissioner.

Section 27-18-22. - Effect on other law.

Section 27-18-23. - Severability.

Section 27-18-24. - Immunity of benefits from process.

Section 27-18-25. - Unfair discrimination prohibited.

Section 27-18-26. - Physical examinations by insurance company.

Section 27-18-27. - Adoptive children.

Section 27-18-28. - [Repealed.]

Section 27-18-29. - Changing coverage.

Section 27-18-30. - Health insurance contracts — Infertility.

Section 27-18-31. - Insurance coverage for services of licensed midwives.

Section 27-18-32. - Discontinuance of coverage — Chronic disabilities.

Section 27-18-33. - Drug coverage.

Section 27-18-33.1. - Insurance coverage for post-partum hospital stays.

Section 27-18-33.2. - Pharmacy benefit manager requirements with respect to multi-source generic pricing updates to pharmacies.

Section 27-18-34. - Health insurance contracts — Certified registered nurse practitioners and psychiatric and mental health nurse clinical specialists.

Section 27-18-35. - Certified counselors in mental health and therapists in marriage and family practice.

Section 27-18-36. - Repealed.

Section 27-18-36.1. - Repealed.

Section 27-18-36.2. - Repealed.

Section 27-18-36.3. - Repealed.

Section 27-18-37. - Repealed.

Section 27-18-38. - Diabetes treatment.

Section 27-18-39. - Mastectomy treatment.

Section 27-18-40. - Insurance coverage for mastectomy hospital stays.

Section 27-18-41. - Mammograms and pap smears — Coverage mandated.

Section 27-18-42. - Mammograms — Quality assurance standards.

Section 27-18-43. - Pap smears — Quality assurance standards.

Section 27-18-44. - Primary and preventive obstetric and gynecological care.

Section 27-18-44.1. - Hysterectomy or myomectomy treatment.

Section 27-18-45. - Whistleblowers protection.

Section 27-18-46. - Penalties and remedies.

Section 27-18-47. - Additional relief and damages — Reinstatement.

Section 27-18-48. - Third party reimbursement for services of certain healthcare workers.

Section 27-18-48.1. - Third party reimbursement for services of registered nurse first assistants.

Section 27-18-49. - Human leukocyte antigen testing.

Section 27-18-50. - Drug coverage.

Section 27-18-50.1. - Medication synchronization.

Section 27-18-51. - Restricted annual rate payments prohibited.

Section 27-18-52. - Genetic testing.

Section 27-18-52.1. - Genetic information.

Section 27-18-53. - Magnetic resonance imaging — Quality assurance standards.

Section 27-18-54. - Health insurance rates.

Section 27-18-55. - Acupuncture services.

Section 27-18-56. - Prohibition against dentists being required to indemnify provider.

Section 27-18-57. - F.D.A. approved prescription contraceptive drugs and devices.

Section 27-18-58. - Prostate and colorectal examinations — Coverage mandated — The Maryellen Goodwin Colorectal Cancer Screening Act.

Section 27-18-59. - Eligibility for children’s benefits.

Section 27-18-60. - Hearing aids.

Section 27-18-61. - Prompt processing of claims.

Section 27-18-62. - Mandatory coverage for certain lyme disease treatments.

Section 27-18-63. - Dental insurance assignment of benefits.

Section 27-18-64. - Coverage for early intervention services.

Section 27-18-65. - Post-payment audits.

Section 27-18-66. - Tobacco cessation programs.

Section 27-18-67. - Reimbursement for orthotic and prosthetic services.

Section 27-18-68. - Mandatory coverage for scalp hair prosthesis.

Section 27-18-69. - Licensed ambulance service.

Section 27-18-70. - Enteral nutrition products.

Section 27-18-71. - Prohibition on preexisting condition exclusions.

Section 27-18-72. - Prohibition on rescission of coverage.

Section 27-18-73. - Prohibition on annual and lifetime limits.

Section 27-18-74. - Coverage for individuals participating in approved clinical trials.

Section 27-18-75. - Medical loss ratio reporting and rebates.

Section 27-18-76. - Emergency services.

Section 27-18-77. - Internal and external appeal of adverse benefit determinations.

Section 27-18-78. - Primary care provider designation requirement.

Section 27-18-79. - Discretionary clauses.

Section 27-18-80. - Orally administered anticancer medication — Cost-sharing requirement.

Section 27-18-81. - Consumer notification.

Section 27-18-82. - Opioid antagonists.

Section 27-18-83. - Healthcare provider credentialing.

Section 27-18-84. - Health insurance contracts — Full year coverage for contraception.

Section 27-18-85. - Prohibition on discrimination in organ transplants.

Section 27-18-86. - Health insurance contracts — Copayments exemption for COVID-19 vaccinations.

Section 27-18-87. - Perinatal doulas.

Section 27-18-88. - Gender rating. [Effective January 1, 2023.]

Section 27-18-89. - Coverage for biomarker testing.

Section 27-18-90. - Mandatory coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome. [Expires December 31, 2025.]