§ 27-20.7-7. Responsibilities of the insurer.
(a) If an insurer utilizes the services of an administrator, the insurer shall be responsible for determining the benefits, premium rates, underwriting criteria and claims payment procedures applicable to the coverage and for securing reinsurance, if any. The rules pertaining to these matters must be provided, in writing, by the insurer to the administrator. The responsibilities of the administrator as to any of these matters shall be set forth in the written agreement between the administrator and the insurer.
(b) It is the sole responsibility of the insurer to provide for competent administration of its programs.
(c) In cases where an administrator administers benefits for more than one hundred (100) certificate holders on behalf of an insurer, the insurer shall, at least semi-annually, conduct a review of the operations of the administrator. At least one of these reviews shall be an on-site audit of the operations of the administrator.
History of Section.P.L. 2001, ch. 83, § 1; P.L. 2001, ch. 242, § 1.
Structure Rhode Island General Laws
Chapter 27-20.7 - Third Party Health Insurance Administrators
Section 27-20.7-1. - Short title.
Section 27-20.7-2. - Definitions.
Section 27-20.7-3. - Written agreement.
Section 27-20.7-4. - Payments to administrator.
Section 27-20.7-5. - Maintenance of records.
Section 27-20.7-6. - Approval of advertising.
Section 27-20.7-7. - Responsibilities of the insurer.
Section 27-20.7-8. - Premium collection and payment of claims.
Section 27-20.7-9. - Compensation to the administrator.
Section 27-20.7-10. - Notice and disclosure of charges and fees.
Section 27-20.7-11. - Delivery of materials.
Section 27-20.7-12. - Certificate of authority required.
Section 27-20.7-13. - Waiver of application for certification.
Section 27-20.7-14. - Annual report and filing fee.
Section 27-20.7-15. - Grounds for suspension or revocation of certificate of authority.
Section 27-20.7-16. - Unauthorized third party administrator business.