Rhode Island 2025 Regular Session

Rhode Island House Bill H5996 Compare Versions

Only one version of the bill is available at this time.

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5	5	2025 -- H 5996
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7	7	LC001839
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9	9	S T A T E O F R H O D E I S L A N D
10	10	IN GENERAL ASSEMBLY
11	11	JANUARY SESSION, A.D. 2025
12	12	____________
13	13
14	14	A N A C T
15	15	RELATING TO STATE AFFAIRS AND GOVERNMENT -- RHODE ISLAND INDIVIDUAL
16	16	MARKET AFFORDABILITY ACT OF 2025
17	17	Introduced By: Representatives Speakman, Tanzi, Cotter, Alzate, Kislak, Boylan,
18	18	Donovan, and Ajello
19	19	Date Introduced: February 28, 2025
20	20	Referred To: House Finance
21	21
22	22
23	23	It is enacted by the General Assembly as follows:
24	24	SECTION 1. Title 42 of the General Laws entitled "STATE AFFAIRS AND 1
25	25	GOVERNMENT" is hereby amended by adding thereto the following chapter: 2
26	26	CHAPTER 157.2 3
27	27	RHODE ISLAND INDIVIDUAL MARKET AFFORDABILITY ACT OF 2025 4
28	28	42-157.2-1. Short title and purpose. 5
29	29	(a) This chapter shall be known and may be cited as the "Rhode Island Individual Market 6
30	30	Affordability Act of 2025." 7
31	31	(b) The purpose of this chapter is to create a state affordability program to reduce out-of-8
32	32	pocket costs for low- and moderate-income consumers enrolled in health insurance coverage 9
33	33	through the Rhode Island health benefits exchange. 10
34	34	42-157.2-2. Definitions. 11
35	35	As used in this chapter: 12
36	36	(1) "Affordability program" means a program to improve affordability for health care or 13
37	37	health insurance coverage as implemented by the board established by § 42-157.2-6. 14
38	38	(2) "Assessment" means the health insurance affordability assessment established by § 42-15
39	39	157.2-5. 16
40	40	(3) "Board" means the health insurance affordability board established by § 42-157.2-6. 17
41	41	(4) "Commissioner'' means the commissioner of the office of the health insurance 18
42	42
43	43
44	44	LC001839 - Page 2 of 13
45	45	commissioner. 1
46	46	(5) "Cost-sharing reduction" means the program set forth in 42 U.S.C. § 18071 by which 2
47	47	certain individuals eligible to purchase health insurance coverage through the exchange are entitled 3
48	48	to purchase a plan with an adjusted actuarial value to lower out-of-pocket expenses. 4
49	49	(6) "Director" means the director of the Rhode Island health benefits exchange. 5
50	50	(7) "Exchange" means the Rhode Island health benefits exchange established within the 6
51	51	department of administration by § 42-157-1. 7
52	52	(8) "Federal poverty line" has the same meaning as "poverty line" as set forth in 42 U.S.C. 8
53	53	§ 9902(2). 9
54	54	(9) "Health insurance carrier" or "carrier'' has the same meaning as set forth in § 27-18.5-10
55	55	2. 11
56	56	(10) "Health insurance coverage" has the same meaning as set forth in § 27-18.5-2. 12
57	57	(11) "Household income" has the same meaning as set forth in 26 U.S.C. § 36B(d)(2) in 13
58	58	effect as of January 1, 2025. 14
59	59	(12) "Individual market" has the same meaning as set forth in § 27-18.5-2. 15
60	60	(13) "Office of the health insurance commissioner" means the entity established by § 42-16
61	61	14.5-1 within the department of business regulation. 17
62	62	(14) "Premium assistance credit amount" has the same meaning as set forth in § 26 USC 18
63	63	36(b)(1), effective January 1, 2025. 19
64	64	(15) "Premium tax credit" means the refundable tax credit available, pursuant to federal 20
65	65	law, to assist certain individuals in purchasing health insurance coverage through the exchange. 21
66	66	(16) "Program" means the individual market affordability program established by § 42-22
67	67	157.2-3. 23
68	68	(17) "Program fund" or "fund" means the fund established by § 42-157.2-4. 24
69	69	(18) "State" means the State of Rhode Island. 25
70	70	42-157.2-3. Establishment of the Rhode Island individual market affordability 26
71	71	program. 27
72	72	(a) The director is authorized to establish a state-based affordability program, to be known 28
73	73	as the Rhode Island individual market affordability program: 29
74	74	(1) To provide for improved affordability for individuals who purchase health insurance 30
75	75	coverage through the exchange; and 31
76	76	(2) That is consistent with state and federal law. 32
77	77	(b) The program is intended to mitigate the impact of high and rising healthcare costs for 33
78	78	low- and middle-income Rhode Islanders who purchase health insurance coverage through the 34
79	79
80	80
81	81	LC001839 - Page 3 of 13
82	82	exchange by reducing out-of-pocket costs through expanded affordability programs. 1
83	83	(c) The director is authorized, based on recommendations advanced by the board, to 2
84	84	implement affordability programs and direct payment to carriers to reduce the cost of health 3
85	85	insurance coverage purchased through the exchange, and to improve the actuarial value of health 4
86	86	insurance coverage, for individuals determined eligible for state-based subsidies. 5
87	87	(d) In addition to the funding contribution established by § 42-157.2-4, the director, in 6
88	88	consultation with the commissioner, the secretary of the executive office of health and human 7
89	89	services, and the Medicaid director, shall collaborate to identify any federal or other external 8
90	90	sources of funding for the program, including funding available through the state's existing section 9
91	91	1115 Medicaid demonstration waiver, the state's existing section 1332 state innovation waiver, or 10
92	92	new funding available under those authorities or any other authority. 11
93	93	(1) The director is authorized to apply for and obtain any available identified funding for 12
94	94	the program. 13
95	95	(2) The secretary of the executive office of health and human services is authorized to apply 14
96	96	for, submit, and negotiate any necessary changes to the Medicaid state plan, the state section 1115 15
97	97	Medicaid demonstration waiver, or any other necessary authorities in order to facilitate the 16
98	98	obtaining of identified funding for the program. 17
99	99	42-157.2-4. Establishment of program fund. 18
100	100	(a) There is created within the general fund a restricted receipt account to be known as the 19
101	101	“health insurance individual market affordability account”. All money in the account shall be 20
102	102	utilized by the exchange to effectuate the provisions of § 42-157.2-3. All money received pursuant 21
103	103	to this section shall be deposited into the health insurance individual market affordability account. 22
104	104	Funding dedicated exclusively to effectuate the provisions of § 42-157.2-3 and this subsection 23
105	105	received by the exchange from sources other than those identified in this section may also be 24
106	106	deposited in the health insurance individual market affordability account. The general treasurer is 25
107	107	authorized and directed to draw the general treasurer's orders on the account upon receipt of 26
108	108	properly authenticated vouchers from the exchange. 27
109	109	(b) Beginning July 1, 2025, a portion of the amount collected pursuant to § 42-7.4-3, up to 28
110	110	the actual amount expended or projected to be expended for the state for the services described in 29
111	111	subsection (a) of this section, less any amount collected in excess of the prior year’s funding 30
112	112	requirement as indicated in subsection (c) of this section, shall be deposited in the health insurance 31
113	113	individual market affordability account. The funds shall be used solely for the purposes of the 32
114	114	health insurance individual market affordability account, and no other. 33
115	115	(c) The exchange shall submit to the general assembly an annual report on the program and 34
116	116
117	117
118	118	LC001839 - Page 4 of 13
119	119	costs related to the program, on or before February 1 of each year. The exchange shall make 1
120	120	available to any entity making a contribution pursuant to § 42-7.4-3, upon its request, detailed 2
121	121	information regarding the health insurance individual market affordability program described in 3
122	122	subsection (a) of this section and the costs related to those programs. Any funds collected in excess 4
123	123	of funds needed to carry out the programs shall be deducted from the subsequent year’s funding 5
124	124	requirements. 6
125	125	(d) The health insurance individual market affordability account shall be exempt from the 7
126	126	indirect cost recovery provisions of § 35-4-27. 8
127	127	(e) Nothing in this chapter shall be construed as obligating the state to make general 9
128	128	revenue appropriations to support the state affordability program. 10
129	129	42-157.2-5. Utilization of program fund -- Affordability programs. 11
130	130	(a) The director shall allocate the program fund, pursuant to regulations adopted under this 12
131	131	chapter: 13
132	132	(1) To provide payments to carriers to increase the affordability of health insurance on the 14
133	133	individual market for individuals who receive federal premium tax credits in the form of 15
134	134	supplemental state premium tax credits; 16
135	135	(2) To provide payments to carriers to increase the affordability of health insurance on the 17
136	136	individual market for individuals who are over the household income limit, as established by federal 18
137	137	law, for federal premium tax credits in the form of state premium tax credits; 19
138	138	(3) To provide subsidies to reduce cost sharing for individuals enrolled in health insurance 20
139	139	coverage through the exchange who are determined eligible for state subsidies; and 21
140	140	(4) To pay for the actual administrative costs for implementing and administering the 22
141	141	program established under this chapter. These actual administrative costs include the following: 23
142	142	(i) The costs to implement the market affordability board established by § 42-157.2-6; 24
143	143	(ii) The actual costs related to implementing and maintaining the program fund established 25
144	144	by § 42-157.2-4; 26
145	145	(iii) The costs for conducting analyses necessary to determine the payments to be made to 27
146	146	carriers for the purposes described in subsections (a)(l), (a)(2), and (a)(3) of this section; and 28
147	147	(iv) Any other costs which accrue to the state traceable to the operation of this program. 29
148	148	(b) The program fund shall be allocated as the director, pursuant to recommendations 30
149	149	established by the board, determines is best in the interest of advancing consumer affordability, 31
150	150	with the following limitations: 32
151	151	(1) For the coverage year beginning January 1, 2026, the director shall rely upon the 33
152	152	recommendations advanced by the marketplace coverage affordability work group and summarized 34
153	153
154	154
155	155	LC001839 - Page 5 of 13
156	156	in the report delivered to the general assembly entitled “coverage at risk: state actions to keep Rhode 1
157	157	Islanders covered” and shall make allocations of the program fund accordingly; 2
158	158	(2) In establishing the amount of the program fund: 3
159	159	(i) For the year beginning January 1, 2026, and so long as federal premium tax credits 4
160	160	remain in place that are no less generous than the federal premium tax credits utilizing the 5
161	161	applicable percentages of household income established in the version of 26 U.S.C. 36B(b)(3)(A)(i) 6
162	162	in effect on January 1, 2025, the director shall set a total funding amount equal to the greater of: 7
163	163	(A) Twenty million dollars ($20,000,000); or 8
164	164	(B) An amount necessary to provide state premium tax credits to enrollees which shall 9
165	165	provide a total premium assistance credit amount for each enrollee, including both federal and state 10
166	166	premium tax credits, which sets an applicable percentage utilizing the following income tier table 11
167	167	in lieu of the income table established in 26 U.S.C. 36B(b)(3)(A)(i): 12
168	168	In the case of household income The initial premium The final premium 13
169	169	(expressed as a percent of the percentage is: percentage is: 14
170	170	Federal Poverty Line) within 15
171	171	the following income tier: 16
172	172	Up to 150.0 percent 0.0 0.0 17
173	173	150.0 percent up to 200.0 percent 0.0 2.0 18
174	174	200.0 percent up to 250.0 percent 2.0 4.0 19
175	175	250.0 percent up to 300.0 percent 4.0 6.0 20
176	176	300.0 percent up to 400.0 percent 6.0 8.5 21
177	177	400.0 percent and higher 8.5 8.5 22
178	178	(ii) For the year beginning January 1, 2026, if the federal premium tax credits in place are 23
179	179	less generous than those that would exist utilizing the applicable percentages established in the 24
180	180	version of 26 U.S.C. 36B(b)(3)(A)(i) in effect on January 1, 2025, the director shall set a total 25
181	181	funding amount no lower than forty million dollars ($40,000,000). 26
182	182	(iii) For subsequent years, the director shall set a total funding amount informed by the 27
183	183	recommendations of the board established in § 42-157.2-6, but shall not recommend a year-over-28
184	184	year reduction in the total funding amount for the program unless accompanied by a report to the 29
185	185	general assembly communicating the decrease along with an explanation of why such a reduction 30
186	186	would align with the goal of improved affordability in the individual market. 31
187	187	42-157.2-6. Individual market affordability board. 32
188	188	(a) There is hereby created the individual market affordability board, which is responsible 33
189	189	for issuing recommendations to the director for the specific terms of the affordability programs 34
190	190
191	191
192	192	LC001839 - Page 6 of 13
193	193	established in § 42-157.2-5. 1
194	194	(b) The board shall consist of the following voting members: 2
195	195	(1) The director of the exchange or designee; 3
196	196	(2) The commissioner of the office of the health insurance commissioner or designee; 4
197	197	(3) Eleven (11) additional members as follows: 5
198	198	(i) One member employed by a health insurance carrier; 6
199	199	(ii) One member who is a representative of a statewide association of health benefit plans; 7
200	200	(iii) One member representing primary care healthcare providers who does not represent a 8
201	201	health insurance carrier; 9
202	202	(iv) One member who represents a healthcare advocacy organization; 10
203	203	(v) One member who is a representative of a business that purchases or otherwise provides 11
204	204	health insurance coverage for its employees; 12
205	205	(vi) One member who represents a hospital; 13
206	206	(vii) Five (5) members who are consumers of healthcare who are not representatives or 14
207	207	employees of a hospital, health insurance carrier, or other healthcare industry entity. To the extent 15
208	208	possible, the governor shall ensure that the consumer members of the board are individuals who 16
209	209	lack affordable offers of coverage from their employers and who otherwise struggle to afford to 17
210	210	purchase health insurance or who struggle to afford to pay for their healthcare. 18
211	211	(c) The members under subsection (b)(3) of this section shall be appointed by the governor 19
212	212	and submitted by the governor to the senate, who may within twelve (12) legislative days confirm 20
213	213	or reject that appointment. If the senate shall fail for twelve (12) legislative days after the 21
214	214	submission to confirm the appointment, the governor shall submit another appointment and so on 22
215	215	in like manner until the senate shall confirm the person named by the governor; however, terms of 23
216	216	current members of the board of review shall not be altered by this chapter. 24
217	217	(d) To the extent possible, the governor shall attempt to appoint board members who reflect 25
218	218	the diversity of the state with regard to race, ethnicity, immigration status, income, wealth, 26
219	219	disability, and geography. 27
220	220	(e) The term of office of the members of the board appointed by the governor is four (4) 28
221	221	years, and those members may serve no more than two (2) four-year (4) terms. 29
222	222	(f) In order to ensure staggered terms of office, the initial terms of office of the members 30
223	223	of the board are: 31
224	224	(1) Two (2) years for the members appointed pursuant to subsections (b)(3)(i), (b)(3)(iii), 32
225	225	and (b)(3)(v) of this section and for three (3) of the members appointed pursuant to subsection 33
226	226	(b)(3)(vii) of this section; and 34
227	227
228	228
229	229	LC001839 - Page 7 of 13
230	230	(2) Four (4) years for the members appointed pursuant to subsections (b)(3)(ii), (b)(3)(iv), 1
231	231	and (b)(3)(vi) of this section and for two (2) of the members appointed pursuant to subsection 2
232	232	(b)(3)(vii) of this section. 3
233	233	(g) Members of the board appointed by the governor serve at the pleasure of the governor 4
234	234	and may be removed by the governor. 5
235	235	(h) In the case of a vacancy on the board while the senate is in session, the governor shall 6
236	236	appoint a replacement subject to the provisions of subsection (c) of this section. A member who is 7
237	237	so appointed to fill a vacancy shall serve the remainder of the unexpired term of the member whose 8
238	238	vacancy is being filled. 9
239	239	(i) In the case of a vacancy on the board while the senate is not in session, the governor 10
240	240	shall appoint a replacement who shall hold office until the beginning of the next session of the 11
241	241	senate. 12
242	242	(j) Members of the board may be reimbursed for actual and necessary expenses, including 13
243	243	any required dependent care and dependent or attendant travel, food, and lodging, while engaged 14
244	244	in the performance of official duties of the board. 15
245	245	(k) The board shall meet as often as necessary to carry out its duties. 16
246	246	(l) The board is authorized to recommend, for approval and establishment by the director 17
247	247	by rule: 18
248	248	(1) The distribution of program fund revenues allocated for carrier payments and for 19
249	249	subsidies in a manner that best improves affordability for subsidized populations; 20
250	250	(2) The parameters, including income limits, for implementing the program and for 21
251	251	identifying subsidized populations, including the appropriate balance between affordability 22
252	252	programs and the most effective method to improve the availability and comprehensiveness of 23
253	253	coverage to serve the goal of improved consumer access to care across all populations: 24
254	254	(m) In formulating recommendations for the year beginning January 1, 2026, the board 25
255	255	shall consider the recommendations advanced by the marketplace coverage affordability work 26
256	256	group and summarized in the report delivered to the general assembly entitled "coverage at risk: 27
257	257	state actions to keep Rhode Islanders covered." 28
258	258	42-157.2-7. Rules and regulations. 29
259	259	(a) The director may promulgate regulations as necessary to carry out the purposes of this 30
260	260	chapter. 31
261	261	(b) In establishing regulations relating to the parameters of the program, the director shall 32
262	262	consider the recommendations of the board and shall explain in writing the reasons for any 33
263	263	deviation from the recommendations of the board. 34
264	264
265	265
266	266	LC001839 - Page 8 of 13
267	267	SECTION 2. Section 35-4-27 of the General Laws in Chapter 35-4 entitled "State Funds" 1
268	268	is hereby amended to read as follows: 2
269	269	35-4-27. Indirect cost recoveries on restricted receipt accounts. 3
270	270	Indirect cost recoveries of ten percent (10%) of cash receipts shall be transferred from all 4
271	271	restricted-receipt accounts, to be recorded as general revenues in the general fund. However, there 5
272	272	shall be no transfer from cash receipts with restrictions received exclusively: (1) From contributions 6
273	273	from nonprofit charitable organizations; (2) From the assessment of indirect cost-recovery rates on 7
274	274	federal grant funds; or (3) Through transfers from state agencies to the department of administration 8
275	275	for the payment of debt service. These indirect cost recoveries shall be applied to all accounts, 9
276	276	unless prohibited by federal law or regulation, court order, or court settlement. The following 10
277	277	restricted receipt accounts shall not be subject to the provisions of this section: 11
278	278	Executive Office of Health and Human Services 12
279	279	Organ Transplant Fund 13
280	280	HIV Care Grant Drug Rebates 14
281	281	Health System Transformation Project 15
282	282	Rhode Island Statewide Opioid Abatement Account 16
283	283	HCBS Support-ARPA 17
284	284	HCBS Admin Support-ARPA 18
285	285	Department of Human Services 19
286	286	Veterans’ home — Restricted account 20
287	287	Veterans’ home — Resident benefits 21
288	288	Pharmaceutical Rebates Account 22
289	289	Demand Side Management Grants 23
290	290	Veteran’s Cemetery Memorial Fund 24
291	291	Donations — New Veterans’ Home Construction 25
292	292	Department of Health 26
293	293	Pandemic medications and equipment account 27
294	294	Miscellaneous Donations/Grants from Non-Profits 28
295	295	State Loan Repayment Match 29
296	296	Healthcare Information Technology 30
297	297	Department of Behavioral Healthcare, Developmental Disabilities and Hospitals 31
298	298	Eleanor Slater non-Medicaid third-party payor account 32
299	299	Hospital Medicare Part D Receipts 33
300	300	RICLAS Group Home Operations 34
301	301
302	302
303	303	LC001839 - Page 9 of 13
304	304	Commission on the Deaf and Hard of Hearing 1
305	305	Emergency and public communication access account 2
306	306	Department of Environmental Management 3
307	307	National heritage revolving fund 4
308	308	Environmental response fund II 5
309	309	Underground storage tanks registration fees 6
310	310	De Coppet Estate Fund 7
311	311	Rhode Island Historical Preservation and Heritage Commission 8
312	312	Historic preservation revolving loan fund 9
313	313	Historic Preservation loan fund — Interest revenue 10
314	314	Department of Public Safety 11
315	315	E-911 Uniform Emergency Telephone System 12
316	316	Forfeited property — Retained 13
317	317	Forfeitures — Federal 14
318	318	Forfeited property — Gambling 15
319	319	Donation — Polygraph and Law Enforcement Training 16
320	320	Rhode Island State Firefighter’s League Training Account 17
321	321	Fire Academy Training Fees Account 18
322	322	Attorney General 19
323	323	Forfeiture of property 20
324	324	Federal forfeitures 21
325	325	Attorney General multi-state account 22
326	326	Forfeited property — Gambling 23
327	327	Department of Administration 24
328	328	OER Reconciliation Funding 25
329	329	Health Insurance Individual Market Affordability Account 26
330	330	Health Insurance Market Integrity Fund 27
331	331	RI Health Benefits Exchange 28
332	332	Information Technology restricted receipt account 29
333	333	Restore and replacement — Insurance coverage 30
334	334	Convention Center Authority rental payments 31
335	335	Investment Receipts — TANS 32
336	336	OPEB System Restricted Receipt Account 33
337	337	Car Rental Tax/Surcharge-Warwick Share 34
338	338
339	339
340	340	LC001839 - Page 10 of 13
341	341	Grants Management Administration 1
342	342	RGGI-Executive Climate Change Coordinating Council Projects 2
343	343	Executive Office of Commerce 3
344	344	Housing Resources Commission Restricted Account 4
345	345	Housing Production Fund 5
346	346	Department of Revenue 6
347	347	DMV Modernization Project 7
348	348	Jobs Tax Credit Redemption Fund 8
349	349	Legislature 9
350	350	Audit of federal assisted programs 10
351	351	Department of Children, Youth and Families 11
352	352	Children’s Trust Accounts — SSI 12
353	353	Military Staff 13
354	354	RI Military Family Relief Fund 14
355	355	RI National Guard Counterdrug Program 15
356	356	Treasury 16
357	357	Admin. Expenses — State Retirement System 17
358	358	Retirement — Treasury Investment Options 18
359	359	Defined Contribution — Administration - RR 19
360	360	Violent Crimes Compensation — Refunds 20
361	361	Treasury Research Fellowship 21
362	362	Business Regulation 22
363	363	Banking Division Reimbursement Account 23
364	364	Office of the Health Insurance Commissioner Reimbursement Account 24
365	365	Securities Division Reimbursement Account 25
366	366	Commercial Licensing and Racing and Athletics Division Reimbursement Account 26
367	367	Insurance Division Reimbursement Account 27
368	368	Historic Preservation Tax Credit Account 28
369	369	Marijuana Trust Fund 29
370	370	Social Equity Assistance Fund 30
371	371	Judiciary 31
372	372	Arbitration Fund Restricted Receipt Account 32
373	373	Third-Party Grants 33
374	374	RI Judiciary Technology Surcharge Account 34
375	375
376	376
377	377	LC001839 - Page 11 of 13
378	378	Department of Elementary and Secondary Education 1
379	379	Statewide Student Transportation Services Account 2
380	380	School for the Deaf Fee-for-Service Account 3
381	381	School for the Deaf — School Breakfast and Lunch Program 4
382	382	Davies Career and Technical School Local Education Aid Account 5
383	383	Davies — National School Breakfast & Lunch Program 6
384	384	School Construction Services 7
385	385	Office of the Postsecondary Commissioner 8
386	386	Higher Education and Industry Center 9
387	387	IGT STEM Scholarships 10
388	388	Department of Labor and Training 11
389	389	Job Development Fund 12
390	390	Rhode Island Council on the Arts 13
391	391	Governors’ Portrait Donation Fund 14
392	392	Statewide records management system account 15
393	393	SECTION 3. Sections 42-7.4-3 and 42-7.4-11 of the General Laws in Chapter 42-7.4 16
394	394	entitled "The Healthcare Services Funding Plan Act" are hereby amended to read as follows: 17
395	395	42-7.4-3. Imposition of healthcare services funding contribution. [As amended by P.L. 18
396	396	2024, ch. 423, § 1; See Compiler’s Note.] 19
397	397	(a) Each insurer is required to pay the healthcare services funding contribution for each 20
398	398	contribution enrollee of the insurer at the time the contribution is calculated and paid, at the rate set 21
399	399	forth in this section. 22
400	400	(1) Beginning July 1, 2024, the secretary shall set the healthcare services funding 23
401	401	contribution each fiscal year in an amount equal to: (i) The child immunization funding requirement 24
402	402	described in § 23-1-46; plus (ii) The adult immunization funding requirement described in § 23-1-25
403	403	46; plus (iii) The children’s health services funding requirement described in § 42-12-29; plus (iv) 26
404	404	The psychiatry resource network funding requirement described in § 23-1-46.1; plus (v) The health 27
405	405	insurance individual market funding requirement described in § 42-157.2-4; and all as divided by; 28
406	406	(v)(vi) The number of contribution enrollees of all insurers. 29
407	407	(2) The contribution set forth herein shall be in addition to any other fees or assessments 30
408	408	upon the insurer allowable by law. 31
409	409	(b) The contribution shall be paid by the insurer; provided, however, a person providing 32
410	410	health benefits coverage on a self-insurance basis that uses the services of a third-party 33
411	411	administrator shall not be required to make a contribution for a contribution enrollee where the 34
412	412
413	413
414	414	LC001839 - Page 12 of 13
415	415	contribution on that enrollee has been or will be made by the third-party administrator. 1
416	416	(c) The secretary shall create a process to facilitate the transition to the healthcare services 2
417	417	funding contribution method that: (i) assures adequate funding beginning July 1, 2016, (ii) reflects 3
418	418	that funding via the healthcare services funding contribution method initially will be for only a 4
419	419	portion of the state’s fiscal year, and (iii) avoids duplicate liability for any insurer that made a 5
420	420	payment under the premium assessment method in effect prior to January 1, 2016, for a period for 6
421	421	which it would also be liable for a contribution under the healthcare services funding contribution 7
422	422	method as described in this chapter. 8
423	423	42-7.4-11. Method of payment and deposit of contribution. 9
424	424	(a) The payments required by this chapter may be made by electronic transfer of monies to 10
425	425	the general treasurer. 11
426	426	(b) The general treasurer shall take all steps necessary to facilitate the transfer of monies 12
427	427	to: 13
428	428	(1) The “childhood immunization account” described in § 23-1-45(a) in the amount 14
429	429	described in § 23-1-46(a); 15
430	430	(2) To the “adult immunization account” described in § 23-1-45(c) in the amount described 16
431	431	in § 23-1-46(a); 17
432	432	(3) To the “children’s health account” described in § 42-12-29(a) in the amount described 18
433	433	in § 42-12-29(b); and 19
434	434	(4) To the “health insurance individual market affordability account” described in § 42-20
435	435	157.2-4(a) in the amount described in § 42-157.2-4(b); and 21
436	436	(4)(5) Any remainder of the payments shall be proportionally distributed to those accounts 22
437	437	and credited against the next year’s healthcare services funding contribution. 23
438	438	(c) The general treasurer shall provide the secretary with a record of any monies transferred 24
439	439	and deposited. 25
440	440	SECTION 4. This act shall take effect upon passage. 26
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442	442	LC001839
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444	444
445	445
446	446	LC001839 - Page 13 of 13
447	447	EXPLANATION
448	448	BY THE LEGISLATIVE COUNCIL
449	449	OF
450	450	A N A C T
451	451	RELATING TO STATE AFFAIRS AND GOVERNMENT -- RHODE ISLAND INDIVIDUAL
452	452	MARKET AFFORDABILITY ACT OF 2025
453	453	***
454	454	This act would create the Rhode Island individual market affordability act of 2025 to help 1
455	455	reduce out-of-pocket costs for low- and moderate-income consumers enrolled in health insurance 2
456	456	coverage through the Rhode Island health benefits exchange. 3
457	457	This act would take effect upon passage. 4
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459	459	LC001839
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