2009 -- S 0843

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LC02271

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STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2009

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A N A C T

RELATING TO INSURANCE - EXTENDED MEDICAL BENEFITS

     Introduced By: Senators DeVall, and Gallo

     Date Introduced: April 02, 2009

     Referred To: Senate Health & Human Services

It is enacted by the General Assembly as follows:

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     SECTION 1. Section 27-19.1-1 of the General Laws in Chapter 27-19.1 entitled

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"Extended Medical Benefits" is hereby amended to read as follows:

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     27-19.1-1. Medical benefits for those who lose eligibility to participate. -- (a)

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Whenever the employment of an insured member of a group hospital, surgical, or medical

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insurance plan is terminated because of involuntary layoff or death, or as a result of the

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workplace ceasing to exist, or the permanent reduction in size of the workforce, the benefits of

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the plan may be continued as provided in this section for a period of up to eighteen (18) months

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from the termination date of the insured member, but in any event not to exceed the shorter of the

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period which represents the period of continuous employment preceding termination with the

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employer under whose contract the member is insured or the time from the termination date of the

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insured member until the member, surviving spouse of a deceased member, and any other

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dependent(s) of the member who were covered under the plan, becomes employed by another

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group and eligible for benefits under another group plan.

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      (b) The extended coverage for the period defined in subsection (a) of this section shall be

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available to the terminated member the surviving spouse of a deceased member, and any other

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dependent(s) of the member who were covered under the plan, at the same monthly premium rate

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or subscription fee for the group in which he or she was previously a member or at a monthly

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premium rate or subscription fee as may be in effect from time to time for the same group

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subsequent to his or her qualification under subsection (a) of this section. The terminated

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member, the surviving spouse of a deceased member, and any other dependent(s) of the member

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who were covered under the plan, shall not be required to pay more than a monthly premium rate

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or subscription fee per month at one time.

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      (c) The involuntarily laid off member or other member qualifying under subsection (a) of

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this section, the surviving spouse of a deceased member, and any other dependent(s) of the

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member who were covered under the plan, may elect to continue participation in the group plan

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within thirty (30) days after the member's qualification under subsection (a) of this section. The

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involuntarily laid off member, the surviving spouse of a deceased member, and any other

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dependent(s) of the member who were covered under the plan shall be responsible for the

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payment of monthly premiums rates or subscription fees directly to the carrier of the surgical,

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hospital, or medical insurance plan, or the group plan's agent or insurance producer, throughout

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the extended coverage period, if the member had been covered under a group plan consisting of

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fifty (50) members or less. Those leaving group plans with more than fifty (50) members shall be

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responsible directly to the employer for the payment of monthly premiums rates or subscription

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fees, or directly to the carrier if the workplace ceases to exist. The terminated member, the

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surviving spouse of a deceased member, and any other dependent(s) of the member who were

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covered under the plan, shall not be required to pay more than a monthly premium rate or

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subscription fee per month at one time.

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      (d) After timely receipt of the monthly premium rate or subscription fee, as defined in

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this subsection, from the qualifying member, the surviving spouse of a deceased member, and any

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other dependent(s) of the member who were covered under the plan, if the employer fails to make

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payment to the carrier with the result that coverage is terminated, the employer shall be liable for

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benefits to the same extent as the carrier would have been liable if coverage had not been

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terminated. "Timely receipt" of the monthly premium payment means the employer's receipt of

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the monthly premium rate or subscription fee for the extended coverage from the qualifying

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member, the surviving spouse of a deceased member, and any other dependent(s) of the member

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who were covered under the plan within the dates or by the date indicated by the employer as a

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requirement of this chapter at the time of the election of the extended coverage. This subsection

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shall not apply to an employer whose workplace ceases to exist.

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      (e) Upon termination of the extended coverage period, the qualifying member, the

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surviving spouse of a deceased member, and any other dependent(s) of the member who were

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covered under the plan shall be entitled to exercise any option which is provided in the group plan

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to elect a converted policy.

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      (f) All employers who provide their employees a group hospital, surgical, or medical

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insurance plan shall post a conspicuous notice to the employees of their options under the

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provisions of this chapter.

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      (g) "Group hospital, surgical, or medical insurance plan" as used herein in this section

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includes any service plan contract of a medical or health service plan corporation. "Carrier" as

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used in this section means shall mean any insurance company which is the insurer of the group

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hospital, surgical, or medical plan or the medical or health service plan corporation which

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provides the group service plan contract, either of which an employer provides for his or her

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employees.

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      (h) This chapter shall not apply to an employee who is employed in the construction

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industry or his or her employer if the employee, at the time benefits could be selected under this

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chapter, is a participant in, and the employer is a contributor to, a multi-employer welfare plan as

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defined in 29 U.S.C. section 1301 et seq., and which the internal revenue service has determined

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is tax exempt as to contributions received and as to benefits received by its participants.

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     (i) Notwithstanding any section to the contrary, any member who qualified for the

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extended coverage as defined in subsection (a) on or after September 1, 2008 but who declined to

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elect coverage within the timeframe as described within subsection (c) may elect, no later than

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May 1, 2009, to resume coverage under this section. Coverage elected under this subsection shall

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commence March 1, 2009 and may be continued as defined in subsection (a).

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     SECTION 2. This act shall take effect upon passage.

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LC02271

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N A C T

RELATING TO INSURANCE - EXTENDED MEDICAL BENEFITS

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     This act would provide a method to resume extended medical coverage when a person

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has declined to elect coverage within the timeframe provided.

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     This act would take effect upon passage.

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LC02271

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