Title 230 - Department of Business Regulation / Chapter 20 - Insurance / Subchapter 30 - Health Insurance / Part 2 - Coordination of Benefits
(230-RICR-20-30-2) is adopted with an effective date of 8/25/2018
The purpose of Part 2 is to:
http://www.dbr.state.ri.us/documents/rules/insurance/230-RICR-20-30-2.pdfInsurance Bulletin Number 2018-8 - Coordination of Benefits Forms -
- Establish a uniform order of benefit determination under which plans pay their claims;
- Reduce duplication of benefits by permitting a reduction of the benefits to be paid by plans that, pursuant to rules established by this part, do not have to pay their benefits first; and
- Provide greater efficiency in the procession of claims when a person is covered by more than one plan.
Bulletin 2018-8 provides the (Model COB Contract Provisions) that the DBR has prescribed to be used for compliance with 230-RICR-20-30-2. The regulation sets forth the standards for coordination of insurance benefits in Rhode Island, specifically Bulletin 2018-8 defines the following:
- Definition of a PLAN
- Order of Benefit Determination Rules (Primary or Secondary, Dependents, COBRA, Allowable Expense)
- Effect on the Benefits of "This Plan"
- Rights to Receive and Release Needed Information
- Faculty of Payment
- Right of Recovery (payments in excess of what should have been paid)