Section 220-RICR-90-00-1.15 - Exchange Trust PaymentsA. Establishment of Trust - The Exchange shall establish the Trust for the following purposes: 1. Collecting health and dental insurance premium payments from qualified employers and qualified individuals;2. Remitting premium payments to QHP issuers on behalf of enrollees who participate in QHPs offered through the Exchange;3. Performing functions ancillary to the collection and payment of premiums to Qualified Health Plan issuers and the receipt of payments for such products and services as may be offered through the Exchange; and4. Carrying out any other functions that are reasonably necessary in furtherance of the foregoing and in accordance with the establishment and maintenance of the Trust.B. Payments to the Trust - Qualified individuals and qualified employers may remit premium payments to the Exchange to maintain participation in a QHP in accordance with all requirements under the Act and the Federal Regulations. 1. Premium payments may be made in advance of the coverage month to which the payment applies.2. The monthly premium payment deadline shall be established by the Exchange.3. Premium payments will be applied against open premium lines in chronological order, beginning with the oldest outstanding premium payment.4. Payments may be received by the Trust from qualified individuals and employers for such products and services as may be offered through the Exchange.C. Overdue Accounts - Individuals and Employers will be considered overdue when they have not paid a monthly bill in full by the designated due date. 1. Overdue accounts will be sent a late notice including the payment amount overdue, any applicable grace period, and the expected coverage termination date.2. Late notices will be mailed or delivered electronically into the individual's or employer's account.D. Payment Deposits - All premium payments described in § 1.15(B) of this Part will be deposited into one (1) or more bank accounts, held in the name of the Trust, and maintained at a bank branch located in the State of Rhode Island and insured by the Federal Deposit Insurance Corporation.E. Payments from the Trust - Upon receipt and reconciliation of accounts among and between the Exchange and a QHP issuer, the Trust will remit premium payments to the QHP issuer in accordance with the issuer agreement and pursuant to procedures set forth by the Exchange. The Trust shall receive any such funds as may be permitted under State and Federal law and Regulation and remit to the Exchange.F. Standards - All activities of the Trust must be performed in accordance with all applicable standards under the Federal Regulations and the Act including, without limitation, the oversight and financial integrity requirements of §1313 of the Act.G. Privacy and Security - All activities of the Trust shall conform with all applicable State and Federal laws pertaining to the privacy and security of financial and confidential health information including, without limitation, those standards described in 45 C.F.R. §§ 155.260(a) through (g) and 155.270(a) and (b), incorporated above at § 1.3 of this Part, relating to conducting electronic transactions.220 R.I. Code R. § 220-RICR-90-00-1.15
Amended effective 12/22/2019
Amended effective 12/31/2020
Amended effective 4/2/2023