§ 27-18.6-11 - Health insurance plan payment and expense reporting.
SECTION 27-18.6-11
§ 27-18.6-11 Health insurance plan paymentand expense reporting. – A health insurance carrier: (1) providing proposed rate, premium, fee, or otherprospective cost information in connection with an offering of health insurancecoverage to a large group or large employer setting forth claims cost as anelement of cost; or (2) providing information to a large group or largeemployer (as so defined) regarding claims paid, shall be required todistinguish, set forth and itemize as separate and distinct elements of cost:(i) sums actually payable (or paid) to health care providers; and (ii) sumsactually (or proposed to be) retained or paid by the carrier foradministration, including, but not limited to, sums relating to claim services,managed care fees, network access fees, and contributions to reserves.