|Applicable CHA-RI Statutes
RI Gen Law 42-12-29 effective until January 2016 – Children's Health Account
RI Gen Law 42-12-29 effective January 2016 – Children’s Health Account
RI Gen Law 42-7.4-3 – Imposition of Healthcare Services Funding Contribution
CHA-RI Contribution Enrollees FAQ
C1. What are “contribution enrollees”?
Contribution enrollee" means an individual residing in Rhode Island, with respect to whom an insurer administers, provides, pays for, insures, or covers health care services, unless excepted by this section.
C2. Who is not a “contribution enrollee”?
Contribution enrollee shall not include an individual whose healthcare services are paid or reimbursed by Part A or Part B of the Medicare program, a Medicare supplemental policy as defined in section 1882(g)(1) of the Social Security Act, 42 U.S.C. 1395ss(g) (1), or Medicare managed care policy, the federal employees' health benefit program, Tricare, CHAMPUS, the Veterans' healthcare program, the Indian health service program, or any local governmental corporation, district, or agency providing health benefits coverage on a self-insured basis.
C3. Must an entity file reports even if it does not provide medical benefits and therefore has zero contribution enrollees?
Yes, but the entity may be eligible to file an Annual or Permanent Zero Contribution Enrollees Report instead of the typical quarterly reports. Please note that if an entity has zero contribution enrollees for one quarter only, then it should file a normal quarterly report with “0” values.
If, however, an entity does not administer medical benefits or is otherwise exempt by Rhode Island statute so that it has zero contribution enrollees, it should file one of two types of Zero Contribution Enrollees Reports. For example, this type of report would be appropriate for entities such as those administering eye care or dental benefit only plans. If the entity has zero contribution enrollees and will continue to have zero contribution enrollees for the balance of the year, then it should file an Annual Zero Contribution Enrollees Report during the first quarter of the calendar year. No other report will be due until the first quarter of the following calendar year. If the entity has zero contribution enrollees and expects to never have contribution enrollees, it should file a Permanent Zero Contribution Enrollees Report to eliminate the need for further compliance follow up. A guide to Zero Contribution Enrollees Reports is available in the “Filing Guides” section under the “REFERENCE” tab.
C6. If my company filed a Permanent Zero Contribution Enrollees Report for RIVAP, should we file the same report for CHA-RI?
No, so long as you continue to have permanent zero covered lives and the Rhode Island law remains unchanged, you will not be required to make any filings or payments with respect to the CHA-RI assessment. Your work to confirm your status as a non-payer for RIVAP also confirms that status for CHA-RI with no further administrative requirement for your firm.
This remains the case as it relates to the current RIVAP & CHA-RI programs under current laws & regulations and administrative guidance KidsVax® has received to date. It does not have any applicability to any other state program administered by KidsVax® and may or may not be affected by any future change in law, regulation, or administrative ruling applicable to CHA-RI.