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Insurance Advocacy Unit

The Insurance Advocacy Unit’s primary function is to represent, protect and advocate the rights of consumers at insurance rate hearings and in the insurance marketplace pursuant to R.I. Gen. Laws § 27-36-1.  Many people turn to the Insurance Advocate to assist them with insurance-related issues, such as denials of payment for treatment, access to medical treatments and procedures under their policies of insurance and other rights under their various policies of insurance and Rhode Island laws. 

The role of the Advocate in connection to rate increase requests for worker’s compensation insurance providers and health insurance providers is to independently evaluate the validity of the rate increase requests, and when appropriate, recommend alternative rates to the regulatory agency. 

Blue Cross and Blue Shield of Rhode Island sought average rate increases of 18.1% for its Direct Pay subscribers, while the Attorney General recommended a decrease of 6.5%.  After a full public hearing, OHIC approved a decrease of 5% from filed rates, resulting in savings of approximately $3.75 million in premium costs.

During 2013, the Unit represented the rights of Rhode Island citizens in connection with two rate filings before the Department of Business Regulation (DBR) and the Office of Health Insurance Commissioner (OHIC), and reviewed 23 rate and form filings filed with OHIC.

The National Council on Compensation Insurance (NCCI) Loss Costs and Rating Values Filing submitted a request to increase overall base premium rates for workers compensation insurance by 8 percent, effective July 2013. The Attorney General submitted alternative calculations to those filed by NCCI, seeking a decrease in overall base premium rates of 0.1 percent.  After a review of the rates submitted by NCCI and the alternative calculations submitted by the Attorney General, the DBR approved an increase of 7.4 percent, resulting in savings of approximately $1.5 million in premium costs.

The difference in rate increases for health and worker’s comp insurance and that of the approved rates saved ratepayers approximately $5.3 million in premium costs.