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https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-50/8051/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062)›§ 8051 - Declaration of purposes | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062) › § 8051 - Declaration of purposes | In view of the problem of financial loss as a result of uncompensated damages to motor vehicles in traffic accidents, the Government of Puerto Rico, through this chapter, adopts a compulsory liability insurance system which covers the damages caused to vehicles in accidents. To such ends, so that a motor vehicle can tr... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-50/8052/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062)›§ 8052 - Definitions | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062) › § 8052 - Definitions | For the purposes of this chapter, the following terms and phrases shall have the meaning stated below:
(a) Insurer.— Means a private insurer as well as the Joint Underwriting Association.
(b) Private insurer. — Means an insurer who is or may be licensed in the future to underwrite insurance in Puerto Rico, against any ... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-50/8053/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062)›§ 8053 - General provisions | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062) › § 8053 - General provisions | (a) Any person who obtains a motor vehicle license for the first time, or who renews it, as required by §§ 5001 et seq. of Title 9, shall be bound to pay the corresponding premium for the compulsory liability insurance together with the payment of the amount of the fees for the issuing or renewing said license, to the ... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-50/8054/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062)›§ 8054 - Who shall offer the compulsory liability insurance | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062) › § 8054 - Who shall offer the compulsory liability insurance | (a) All private insurers shall be bound to provide the compulsory liability insurance to those motor vehicle owners that request it, except as provided in subsection (b) of this section.
(b) The Commissioner shall establish the criteria through regulations to such effects, that the private insurers shall take into cons... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-50/8055/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062)›§ 8055 - Joint Underwriting Association—Creation | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062) › § 8055 - Joint Underwriting Association—Creation | (a) The Joint Underwriting Association of the Compulsory Liability Insurance is hereby created as a private association that shall provide and administer the compulsory liability insurance, which shall be acquired through the payment of fees for the [issuance] or renewal of a motor vehicle license. It shall be composed... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-50/8056/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062)›§ 8056 - Premiums | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062) › § 8056 - Premiums | (a) The initial uniform premium of the compulsory liability insurance shall be ninety-nine dollars ($99) for each private passenger vehicle and one hundred forty-eight dollars ($148) for each commercial vehicle. The premium shall not be increased until three (3) years have elapsed in the case of private insurers, and t... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-50/8057/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062)›§ 8057 - Investigation, adjustment and resolution of claims | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062) › § 8057 - Investigation, adjustment and resolution of claims | (a) The Joint Underwriting Association shall establish an initial liability determination system that shall facilitate, expedite, and uniform the payment of claims. Said system shall provide a reasonable term to make the liability determination. This system shall not impair the right of claimants to resort to the court... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-50/8058/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062)›§ 8058 - Term for the payment of claims and penalties | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062) › § 8058 - Term for the payment of claims and penalties | Once the liability and the amount of the damages to a motor vehicle in an accident has been determined through the initial liability determination system or by the courts with jurisdiction, payment of the claim shall be made in a term which shall not exceed five (5) calendar days as of said determination. If payment is... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-50/8059/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062)›§ 8059 - Prescription | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062) › § 8059 - Prescription | Any right to a claim against an insurer under the compulsory liability insurance shall prescribe after one (1) year has elapsed since the cause of action occurred.
History —Dec. 27, 1995, No. 253, § 10. |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-50/8060/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062)›§ 8060 - Penalty for driving an uninsured motor vehicle | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062) › § 8060 - Penalty for driving an uninsured motor vehicle | (a) Any person who fails to comply with the provisions of § 8053(b) of this title shall incur a misdemeanor and, upon conviction, shall be sanctioned with a five hundred dollar ($500) fine. Furthermore, the court shall impose the payment of damages, as established in Section 16-102A [sic] of the Puerto Rico Vehicles an... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-50/8061/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062)›§ 8061 - Relationship between traditional liability insurance and compu... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062) › § 8061 - Relationship between traditional liability insurance and compulsory liability insurance | (a) Those motor vehicle owners who have traditional liability insurance in effect at the time of the [issuance] or renewal of the motor vehicle license with a coverage similar to or greater than that of the compulsory liability insurance may continue to use said traditional insurance to comply with the insurance requir... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-50/8062/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062)›§ 8062 - Annual report | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 50 - Compulsory Motor Vehicle Liability Insurance (§§ 8051 — 8062) › § 8062 - Annual report | The Joint Underwriting Association shall submit an annual report to the Legislative Assembly at the Office of the Secretary and Clerk of each legislative body on or before March 15 of every year, which shall detail the incidence of accidents covered and the costs incurred in the repair of damages to motor vehicles insu... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-51/8071/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 51 - Prohibition of Restricted Use of 9-1-1 Services by Health Plans (§§ 8071 — 8074)›§ 8071 - Definitions | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 51 - Prohibition of Restricted Use of 9-1-1 Services by Health Plans (§§ 8071 — 8074) › § 8071 - Definitions | For the purpose of this chapter:
(a) Medical emergencies.— Shall mean any medical condition manifested by acute or severe symptoms that could include severe pain, before which a lay person with average medicine and health knowledge may think that the lack of medical assistance could result in:
(1) A health risk for a p... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-51/8072/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 51 - Prohibition of Restricted Use of 9-1-1 Services by Health Plans (§§ 8071 — 8074)›§ 8072 - Applicability | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 51 - Prohibition of Restricted Use of 9-1-1 Services by Health Plans (§§ 8071 — 8074) › § 8072 - Applicability | This chapter shall apply to the following entities:
(a) Insurance companies and health plans, nonprofit organizations that render health services to individuals or groups, under medical insurance policies issued or underwritten in Puerto Rico, or
(b) to health maintenance organizations (HMO), as defined in subsection (... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-51/8073/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 51 - Prohibition of Restricted Use of 9-1-1 Services by Health Plans (§§ 8071 — 8074)›§ 8073 - Prohibitions | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 51 - Prohibition of Restricted Use of 9-1-1 Services by Health Plans (§§ 8071 — 8074) › § 8073 - Prohibitions | For the purpose of this chapter:
(a) Any entity subject to its provisions shall not favor nor instruct its clients or insured people to exclusively contact a medical emergency system other than 9-1-1 during an emergency. It is provided that any entity subject to the provisions of this chapter may use a transportation s... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-51/8074/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 51 - Prohibition of Restricted Use of 9-1-1 Services by Health Plans (§§ 8071 — 8074)›§ 8074 - Payment of medical services | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 51 - Prohibition of Restricted Use of 9-1-1 Services by Health Plans (§§ 8071 — 8074) › § 8074 - Payment of medical services | Every entity subject to the provisions of this chapter shall pay directly to its service providers, with the exception of the co-payment percentages for any necessary medical service that had been provided to an insured or client using the 9-1-1 system due to a medical emergency.
History —Sept. 6, 2000, No. 383, § 4. |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-52/8081/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 52 - Insurance Products (§§ 8081 — 8096)›§ 8081 - Adoption and purpose | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 52 - Insurance Products (§§ 8081 — 8096) › § 8081 - Adoption and purpose | It is the interest of the Commonwealth of Puerto Rico to accept and adopt the clauses and conditions established in the “Compact for the Interstate Regulation of Insurance Products”, which reads as follows:
The purpose of the present Compact is to promote and protect, through the joint action of and the cooperation bet... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-52/8082/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 52 - Insurance Products (§§ 8081 — 8096)›§ 8082 - Definitions | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 52 - Insurance Products (§§ 8081 — 8096) › § 8082 - Definitions | For the purpose of this Compact, the following terms and phrases shall have the meaning expressed below:
(a) Advertisement.— Means any material designed to create public interest in a product or to induce the public to purchase, increase, modify, reinstate, deliver, replace or retain a policy or to take money on loan o... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-52/8083/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 52 - Insurance Products (§§ 8081 — 8096)›§ 8083 - Interstate Commission | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 52 - Insurance Products (§§ 8081 — 8096) › § 8083 - Interstate Commission | The subscribing states hereby create and establish an entity known as the “Interstate Insurance Products Regulatory Commission”. Pursuant to § 8084 of this title, the Commission shall have the power to develop uniform standards for the product lines, to receive and make an expeditious review of the products introduced ... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-52/8084/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 52 - Insurance Products (§§ 8081 — 8096)›§ 8084 - Interstate Commission—Powers and duties | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 52 - Insurance Products (§§ 8081 — 8096) › § 8084 - Interstate Commission—Powers and duties | The Commission shall have the following powers and duties:
(a) To promulgate regulations pursuant to § 8087 of this title that shall have the force of law and bind the subscribing states as provided in the present Compact.
(b) To establish regulations and uniform standards for the products covered by the present Compac... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-52/8085/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 52 - Insurance Products (§§ 8081 — 8096)›§ 8085 - Interstate Commission—Organization and operation | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 52 - Insurance Products (§§ 8081 — 8096) › § 8085 - Interstate Commission—Organization and operation | (a) Members, voting and statutes.—
(1) Every subscribing state shall have a member. Every member shall be qualified to serve as such pursuant to the laws of the subscribing state. Any member may be discharged or suspended from office pursuant to the laws of the state that appointed him/her. Any vacancy that may arise i... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-52/8086/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 52 - Insurance Products (§§ 8081 — 8096)›§ 8086 - Interstate Commission—Meetings and acts | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 52 - Insurance Products (§§ 8081 — 8096) › § 8086 - Interstate Commission—Meetings and acts | The Commission shall meet and take those actions that are consistent with the provisions of this Compact.
All members of the Commission shall be entitled and have the power to cast their vote to which the subscribing state is entitled and to participate in the work and affairs of the Commission. Every member shall cast... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-52/8087/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 52 - Insurance Products (§§ 8081 — 8096)›§ 8087 - Regulations and operating procedures; functions and exclusion | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 52 - Insurance Products (§§ 8081 — 8096) › § 8087 - Regulations and operating procedures; functions and exclusion | (a) Regulating authority.— The Commission shall establish through regulations uniform standards and operating procedures in order to achieve the purposes of the present Compact. However, should the Commission, while exercising its authority, exceed the scope of this chapter or the powers conferred by the same, said act... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-52/8088/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 52 - Insurance Products (§§ 8081 — 8096)›§ 8088 - Registers and compliance | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 52 - Insurance Products (§§ 8081 — 8096) › § 8088 - Registers and compliance | The Commission shall promulgate the rules that establish conditions and procedures according to which the official information and registers are to be disclosed to the public to be examined or copied. The Commission may promulgate additional rules according to which the registers and the information that otherwise woul... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-52/8089/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 52 - Insurance Products (§§ 8081 — 8096)›§ 8089 - Resolution of controversies | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 52 - Insurance Products (§§ 8081 — 8096) › § 8089 - Resolution of controversies | At the request of a member, the Commission shall resolve all controversies or matters that may arise between two or more subscribing states as well as among the non-subscribing states. The Commission shall promulgate an operating procedure in order to provide for the resolution of said controversies.
History —Dec. 22, ... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-52/8090/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 52 - Insurance Products (§§ 8081 — 8096)›§ 8090 - Introduction and approval of products | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 52 - Insurance Products (§§ 8081 — 8096) › § 8090 - Introduction and approval of products | The insurers and third party intermediaries that promote the approval of a product by the Commission shall introduce said product before the Commission and pay the applicable introduction fees. It shall not be construed that the provisions of this Compact restrict or prevent the insurer from introducing a product with ... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-52/8091/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 52 - Insurance Products (§§ 8081 — 8096)›§ 8091 - Review of the decisions | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 52 - Insurance Products (§§ 8081 — 8096) › § 8091 - Review of the decisions | Not later than the thirty (30) days after the Commission has notified the disapproval of a publicity product or material introduced before the Commission, the insurer or third party intermediary whose introduction has been disapproved may appeal the determination before a review board appointed by the Commission. The C... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-52/8092/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 52 - Insurance Products (§§ 8081 — 8096)›§ 8092 - Finances | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 52 - Insurance Products (§§ 8081 — 8096) › § 8092 - Finances | The Commission shall pay or provide for the payment of reasonable expenses incurred for its establishment and organization. In order to subsidize the cost of its initial operations, the Commission may accept contributions and other types of subsidies from the National Association of Insurance Commissioners, the subscri... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-52/8093/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 52 - Insurance Products (§§ 8081 — 8096)›§ 8093 - Subscribing states, effective date and amendments | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 52 - Insurance Products (§§ 8081 — 8096) › § 8093 - Subscribing states, effective date and amendments | Any state shall be eligible to become a subscribing state.
The Compact shall take effect and be obligatory as of the moment in which two (2) subscribing states turn the Compact into law; Provided, That the Commission shall be effective for the purpose of adopting uniform standards for the products introduced to the Com... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-52/8094/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 52 - Insurance Products (§§ 8081 — 8096)›§ 8094 - Disaffiliation, default and dissolution | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 52 - Insurance Products (§§ 8081 — 8096) › § 8094 - Disaffiliation, default and dissolution | (a) Disaffiliation.— Once the Compact is in effect it shall remain in effect and shall be obligatory in all subscribing states; Provided, That a subscribing state may disaffiliate itself from the Compact through the approval of a law that repeals the statute by which the Compact became law.
The effective date of the di... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-52/8095/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 52 - Insurance Products (§§ 8081 — 8096)›§ 8095 - Separability and construction | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 52 - Insurance Products (§§ 8081 — 8096) › § 8095 - Separability and construction | The provisions of the present Compact shall be separable and if it is determined that any phrase, clause or sentence cannot be enforced or is declared unconstitutional by a competent court of any participating state or territory or by the United States, the judgment rendered to that effect shall not affect, prejudice o... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-52/8096/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 2 - Other Insurances (§§ 8001 — 8096)›Chapter 52 - Insurance Products (§§ 8081 — 8096)›§ 8096 - Obligatory effect of the Compact and other laws | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 52 - Insurance Products (§§ 8081 — 8096) › § 8096 - Obligatory effect of the Compact and other laws | (a) Other laws.— Nothing of what is [herein] provided shall prevent compliance with any other law of a participating state which is not inconsistent with this Compact, except as provided in this section.
In relation to the products approved or certified by the Commission, the regulations, the uniform standards and all ... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-100/9001/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 100 - General Provisions (§§ 9001 — 9008)›§ 9001 - Title | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 100 - General Provisions (§§ 9001 — 9008) › § 9001 - Title | This subtitle constitutes the Puerto Rico Health Insurance Code and may be cited as such.
History —Aug. 29, 2011, No. 194, § 2.010, eff. 180 days after Aug. 29, 2011. |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-100/9002/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 100 - General Provisions (§§ 9001 — 9008)›§ 9002 - Declaration of public policy | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 100 - General Provisions (§§ 9001 — 9008) › § 9002 - Declaration of public policy | Guaranteeing the most effective regulation of the health insurance industry, including the regulation of those entities that offer group and individual health plans, is hereby adopted as public policy by the Government of Puerto Rico. As part of this public policy, it is vital to comply with the rules set forth under t... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-100/9003/1/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 100 - General Provisions (§§ 9001 — 9008)›§ 9003 - Definitions (§ 9003)›1 | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 100 - General Provisions (§§ 9001 — 9008) › § 9003 - Definitions (§ 9003) › 1 | For purposes of this Code, except in those chapters where a more specific definition is provided, the following terms shall have the meaning stated below:
(a) Covered benefits or Benefits.— Means the healthcare services to which a covered person or enrollee is entitled under a health plan.
(b) Insurance Code of Puerto ... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-100/9003/2/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 100 - General Provisions (§§ 9001 — 9008)›§ 9003 - Definitions (§ 9003)›2 | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 100 - General Provisions (§§ 9001 — 9008) › § 9003 - Definitions (§ 9003) › 2 | For purposes of this Code, except in those chapters in which a more specific definition is provided, the following terms shall have the meaning stated below:
(a) Covered benefits or Benefits.— Means the healthcare services to which a covered person or enrollee is entitled under a health plan.
(b) Insurance Code of Puer... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-100/9004/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 100 - General Provisions (§§ 9001 — 9008)›§ 9004 - Insurance Code of Puerto Rico | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 100 - General Provisions (§§ 9001 — 9008) › § 9004 - Insurance Code of Puerto Rico | The provisions of the Insurance Code of Puerto Rico shall apply to health insurance plans and entities regulated by this Code inasmuch as they are not inconsistent with the provisions thereof.
Nothing provided in this Code shall be construed to amend or repeal the laws, regulations, or procedures administered by the Pa... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-100/9005/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 100 - General Provisions (§§ 9001 — 9008)›§ 9005 - Conformity to federal laws | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 100 - General Provisions (§§ 9001 — 9008) › § 9005 - Conformity to federal laws | Any provision of this Code that is in conflict or deals with matters regulated by any federal law, regulations, or administrative rule issued by a federal agency and applicable to Puerto Rico in the fields of healthcare or health plans shall be deemed to be amended to conform to such federal law or regulations. In addi... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-100/9006/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 100 - General Provisions (§§ 9001 — 9008)›§ 9006 - Powers and duties of the Commissioner | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 100 - General Provisions (§§ 9001 — 9008) › § 9006 - Powers and duties of the Commissioner | According to this Code, the Commissioner shall have the powers, authorities, and duties vested in him/her by virtue thereof and, also, the powers, authorities, and duties established in the Insurance Code of Puerto Rico.
History —Aug. 29, 2011, No. 194, § 2.060, eff. 180 days after Aug. 29, 2011. |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-100/9007/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 100 - General Provisions (§§ 9001 — 9008)›§ 9007 - Severability | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 100 - General Provisions (§§ 9001 — 9008) › § 9007 - Severability | If any provision of this Code or the applicability thereof to any person or circumstance were held to be void or invalid by a court with jurisdiction and competence, such holding shall not affect the validity of all other provisions of the Code or their applicability to persons or circumstances other than those that we... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-100/9008/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 100 - General Provisions (§§ 9001 — 9008)›§ 9008 - Sanctions | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 100 - General Provisions (§§ 9001 — 9008) › § 9008 - Sanctions | Any violations of the provisions of this Code or the rules or regulations promulgated thereunder for which a sanction or penalty has not been expressly prescribed shall be subject to an administrative fine of not less than five hundred dollars ($500) or more than ten thousand dollars ($10,000) for each violation.
Histo... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-102/9041/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 102 - Prescription Drug Management (§§ 9041 — 9052)›§ 9041 - Title | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 102 - Prescription Drug Management (§§ 9041 — 9052) › § 9041 - Title | This chapter shall be known and may be cited as the chapter on Prescription Drug Management.
History —Aug. 29, 2011, No. 194, § 4.010, eff. 180 days after Aug. 29, 2011. |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-102/9042/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 102 - Prescription Drug Management (§§ 9041 — 9052)›§ 9042 - Purpose | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 102 - Prescription Drug Management (§§ 9041 — 9052) › § 9042 - Purpose | The purpose of this chapter is to provide standards for the development, maintenance, and management of prescription drug formularies and other procedures as part of the prescription drug benefits established by health insurance organizations or issuers that provide such services.
History —Aug. 29, 2011, No. 194, § 4.0... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-102/9043/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 102 - Prescription Drug Management (§§ 9041 — 9052)›§ 9043 - Definitions | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 102 - Prescription Drug Management (§§ 9041 — 9052) › § 9043 - Definitions | For purposes of this chapter:
(a) Prior authorization.— Means the process of obtaining prior approval from a health insurance organization or issuer, required under the terms of a health plan, for coverage of a prescription drug.
(b) Pharmacy and Therapeutics Committee.— Means a committee or equivalent body that is com... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-102/9044/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 102 - Prescription Drug Management (§§ 9041 — 9052)›§ 9044 - Applicability and scope | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 102 - Prescription Drug Management (§§ 9041 — 9052) › § 9044 - Applicability and scope | This chapter shall apply to all health insurance organizations or issuers, or their designees, who provide or administer benefits for outpatient prescription drugs in accordance with the provisions of the health plan, through the use of a formulary or through the application of any other pharmaceutical benefit manageme... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-102/9045/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 102 - Prescription Drug Management (§§ 9041 — 9052)›§ 9045 - Requirements for the development, maintenance, and manageme... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 102 - Prescription Drug Management (§§ 9041 — 9052) › § 9045 - Requirements for the development, maintenance, and management of prescription drug formularies and other ph... | (a) Each health insurance organization or issuer that provides benefits for prescription drugs and manages such benefit through the use of a formulary or other procedure shall establish one or more Pharmacy and Therapeutics Committees, as considered appropriate by the health insurance organization or issuer, to develop... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-102/9046/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 102 - Prescription Drug Management (§§ 9041 — 9052)›§ 9046 - Information to prescribers, pharmacies, covered persons or ... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 102 - Prescription Drug Management (§§ 9041 — 9052) › § 9046 - Information to prescribers, pharmacies, covered persons or enrollees, and prospective covered persons or en... | (a) Health insurance organizations or issuers or pharmacy benefit managers shall meet the following requirements:
(1) Every health insurance organization or issuer or pharmacy benefits manager shall maintain and make available to covered persons or enrollees, prescribers and pharmacies, or those providing healthcare se... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-102/9047/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 102 - Prescription Drug Management (§§ 9041 — 9052)›§ 9047 - Medical exceptions approval process requirements and proced... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 102 - Prescription Drug Management (§§ 9041 — 9052) › § 9047 - Medical exceptions approval process requirements and procedures | (a) If the health insurance organization or issuer that provides prescription drug benefits and manages this benefit through the use of a formulary or through the application of a dose restriction that causes a prescription for a particular drug not to be covered for the number of doses prescribed, or step therapy requ... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-102/9048/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 102 - Prescription Drug Management (§§ 9041 — 9052)›§ 9048 - Record keeping and reporting requirements | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 102 - Prescription Drug Management (§§ 9041 — 9052) › § 9048 - Record keeping and reporting requirements | (a) Each health insurance organization or issuer shall maintain sufficient written or electronic records to demonstrate compliance with this chapter, including records documenting the process for making decisions on formularies and other prescription drug management processes and records documenting the application of ... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-102/9049/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 102 - Prescription Drug Management (§§ 9041 — 9052)›§ 9049 - Oversight and contracting responsibilities | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 102 - Prescription Drug Management (§§ 9041 — 9052) › § 9049 - Oversight and contracting responsibilities | (a) A health insurance organization or issuer shall be responsible for the oversight of all activities carried out under this chapter and for ensuring that all the requirements thereof and applicable regulations are met.
(b) If a health insurance organization or issuer contracts with another person to carry out activit... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-102/9050/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 102 - Prescription Drug Management (§§ 9041 — 9052)›§ 9050 - Disclosure requirements | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 102 - Prescription Drug Management (§§ 9041 — 9052) › § 9050 - Disclosure requirements | (a) Each health insurance organization or issuer that uses a formulary or any other prescription drug management process shall, in the policy, certificate, membership booklet, outline of coverage, evidence of coverage, or any other document provided to a covered person or enrollee;
(1) Disclose the existence of the for... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-102/9051/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 102 - Prescription Drug Management (§§ 9041 — 9052)›§ 9051 - Incentive or bonus programs | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 102 - Prescription Drug Management (§§ 9041 — 9052) › § 9051 - Incentive or bonus programs | (a) No pharmacy, pharmacy benefit manager (PBM), drug manufacturer or distributor, or health insurance organization or issuer shall encourage the practice or participate in incentives programs, or bonus programs or similar transactions directed to healthcare professionals in order to influence them, directly or indirec... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-102/9052/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 102 - Prescription Drug Management (§§ 9041 — 9052)›§ 9052 - Maintenance drugs | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 102 - Prescription Drug Management (§§ 9041 — 9052) › § 9052 - Maintenance drugs | (a) When the history of the covered person or enrollee so requires, insofar as it does not jeopardize the patient's health, and at the discretion of the healthcare provider, such healthcare provider may prescribe refills for maintenance drugs up to a term that shall not exceed one hundred eighty (180) days, subject to ... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-104/9081/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 104 - Health Insurance Organizations or Issuers Claim Audits (§§ 9081 — 9091)›§ 9081 - Title | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 104 - Health Insurance Organizations or Issuers Claim Audits (§§ 9081 — 9091) › § 9081 - Title | This chapter shall be known and may be cited as the chapter on Health Insurance Organizations or Issuers Claim Audit.
History —Aug. 29, 2011, No. 194, § 6.010, eff. 180 days after Aug. 29, 2011. |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-104/9082/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 104 - Health Insurance Organizations or Issuers Claim Audits (§§ 9081 — 9091)›§ 9082 - Purpose | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 104 - Health Insurance Organizations or Issuers Claim Audits (§§ 9081 — 9091) › § 9082 - Purpose | The purpose of this chapter is to provide for the standardization of claim audits of bills for healthcare services presented to health insurance organizations or issuers, third party administrators, or any other health plans. Such audits shall be carried out to determine whether data in a healthcare record of a provide... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-104/9083/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 104 - Health Insurance Organizations or Issuers Claim Audits (§§ 9081 — 9091)›§ 9083 - Definitions | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 104 - Health Insurance Organizations or Issuers Claim Audits (§§ 9081 — 9091) › § 9083 - Definitions | For purposes of this chapter:
(a) Qualified claim auditor.— Means a person employed or hired by a health insurance organization or issuer that is recognized as competent to perform or coordinate claim audits and that abides by policies and procedures geared to protect the confidentiality and properly manage all patient... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-104/9084/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 104 - Health Insurance Organizations or Issuers Claim Audits (§§ 9081 — 9091)›§ 9084 - Applicability and scope | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 104 - Health Insurance Organizations or Issuers Claim Audits (§§ 9081 — 9091) › § 9084 - Applicability and scope | This chapter shall apply to all health insurance organizations or issuers. The provider accepting assignment of benefits of a covered person or enrollee shall be responsible for the billing process and the results of the claim audits whether conducted by an employee or by contract with another firm. The provider and he... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-104/9085/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 104 - Health Insurance Organizations or Issuers Claim Audits (§§ 9081 — 9091)›§ 9085 - Qualifications of auditors and pr... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 104 - Health Insurance Organizations or Issuers Claim Audits (§§ 9081 — 9091) › § 9085 - Qualifications of auditors and provider audit coordinators | (a) Claim auditors and provider audit coordinators shall have appropriate knowledge, experience, and expertise in the field of healthcare including, but not limited to, the following areas:
(1) Format and content of the health record as well as other forms of medical and clinical documentation;
(2) generally accepted a... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-104/9086/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 104 - Health Insurance Organizations or Issuers Claim Audits (§§ 9081 — 9091)›§ 9086 - Notice of audit | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 104 - Health Insurance Organizations or Issuers Claim Audits (§§ 9081 — 9091) › § 9086 - Notice of audit | (a) Health insurance organizations or issuers and providers shall make every effort to resolve claim inquiries directly. The name, contact telephone number, and fax number of each representative of the health insurance organization or issuer or the provider shall be exchanged no later than at the time of billing for a ... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-104/9087/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 104 - Health Insurance Organizations or Issuers Claim Audits (§§ 9081 — 9091)›§ 9087 - Provider audit coordinators | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 104 - Health Insurance Organizations or Issuers Claim Audits (§§ 9081 — 9091) › § 9087 - Provider audit coordinators | (a) Providers shall designate an individual to coordinate all claim audit activities. An audit coordinator shall have the same qualifications as required for an auditor pursuant to § 9085 of this title. The duties of an audit coordinator include, among others, the following:
(1) Scheduling an audit to be carried out du... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-104/9088/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 104 - Health Insurance Organizations or Issuers Claim Audits (§§ 9081 — 9091)›§ 9088 - Conditions and scheduling of audi... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 104 - Health Insurance Organizations or Issuers Claim Audits (§§ 9081 — 9091) › § 9088 - Conditions and scheduling of audits | (a) In order to have a fair, efficient, and effective audit process, providers and health insurance organization or issuer’ [sic] auditors shall adhere to the following requirements:
(1) Whatever the original intended purpose of the claim audit, all parties shall agree to recognize, record or present any identified uns... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-104/9089/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 104 - Health Insurance Organizations or Issuers Claim Audits (§§ 9081 — 9091)›§ 9089 - Confidentiality and authorization... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 104 - Health Insurance Organizations or Issuers Claim Audits (§§ 9081 — 9091) › § 9089 - Confidentiality and authorizations | (a) All parties to a claim audit shall recognize and comply with all federal and Commonwealth laws and any contractual agreements regarding the protection of information within clinical records and the confidentiality and security of patient information.
(b) The release of medical records requires authorization from th... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-104/9090/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 104 - Health Insurance Organizations or Issuers Claim Audits (§§ 9081 — 9091)›§ 9090 - Documentation | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 104 - Health Insurance Organizations or Issuers Claim Audits (§§ 9081 — 9091) › § 9090 - Documentation | (a) Verification of charges shall include the investigation of whether or not:
(1) Charges are reported on the bill accurately;
(2) services are documented in medical or other records as having been rendered to the patient, and
(3) Services were delivered in compliance with the physician’s plan of treatment. In appropr... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-104/9091/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 104 - Health Insurance Organizations or Issuers Claim Audits (§§ 9081 — 9091)›§ 9091 - Fees and payments | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 104 - Health Insurance Organizations or Issuers Claim Audits (§§ 9081 — 9091) › § 9091 - Fees and payments | (a) A health insurance organization or issuer shall make prompt payment of a bill in accordance with the provisions of §§ 301–335 of this title and shall not delay payment for an audit process. Payment on a submitted bill from a third-party shall be based on amounts billed and covered by the patient’s health plan.
(b) ... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-106/9121/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137)›§ 9121 - Title | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137) › § 9121 - Title | This chapter shall be known and may be cited as the chapter on Small- and Medium-sized Businesses (PYMES, Spanish acronym) Employer Health Insurance Availability.
History —Aug. 29, 2011, No. 194, § 8.010, eff. 180 days after Aug. 29, 2011. |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-106/9122/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137)›§ 9122 - Purpose | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137) › § 9122 - Purpose | The purpose of this chapter is to enhance the availability of health insurance coverage to PYMES employers regardless of their health status or claims experience, to prevent abusive rating practices, to prevent segmentation of the health insurance market based upon health risk, to require disclosure of rating practices... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-106/9123/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137)›§ 9123 - Definitions | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137) › § 9123 - Definitions | For purposes of this chapter:
(a) Affiliate or affiliate company.— Means any entity or person that directly or indirectly, through one or more intermediaries, controls or is controlled by, or is under the same control that a specific entity or person.
(b) Geographic service area.— Means a geographic area, as constitute... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-106/9124/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137)›§ 9124 - Applicability a... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137) › § 9124 - Applicability and scope | (a) This chapter shall apply to an issuer that offers health plans to the employees of PYMES employers in Puerto Rico, provided that the PYMES employer pays all or part of the premium or benefits, or the eligible employee is reimbursed for any portion of the premium, whether through wage adjustments or otherwise, as ag... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-106/9125/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137)›§ 9125 - Restrictions re... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137) › § 9125 - Restrictions relating to premium rates | (a) Premium rates for health plans shall be subject to the following provisions:
(1) The PYMES employer issuer shall develop its rates based on an adjusted community rate and may only vary the adjusted community rate with regards to geographic area, family composition, age, and tobacco use.
(2) Any adjustment shall be ... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-106/9126/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137)›§ 9126 - Renewability of... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137) › § 9126 - Renewability of health plan | (a) An issuer providing health plans to PYMES employers shall renew the same to all eligible employees and their dependents, except in any of the following cases:
(1) Failure to pay premiums, considering the grace period.
(2) When the covered person or enrollee has performed an act that constitutes fraud. In such case ... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-106/9127/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137)›§ 9127 - Availability of... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137) › § 9127 - Availability of health plan | (a) As a condition for transacting business in Puerto Rico, employers and, except for the provisions of this chapter, those issuers offering insurance to PYMES employers shall offer all the health plans that they actively market to PYMES employers, including at least two (2) basic health plans in at least one metal lev... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-106/9128/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137)›§ 9128 - Certification o... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137) › § 9128 - Certification of creditable coverage | (a) PYMES employer issuers shall provide written certification of creditable coverage to individuals in accordance with subsection (b) of this section.
(b) The certification of creditable coverage shall be provided:
(1) At the time an individual ceases to be covered under the health plan or otherwise becomes covered un... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-106/9129/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137)›§ 9129 - Repealed. Act J... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137) › § 9129 - Repealed. Act July 10, 2013, No. 55, § 18, eff. 30 days after J... | History Aug. 29, 2011, No. 194, —Aug. 29, 2011, No. 194, § 8.090, eff. 180 days after Aug. 29, 2011; Act July 10, 2013, No. 55, § 18, eff. 30 day after July 10, 2013, effective July 10, 2013. |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-106/9130/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137)›§ 9130 - Transitory prov... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137) › § 9130 - Transitory provisions for issuers offering health plans to PYME... | (a) Issuers interested in offering and marketing, or who wish to continue offering and marketing the health plans authorized under this chapter, or any other designed for PYMES employers in Puerto Rico, shall comply with the following:
(1) As a transition measure, and while the provisions of this chapter are implemente... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-106/9131/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137)›§ 9131 - Repealed. Act J... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137) › § 9131 - Repealed. Act July 10, 2013, No. 55, § 18, eff. 30 days after J... | History Aug. 29, 2011, No. 194, —Aug. 29, 2011, No. 194, § 8.110, eff. 180 days after Aug. 29, 2011; Act Aug. 9, 2013, No. 55, § 20, effective July 10, 2013. |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-106/9132/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137)›§ 9132 - Basic health pl... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137) › § 9132 - Basic health plan | (a) The Commissioner shall authorize the manner and level in which the PYMES employer issuer shall provide coverage according to this chapter and the provisions of § 9005 of this title.
(b) The Commissioner shall provide the benefit levels, cost-sharing, exclusions, and limitations of the basic health plan in its diffe... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-106/9133/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137)›§ 9133 - Periodic market... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137) › § 9133 - Periodic market evaluation | The Commissioner shall conduct a study at least every three (3) years on the effectiveness of the provisions of this chapter. The report shall analyze the effectiveness of the provisions of this chapter in promoting rate stability, product availability, and coverage affordability of health plans for PYMES employers. Th... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-106/9134/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137)›§ 9134 - Waiver of certa... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137) › § 9134 - Waiver of certain Commonwealth laws | No Commonwealth law or regulation approved after the effective date of this chapter requiring the coverage of a healthcare service or benefit, or requiring the reimbursement, utilization or inclusion of a specific category of healthcare provider or person, shall apply to the health plans delivered by PYMES employer iss... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-106/9135/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137)›§ 9135 - Administrative ... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137) › § 9135 - Administrative procedures | The Commissioner shall issue policy letters or regulations as necessary for the implementation of the provisions of this chapter following the procedure established therefor in §§ 201-232 of this title.
History —Aug. 29, 2011, No. 194, § 8.150, eff. 180 days after Aug. 29, 2011; July 10, 2013, No. 55, § 23, eff. 30 day... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-106/9136/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137)›§ 9136 - Standards to as... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137) › § 9136 - Standards to assure fair marketing | (a) Each issuer shall actively market all health plans sold by the issuer to all PYMES employers in Puerto Rico.
(b) No PYMES employer issuer or producer shall, directly or indirectly, engage in the following activities:
(1) Encouraging or directing PYMES employers to refrain from filing an application for coverage wit... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-106/9137/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137)›§ 9137 - Required disclo... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 106 - Small and Medium-sized Businesses Employer Health Insurance Availability (§§ 9121 — 9137) › § 9137 - Required disclosure | (a) In connection with the offering for sale of any health plan to a PYMES employer, the issuer shall make a reasonable disclosure, as part of its solicitation and sales materials, of all of the following:
(1) The provisions of the health plan that, in accordance with this chapter, grant the issuer the right to change ... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-108/9161/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175)›§ 9161 - Title | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175) › § 9161 - Title | This chapter shall be known and cited as the Chapter on Individual Health Plan and Guaranteed Availability.
History —Aug. 29, 2011, No. 194, added as § 10.010 on July 22, 2013, No. 69, § 1, eff. 60 days after July 22, 2013. |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-108/9162/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175)›§ 9162 - Public policy | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175) › § 9162 - Public policy | The purpose of this chapter is to enhance the availability of health insurance coverage to persons who are not insured under an employer or labor union group health plan, regardless of their health status or claim experience; to prevent abusive rating practices; to require disclosure of rating practices in the individu... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-108/9163/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175)›§ 9163 - Definitions | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175) › § 9163 - Definitions | As used in this chapter, the term:
(a) Affiliate or affiliated to.— Means “affiliate” as defined in §§ 9121-9137 of this title.
(b) Geographic service area.— Means a geographic area as defined in §§ 9121-9137 of this title.
(c) Issuer or Individual health plan issuer.— Means a health insurance organization or issuer as... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-108/9164/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175)›§ 9164 - Applicability and scope | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175) › § 9164 - Applicability and scope | (a) The provisions of this chapter concerning individual health plans and the issuers that offer them shall apply to:
(1) Individual health plan offered to and that covers enrollees and their dependents who are residents of Puerto Rico or dependents who study and reside outside of Puerto Rico at the time of issue, rega... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-108/9165/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175)›§ 9165 - Restrictions related to rates and fo... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175) › § 9165 - Restrictions related to rates and forms | (a) Rates for individual health plans shall be subject to the provisions of the Affordable Care Act and the interpretive regulations adopted thereunder. Moreover, individual health plan issuers shall establish their rates based on the rating characteristics defined in this chapter and those established for such purpose... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-108/9166/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175)›§ 9166 - Renewability of coverage | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175) › § 9166 - Renewability of coverage | (a) An individual health plan issuer shall be renewable or shall continue in force the coverage for the enrollee and his/her dependent, at the option of the enrollee, and in accordance with the applicable federal regulations and legislation, except in the following cases:
(1) The enrollee has failed to pay premiums or ... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-108/9167/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175)›§ 9167 - Availability of coverage under a con... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175) › § 9167 - Availability of coverage under a conversion privilege clause from a group health pla... | (a)
(1) As a condition of transacting insurance in Puerto Rico, individual health plan issuers shall offer approved basic health plans in its different metal levels of coverage to recently insured individuals who apply for an individual health plan and agree to make premium payments and satisfy the other reasonable req... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-108/9168/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175)›§ 9168 - Availability of coverage in the indi... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175) › § 9168 - Availability of coverage in the individual market—Federally defined eligible individ... | (a) Notwithstanding the provisions of § 9167 of this title and subject to subsection (b) of this section and the applicable federal regulations, if an eligible individual who is a federally defined eligible individual applies for coverage under an individual health plan within sixty-three (63) days of termination of th... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-108/9169/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175)›§ 9169 - Health plan standards | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175) › § 9169 - Health plan standards | The Commissioner shall provide through policy letter the form and level of coverage of the basic health plan in its different metal plans options for the individual market, so as to comply with the federal provisions and provide, at least, the Essential Health Benefit Package in accordance with § 9005 of this title, wh... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-108/9170/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175)›§ 9170 - Certification of creditable coverage | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175) › § 9170 - Certification of creditable coverage | (a) Individual health plan issuers offering individual health plans shall provide written certification of creditable coverage to all individuals in accordance with subsection (b).
(b) The certification of creditable coverage shall be provided:
(1) At the time an individual ceases to be covered under the health plan or... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-108/9171/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175)›§ 9171 - Standards to assure fair marketing | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175) › § 9171 - Standards to assure fair marketing | (a)
(1) If an issuer denies individual health plan coverage to an eligible person on the basis of his/her health status or claims experience or that of his/her dependents, the issuer shall offer such person the opportunity to purchase an approved basic health plan in any of its different metal levels of coverage.
(2) E... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-108/9172/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175)›§ 9172 - Health Plan Issuer Association | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175) › § 9172 - Health Plan Issuer Association | (a)
(1) A nonprofit corporation is hereby established to be known as the “Health Plan Issuer Association”. All issuers that underwrite individual health plans and basic health plans for PYMES employers in any of its different metal levels of coverage in Puerto Rico shall be members of this Association.
(2) The Associat... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-108/9173/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175)›§ 9173 - Participation in employer-sponsored ... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175) › § 9173 - Participation in employer-sponsored health plans | A health plan sponsored and paid by an employer qualified under the Employee Retirement Income Security Act of 1974 (ERISA), as amended, specifically basic health plans for PYMES employers in any of its different metal levels of coverage may participate in the Health Plan Issuer Association established in § 9172 of thi... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-108/9174/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175)›§ 9174 - Special rules related to converted p... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175) › § 9174 - Special rules related to converted policies | (a) Upon the approval of the basic health plans in the different metal levels of coverage in accordance with § 9169 of this title, all issuers required to offer a converted policy to an individual, pursuant to the provisions of this Code, may offer as a converted policy a choice of the individual basic health plans onl... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-108/9175/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175)›§ 9175 - Guaranteed availability of individua... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 108 - Individual Health Plans and Guaranteed Availability (§§ 9161 — 9175) › § 9175 - Guaranteed availability of individual health plans | (a) Subject to the applicable federal legislation and regulations, all issuers shall allow individuals to enroll in at least the individual basic health plans they have available in the individual market from October 1, 2013 to March 31, 2014, without risk assessment. For subsequent years, the enrollment period shall b... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-110/9201/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 110 - Prohibition on the Use of Discretionary Clauses (§§ 9201 — 9204)›§ 9201 - Title | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 110 - Prohibition on the Use of Discretionary Clauses (§§ 9201 — 9204) › § 9201 - Title | This chapter shall be known and may be cited as the chapter on the Prohibition on the Use of Discretionary Clauses.
History —Aug. 29, 2011, No. 194, § 12.010, eff. 180 days after Aug. 29, 2011. |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-110/9202/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 110 - Prohibition on the Use of Discretionary Clauses (§§ 9201 — 9204)›§ 9202 - Purpose | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 110 - Prohibition on the Use of Discretionary Clauses (§§ 9201 — 9204) › § 9202 - Purpose | The purpose of this chapter is to assure that health insurance benefits and disability income protection coverage are contractually guaranteed so as to prevent the conflict of interest that occurs when health insurance organizations or issuers have discretionary authority to decide what benefits are due. Nothing in thi... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-110/9203/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 110 - Prohibition on the Use of Discretionary Clauses (§§ 9201 — 9204)›§ 9203 - Definitions | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 110 - Prohibition on the Use of Discretionary Clauses (§§ 9201 — 9204) › § 9203 - Definitions | (a) Disability income protection coverage.— Is a policy, contract, certificate or agreement that provides for periodic payments, weekly or monthly, for a specified period during the continuance of disability resulting from either sickness or injury or a combination of them.
(b) Healthcare services.— Means services for ... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-3/chapter-110/9204/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377)›Chapter 110 - Prohibition on the Use of Discretionary Clauses (§§ 9201 — 9204)›§ 9204 - Discretionary clauses prohibited | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 3 - Puerto Rico Health Insurance Code (§§ 9001 — 10377) › Chapter 110 - Prohibition on the Use of Discretionary Clauses (§§ 9201 — 9204) › § 9204 - Discretionary clauses prohibited | (a) No policy, contract, certificate or agreement offered or issued in Puerto Rico by a health insurance organization or issuer to provide, deliver, arrange for, pay for or reimburse any of the costs of healthcare services may contain a provision purporting to reserve discretion to health insurance organizations or iss... |
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Calculates the total number of words in the content of entries related to 'Title 8' in Colorado, providing insight into the volume of text data available for that specific category and state.