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https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-1/chapter-44/4406/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 1 - Insurance Generally (§§ 101 — 4513)›Chapter 44 - Insurance Holding Company System Regulatory Act (§§ 4401 — 4414)›§ 4406 - Standards and management of an insurer or health service ... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 1 - Insurance Generally (§§ 101 — 4513) › Chapter 44 - Insurance Holding Company System Regulatory Act (§§ 4401 — 4414) › § 4406 - Standards and management of an insurer or health service organization within an insurance holding company... | (a) Transactions within an insurance holding company system.—
(1) Transactions within an insurance holding company system, to which an insurer or health service organization subject to registration is a party, shall be subject to the following standards:
(A) The terms shall be fair and reasonable;
(B) Charges or fees f... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-1/chapter-44/4407/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 1 - Insurance Generally (§§ 101 — 4513)›Chapter 44 - Insurance Holding Company System Regulatory Act (§§ 4401 — 4414)›§ 4407 - Examination | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 1 - Insurance Generally (§§ 101 — 4513) › Chapter 44 - Insurance Holding Company System Regulatory Act (§§ 4401 — 4414) › § 4407 - Examination | (a) Powers of Commissioner.— In addition to the powers which the Commissioner has under the provisions of Chapter 2 of the Insurance Code, he/she may order any insurer registered under § 4405 of this title to produce such records, books, or other information papers in the possession of the insurer or its affiliates as ... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-1/chapter-44/4408/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 1 - Insurance Generally (§§ 101 — 4513)›Chapter 44 - Insurance Holding Company System Regulatory Act (§§ 4401 — 4414)›§ 4408 - Confidential treatment | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 1 - Insurance Generally (§§ 101 — 4513) › Chapter 44 - Insurance Holding Company System Regulatory Act (§§ 4401 — 4414) › § 4408 - Confidential treatment | (a) Any documents, materials, or other information in the possession or control of the Office of the Insurance Commissioner that are obtained by or disclosed to the Commissioner or any other person in the course of an examination or investigation made pursuant to § 4407 of this title and all reports filed pursuant to §... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-1/chapter-44/4409/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 1 - Insurance Generally (§§ 101 — 4513)›Chapter 44 - Insurance Holding Company System Regulatory Act (§§ 4401 — 4414)›§ 4409 - Rules and regulations | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 1 - Insurance Generally (§§ 101 — 4513) › Chapter 44 - Insurance Holding Company System Regulatory Act (§§ 4401 — 4414) › § 4409 - Rules and regulations | The Commissioner may, upon notice and opportunity for all interested persons to be heard, issue such rules and orders as shall be necessary to carry out the provisions of this chapter.
History —Ins. Code, added as § 44.090 on Mar. 7, 2012, No. 51, § 1, eff. 30 days after Mar. 7, 2012. |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-1/chapter-44/4410/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 1 - Insurance Generally (§§ 101 — 4513)›Chapter 44 - Insurance Holding Company System Regulatory Act (§§ 4401 — 4414)›§ 4410 - Injunctions, prohibitions against voting securities, sequ... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 1 - Insurance Generally (§§ 101 — 4513) › Chapter 44 - Insurance Holding Company System Regulatory Act (§§ 4401 — 4414) › § 4410 - Injunctions, prohibitions against voting securities, sequestration of voting securities | (a) Injunctions.— Whenever it appears to the Commissioner that any insurer or any director, officer, employee, or agent thereof has committed or is about to commit a violation of the provisions of this chapter or of any rule, regulation or order issued by the Commissioner hereunder, the Commissioner may apply to the co... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-1/chapter-44/4411/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 1 - Insurance Generally (§§ 101 — 4513)›Chapter 44 - Insurance Holding Company System Regulatory Act (§§ 4401 — 4414)›§ 4411 - Sanctions | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 1 - Insurance Generally (§§ 101 — 4513) › Chapter 44 - Insurance Holding Company System Regulatory Act (§§ 4401 — 4414) › § 4411 - Sanctions | Any person that violates a provision of this chapter shall be subject to the penalties established in Chapters 3, 27, and 29 of the Insurance Code.
History —Ins. Code, added as § 44.110 on Mar. 7, 2012, No. 51, § 1, eff. 30 days after Mar. 7, 2012. |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-1/chapter-44/4412/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 1 - Insurance Generally (§§ 101 — 4513)›Chapter 44 - Insurance Holding Company System Regulatory Act (§§ 4401 — 4414)›§ 4412 - Receivership | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 1 - Insurance Generally (§§ 101 — 4513) › Chapter 44 - Insurance Holding Company System Regulatory Act (§§ 4401 — 4414) › § 4412 - Receivership | Whenever it appears to the Commissioner that any person has committed a violation of this chapter which so impairs the financial condition of a domestic insurer or health service organization as to threaten insolvency or make the further transaction of business by it hazardous to its policyholders, creditors, sharehold... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-1/chapter-44/4413/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 1 - Insurance Generally (§§ 101 — 4513)›Chapter 44 - Insurance Holding Company System Regulatory Act (§§ 4401 — 4414)›§ 4413 - Recovery | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 1 - Insurance Generally (§§ 101 — 4513) › Chapter 44 - Insurance Holding Company System Regulatory Act (§§ 4401 — 4414) › § 4413 - Recovery | (a) If an order for liquidation or rehabilitation of a domestic insurer or health service organization has been entered, the judicial administrator or receiver appointed under the order shall have a right to recover on behalf of the insurer:
(1) From any parent corporation or holding company or person or affiliate who ... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-1/chapter-44/4414/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 1 - Insurance Generally (§§ 101 — 4513)›Chapter 44 - Insurance Holding Company System Regulatory Act (§§ 4401 — 4414)›§ 4414 - Revocation, suspension, or nonrenewal of an insurer or he... | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 1 - Insurance Generally (§§ 101 — 4513) › Chapter 44 - Insurance Holding Company System Regulatory Act (§§ 4401 — 4414) › § 4414 - Revocation, suspension, or nonrenewal of an insurer or health service organization license | Whenever it appears to the Commissioner that any person has committed a violation of this chapter which makes the continued operation of an insurer contrary to the interests of policyholders or the public, the Commissioner may, after giving notice and an opportunity to be heard, suspend, revoke, or refuse to renew the ... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-1/chapter-45/4501/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 1 - Insurance Generally (§§ 101 — 4513)›Chapter 45 - Risk Based Capital (§§ 4501 — 4513)›§ 4501 - Purpose | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 1 - Insurance Generally (§§ 101 — 4513) › Chapter 45 - Risk Based Capital (§§ 4501 — 4513) › § 4501 - Purpose | The purpose of this chapter is to further the public welfare by regulating and overseeing the financial solvency of insurers and health maintenance organizations. To that end, this chapter provides the Commissioner, as a tool for oversight, with the standards, formulas and reports originated by the NAIC with the purpos... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-1/chapter-45/4502/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 1 - Insurance Generally (§§ 101 — 4513)›Chapter 45 - Risk Based Capital (§§ 4501 — 4513)›§ 4502 - Definitions | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 1 - Insurance Generally (§§ 101 — 4513) › Chapter 45 - Risk Based Capital (§§ 4501 — 4513) › § 4502 - Definitions | For the purposes of this chapter, the following terms shall have the meaning stated below:
(1) Local insurer.— Means any entity as defined in § 301(1) of this title. This term also includes health maintenance organizations defined in § 1902(6) of this title, except in those instances in which it is indicated otherwise.... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-1/chapter-45/4503/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 1 - Insurance Generally (§§ 101 — 4513)›Chapter 45 - Risk Based Capital (§§ 4501 — 4513)›§ 4503 - Risk based capital reports | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 1 - Insurance Generally (§§ 101 — 4513) › Chapter 45 - Risk Based Capital (§§ 4501 — 4513) › § 4503 - Risk based capital reports | (1) By or before March 31 of every year, all local insurers shall prepare and submit before the Commissioner, a report on their risk based capital level at the close of the preceding calendar year, with such information and in such a manner as required in the risk based capital instructions. Furthermore, all local insu... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-1/chapter-45/4504/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 1 - Insurance Generally (§§ 101 — 4513)›Chapter 45 - Risk Based Capital (§§ 4501 — 4513)›§ 4504 - Insurer action level event | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 1 - Insurance Generally (§§ 101 — 4513) › Chapter 45 - Risk Based Capital (§§ 4501 — 4513) › § 4504 - Insurer action level event | (1) An “insurer action level event” means any of the following events:
(a) The filing by an insurer of a risk-based capital report indicating that:
(i) The adjusted capital of the insurer is greater than or equal to the regulatory action level, but lesser than the insurer action level, or
(ii) if a life or disability i... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-1/chapter-45/4505/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 1 - Insurance Generally (§§ 101 — 4513)›Chapter 45 - Risk Based Capital (§§ 4501 — 4513)›§ 4505 - Regulatory action level event | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 1 - Insurance Generally (§§ 101 — 4513) › Chapter 45 - Risk Based Capital (§§ 4501 — 4513) › § 4505 - Regulatory action level event | (1) Regulatory action level event.— Means, in respect of all insurers, any of the following events:
(a) Submission of the insurer of a risk based capital report indicating that the adjusted capital of the insurer is greater than or equal to its authorized control level, but lesser than its regulatory action level.
(b) ... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-1/chapter-45/4506/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 1 - Insurance Generally (§§ 101 — 4513)›Chapter 45 - Risk Based Capital (§§ 4501 — 4513)›§ 4506 - Authorized control level event | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 1 - Insurance Generally (§§ 101 — 4513) › Chapter 45 - Risk Based Capital (§§ 4501 — 4513) › § 4506 - Authorized control level event | (1) Authorized control level event— Means any of the following events:
(a) Submission by the insurer of a risk based capital report indicating that the adjusted capital of the insurer is greater than or equal to the mandatory control level, but lesser than the authorized control level;
(b) notice by the Commissioner to... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-1/chapter-45/4507/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 1 - Insurance Generally (§§ 101 — 4513)›Chapter 45 - Risk Based Capital (§§ 4501 — 4513)›§ 4507 - Mandatory control level event | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 1 - Insurance Generally (§§ 101 — 4513) › Chapter 45 - Risk Based Capital (§§ 4501 — 4513) › § 4507 - Mandatory control level event | (1) A “mandatory control level event” means any of the following events:
(a) Submission of a risk based capital report indicating that the adjusted capital of the insurer is lesser than the mandatory control level;
(b) notice to the insurer by the Commissioner concerning a revised risk based capital report that indicat... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-1/chapter-45/4508/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 1 - Insurance Generally (§§ 101 — 4513)›Chapter 45 - Risk Based Capital (§§ 4501 — 4513)›§ 4508 - Adjudicative procedure | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 1 - Insurance Generally (§§ 101 — 4513) › Chapter 45 - Risk Based Capital (§§ 4501 — 4513) › § 4508 - Adjudicative procedure | Under any of the following circumstances, the insurer shall be entitled to object to any determination or action taken by the Commissioner through the adjudicative procedure pursuant to the “Uniform Administrative Procedures Act”, §§ 2101 et seq. of Title 3, and the Insurance Code.
(1) When the Commissioner notifies to... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-1/chapter-45/4509/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 1 - Insurance Generally (§§ 101 — 4513)›Chapter 45 - Risk Based Capital (§§ 4501 — 4513)›§ 4509 - Confidentiality | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 1 - Insurance Generally (§§ 101 — 4513) › Chapter 45 - Risk Based Capital (§§ 4501 — 4513) › § 4509 - Confidentiality | (1) All risk based capital plans and all corrective orders issued by the Commissioner pursuant to this chapter, or which is under the power or control of the Office of the Insurance Commissioner, shall not be open to public inspection.
(2) In order to be able to discharge his/her duties, the Commissioner:
(a) May share... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-1/chapter-45/4510/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 1 - Insurance Generally (§§ 101 — 4513)›Chapter 45 - Risk Based Capital (§§ 4501 — 4513)›§ 4510 - Rules; exemption | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 1 - Insurance Generally (§§ 101 — 4513) › Chapter 45 - Risk Based Capital (§§ 4501 — 4513) › § 4510 - Rules; exemption | (1) The Commissioner may approve regulations as he/she deems necessary to adequately implement this chapter.
(2) The Commissioner shall have discretion, on a case-by-case basis, to exempt a local insurer from any of the provisions of this chapter, if the reason for which such insurer fails to comply with the risk based... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-1/chapter-45/4511/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 1 - Insurance Generally (§§ 101 — 4513)›Chapter 45 - Risk Based Capital (§§ 4501 — 4513)›§ 4511 - Foreign insurers | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 1 - Insurance Generally (§§ 101 — 4513) › Chapter 45 - Risk Based Capital (§§ 4501 — 4513) › § 4511 - Foreign insurers | (1) When the Commissioner so requests in writing, any foreign insurer shall submit before the Commissioner, a risk based capital report for the close of the preceding calendar year, by or before:
(a) The date on which, pursuant to § 4503 of this title, it is required that a local insurer submit a risk based capital rep... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-1/chapter-45/4512/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 1 - Insurance Generally (§§ 101 — 4513)›Chapter 45 - Risk Based Capital (§§ 4501 — 4513)›§ 4512 - Immunity | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 1 - Insurance Generally (§§ 101 — 4513) › Chapter 45 - Risk Based Capital (§§ 4501 — 4513) › § 4512 - Immunity | Neither the Office of the Insurance Commissioner of Puerto Rico, nor the Commissioner, his/her employees, agents, or authorized representatives shall be responsible, neither in their official capacity nor in their personal capacity, nor shall any action be taken against any of the aforementioned, for reason of an actio... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-1/chapter-45/4513/ | PR | Justia›US Law›US Codes and Statutes›Laws of Puerto Rico›2023 Laws of Puerto Rico›TITLE TWENTY-SIX - Insurance (§§ 101 — 10377)›Subtitle 1 - Insurance Generally (§§ 101 — 4513)›Chapter 45 - Risk Based Capital (§§ 4501 — 4513)›§ 4513 - Notices | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 1 - Insurance Generally (§§ 101 — 4513) › Chapter 45 - Risk Based Capital (§§ 4501 — 4513) › § 4513 - Notices | All notices remitted by the Commissioner to an insurer which may lead to regulatory action, shall take effect on the date on which the same are sent through registered or certified mail, and in the case any other means is used, the same shall take effect as soon as the insurer receives such a notice.
History —Ins. Code... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-49/8001/ | 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 49 - Health; Insurance Underwriting (§§ 8001 — 8005)›§ 8001 - Design and adoption of billing system | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 49 - Health; Insurance Underwriting (§§ 8001 — 8005) › § 8001 - Design and adoption of billing system | All insurers, health services organizations organized pursuant to §§ 1901–1927 of this title, and nonprofit organizations, organized under §§ 41 et seq. of Title 6, who underwrite health insurance services in Puerto Rico, are hereby directed to design and adopt a uniform billing system to be used by them in billing for... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-49/8002/ | 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 49 - Health; Insurance Underwriting (§§ 8001 — 8005)›§ 8002 - Presentation and evaluation of terms | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 49 - Health; Insurance Underwriting (§§ 8001 — 8005) › § 8002 - Presentation and evaluation of terms | All insurers, health services organizations and nonprofit associations underwriting health insurance services in Puerto Rico shall design said uniform billing system in coordination with the Insurance Commissioner within a term that shall not exceed six (6) months, starting from the effective date of this act. Said sys... |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-49/8003/ | 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 49 - Health; Insurance Underwriting (§§ 8001 — 8005)›§ 8003 - Prohibition | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 49 - Health; Insurance Underwriting (§§ 8001 — 8005) › § 8003 - Prohibition | As of the date in which the billing system provided herein is put to use, it shall be illegal to use any other billing form other than that created under this chapter.
History —Aug. 10, 1997, No. 61, § 3. |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-49/8004/ | 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 49 - Health; Insurance Underwriting (§§ 8001 — 8005)›§ 8004 - Penalties | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 49 - Health; Insurance Underwriting (§§ 8001 — 8005) › § 8004 - Penalties | Any violation of the provisions of this chapter shall be punished with a fine of one hundred dollars ($100), and each billing form used in contravention of the provisions of this chapter shall constitute a separate violation.
History —Aug. 10, 1997, No. 61, § 4. |
https://law.justia.com/codes/puerto-rico/title-twenty-six/subtitle-2/chapter-49/8005/ | 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 49 - Health; Insurance Underwriting (§§ 8001 — 8005)›§ 8005 - Implementation and enforcement | 2023 Laws of Puerto Rico › TITLE TWENTY-SIX - Insurance (§§ 101 — 10377) › Subtitle 2 - Other Insurances (§§ 8001 — 8096) › Chapter 49 - Health; Insurance Underwriting (§§ 8001 — 8005) › § 8005 - Implementation and enforcement | The Insurance Commissioner shall be the official responsible for the administration, implementation and enforcement of this chapter. To such effects, it shall be understood that the provisions of §§ 101 et seq. of this title, known as the “Insurance Code of Puerto Rico,” shall be complementary to the provisions of this... |
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. |
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