RHODE ISLAND EXCHANGE

The Rhode Island Insurance Exchange (Marketplace) is called HealthSource RI. HealthSource RI is administered by the State of Rhode Island.

General information about HealthSource RI can be found at: http://www.healthsourceri.com/.

PATIENTS

HealthSource RI is essentially a marketplace for individuals and small businesses with up to 100 employees to shop for health insurance if they do not already have insurance coverage from another source. If they have insurance from another source (such as employment, retirement benefits, or spousal benefits), they do not need to obtain it from the Marketplace

HIV PROVIDERS

Providers must contract with each of the plans in the marketplace individually in order to fully participate in the Alabama Health Benefit Exchange.

This process is similar to enrolling in insurance or managed care organization provider networks. See below for a list of insurers participating in the state marketplace, and information on contacting them.

As an HIV provider, you may qualify for designation as an “Essential Community Provider (ECP).” The Qualified Health Plans participating in the Insurance Exchange (Marketplace) are required to contract with a minimum number of ECPs and Specialists to ensure network adequacy.

Visit our Provider Resources Section for more specific instructions to assist you in contacting health plans.

REPORTING PROBLEMS

The state office of insurance is primarily responsible for examining and addressing issues with the plans offered within the state Exchange (Marketplace), and the companies that offer them.

If you are experiencing problems as a medical provider with the plans or companies in the state exchange, or if your patients are experiencing problems with the plans or companies in the state exchange, including trouble with access to medications, access to preferred providers, navigating the appeals process, excessive costs, or possible discriminatory policies, or any otherproblems related to the Affordable Care Act, please report these problems to the state office of insurance:

Office of the Health Insurance Commissioner
1511 Pontiac Ave Bldg 69-1
Cranston, RI 02920
401-462-9517

www.ohic.ri.gov/
Complaints: http://www.ohic.ri.gov/Complaints.php

Additionally, if you are experiencing these or other problems, please report these problems to AAHIVM, so that we may track issues affecting our members, and seek additional policies remedies.

QUALIFIED HEALH PLANS PARTICIPATING IN THE EXCHANGE

Below is a list of the Qualified Health Plans that have publicly announced that they will offer plans in the Alabama Health Benefit Exchange.

Alabama has established Blue Cross Blue Shield of AL as the “benchmark” plan.

This list is being routinely updated, and may change as insurers join or drop out of the exchange. Please check back for updates

Blue Cross Blue Shield of Rhode Island
Plan Website: https://www.bcbsri.com/
Provider Enrollment: https://www.bcbsri.com/providers/become-participating-provider
Plan types offered: Individual, SHOP

Neighborhood Health Plan of Rhode Island
Plan Website: http://www.nhpri.org/
Provider Enrollment: http://www.nhpri.org/Providers/Welcome.aspx
Plan types offered: Individual, SHOP

United Healthcare of New England
Plan Website: http://www.uhccommunityplan.com/plan/state/RI/index
Provider Enrollment: http://www.uhccommunityplan.com/health-professionals/RI/provider-information
Plan types offered: Individual, SHOP