RIte Share Premium Assistance Program (210-RICR-30-05-3)


210-RICR-30-05-3 ACTIVE RULE

My Page Title

3.1Overview / Legal Authority

3.2Scope and Purpose

3.3Incorporated Materials

3.4Definitions

3.5RIte Share Populations

3.6RIte Share Enrollment as a Condition of Eligibility

3.7RI Works Participants (TANF)

3.8RIte Share Premium Assistance Payments

3.9RIte Share Buy-in Requirement

3.10Basis for Approving ESI Plans

3.11Methodology for Determining Cost-Effectiveness

3.12Scope and Consequence of Approving an ESI Plan

3.13Member Enrollment Process

3.14Continuing Eligibility – Medicaid Renewals

3.15Renewal of RI Works Participants (TANF)

3.16Role of RIte Share Unit

3.17ESI Enrollment Verification

3.18Failure to Enroll

3.19Disenrollment from RIte Share-Approved Plan

3.20Cooperation Requirements

3.21Good Cause

3.22Notice and Appeal Rights

3.23Severability


Title 210 Executive Office of Health and Human Services
Chapter 30 Medicaid for Children, Families, and Affordable Care Act (ACA) Adults
Subchapter 05 Service Delivery Options
Part 3 RIte Share Premium Assistance Program (210-RICR-30-05-3)
Type of Filing Amendment
Regulation Status Active
Effective 08/17/2025

Regulation Authority:

R.I. Gen. Laws § 40-8.4-12; Section 1906 of Title XIX of the Social Security Act

Purpose and Reason:

EOHHS is revising regulation to remove the incorrect Parent/Caretaker income threshold.  The agency incorrectly implemented a threshold of 136% FPL (141% with the 5% disregard) for which the agency does not have authority. 

 Additionally, EOHHS is revising and restructuring the regulation for clarity and to more accurately reflect RIte Share Program operations.  Such revisions include the removal of language describing how the RIte Share program navigates employer sponsored insurance (ESI) of a non-custodial parent, as this policy is no longer in effect, and addition of insurance brokers and carriers as accessible sources of information regarding ESI.   

Rulemaking Documents are organized by document type and are part of this rule’s rulemaking record (R.I. Gen. Laws § 42-35-2.3). If multiple documents of the same type are listed below, each is a unique document. If there are multiple Public Notice of Proposed Rulemaking documents, view each document to identify the most recently amended version, as it may be amended at any point during the Public Comment Period.