Conn. Gen. Stat. § 38a-492v — Connecticut Code / Title 38a / Chapter 700c / Section 38a-492v
Sec. 38a-492v. Mandatory coverage for hospice services provided in home through a hospice care program to the extent provided for inpatient hospice services.
Status: in_force

(b) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state shall provide coverage for hospice services provided to an insured in the home through a hospice care program, to the extent coverage is provided for inpatient hospice services in a hospital. Such coverage shall be subject to the same terms and conditions applicable to all other benefits under such policy.

(c) No such policy shall exclude a hospice service for coverage solely because such hospice service is provided in the home and not at a hospital, provided hospice care in the home is appropriate for the insured.

(d) Nothing in this section shall prohibit or limit a health insurer, health care center, hospital service corporation, medical service corporation or other entity from conducting utilization review for in-home hospice services, provided such utilization review is conducted in the same manner and uses the same clinical review criteria as a utilization review for the same hospice services provided in a hospital.

See Sec. 38a-518v for similar provisions re group policies.
Conn. Gen. Stat. § 38a-519 — Connecticut Code / Title 38a / Chapter 700c / Section 38a-519
Sec. 38a-519. (Formerly Sec. 38-174j). Offset proviso prohibited in certain policies. Required disclosures for group long-term disability policies.
Status: in_force

(b) For each group long-term disability income protection coverage policy delivered, issued for delivery, renewed, amended or continued in this state that contains an offset, the insurer shall disclose to a policyholder in a separate document and in a conspicuous manner in not less than fourteen-point boldface type: (1) That the policy contains an offset; (2) that such offset will function to limit payments to an insured under the policy, taking into account Social Security disability benefits and other benefits the insured may receive; (3) for what other categories of benefits the policy will offset; (4) the percentage of income the policy covers and the maximum dollar limit of the policy, if applicable; and (5) at least one example showing how such offset will operate. Such disclosure shall include a statement that, if an eligible individual wants a policy that does not contain an offset, the individual may contact an insurance agent or company for an individual policy.

(c) The policyholder shall provide to each eligible individual the information and the statement required to be disclosed under subsection (b) of this section.
Conn. Gen. Stat. § 38a-954 — Connecticut Code / Title 38a / Chapter 704c / Section 38a-954
Sec. 38a-954. (Formerly Sec. 38-472). Domiciliary liquidators in other states.
Status: in_force

(b) If a domiciliary liquidator is appointed for an insurer not domiciled in a reciprocal state, the commissioner of this state shall be vested by operation of law with the title to all of the property, contracts and rights of action and all of the books, accounts and other records of the insurer located in this state, at the same time that the domiciliary liquidator is vested with title in the domicile. The commissioner of this state may petition for a conservation or liquidation order pursuant to section 38a-952 or 38a-953 , or for an ancillary receivership pursuant to section 38a-955 , or after approval by the Superior Court may transfer title to the domiciliary liquidator, as the interests of justice and the equitable distribution of the assets require.

(c) Claimants residing in this state may file claims with the liquidator or ancillary receiver, if any, in this state or with the domiciliary liquidator, if the domiciliary law permits. The claims shall be filed on or before the last date fixed for the filing of claims in the domiciliary liquidation proceedings.
Conn. Gen. Stat. § 38a-989 — Connecticut Code / Title 38a / Chapter 705 / Section 38a-989
Sec. 38a-989. (Formerly Sec. 38-514). Powers of commissioner.
Status: in_force

(b) The commissioner shall have the power to examine and investigate into the affairs of every insurance-support organization acting on behalf of an insurance institution or agent which transacts business within this state or without this state which has an effect on a resident of this state in order to determine whether such insurance-support organization has been engaged or is engaging in any conduct in violation of sections 38a-975 to 38a-998 , inclusive.
Conn. Gen. Stat. § 38a-625 — Connecticut Code / Title 38a / Chapter 700d / Section 38a-625
Sec. 38a-625. (Formerly Sec. 38-247). Exempt societies, orders and associations.
Status: in_force

(b) Any such society or association described in subdivision (3) or (4) of subsection (a) of this section, that provides for death or disability benefits for which benefit certificates are issued, and any such society or association included in subdivision (4) of subsection (a) of this section that has more than one thousand members, shall not be exempt from the provisions of sections 38a-595 to 38a-626 , inclusive, 38a-631 to 38a-640 , inclusive, and 38a-800 but shall comply with all requirements in said sections. No society that, by the provisions of this section, is exempt from the requirements of said sections, except any society described in subdivision (2) of subsection (a) of this section, shall give or allow, or promise to give or allow, to any person any compensation for procuring new members. Every society that provides for benefits in case of death or disability resulting solely from accidents, and that does not obligate itself to pay natural death or sick benefits, shall have all the privileges and be subject to all the applicable provisions and regulations of said sections, except that the provisions in said sections relating to medical examination, valuations of benefit certificates and incontestability shall not apply to such society. The commissioner may require from any society or association, by examination or otherwise, such information as will enable the commissioner to determine whether such society or association is exempt from the provisions of said sections. Societies exempted under the provisions of this section shall also be exempt from all other provisions of the insurance laws of this state. Except as provided in subsection (b) of section 38a-614 and section 38a-615 , associations exempted under the provisions of subdivision (6) of subsection (a) of this section shall also be exempt from all other provisions of the insurance laws of this state.
Conn. Gen. Stat. § 38a-702h — Connecticut Code / Title 38a / Chapter 701a / Section 38a-702h
Sec. 38a-702h. Exemption from examination. Requirements for producers in other states who become residents of Connecticut. Waiver of examination for certain chartered underwriters.
Status: in_force

(b) A person licensed as an insurance producer in another state who moves to this state shall make application not later than ninety days after establishing legal residence to become a resident licensee pursuant to section 38a-702e . No prelicensing education or examination shall be required of such person for any line of authority previously held in the prior state except where the commissioner determines otherwise by regulation, which the commissioner may adopt in accordance with chapter 54.

(c) The commissioner may waive the requirement of an examination for a license to act as a producer for (1) property and casualty insurance in the case of any applicant who has been awarded the professional designation of Chartered Property and Casualty Underwriter, and (2) life and accident insurance in the case of any applicant who has been awarded the professional designation of Chartered Life Underwriter.
Conn. Gen. Stat. § 38a-518g — Connecticut Code / Title 38a / Chapter 700c / Section 38a-518g
Sec. 38a-518g. Mandatory coverage for prostate cancer screening and treatment.
Status: in_force

(1) Laboratory and diagnostic tests, including, but not limited to, prostate specific antigen (PSA) tests, to screen for prostate cancer for men who are symptomatic or whose biological father or brother has been diagnosed with prostate cancer, and for all men fifty years of age or older; and

(2) The treatment of prostate cancer, provided such treatment is medically necessary and in accordance with guidelines established by the National Comprehensive Cancer Network, the American Cancer Society or the American Society of Clinical Oncology.

See Sec. 38a-492g for similar provisions re individual policies.
Conn. Gen. Stat. § 38a-993 — Connecticut Code / Title 38a / Chapter 705 / Section 38a-993
Sec. 38a-993. (Formerly Sec. 38-518). Penalties.
Status: in_force

(b) (1) In any case where a hearing pursuant to section 38a-990 results in the finding of an intentional violation of sections 38a-975 to 38a-998 , inclusive, the commissioner may, in addition to the issuance of a cease and desist order as prescribed in section 38a-992 , order payment of a penalty of not more than five thousand dollars for each violation but not to exceed fifty thousand dollars in the aggregate for multiple violations.

(2) In any case where a hearing pursuant to section 38a-990 results in the finding of an intentional violation of section 38a-988a , the commissioner may, in addition to the issuance of a cease and desist order as prescribed in section 38a-992 , order payment of a penalty of not more than twenty thousand dollars for each violation but not to exceed one hundred thousand dollars in the aggregate for multiple violations.

(c) Any person who violates a cease and desist order of the commissioner under section 38a-992 may, after notice and hearing and upon order of the commissioner, be subject to one or more of the following, at the discretion of the commissioner: (1) A penalty of not more than twenty thousand dollars for each violation; or (2) a penalty of not more than one hundred thousand dollars if the commissioner finds that violations have occurred with such frequency as to indicate a general business practice; or (3) suspension or revocation of an insurance institution's or agent's license.
Conn. Gen. Stat. § 38a-947 — Connecticut Code / Title 38a / Chapter 704c / Section 38a-947
Sec. 38a-947. (Formerly Sec. 38-465). Unclaimed and withheld funds.
Status: in_force

(b) All funds withheld pursuant to section 38a-939 and not distributed shall upon discharge of the liquidator be deposited with the State Treasurer and paid by him in accordance with section 38a-944 . Any sums remaining which pursuant to section 38a-944 would revert to the undistributed assets of the insurer shall be transferred to the State Treasurer and become the property of the state under subsection (a), unless the commissioner in his discretion petitions the court to reopen the liquidation pursuant to section 38a-949 .
Conn. Gen. Stat. § 38a-720b — Connecticut Code / Title 38a / Chapter 701a / Section 38a-720b
Sec. 38a-720b. Payments of premiums or charges to a third-party administrator.
Status: in_force

(b) Return premium payments or claim payments forwarded by the insurer or other person utilizing the services of the third-party administrator to the third-party administrator shall not be deemed to have been paid to the insured or claimant until such payments are received by such insured or claimant.

(c) Nothing in this section shall limit any right of an insurer or other person utilizing the services of a third-party administrator to bring a cause of action arising from the failure of such third-party administrator to make payments to the insurer, other person utilizing the services of the third-party administrator, insureds or claimants.
Conn. Gen. Stat. § 38a-252 — Connecticut Code / Title 38a / Chapter 698c / Section 38a-252
Sec. 38a-252. (Formerly Sec. 38-532). Requirements for risk retention groups chartered outside the state.
Status: in_force

(b) A risk retention group under subsection (a) of this section shall submit to the commissioner a copy of any material revisions of its plan of operations or a feasibility study submitted to its state of domicile not later than thirty days after the date the chief insurance regulatory official of such group's state of domicile approves such revisions or, if no such approval is required, not later than thirty days after submission to such group's state of domicile.
Conn. Gen. Stat. § 38a-91ee — Connecticut Code / Title 38a / Chapter 698 / Section 38a-91ee
Sec. 38a-91ee. Payment of dividends and other distributions.
Status: in_force

(b) No special purpose financial captive insurance company may declare or pay a dividend or distribution if such dividend or distribution would jeopardize the ability of such company or any other person to fulfill such company's or other person's respective obligations under such company's securitization agreements, reinsurance contract or any related transaction.
Conn. Gen. Stat. § 38a-707b — Connecticut Code / Title 38a / Chapter 701a / Section 38a-707b
Sec. 38a-707b. Disclosure of producer fees and compensation upon request of municipality or board of education.
Status: in_force

(b) Any insurance producer who sells, solicits or negotiates insurance on behalf of an insurer to a municipality or local or regional board of education shall, upon request from the municipality or local or regional board of education, fully disclose, in writing, the amount of any fees or compensation such insurance producer receives from the insurer for such services pursuant to the written memorandum required under section 38a-707 or the Investment Advisers Act of 1940, 15 USC 80b-1, et. seq., as amended from time to time.
Conn. Gen. Stat. § 38a-818 — Connecticut Code / Title 38a / Chapter 704 / Section 38a-818
Sec. 38a-818. (Formerly Sec. 38-63). Hearing on unfair practice not so defined. Injunction.
Status: in_force

Annotations to former section 38-63:

Cited. 186 C. 507. Legislative intent is to make insurance practices subject to both the Connecticut Unfair Insurance Practices Act and the Connecticut Unfair Trade Practices Act. 199 C. 651. Cited. 206 C. 668; 207 C. 77; 215 C. 277; 216 C. 830.

Cited. 13 CA 208.
Conn. Gen. Stat. § 38a-992 — Connecticut Code / Title 38a / Chapter 705 / Section 38a-992
Sec. 38a-992. (Formerly Sec. 38-517). Commissioner to prepare findings.
Status: in_force

(b) If, after a hearing pursuant to section 38a-990 , the commissioner determines that the insurance institution, agent or insurance-support organization charged has not engaged in conduct or practices in violation of sections 38a-975 to 38a-998 , inclusive, the commissioner shall prepare a written report which sets forth the findings of fact and conclusions. Such report shall be served upon the insurance institution, agent or insurance-support organization charged and upon the person, if any, whose rights under said sections were allegedly violated.

(c) The commissioner may modify or set aside any order or report issued under this section until the expiration of the time allowed under section 38a-994 for filing a petition for review or until such petition is actually filed, whichever occurs first. If, after the expiration of the time allowed under section 38a-994 for filing a petition for review, no petition has been filed, the commissioner may, after notice and opportunity for hearing, alter, modify or set aside, in whole or in part, any order or report issued under this section whenever conditions of fact or law warrant such action or if the public interest so requires.

Annotation to former section 38-517:

Cited. 215 C. 277.
Conn. Gen. Stat. § 38a-341 — Connecticut Code / Title 38a / Chapter 700 / Section 38a-341
Sec. 38a-341. (Formerly Sec. 38-175f). Cancellation of motor vehicle liability policy: Definitions.
Status: in_force

(1) “Policy” means an automobile liability insurance policy providing among other coverage bodily injury liability, delivered or issued for delivery in this state, insuring a single individual or spouses resident of the same household, as named insured, and under which the insured vehicles therein designated are of the following types only: (A) A motor vehicle of the private passenger or station wagon type that is not used as a public or livery conveyance for passengers, nor rented to others, or (B) any other four-wheel motor vehicle with a load capacity of fifteen hundred pounds or less that is not used in the occupation, profession or business of the insured, provided said sections shall not apply to (i) any policy insuring more than four automobiles, (ii) any policy covering garage, automobile sales agency, repair shop, service station or public parking place operation hazards, or (iii) any policy of insurance issued principally to cover personal or premises liability of an insured even though the insurance may also provide some incidental coverage for liability arising out of the ownership, maintenance or use of a motor vehicle on the premises of the insured or on the ways immediately adjoining the premises;

(2) “Renewal” or “to renew” means the issuance and delivery by an insurer of a policy replacing at the end of the policy period a policy previously issued and delivered by the same insurer, or the issuance and delivery of a certificate or notice extending the term of the policy beyond its policy period or term. Any policy with a policy period or term of less than six months shall, for the purpose of sections 38a-341 to 38a-346 , inclusive, be considered as if written for a policy period or term of six months and any policy written for a term longer than one year or any policy with no fixed expiration date, shall for the purpose of said sections, be considered as if written for successive policy periods or terms of one year. Such a policy may be terminated at the expiration of any annual period upon giving thirty days' notice of cancellation prior to the anniversary date, and such cancellation shall not be subject to any other provisions of said sections;

(3) “Nonpayment of premium” means failure of the named insured to discharge when due any of such insured's obligations in connection with the payment of premiums on the policy, or any installment of such premium, whether the premium is payable directly to the insurer or its agent or indirectly under any premium finance plan or extension of credit. Nonpayment of premium includes, but is not limited to, the dishonor of any check, draft or other remittance upon presentment for payment;

(4) “Declination” means: (A) With respect to a producer, denial in whole or in part of an applicant's written request for coverage; failure to submit within a reasonable period of time a completed written application for coverage to a specific insurer that the producer represents or with which the producer has an account and that is requested in writing by the applicant; placement of a risk with a residual market, an unauthorized insurer, or an insurer that specializes in substandard risks; or refusal to provide, upon written request, an application for coverage; (B) with respect to an insurer that conducts its business through independent licensed insurance producers, refusal to issue a policy after receipt of a completed written application for coverage from a producer who represents it or from a producer with whom it has an account; or (C) with respect to an insurer other than one specified in subparagraph (B) of this subdivision, refusal to issue a policy after receipt of a completed written application, or refusal to provide, upon written request, an application for coverage.

Annotations to former section 38-175f:

Cited. 160 C. 280. Regulations under statute make “other insurance” clauses in conflict with the regulations. 161 C. 169. Cited. 203 C. 45.

Cited. 1 CA 409.

Annotations to present section:

Cited. 234 C. 182; 240 C. 86.

Cited. 25 CA 492; judgment reversed, see 222 C. 744; 42 CA 177. Subdiv. (2) did not require insurer to issue cancellation notice in accordance with Sec. 38a-343 before terminating plaintiff's policy. 52 CA 497.
Conn. Gen. Stat. § 38a-788 — Connecticut Code / Title 38a / Chapter 702 / Section 38a-788
Sec. 38a-788. License. Examination.
Status: in_force

(b) Each applicant for a public adjuster's license shall, before being admitted to such examination, prove to the satisfaction of the commissioner that he has successfully completed a course approved by the commissioner requiring not less than forty hours covering property insurance policies and forms.

(c) Any license to be a public adjuster issued by the commissioner shall be in force only until the first day of May in each even-numbered year unless sooner revoked or suspended. The license may be renewed upon payment of the license fee specified in section 38a-11 .

(d) The commissioner may adopt such regulations in accordance with the provisions of chapter 54, with respect to the form and manner of filing of application for license as a public adjuster and the issuance, suspension and revocation of such licenses and the conduct of hearings in connection therewith, the manner in which public adjusters shall conduct their business, including limitations on fees that may be charged and the form of the employment contract between a public adjuster and a client. The use of such contract shall be mandatory. Such contract shall contain the provision specified in subsection (a) of section 38a-724 .
Conn. Gen. Stat. § 38a-760e — Connecticut Code / Title 38a / Chapter 701e / Section 38a-760e
Sec. 38a-760e. Prohibited practices of insurers. Annual statements of financial condition.
Status: in_force

(b) An insurer may not employ an individual who is employed by a reinsurance intermediary-broker with which it transacts business, unless such reinsurance intermediary-broker is under common control with the insurer and subject to the provisions of sections 38a-129 to 38a-140 , inclusive.

(c) The insurer shall annually obtain a copy of statements of the financial condition of each reinsurance intermediary-broker with which it transacts business.
Conn. Gen. Stat. § 38a-606 — Connecticut Code / Title 38a / Chapter 700d / Section 38a-606
Sec. 38a-606. (Formerly Sec. 38-218). Amendment of articles of incorporation, constitution or laws.
Status: in_force

(b) No amendment to the articles of incorporation, constitution or laws of any domestic society shall take effect unless approved by the commissioner, who shall approve the amendment if he finds that it has been duly adopted and is not inconsistent with any requirement of the laws of this state or with the character, objects and purposes of the society. Unless the commissioner disapproves any such amendment within sixty days after the filing of the same, the amendment shall be considered approved. The approval or disapproval of the commissioner shall be in writing and mailed to the secretary or corresponding officer of the society at its principal office. If he disapproves the amendment, the reasons for disapproval shall be stated in the written notice.

(c) Within ninety days from the approval thereof by the commissioner, all such amendments, or a synopsis thereof, shall be furnished to all members of the society either by mail or by publication in full in the official organ of the society. The affidavit of any officer of the society, or of anyone authorized by it to mail any amendments or synopsis thereof, stating facts which show that the same have been duly addressed and mailed, shall be prima facie evidence that the amendments or synopsis thereof have been furnished the addressee. Every foreign or alien society authorized to do business in this state shall file with the commissioner a certified copy of all amendments of, or additions to, its articles of incorporation, constitution or laws within ninety days after the enactment of the same.

(d) Printed copies of the constitution or laws as amended, certified by the secretary or corresponding officer of the society, shall be prima facie evidence of the legal adoption thereof.
Conn. Gen. Stat. § 38a-660h — Connecticut Code / Title 38a / Chapter 700f / Section 38a-660h
Sec. 38a-660h. Return of collateral security or other indemnity. Penalty.
Status: in_force

(b) No fee or other charge, other than as authorized under sections 38a-660b to 38a-660k , inclusive, shall be deducted from the collateral security or other indemnity due. Actual expenses incurred by a surety bail bond agent in the apprehension of a defendant because of a forfeiture of a bail bond or judgment may be deducted if such expenses are accounted for.

(c) Any person who violates this section shall be subject to the penalties for larceny under sections 53a-122 to 53a-125b , inclusive, depending on the amount involved.
Conn. Gen. Stat. § 38a-702m — Connecticut Code / Title 38a / Chapter 701a / Section 38a-702m
Sec. 38a-702m. Agent appointments. Fees.
Status: in_force

(b) To appoint a producer as its agent, the appointing insurer shall file, in a form approved by the commissioner, a notice of appointment not later than fifteen days after the date the agency contract is executed or the first insurance application is submitted. An insurer may elect to appoint a producer to all or some of the affiliated companies within the insurer's holding company system or group by filing a single appointment request, provided the commissioner (1) has implemented an electronic system capable of processing such filings; and (2) has previously notified insurers doing business in this state that such filings are acceptable. An insurer that appoints a producer to more than one affiliated company within the insurer's holding company or system shall pay the fee specified by section 38a-11 for each affiliated company to which the producer is appointed.

(c) Upon receipt of the notice of appointment, the commissioner shall verify within a reasonable time not to exceed thirty days that the insurance producer is eligible for appointment. If the insurance producer is determined to be ineligible for appointment, the commissioner shall notify the insurer not later than five days after the commissioner's determination.

(d) An insurer shall pay an appointment fee, in the amount set forth in section 38a-11 , for each insurance producer appointed by the insurer.

(e) An insurer shall remit, in a manner prescribed by the commissioner, a renewal appointment fee in the amount set forth in section 38a-11 .
Conn. Gen. Stat. § 38a-346 — Connecticut Code / Title 38a / Chapter 700 / Section 38a-346
Sec. 38a-346. (Formerly Sec. 38-175l). Liability of persons furnishing information to insured.
Status: in_force

Annotations to former section 38-175 l :

Cited. 160 C. 280. Regulations under statute make “other insurance” clauses in conflict with the regulations. 161 C. 169.

Annotations to present section:

Cited. 234 C. 182.

Cited. 42 CA 177.
Conn. Gen. Stat. § 38a-530e — Connecticut Code / Title 38a / Chapter 700c / Section 38a-530e
Sec. 38a-530e. Mandatory coverage for contraceptives and sterilization.
Status: in_force

(1) All contraceptive drugs, including, but not limited to, all over-the-counter contraceptive drugs, approved by the federal Food and Drug Administration. Such policy may require an insured to use, prior to using a contraceptive drug prescribed to the insured, a contraceptive drug that the federal Food and Drug Administration has designated as therapeutically equivalent to the contraceptive drug prescribed to the insured, unless otherwise determined by the insured's prescribing health care provider.

(2) All contraceptive devices and products, excluding all over-the-counter contraceptive devices and products, approved by the federal Food and Drug Administration. Such policy may require an insured to use, prior to using a contraceptive device or product prescribed to the insured, a contraceptive device or product that the federal Food and Drug Administration has designated as therapeutically equivalent to the contraceptive device or product prescribed to the insured, unless otherwise determined by the insured's prescribing health care provider.

(3) If a contraceptive drug, device or product described in subdivision (1) or (2) of this subsection is prescribed by a licensed physician, physician assistant or advanced practice registered nurse, a twelve-month supply of such contraceptive drug, device or product dispensed at one time or at multiple times, unless the insured or the insured's prescribing health care provider requests less than a twelve-month supply of such contraceptive drug, device or product. No insured shall be entitled to receive a twelve-month supply of a contraceptive drug, device or product pursuant to this subdivision more than once during any policy year.

(4) All sterilization methods approved by the federal Food and Drug Administration for women.

(5) Routine follow-up care concerning contraceptive drugs, devices and products approved by the federal Food and Drug Administration.

(6) Counseling in (A) contraceptive drugs, devices and products approved by the federal Food and Drug Administration, and (B) the proper use of contraceptive drugs, devices and products approved by the federal Food and Drug Administration.

(b) No policy described in subsection (a) of this section shall impose a coinsurance, copayment, deductible or other out-of-pocket expense for the benefits and services required under said subsection (a), except that any such policy that uses a provider network may require cost-sharing when such benefits and services are rendered by an out-of-network provider. The cost-sharing limits imposed under this subsection shall apply to a high deductible health plan, as that term is used in subsection (f) of section 38a-520 , to the maximum extent permitted by federal law, except if such plan is used to establish a medical savings account or an Archer MSA pursuant to Section 220 of the Internal Revenue Code of 1986 or any subsequent corresponding internal revenue code of the United States, as amended from time to time, or a health savings account pursuant to Section 223 of said Internal Revenue Code, as amended from time to time, the provisions of this subsection shall apply to such plan to the maximum extent that (1) is permitted by federal law, and (2) does not disqualify such account for the deduction allowed under said Section 220 or 223, as applicable.

(c) (1) Notwithstanding any other provision of this section, any insurance company, hospital service corporation, medical service corporation or health care center may issue to a religious employer a group health insurance policy that excludes coverage for benefits and services required under subsection (a) of this section that are contrary to the religious employer's bona fide religious tenets.

(2) Notwithstanding any other provision of this section, upon the written request of an individual who states in writing that benefits and services required under subsection (a) of this section are contrary to such individual's religious or moral beliefs, any insurance company, hospital service corporation, medical service corporation or health care center may issue to or on behalf of the individual a policy or rider thereto that excludes coverage for benefits and services required under subsection (a) of this section.

(d) Any health insurance policy issued pursuant to subsection (c) of this section shall provide written notice to each insured or prospective insured that benefits and services required under subsection (a) of this section are excluded from coverage pursuant to subsection (c) of this section. Such notice shall appear, in not less than ten-point type, in the policy, application and sales brochure for such policy.

(e) Nothing in this section shall be construed as authorizing a group health insurance policy to exclude coverage for prescription contraceptive drugs, devices and products ordered by a health care provider with prescriptive authority for reasons other than contraceptive purposes.

(f) Notwithstanding any other provision of this section, any insurance company, hospital service corporation, medical service corporation or health care center that is owned, operated or substantially controlled by a religious organization that has religious or moral tenets that conflict with the requirements of this section may provide for the coverage of benefits and services as required under this section through another such entity offering a limited benefit plan. The cost, terms and availability of such coverage shall not differ from the cost, terms and availability of other coverage offered to the insured.

(g) As used in this section, “religious employer” means an employer that is a “qualified church-controlled organization” as defined in 26 USC 3121 or a church-affiliated organization.

See Sec. 38a-503e for similar provisions re individual policies.
Conn. Gen. Stat. § 38a-22 — Connecticut Code / Title 38a / Chapter 697 / Section 38a-22
Sec. 38a-22. Electronic filing and submission.
Status: in_force

(b) Any person required to make a filing or submission to the commissioner by electronic means pursuant to subsection (a) of this section may submit a request to the commissioner seeking an exception to the requirement.

(c) The commissioner shall grant a request submitted pursuant to subsection (b) of this section if the commissioner determines that compliance with the requirement imposed pursuant to subsection (a) of this section is impractical, would cause the person seeking the exception to suffer undue hardship or that good cause exists to grant the requested exception.
Conn. Gen. Stat. § 38a-63 — Connecticut Code / Title 38a / Chapter 698 / Section 38a-63
Sec. 38a-63. Limitation of liability of director of mutual insurance company.
Status: in_force

(b) Notwithstanding any inconsistent provision in the charter of a domestic mutual insurance company or in the general statutes, the provisions of this section shall become effective on the date it is approved by a majority of the members present and voting, in the manner customary for such company's meetings, in person or by proxy at an annual or other meeting of such domestic mutual insurance company.
Conn. Gen. Stat. § 38a-760b — Connecticut Code / Title 38a / Chapter 701e / Section 38a-760b
Sec. 38a-760b. Licensing. Service of process.
Status: in_force

(b) No person, firm, association or corporation shall act as a reinsurance intermediary-manager (1) for a reinsurer domiciled in this state, unless such reinsurance intermediary-manager is a licensed producer in this state; (2) if the reinsurance intermediary-manager maintains an office either directly or as a member or employee of a firm or association, or an officer, director or employee of a corporation in this state, unless such reinsurance intermediary-manager is a licensed producer in this state; (3) in another state for a nondomestic insurer, unless such reinsurance intermediary-manager is a licensed producer in this state or another state having a law substantially similar to the provisions of this section or such person is licensed in this state as a nonresident reinsurance intermediary.

(c) The commissioner may require a reinsurance intermediary-manager subject to subsection (b) of this section to (1) file a bond in an amount, from an insurer, acceptable to the commissioner for the protection of the reinsurer; and (2) maintain an errors and omissions policy in an amount acceptable to the commissioner.

(d) (1) The commissioner may issue a reinsurance intermediary license to any person, firm, association or corporation who has complied with the requirements of sections 38a-760 to 38a-760i , inclusive. Any such license issued to a firm or association will authorize all the members of such firm or association and any designated employees to act as reinsurance intermediaries under the license, and all such persons shall be named in the application and any supplements thereto. Any such license issued to a corporation shall authorize all of the officers, and any designated employees and directors thereof to act as reinsurance intermediaries on behalf of such corporation, and all such persons shall be named in the application and any supplements thereto.

(2) If the applicant for a reinsurance intermediary license is a nonresident, such applicant, as a condition precedent to receiving or holding a license, shall designate the Insurance Commissioner as agent for service of process in the manner, and with the same legal effect, provided for by sections 38a-760 to 38a-760i , inclusive, for designation of service of process upon unauthorized insurers and also shall furnish the commissioner with the name and address of a resident of this state upon whom notices or orders of the commissioner or process affecting such nonresident reinsurance intermediary may be served. Such licensee shall promptly notify the commissioner in writing of every change in its designated agent for service of process, and such change shall not become effective until acknowledged by the commissioner.

(e) The commissioner may refuse to issue a reinsurance intermediary license if, in his judgment, the applicant, anyone named on the application, or any member, principal, officer or director of the applicant, is not trustworthy, or if any controlling person of such applicant is not trustworthy to act as a reinsurance intermediary, or if any of the foregoing has given cause for revocation or suspension of such license or has failed to comply with any prerequisite for the issuance of such license. The provisions of section 38a-774 shall apply to any action taken by the commissioner under this subsection.

(f) Licensed attorneys-at-law of this state when acting in their professional capacity as such shall be exempt from this section.
Conn. Gen. Stat. § 38a-208 — Connecticut Code / Title 38a / Chapter 698a / Section 38a-208
Sec. 38a-208. (Formerly Sec. 33-166). Approval of rates to be paid by subscribers and contracts.
Status: in_force

(b) Premium rates and special enrollment periods offered to individuals shall be consistent with the requirements set forth in section 38a-481 .

(c) Premium rates offered to small employers, as defined in section 38a-564 , shall be consistent with the requirements set forth in section 38a-567 .

(d) No hospital service corporation shall enter into any contract with subscribers unless and until it has filed with the Insurance Commissioner a copy of such contract, including all riders and endorsements thereof, and until said commissioner's approval thereof has been obtained. The Insurance Commissioner shall, within a reasonable time after the filing of any such form, notify such corporation of the commissioner's approval or disapproval thereof.

Annotation to former section 33-166:

Insurance Commissioner's judgment modifying a filed schedule of rates of Blue Cross services is affirmed as record contains sufficient evidence to support same. 31 CS 257.
Conn. Gen. Stat. § 38a-41 — Connecticut Code / Title 38a / Chapter 698 / Section 38a-41
Sec. 38a-41. (Formerly Sec. 38-20). Authority to do business. Licensure. Revocation or refusal to renew license. Fines. Company owned by a state or foreign nation or company controlled by insureds not to be issued license. Appeals. Plan of operations. Type of business to be conducted.
Status: in_force

(b) The commissioner shall adopt regulations in accordance with the provisions of chapter 54 specifying the information and evidence that an insurance company or health care center desiring to obtain or renew a license to do an insurance business or health care center business shall submit and the requirements with which it shall comply.

(c) The commissioner may, at any time, for cause, suspend, revoke or refuse to renew any such license or in lieu of or in addition to suspension or revocation of such license the commissioner, after reasonable notice to and hearing of any holder of such license, may impose a fine not to exceed fifty thousand dollars. Such hearings may be held by the commissioner or any person designated by the commissioner. Whenever a person other than the commissioner acts as the hearing officer, the person shall submit to the commissioner a memorandum of the person's findings and recommendations upon which the commissioner may base a decision. The commissioner may, if the commissioner deems it in the interest of the public, publish in one or more newspapers of the state a statement that, under the provisions of this section, the commissioner has suspended or revoked the license of any insurance company or health care center to do business in this state.

(d) No license to do an insurance business within this state shall be issued to a foreign insurance company owned or financially controlled by another state of the United States or to an alien insurance company owned or financially controlled by a foreign nation or any state or province thereof.

(e) No license to do an insurance business within this state shall be issued to any company which insures or plans to insure the separate risks of the employees of an employer that directly or indirectly controls the insurer by stock ownership or otherwise or exercises control of the operations of the insurer where the premiums written annually by the insurer on the separate risks of such employees exceed or will exceed ten per cent of the total premiums which the insurer writes or will write annually or where the commissions payable, if any, on premiums covering the risks of such employees written by the insurer annually exceed or will exceed ten per cent of the total commissions to agents which are or will be paid annually by the insurer.

(f) Any company aggrieved by the action of the commissioner in revoking, suspending or refusing to renew a license or in imposing a fine may appeal therefrom, in accordance with the provisions of section 4-183 , except venue for such appeal shall be in the judicial district of New Britain. Appeals under this section shall be privileged in respect to the order of trial assignment.

(g) Except as provided in section 38a-92 l an insurer shall be required to be licensed to transact financial guaranty insurance in this state, as defined in subdivision (1) of section 38a-92a . Prior to the issuance of a license to transact financial guaranty insurance business, an insurer shall submit for the approval of the commissioner a plan of operation detailing the types and projected diversification of guaranties that will be issued, the underwriting procedures that will be followed, managerial oversight methods, investment policies and other matters as may be prescribed by the commissioner. An insurer licensed to transact the business of financial guaranty insurance may also be licensed to transact the business of surety, credit and residual value insurance, but may not be licensed to transact any other lines of insurance in this state.

Annotations to former section 38-20:

Powers of Insurance Commissioner are discretionary or quasi-judicial, rather than ministerial; courts will not interfere with the exercise of commissioner's discretion; mandamus will not lie to control action of commissioner under section. 60 C. 448. Cited. 122 C. 295; 188 C. 152.
Conn. Gen. Stat. § 38a-492i — Connecticut Code / Title 38a / Chapter 700c / Section 38a-492i
Sec. 38a-492i. Mandatory coverage for pain management.
Status: in_force

(b) (1) No such policy that provides coverage for prescription drugs shall require an insured to use, prior to using a brand name prescription drug prescribed by a licensed physician for pain treatment, any alternative brand name prescription drugs or over-the-counter drugs.

(2) Such policy may require an insured to use, prior to using a brand name prescription drug prescribed by a licensed physician for pain treatment, a therapeutically equivalent generic drug.

(c) As used in this section, “pain” means a sensation in which a person experiences severe discomfort, distress or suffering due to provocation of sensory nerves, and “pain management specialist” means a physician who is credentialed by the American Academy of Pain Management or who is a board-certified anesthesiologist, physiatrist, neurologist, oncologist or radiation oncologist with additional training in pain management.

See Sec. 38a-518i re group health insurance coverage for pain management.
Conn. Gen. Stat. § 38a-1006 — Connecticut Code / Title 38a / Chapter 706 / Section 38a-1006
Sec. 38a-1006. Group board of trustees.
Status: in_force

(1) The board of trustees shall:

(A) Maintain responsibility for all moneys collected or disbursed from the group and segregate all moneys into a claims fund account and an administrative fund account. At least seventy per cent of the net premium shall be placed into a designated depository for the sole purpose of paying claims, allocated claims expenses, reinsurance or excess insurance and special fund contributions, including second injury and other loss-related funds. This shall be called the “claims fund account”. The remaining net premium shall be placed into a designated depository for the payment of taxes, general regulatory fees and assessments and administrative costs. This shall be called the “administrative fund account”. The commissioner may approve an administrative fund account of more than thirty per cent and a claims fund account of less than seventy per cent only if the group shows to the commissioner's satisfaction that: (i) More than thirty per cent is needed for an effective safety and loss control program; or (ii) the group's aggregate excess insurance attaches at less than seventy per cent.

(B) Maintain minutes of its meetings and make the minutes available to the commissioner.

(C) Designate an administrator to carry out the policies established by the board of trustees and to provide day-to-day management of the group, and delineate in the written minutes of its meetings the areas of authority it delegates to the administrator.

(D) Retain an independent certified public accountant to prepare the statement of financial condition required by subsection (a) of section 38a-1010 .

(2) The board of trustees shall not:

(A) Extend credit to individual members for payment of a premium, except pursuant to payment plans approved by the commissioner.

(B) Borrow any moneys from the group or in the name of the group except in the ordinary course of business without first advising the commissioner of the nature and purpose of the loan and obtaining prior approval from the commissioner.
Conn. Gen. Stat. § 38a-318 — Connecticut Code / Title 38a / Chapter 700 / Section 38a-318
Sec. 38a-318. (Formerly Sec. 38-114h). Information to be furnished relative to fire or explosion losses. Limitation on liability. Confidentiality of information. Testimony concerning information given authorized agencies.
Status: in_force

(b) If any insurance company has reason to suspect that a fire or explosion loss to its insured's real or personal property was caused by undetermined or incendiary means, the insurance company shall furnish any authorized agency with all relevant material acquired during its investigation of the fire or explosion loss, cooperate with and take such action as may be requested of the insurance company by the authorized agency and permit any person ordered by a court to inspect any of its records pertaining to the policy and the fire or explosion loss. The insurance company may request any authorized agency to release information relative to any investigation it has made concerning any such fire or explosion loss of undetermined or incendiary origin.

(c) No insurance company, authorized agency or person who furnished information on behalf of such insurance company or agency shall be liable for damages in a civil action or subject to criminal prosecution for any oral or written statement made or any other action taken that is necessary to supply information requested pursuant to this section, unless there is fraud, actual malice or conduct relating to the release of such information which constitutes a criminal act.

(d) Except as provided in subsection (g) of this section, any authorized agency receiving any information furnished pursuant to this section shall hold the information in confidence until such time as its release is required pursuant to a criminal or civil proceeding.

(e) Any authorized agency personnel may be required to testify as to any information in the agency's possession regarding the fire or explosion loss of real or personal property in any civil action in which any person seeks recovery under a policy against an insurance company for the fire or explosion loss.

(f) For the purposes of this section, (1) “authorized agency” means: (A) The State Fire Marshal or the local fire marshal when authorized or charged with the investigation of fires or explosions at the place where the fire or explosion actually took place, (B) the Insurance Commissioner, or (C) a federal, state or local law enforcement officer when authorized or charged with the investigation of fires or explosions at the place where the fire or explosion actually took place; and (2) “insurance company” includes organizations issuing insurance policies in this state pursuant to the provisions of section 38a-328 .

(g) Any authorized agency provided with information pursuant to subsection (a) or (b) of this section may, in furtherance of its own purposes, release any information in its possession to any other authorized agency.

(h) The provisions of this section shall apply to fire losses occurring on or after October 1, 1979.

Private investigators for insurance companies were not agents of the state because of reporting requirement of statute and their entry into defendant's business premises did not constitute an illegal search under federal and state constitutions. 40 CA 789. Defendants were required pursuant to Subsec. (b) to turn over to the authorities all relevant material acquired during their investigation of suspicious fires, and because the record revealed nothing that could be considered malicious in the disclosure by defendants, the protections afforded under Subsec. (c) applied to bar a claim of malicious prosecution against defendants. 118 CA 480.
Conn. Gen. Stat. § 38a-542e — Connecticut Code / Title 38a / Chapter 700c / Section 38a-542e
Sec. 38a-542e. Clinical trials: Billing. Payments.
Status: in_force

(b) Providers, hospitals, institutions and insured persons may appeal a health plan's denials of payment for services only to the extent permitted by the contract between the insurer or health care center and the provider, hospital or institution.

(c) Providers, hospitals or institutions that have contracts with the insurer or health care center to render covered routine patient care services to insured persons as part of a clinical trial shall not bill the insured person for the cost of any covered routine patient care service.

(d) Providers, hospitals or institutions that do not have a contract with the insurer or health care center to render covered routine patient care services to insured persons as part of a clinical trial shall not bill the insured person for the cost of any covered routine patient care service.

(e) Nothing in this section shall be construed to prohibit a provider, hospital or institution from collecting a deductible or copayment as set forth in the insured person's contract for any covered routine patient care service.

(f) Pursuant to subsection (b) of section 38a-542d , insurers or health care centers shall be required to pay providers, hospitals and institutions that do not have a contract with the insurer or health care center to render covered routine patient care services to insured persons the lesser of (1) the lowest contracted per diem, fee schedule rate or case rate that the insurer or health care center pays to any participating provider in the state of Connecticut for similar in-network services, or (2) the billed charges. Providers, hospitals or institutions shall not collect any amount more than the total amount paid by the insurer or health care center and the insured person in the form of a deductible or copayment set forth in the insured person's contract. Such amount shall be deemed by the provider, hospital or institution to be payment in full.

See Sec. 38a-504e for similar provisions re individual policies.
Conn. Gen. Stat. § 38a-161 — Connecticut Code / Title 38a / Chapter 698 / Section 38a-161
Sec. 38a-161. (Formerly Sec. 38-291). Definitions.
Status: in_force

(1) “Insurance premium finance company” means a person engaged in the business of entering into insurance premium finance agreements;

(2) “Insurance premium finance agreement” means an agreement by which an insured or prospective insured promises to pay to an insurance premium finance company the amount advanced or to be advanced under the agreement to an insurer or to an insurance producer in payment of premiums on an insurance contract together with a service charge as authorized and limited by sections 38a-160 to 38a-170 , inclusive;

(3) “Licensee” means an insurance premium finance company holding a license issued by the Insurance Commissioner under sections 38a-160 to 38a-170 , inclusive;

(4) “Person” means any individual, partnership, association, limited liability company or corporation;

(5) “Commissioner” means the Insurance Commissioner;

(6) “Consumer”, when used with reference to an insurance premium finance agreement, has the same meaning given to it in Title 1, Chapter 1, Section 103(H) of the Truth-in-Lending Act, Public Law 90-321.
Conn. Gen. Stat. § 38a-479aaa — Connecticut Code / Title 38a / Chapter 700c / Section 38a-479aaa
Sec. 38a-479aaa. Pharmacy benefits managers. Definitions.
Status: in_force

(1) “Commissioner” means the Insurance Commissioner;

(2) “Department” means the Insurance Department;

(3) “Drug” has the same meaning as provided in section 21a-92 ;

(4) “Person” has the same meaning as provided in section 38a-1 ;

(5) “Pharmacist services” includes (A) drug therapy and other patient care services provided by a licensed pharmacist intended to achieve outcomes related to the cure or prevention of a disease, elimination or reduction of a patient's symptoms, and (B) education or intervention by a licensed pharmacist intended to arrest or slow a disease process;

(6) “Pharmacist” means an individual licensed to practice pharmacy under section 20-590 , 20-591 , 20-592 or 20-593 , and who is thereby recognized as a health care provider by the state of Connecticut;

(7) “Pharmacy” means a place of business where drugs may be sold at retail and for which a pharmacy license has been issued to an applicant pursuant to section 20-594 ; and

(8) “Pharmacy benefits manager” or “manager” means any person that administers the prescription drug, prescription device, pharmacist services or prescription drug and device and pharmacist services portion of a health benefit plan on behalf of plan sponsors such as self-insured employers, insurance companies, labor unions and health care centers.
Conn. Gen. Stat. § 38a-591k — Connecticut Code / Title 38a / Chapter 700c / Section 38a-591k
Sec. 38a-591k. Violations. Notice and hearing. Penalties. Appeal.
Status: in_force

(b) If, after such hearing, the commissioner determines that the utilization review company charged has engaged in a violation of section 38a-591d , the commissioner shall reduce the findings to writing and shall issue and cause to be served upon the utilization review company a copy of such findings and an order requiring such company to cease and desist from engaging in such violation. The commissioner may order any of the following:

(1) Payment of a civil penalty of not more than one thousand five hundred dollars for each act or violation, provided such penalty shall not exceed an aggregate penalty of fifteen thousand dollars unless the company knew or reasonably should have known it was in violation of section 38a-591d , in which case the penalty shall be not more than seven thousand five hundred dollars for each act or violation, not to exceed an aggregate penalty of seventy-five thousand dollars in any six-month period;

(2) Suspension or revocation of the utilization review company's license to do business in this state if it knew or reasonably should have known that it was in violation of section 38a-591d ; or

(3) Payment of such reasonable expenses as may be necessary to compensate the commissioner in connection with the proceedings under this subsection, which shall be dedicated exclusively to the regulation of utilization review.

(c) Any company aggrieved by any such order of the commissioner may appeal therefrom in accordance with the provisions of section 4-183 , except venue for such appeal shall be in the judicial district of New Britain.

(d) Any person who violates a cease and desist order of the commissioner made pursuant to this section and while such order is in effect shall, after notice and hearing and upon order of the commissioner, be subject to the following: (1) A civil penalty of not more than seventy-five thousand dollars; or (2) suspension or revocation of such person's license.
Conn. Gen. Stat. § 38a-477h — Connecticut Code / Title 38a / Chapter 700c / Section 38a-477h
Sec. 38a-477h. Participating provider directories.
Status: in_force

(b) (1) Each health carrier shall post on its Internet web site a current and accurate participating provider directory, updated at least monthly, for each of its network plans. The health carrier shall ensure that consumers are able to view all of the current participating providers for a network plan through a clearly identifiable link or tab on such health carrier's Internet web site, without being required to create or access an account or enter a policy or contract number.

(2) Each health carrier shall provide, upon request from a covered person or a covered person's representative, a print copy of such directory or of requested information from such directory.

(c) (1) A health carrier shall include in each such electronic or print directory the following information in plain language: (A) A description of the criteria the health carrier used to build its network; (B) if applicable, a description of the criteria the health carrier used to tier its participating providers; (C) if applicable, a description of how the health carrier designates the different participating provider tiers or levels in the network and identifies, for each specific participating provider, in which tier each is placed, such as by name, symbols or grouping, to allow a consumer to be able to identify the participating provider tiers; and (D) if applicable, a statement that authorization or referral may be required to access some participating providers.

(2) Each such directory shall also include a customer service electronic mail address and telephone number or an Internet web site address that covered persons or consumers may use to notify the health carrier of any inaccurate participating provider information in such directory.

(3) Each health carrier shall make it clear for each such electronic or print directory which directory applies to which network plan, such as by including the specific name of the network plan as marketed and issued in this state.

(4) Each such electronic or print directory shall accommodate the communication needs of individuals with disabilities and include an Internet web site address or information regarding available assistance for individuals with limited English proficiency.

(d) (1) The health carrier shall make available through an electronic participating provider directory, for each of its network plans, the following information in a searchable format:

(A) For health care providers, (i) the health care provider's name, gender, participating office location or locations, specialty, if applicable, medical group affiliations, if any, facility affiliations, if applicable, participating facility affiliations, if applicable, (ii) any languages other than English spoken by such health care provider, (iii) whether such health care provider is accepting new patients, and (iv) if such health care provider is accepting new patients, whether such health care provider is accepting new patients on an outpatient services basis;

(B) For hospitals, the hospital name, the hospital type, such as acute, rehabilitation, children's or cancer, the participating hospital location and the hospital's accreditation status; and

(C) For facilities other than hospitals, by type, the facility name, the facility type, the types of health care services performed at the facility and the participating facility location or locations and telephone number or numbers.

(2) In addition to the information required under subdivision (1) of this subsection, the health carrier shall make available through the electronic directory specified under subdivision (1) of this subsection, for each of its network plans, the following information:

(A) For health care providers, the health care provider's contact information, board certification and any languages other than English spoken by clinical staff, if applicable;

(B) For hospitals, the hospital's telephone number; and

(C) For facilities other than hospitals, the facility's telephone number.

(3) (A) Each health carrier shall make available in print, upon request, the following participating provider directory information for the applicable network plan:

(i) For health care providers, (I) the health care provider's name, contact information, specialty, if applicable and participating office location or locations, (II) any languages other than English spoken by such health care provider, (III) whether such health care provider is accepting new patients, and (IV) if such health care provider is accepting new patients, whether such health care provider is accepting new patients on an outpatient services basis;

(ii) For hospitals, the hospital name, the hospital type, such as acute, rehabilitation, children's or cancer and the participating hospital location and telephone number; and

(iii) For facilities other than hospitals, by type, the facility name, the facility type, the types of health care services performed at the facility and the participating facility location or locations and telephone number or numbers.

(B) Each health carrier shall include with the print directory information under subparagraph (A) of this subdivision and in the print participating provider directory under subdivision (2) of subsection (a) of this section a statement that the information provided or included is accurate as of the date of printing, that covered persons or prospective covered persons should consult the health carrier's electronic participating provider directory on such health carrier's Internet web site and that covered persons may call the telephone number on such covered person's insurance card for more information.

(4) For the information required to be included in a participating provider directory pursuant to subdivisions (1) and (2) of this subsection, each health carrier shall make available through such directory the sources of such information and any limitations on such information, if applicable.

(e) Each health carrier shall periodically audit at least a reasonable sample size of its participating provider directories for accuracy and retain documentation of such audit to be made available to the commissioner upon request.
Conn. Gen. Stat. § 38a-477nn — Connecticut Code / Title 38a / Chapter 700c / Section 38a-477nn
Sec. 38a-477nn. Prohibition on denial of reimbursement or prevention from participating in provider network based solely on health care provider's decision not to maintain specialty certification.
Status: in_force

(1) “Health care provider” has the same meaning as provided in section 38a-477aa ;

(2) “Maintenance of certification” means any process requiring periodic recertification examinations or other professional development activities to maintain specialty certification; and

(3) “Specialty certification” means any certification by a medical board that specializes in one area of medicine and has requirements in addition to licensing requirements in this state.

(b) No insurer, health care center, hospital service corporation, medical service corporation, fraternal benefit society or other entity that delivers, issues for delivery, renews, amends or continues an individual or group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 in this state on or after January 1, 2025, shall deny reimbursement to a health care provider or prevent any health care provider from participating in any provider network based solely on such health care provider's decision not to maintain a specialty certification, including, but not limited to, through participation in any maintenance of certification program, provided such health care provider does not hold such health care provider out to be a specialist under such specialty certification.
Conn. Gen. Stat. § 38a-720a — Connecticut Code / Title 38a / Chapter 701a / Section 38a-720a
Sec. 38a-720a. License. Exemptions. Written agreement required.
Status: in_force

(b) (1) Any insurer licensed in this state that directly or indirectly underwrites, collects premiums or charges from, or adjusts or settles claims for other than its policyholders, subscribers and certificate holders shall be exempt from sections 38a-720 to 38a-720n , inclusive, provided such activities only involve the lines of insurance for which such insurer is licensed in this state. Any such insurer shall (A) be subject to the provisions of chapter 704, (B) respond to all complaint inquiries received from the Insurance Department, not later than ten calendar days after the date a complaint is received by the insurer, and (C) with respect to any advertising that mentions any customer, obtain such customer's prior written consent.

(2) Nothing in this section shall authorize the commissioner to regulate a self-insured health plan subject to the Employee Retirement Income Security Act of 1974. The commissioner is authorized to regulate those activities an insurer undertakes for the administration of a self-insured health plan that do not relate to the health benefit plan and that comport with the commissioner's statutory authority to regulate insurance and the business of insurance as provided for in 29 USC 1144, as amended from time to time.

(c) No third-party administrator shall act as such without a written agreement between such third-party administrator and an insurer or other person utilizing the services of the third-party administrator, which shall be retained as part of the official records of both the third-party administrator and such insurer or other person for the duration of such agreement and for five years thereafter. The agreement shall contain all provisions required by this section, except insofar as those provisions that do not apply to the activities performed by the third-party administrator.

(d) The written agreement set forth in subsection (c) of this section shall include, but not be limited to:

(1) A statement of activities that the third-party administrator shall undertake on behalf of the insurer or other person utilizing the services of the third-party administrator, and the lines, classes or types of insurance such third-party administrator is authorized to administer;

(2) A statement of the activities and responsibilities of the third-party administrator regarding the administration of or any standards pertaining to business underwritten by the insurer, benefits, premium rates, underwriting criteria or claims payment;

(3) A provision requiring the third-party administrator to render an accounting, on such frequency as the parties agree, that details all transactions performed by the third-party administrator pertaining to the business underwritten by the insurer or the business of the person utilizing the services of the third-party administrator;

(4) The procedures for any withdrawals to be made by the third-party administrator from the fiduciary account established under section 38a-720f . Such procedures shall address, but not be limited to: (A) Remittance to an insurer or other person utilizing the services of the third-party administrator who is entitled to remittance, (B) deposit in an account maintained in the name of the insurer or other person utilizing the services of the third-party administrator, (C) transfer to and deposit in a claims-paying account, with claims to be paid as provided for in subsection (d) of section 38a-720f , (D) payment to a group policyholder for remittance to the insurer or other person utilizing the services of the third-party administrator entitled to such remittance, (E) payment to the third-party administrator for its commissions, fees or charges, and (F) remittance of return premiums to the person or persons entitled to such return premiums;

(5) Procedures and requirements for the disclosures required to be made by the third-party administrator under section 38a-720h ; and

(6) A termination provision, by which either party to the written agreement may terminate such agreement for cause, that includes a procedure to resolve any disputes regarding the cause for termination of such agreement.

(e) A third-party administrator or insurer or other person utilizing the services of the third-party administrator may, with written notice, terminate the written agreement for cause as provided in such written agreement. The insurer may suspend the underwriting authority of the third-party administrator during the pendency of any dispute regarding the cause for termination of the written agreement. The insurer or other person utilizing the services of the third-party administrator shall fulfill any legal obligations with respect to policies or plans affected by the written agreement, regardless of any dispute between the third-party administrator and the insurer or other person utilizing the services of the third-party administrator.

See Sec. 19a-7j re assessment of health and welfare fee on third-party administrators doing health insurance business in state.
Conn. Gen. Stat. § 38a-336c — Connecticut Code / Title 38a / Chapter 700 / Section 38a-336c
Sec. 38a-336c. Claims for uninsured or underinsured motorist benefits.
Status: in_force

(b) For any motor vehicle accident occurring on or after October 1, 2006, no insurer may require its insured, as a condition of eligibility for payment of uninsured motorist benefits, to provide affidavits or written statements from the owner or operator of the alleged uninsured vehicle attesting to the fact that the individual did not maintain any liability coverage at the time of the motor vehicle accident.

(c) For any motor vehicle accident occurring on or after October 1, 2006, no insurer may require its insured, as a condition of eligibility for payment of underinsured motorist benefits, to provide affidavits or written statements from the owner or operator of the alleged underinsured vehicle attesting to the lack of any additional bodily injury liability bonds or insurance applicable at the time of the motor vehicle accident.

(d) Nothing in this section shall relieve any person seeking to secure any coverage under an automobile insurance policy of any duty or obligation imposed by contract or law.
Conn. Gen. Stat. § 38a-490a — Connecticut Code / Title 38a / Chapter 700c / Section 38a-490a
Sec. 38a-490a. Coverage for birth-to-three program.
Status: in_force

(b) No such policy shall impose a coinsurance, copayment, deductible or other out-of-pocket expense for such services, except that a high deductible health plan, as that term is used in subsection (f) of section 38a-493 , shall not be subject to the deductible limits set forth in this section.

(c) No payment made under this section shall (1) adversely affect the availability of health insurance to the child, the child's parent or the child's family members insured under any such policy, or (2) be a reason for the insurer, health care center or plan administrator to rescind or cancel such policy. Payments made under this section shall not be treated differently than other claim experience for purposes of premium rating.

See Sec. 38a-516a for similar provisions re group policies.
Conn. Gen. Stat. § 38a-488e — Connecticut Code / Title 38a / Chapter 700c / Section 38a-488e
Sec. 38a-488e. Coverage for mental health wellness examinations.
Status: in_force

(1) “Licensed mental health professional” means: (A) A licensed professional counselor or professional counselor, both as defined in section 20-195aa ; (B) a person who is under professional supervision, as defined in section 20-195aa ; (C) a physician licensed pursuant to chapter 370, who is certified in psychiatry by the American Board of Psychiatry and Neurology; (D) an advanced practice registered nurse licensed pursuant to chapter 378, who is certified as a psychiatric and mental health clinical nurse specialist or nurse practitioner by the American Nurses Credentialing Center; (E) a psychologist licensed pursuant to chapter 383; (F) a marital and family therapist licensed pursuant to chapter 383a; (G) a licensed clinical social worker licensed pursuant to chapter 383b; or (H) an alcohol and drug counselor licensed under chapter 376b; and

(2) “Mental health wellness examination” means a screening or assessment that seeks to identify any behavioral or mental health needs and appropriate resources for treatment. The examination may include: (A) Observation; (B) a behavioral health screening; (C) education and consultation on healthy lifestyle changes; (D) referrals to ongoing treatment, mental health services and other necessary supports; (E) discussion of potential options for medication; (F) age-appropriate screenings or observations to understand the mental health history, personal history and mental or cognitive state of the person being examined; and (G) if appropriate, relevant input from an adult through screenings, interviews or questions.

(b) (1) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 and delivered, issued for delivery, renewed, amended or continued in this state on or after January 1, 2023, (A) shall provide coverage for two mental health wellness examinations per year that are performed by a licensed mental health professional, and (B) shall not require prior authorization of such examinations.

(2) The mental health wellness examinations shall be covered with no patient cost sharing.

(c) The provisions of this section shall apply to a high deductible health plan, as that term is used in subsection (f) of section 38a-493 , to the maximum extent permitted by federal law, except if such plan is used to establish a medical savings account or an Archer MSA pursuant to Section 220 of the Internal Revenue Code of 1986, as amended from time to time, or any subsequent corresponding Internal Revenue Code of the United States, as amended from time to time, or a health savings account pursuant to Section 223 of said Internal Revenue Code of 1986, as amended from time to time, the provisions of this section shall apply to such plan to the maximum extent that (1) is permitted by federal law, and (2) does not disqualify such account for the deduction allowed under said Section 220 or 223, as applicable.
Conn. Gen. Stat. § 38a-531 — Connecticut Code / Title 38a / Chapter 700c / Section 38a-531
Sec. 38a-531. (Formerly Sec. 38-174hh). Mandatory coverage for employees of certain employers. Approval of policy forms.
Status: in_force

(b) Notwithstanding any other provisions of the general statutes, each group health insurance policy providing coverage of the type specified in subdivisions (1), (2) and (4) of section 38a-469 delivered, issued for delivery, renewed or continued in any other state offered by an employer, shall provide to covered employees of such employer employed in this state whenever, on the initial effective date of such policy or any renewal or continuance date thereafter, fifty-one per cent or more of the covered employees of such employer are employed in this state, coverage that meets the requirements of this title. The forms of such policies shall be submitted to the Insurance Commissioner for approval.
Conn. Gen. Stat. § 38a-478w — Connecticut Code / Title 38a / Chapter 700c / Section 38a-478w
Sec. 38a-478w. Managed care organization's calculation of enrollee liability for covered benefits. Credit required for third-party discounts and payments.
Status: in_force

(b) The provisions of subsection (a) of this section shall apply to a high deductible health plan, as that term is used in subsection (f) of section 38a-493 or subsection (f) of section 38a-520 , as applicable, to the maximum extent permitted by federal law, except if such plan is used to establish a medical savings account or an Archer MSA pursuant to Section 220 of the Internal Revenue Code of 1986, or any subsequent corresponding internal revenue code of the United States, as amended from time to time, or a health savings account pursuant to Section 223 of said Internal Revenue Code, as amended from time to time, the provisions of said subsection (a) shall apply to such plan to the maximum extent that (1) is permitted by federal law, and (2) does not disqualify such account for the deduction allowed under said Section 220 or 223, as applicable.
Conn. Gen. Stat. § 38a-838 — Connecticut Code / Title 38a / Chapter 704a / Section 38a-838
Sec. 38a-838. (Formerly Sec. 38-275). Definitions.
Status: in_force

(1) “Account” means any one of the three accounts created by section 38a-839 ;

(2) “Affiliate” means any affiliate, as defined in section 38a-1 , of an insolvent insurer;

(3) “Association” means the Connecticut Insurance Guaranty Association created under section 38a-839 ;

(4) “Commissioner” means the Insurance Commissioner;

(5) (A) “Covered claim” means an unpaid claim, including, but not limited to, one for unearned premiums, that arises out of and is within the coverage and subject to the applicable limits of an insurance policy to which sections 38a-836 to 38a-853 , inclusive, apply, if such insurer becomes an insolvent insurer or such claim was assumed as a direct obligation by an insurer that becomes an insolvent insurer, where such obligation was assumed through a merger or an acquisition, pursuant to an acquisition of assets and assumption of liabilities or pursuant to an assumption reinsurance transaction, and (i) the claimant or insured is a resident of this state at the time of the insured event, or (ii) the claim is a first party claim for damage to property with a permanent location in this state. For the purposes of this subparagraph, the residence of a claimant or an insured that is not an individual shall be the state in which such claimant's or insured's principal place of business is located at the time of the insured event.

(B) “Covered claim” does not include (i) any claim by or for the benefit of any reinsurer, insurer, insurance pool or underwriting association, as subrogation recoveries or otherwise, provided a claim for any such amount, asserted against a person insured under a policy issued by an insurer that has become an insolvent insurer, that, if it were not a claim by or for the benefit of a reinsurer, insurer, insurance pool or underwriting association, would be a “covered claim”, may be filed directly with the receiver of the insolvent insurer but in no event shall any such claim be asserted against the insured of such insolvent insurer, (ii) any claim by or on behalf of an individual who is neither a citizen of the United States nor an alien legally resident in the United States at the time of the insured event, or an entity other than an individual whose principal place of business is not in the United States at the time of the insured event, and it arises out of an accident, occurrence, offense, act, error or omission that takes place outside of the United States, or a loss to property normally located outside of the United States or, if a workers' compensation claim, it arises out of employment outside of the United States, (iii) any claim by or on behalf of a person who is not a resident of this state, other than a claim for compensation or any other benefit that arises out of and is within the coverage of a workers' compensation policy, against an insured whose net worth at the time the policy was issued or at any time thereafter exceeded twenty-five million dollars, provided an insured's net worth for purposes of this section and section 38a-844 shall be deemed to include the aggregate net worth of the insured and all of its subsidiaries as calculated on a consolidated basis, (iv) any claim by or on behalf of an affiliate of the insolvent insurer at the time the policy was issued or at the time of the insured event, (v) any claim arising out of a policy issued by an insurer that was not licensed to transact insurance in this state at the time the policy was issued, when it assumed the obligation for the covered claim or when the insured event occurred, (vi) any amount due under any policy originally issued by a surplus lines carrier, risk retention group, self-insurer or group self-insurer, (vii) any obligation assumed by an insolvent insurer after the commencement of any delinquency proceeding, as defined in section 38a-905 , involving the insolvent insurer or the original insurer, unless it would have been a covered claim absent such assumption, or (viii) any obligation assumed by an insolvent insurer in a transaction in which the original insurer remains separately liable;

(6) “Insolvent insurer” means an insurer (A) (i) licensed to transact insurance in this state at the time the policy was issued, when it assumed the obligation for the covered claim or when the insured event occurred, and (ii) against which a final order of liquidation with a finding of insolvency has been entered by a court of competent jurisdiction in the insurer's state of domicile; (B) that is (i) the legal successor of an insurer that was licensed to transact insurance in this state either at the time the policy was issued or when the insured event occurred, by reason of a merger, provided such merger is approved by an insurance regulator having jurisdiction over such merger, and (ii) against which a final order of liquidation with a finding of insolvency has been entered by a court of competent jurisdiction in the insurer's state of domicile; or (C) that (i) succeeds to the policy obligations of an insurer that was licensed to transact insurance in this state either at the time the policy was issued or when the insured event occurred, by reason of a division whereby policies issued by such licensed insurer are allocated to or otherwise become the obligation of a successor insurer, provided such division is approved (I) in a jurisdiction that allows such division, and (II) by an insurance regulator having jurisdiction over such division, and (ii) against which a final order of liquidation with a finding of insolvency has been entered by a court of competent jurisdiction in the succeeding insurer's state of domicile. “Insolvent insurer” shall not be construed to mean any insurer with respect to which an order, decree, judgment or finding of insolvency, whether permanent or temporary in nature, or order of rehabilitation or conservation has been issued by a court of competent jurisdiction prior to October 1, 1971;

(7) “Member insurer” means any person who (A) writes any kind of insurance to which sections 38a-836 to 38a-853 , inclusive, apply under section 38a-837 , including, but not limited to, the exchange of reciprocal or interinsurance contracts, and (B) is licensed to transact insurance in this state. An insurer shall cease to be a member insurer effective on the day following the termination or expiration of its license to transact the kinds of insurance to which said sections 38a-836 to 38a-853 , inclusive, apply, however such insurer shall remain liable as a member insurer for any obligations, including obligations for assessments levied prior to the termination or expiration of the insurer's license and for assessments levied after the termination or expiration which relate to any insurer which became an insolvent insurer prior to the termination or expiration of such insurer's license. In the case of such insurer, the average of its net direct written premium for the five calendar years prior to expiration or termination of its license, whether or not the insurer has net direct written premium in the year preceding such expiration or termination, shall be used as its assessment base for any year following such expiration or termination in which the insurer has no direct written premium;

(8) “Net direct written premiums” means direct gross premiums written in this state on insurance policies to which sections 38a-836 to 38a-853 , inclusive, apply, less return premiums thereon and dividends paid or credited to policyholders on such direct business, provided the term “net direct written premiums” shall not include premiums on any contract between insurers or reinsurers;

(9) “Person” means an individual, corporation, partnership, association, joint stock company, business trust, limited liability company, unincorporated organization, voluntary organization, governmental entity or other legal entity;

(10) “Residence” means, when used in reference to a corporation, its principal place of business;

(11) “United States” has the same meaning as provided in section 38a-1 .

Annotations to former section 38-275:

Cited. 215 C. 224.

Annotations to present section:

Subdiv. (5):

Subpara. (B)(i): Waiver by state's indemnity insurer of its contractual right to reimbursement restored status of state's claim as a “covered claim” that was reimbursable by association since claim was no longer for the benefit of an insurer. 278 C. 77. Subpara. (B)(i): Association payment to plaintiff who was injured when her motor vehicle was struck by municipally owned police cruiser did not relieve plaintiff's automobile insurance company of obligation for purposes of statutory limitation on association payments for the benefit of a solvent insurer, nor did that payment violate Sec. 38a-845 requirement of exhaustion of solvent carrier policies; statutory sections do not have effect of automatically shifting liability from association to the nearest solvent insurer when liability does not rest there already. Id., 794. Because the obligation of association re a “covered claim” is limited to that “which arises out of and is within” the coverage of the underlying insurance policy, association is not liable for sanctions imposed by workers' compensation commissioner because the sanctions arose out of association's conduct in handling the claim and not out of the coverage of the policy. 298 C. 620. An insurer's preinsolvency misconduct during underlying litigation does not estop association from challenging the existence of a covered claim, which is a predicate for association's liability under the guaranty act. 314 C. 161.

Subdiv. (6):

Cited. 217 C. 371. All claims by insurers are excluded from definition of “covered claim”. 243 C. 438. Employer that is self-insurer under Workers' Compensation Act is not an “insurer” under definition of “covered claim”. 247 C. 442.
Conn. Gen. Stat. § 38a-760d — Connecticut Code / Title 38a / Chapter 701e / Section 38a-760d
Sec. 38a-760d. Record of transactions. Insurers' right to access.
Status: in_force

(b) The insurer shall have access and the right to copy and audit all accounts and records maintained by the reinsurance intermediary-broker related to its business in a form usable by the insurer.
Conn. Gen. Stat. § 38a-492r — Connecticut Code / Title 38a / Chapter 700c / Section 38a-492r
Sec. 38a-492r. Mandatory coverage for certain immunizations and consultation with health care provider.
Status: in_force

(b) No policy described in subsection (a) of this section shall impose a coinsurance, copayment, deductible or other out-of-pocket expense for the benefits and services required under said subsection. The provisions of this subsection shall apply to a high deductible health plan, as that term is used in subsection (f) of section 38a-493 , to the maximum extent permitted by federal law, except if such plan is used to establish a medical savings account or an Archer MSA pursuant to Section 220 of the Internal Revenue Code of 1986, or any subsequent corresponding internal revenue code of the United States, as amended from time to time, or a health savings account pursuant to Section 223 of said Internal Revenue Code, as amended from time to time, the provisions of this subsection shall apply to such plan to the maximum extent that (1) is permitted by federal law, and (2) does not disqualify such account for the deduction allowed under said Section 220 or 223, as applicable. Nothing in this section shall preclude a policy that provides the coverage required under subsection (a) of this section and uses a provider network from imposing cost-sharing requirements for any benefit or service required under said subsection (a) that is delivered by an out-of-network provider.

See Sec. 38a-518r for similar provisions re group policies.
Conn. Gen. Stat. § 38a-395a — Connecticut Code / Title 38a / Chapter 700 / Section 38a-395a
Sec. 38a-395a. Prohibition on denying coverage of health care provider based solely on such health provider's decision not to maintain specialty certification or requiring evidence of maintenance of specialty certification as prerequisite for obtaining professional liability insurance or other indemnity against liability for professional malpractice.
Status: in_force

(1) “Health care provider” has the same meaning as provided in section 38a-477aa ;

(2) “Maintenance of certification” means any process requiring periodic recertification examinations or other professional development activities to maintain specialty certification;

(3) “Professional liability insurance” has the same meaning as provided in section 38a-393 ; and

(4) “Specialty certification” means any certification by a medical board that specializes in one area of medicine and has requirements in addition to licensing requirements in this state.

(b) No insurance company that delivers, issues for delivery, renews, amends or continues a professional liability insurance policy in this state on or after January 1, 2025, shall (1) deny coverage of a health care provider based solely on such health provider's decisions not to maintain a specialty certification, including, but not limited to, through participation in a maintenance of certification program, or (2) require evidence of maintenance of such specialty certification as a prerequisite for obtaining professional liability insurance or other indemnity against liability for professional malpractice in accordance with section 20-11b , provided such health care provider does not hold such health care provider out to be a specialist under such specialty certification.
Conn. Gen. Stat. § 38a-977 — Connecticut Code / Title 38a / Chapter 705 / Section 38a-977
Sec. 38a-977. (Formerly Sec. 38-502). Applicability. Exceptions.
Status: in_force

(b) The rights granted by sections 38a-975 to 38a-998 , inclusive, shall extend to: (1) In the case of life, health or disability insurance, the following persons who are residents of this state: (A) Individuals who are the subject of information collected, received or maintained in connection with insurance transactions and (B) applicants, individuals or policyholders who engage in or seek to engage in insurance transactions, and (2) in the case of property or casualty insurance, the following persons: (A) Individuals who are the subject of information collected, received or maintained in connection with insurance transactions involving policies, contracts or certificates of insurance delivered, issued for delivery or renewed in the state and (B) applicants, individuals or policyholders who engage in or seek to engage in insurance transactions involving policies, contracts or certificates of insurance delivered, issued for delivery or renewed in this state.

(c) For purposes of this section, a person shall be considered a resident of this state if the person's last-known mailing address, as shown in the records of the insurance institution, agent or insurance-support organization, is located in this state.

(d) Notwithstanding the provisions of subsections (a) and (b) of this section, sections 38a-975 to 38a-998 , inclusive, shall not apply to information collected from the public records of a governmental authority and maintained by an insurance institution or its representatives for the purpose of insuring the title to real property located in this state.
Conn. Gen. Stat. § 38a-523 — Connecticut Code / Title 38a / Chapter 700c / Section 38a-523
Sec. 38a-523. (Formerly Sec. 38-174p). Group hospital or medical insurance coverage for comprehensive rehabilitation services.
Status: in_force

(1) “Comprehensive rehabilitation services” shall consist of the following when provided in a comprehensive rehabilitation facility pursuant to a plan of care approved in writing by a physician licensed in accordance with the provisions of chapter 370, a physician assistant licensed in accordance with the provisions of chapter 370 or an advanced practice registered nurse licensed in accordance with the provisions of chapter 378 and reviewed by such physician, physician assistant or advanced practice registered nurse at least every thirty days to determine that continuation of such services are medically necessary for the rehabilitation of the patient: (A) Physician services, physical and occupational therapy, nursing care, psychological and audiological services and speech therapy provided by health care professionals who are licensed by the appropriate state licensing authority to perform such services; (B) social services by a social worker holding a master's degree from an accredited school of social work; (C) respiratory therapy by a certified respiratory therapist; (D) prescription drugs and medicines which cannot be self-administered; (E) prosthetic and orthotic devices, including the testing, fitting or instruction in the use of such devices; (F) other supplies or services prescribed by a physician, a physician assistant or an advanced practice registered nurse for the rehabilitation of a patient and ordinarily furnished by a comprehensive rehabilitation facility.

(2) “Comprehensive rehabilitation facility” means a facility that is: (A) Primarily engaged in providing diagnostic, therapeutic and restorative services through such licensed health care professionals to persons who have an injury, sickness or disability solely on an outpatient basis and (B) accredited for the provision of such services by the Commission on Accreditation for Rehabilitation Facilities or the Professional Services Board of the American Speech-Language Hearing Association.

(b) Any insurance company, hospital service corporation, medical service corporation or health care center authorized to do the business of health insurance in this state shall offer to any individual, partnership, corporation or unincorporated association providing group health insurance coverage of the type specified in subdivisions (1), (2), (4), (6), (11) and (12) of section 38a-469 for its employees or members, a group hospital or medical service plan or contract providing coverage for expenses incurred for comprehensive rehabilitation services under such terms and conditions as are agreed to by the policyholder and the insurer.
Conn. Gen. Stat. § 38a-471 — Connecticut Code / Title 38a / Chapter 700c / Section 38a-471
Sec. 38a-471. (Formerly Sec. 38-174o). Third party prescription programs. Notice of cancellation. Applicability of section.
Status: in_force

(b) Any agreement or contract entered into in this state between an administrator and a pharmacy shall include a statement of the method and amount of reimbursement to the pharmacy for drugs or services provided to persons enrolled in the program, and the frequency of payment by the administrator to the pharmacy for such drugs or services.

(c) (1) Each administrator of a program shall notify all pharmacies enrolled in such program of any cancellation of coverage or benefits of any group enrolled in the program at least thirty days prior to the effective date of such cancellation or within ten business days following the date on which he receives notice of a cancellation, if he receives such notice less than forty days prior to its effective date.

(2) Each employer shall give written notice to all persons enrolled in such program of the cancellation of the plan and written notice to any person whose enrollment is terminated. Such notice shall be given as soon as is practicable but in no case later than thirty days after cancellation or termination. Such notice shall include a demand for the return of any plan identification cards such persons may have been issued by reason of their enrollment in such program.

(3) Any person who uses a program identification card to obtain drugs or services from a pharmacy after having received notice of the cancellation of his program shall be liable to the administrator for all moneys paid by the administrator for any drugs or services obtained by the illegal use of such card.

(d) (1) No administrator shall deny payment to any pharmacy for drugs or services which were provided as the result of the fraudulent or illegal use of an identification card by any person to whom an identification card was issued, unless the pharmacy was notified of the cancellation of such card.

(2) No administrator shall withhold payments for uncontested claims to any pharmacy beyond the time period specified in the payment schedule provisions of the agreement.

(e) Each administrator shall mail to any pharmacist, upon written request, a copy of each contract or agreement form in use in this state between such administrator and a pharmacy.

(f) No administrator shall prohibit a pharmacy from enrolling in a program except for cause, including, but not limited to, previous fraudulent use of program identification cards.

(g) The provisions of this section shall not apply to the providing of drugs or services under the provisions of Title XIX of the Social Security Act.
Conn. Gen. Stat. § 38a-329 — Connecticut Code / Title 38a / Chapter 700 / Section 38a-329
Sec. 38a-329. (Formerly Sec. 38-185l). Residual market mechanism for property and casualty insurance.
Status: in_force

(b) Notwithstanding the provisions of subdivision (5) of subsection (a) of this section, the insured shall be refunded the unearned portion of the premium down payment whenever, prior to completion of the period covered by the premium down payment: (1) The insured requests the cancellation of the policy because (A) the insured motor vehicle is sold or repossessed, (B) the motor vehicle is stolen or destroyed, (C) the insured enters the armed forces of the United States, (D) the insured replaces such coverage in the voluntary market, (E) the insured has not taken title or possession of the motor vehicle, or (F) the insured moves out of state and the vehicle is thereafter registered in another state; or (2) the insured requests an adjustment in such policy premium because he has cancelled one motor vehicle from the policy and such policy remains in effect for one or more other motor vehicles.

Cited. 36 CA 587.
Conn. Gen. Stat. § 38a-771 — Connecticut Code / Title 38a / Chapter 702 / Section 38a-771
Sec. 38a-771. (Formerly Sec. 38-92l). Licensee to notify commissioner of change in information. Violations. Hearings. Penalties.
Status: in_force

(b) Any person, firm, partnership, association or corporation, or any person, firm, partnership, association or corporation acting as a trade name, holding a license issued pursuant to sections 38a-702j , 38a-703 to 38a-718 , inclusive, 38a-731 to 38a-735 , inclusive, 38a-769 to 38a-777 , inclusive, 38a-786 , 38a-790 , 38a-792 and 38a-794 , shall notify the Insurance Commissioner, in writing, not later than thirty days after any bankruptcy proceeding or the conviction of a felony, or any administrative action taken against such licensee in another state not later than thirty days after the entering of the administrative order in that state. Such notification shall be accompanied by all supporting documentation.

(c) If, upon investigation, the commissioner determines that a producer has violated the provisions of subsection (b) of this section, the commissioner may, following a hearing as specified in section 38a-774 , impose a fine upon and suspend or revoke the license of the producer.
Conn. Gen. Stat. § 38a-220 — Connecticut Code / Title 38a / Chapter 698a / Section 38a-220
Sec. 38a-220. (Formerly Sec. 33-174). Investments.
Status: in_force

Annotations to former section 33-174:

Cited. 184 C. 352.

Cited. 29 CS 474.
Conn. Gen. Stat. § 38a-492w — Connecticut Code / Title 38a / Chapter 700c / Section 38a-492w
Sec. 38a-492w. Medically necessary wheelchair repairs, replacements. Coverage requirements.
Status: in_force

(b) Each individual health insurance policy providing coverage of the types specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state on and after January 1, 2025, shall not require a new prescription or prior authorization for the medically necessary repair or replacement of a complex rehabilitation technology wheelchair unless the original prescription is more than five years old.

(c) The Insurance Commissioner shall adopt regulations, in accordance with chapter 54, to implement the provisions of this section.
Conn. Gen. Stat. § 38a-479ooo — Connecticut Code / Title 38a / Chapter 700c / Section 38a-479ooo
Sec. 38a-479ooo. Definitions.
Status: in_force

(1) “Commissioner” means the Insurance Commissioner.

(2) “Department” means the Insurance Department.

(3) “Drug” has the same meaning as provided in section 21a-92 .

(4) “Health care plan” means an individual or a group health insurance policy that provides coverage of the types specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 and includes coverage for outpatient prescription drugs.

(5) “Health carrier” means an insurance company, health care center, hospital service corporation, medical service corporation, fraternal benefit society or other entity that delivers, issues for delivery, renews, amends or continues a health care plan in this state.

(6) “Person” has the same meaning as provided in section 38a-1 .

(7) “Pharmacist” has the same meaning as provided in section 38a-479aaa .

(8) “Pharmacist services” has the same meaning as provided in section 38a-479aaa .

(9) “Pharmacy” has the same meaning as provided in section 38a-479aaa .

(10) “Pharmacy benefits manager” or “manager” means any person that administers the prescription drug, prescription device, pharmacist services or prescription drug and device and pharmacist services portion of a health care plan on behalf of a health carrier.

(11) (A) “Rebate” means a discount or concession, which affects the price of an outpatient prescription drug, that a pharmaceutical manufacturer directly provides to a (i) health carrier for an outpatient prescription drug manufactured by the pharmaceutical manufacturer, or (ii) pharmacy benefits manager after the manager processes a claim from a pharmacy or a pharmacist for an outpatient prescription drug manufactured by the pharmaceutical manufacturer.

(B) “Rebate” does not mean a bona fide service fee, as such term is defined in Section 447.502 of Title 42 of the Code of Federal Regulations, as amended from time to time.

(12) “Specialty drug” means a prescription outpatient specialty drug covered under the Medicare Part D program established pursuant to Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, as amended from time to time, that exceeds the specialty tier cost threshold established by the Centers for Medicare and Medicaid Services.
Conn. Gen. Stat. § 38a-999 — Connecticut Code / Title 38a / Chapter 705 / Section 38a-999
Sec. 38a-999. Written policies, standards and procedures re medical record information.
Status: in_force

(1) Limitation on access to medical record information by only those persons who need to use the medical record information in order to perform their jobs;

(2) Appropriate training for all employees identified in subdivision (4) of this subsection;

(3) Disciplinary measures for violations of the medical record information policies, standards and procedures;

(4) Identification of the job titles of persons that are authorized to use or disclose medical record information;

(5) Procedures for authorizing and restricting the collection, use or disclosure of medical record information;

(6) Methods for handling, disclosing, storing and disposing of medical record information;

(7) Periodic monitoring of the employees' compliance with the policies, standards and procedures in a manner sufficient for the insurance institution, agent or insurance support organization to determine compliance with this section and to enforce its policies, standards and procedures; and

(8) Additional protection against unauthorized disclosure of sensitive health information, which shall include information regarding: Sexually transmitted diseases; mental health; substance abuse; the human immunodeficiency virus and acquired immune deficiency syndrome; and genetic testing, including the fact that an individual has undergone a genetic test.

(b) An insurance institution, agent or insurance support organization shall make the medical record information policies, standards and procedures developed pursuant to this section available for review by the Insurance Commissioner.

(c) A summary of such policies, standards and procedures shall be made available to enrollees upon enrollment and upon request.
Conn. Gen. Stat. § 38a-316g — Connecticut Code / Title 38a / Chapter 700 / Section 38a-316g
Sec. 38a-316g. Cancellation of homeowners insurance policies. Notice refund of excess premium.
Status: in_force

(A) If such policy is not a renewal policy and has been in effect for fewer than sixty days, such insurer sends a written cancellation notice to the named insured:

(i) At least ten days before the effective date of such cancellation for nonpayment of premium disclosing:

(I) Such cancellation;

(II) That the named insured may avoid such cancellation and continue coverage under such policy by paying, before the effective date of such cancellation, such unpaid premium; and

(III) That any excess premium, if not tendered by the insurer, shall be refunded to the named insured upon demand by the named insured; or

(ii) At least thirty days before the effective date of such cancellation for any reason other than nonpayment of premium disclosing:

(I) Such cancellation;

(II) The reason for such cancellation;

(III) The effective date of such cancellation; and

(IV) That any excess premium, if not tendered by the insurer, shall be refunded to the named insured upon demand by the named insured; or

(B) If such policy is not a renewal policy and has been in effect for at least sixty days, or if such policy is an effective renewal policy, such insurer sends a written cancellation notice to the named insured:

(i) At least ten days before the effective date of such cancellation for nonpayment of premium disclosing:

(I) Such cancellation;

(II) That the named insured may avoid such cancellation and continue coverage under such policy by paying, before the effective date of such cancellation, such unpaid premium; and

(III) That any excess premium, if not tendered by the insurer, shall be refunded to the named insured upon demand by the named insured; or

(ii) At least thirty days before the effective date of such cancellation for fraud or misrepresentation of any material fact made by the named insured in obtaining coverage under such policy that, if discovered by such insurer, would have caused such insurer not to issue or renew such policy, as applicable, or any physical change in the covered property that materially increases a hazard insured against under such policy disclosing:

(I) The effective date of such cancellation; and

(II) That any excess premium, if not tendered by the insurer, shall be refunded to the named insured upon demand by the named insured.

(2) No insurer may cancel a homeowners insurance policy described in subparagraph (B) of subdivision (1) of this subsection for any reason other than:

(A) Nonpayment of premium;

(B) Fraud or misrepresentation of any material fact made by the named insured in obtaining coverage under such policy that, if discovered by the insurer, would have caused the insurer not to issue or renew such policy, as applicable; or

(C) Any physical change in the covered property that materially increases a hazard insured against under such policy.

(3) No notice of cancellation required under subdivision (1) of this subsection shall be effective unless such notice is sent to the named insured by registered mail, certified mail or mail evidenced by a certificate of mailing, or, if agreed by the insurer and the named insured, by electronic means evidenced by a delivery receipt.

(b) No notice of cancellation is required under subsection (a) of this section if the homeowners insurance policy is transferred from the insurer to an affiliate of such insurer for another policy with no interruption of coverage and the same terms, conditions and provisions, including policy limits, as the transferred policy, except that the insurer to which the policy is transferred shall not be prohibited from applying such insurer's rates and rating plans at the time of renewal.

(c) The named insured under a homeowners insurance policy described in subsection (a) of this section may cancel such policy at any time by sending to the insurer that delivered, issued for delivery, renewed, amended or endorsed such policy a written notice disclosing the effective date of such cancellation.
Conn. Gen. Stat. § 38a-1020 — Connecticut Code / Title 38a / Chapter 706 / Section 38a-1020
Sec. 38a-1020. Revocation of certificate of approval.
Status: in_force

(b) In addition, the commissioner may revoke a group's certificate of approval if, after notice and opportunity for hearing, the commissioner finds that: (1) Any certificate of approval that was issued to the group was obtained by fraud; (2) there was a material misrepresentation in the application for the certificate of approval; or (3) the group or its administrator has misappropriated, converted, illegally withheld or refused to pay over upon proper demand any moneys that belong to a member, an employee of a member, or a person otherwise entitled thereto and that have been entrusted to the group or its administrator in its fiduciary capacities.
Conn. Gen. Stat. § 38a-943 — Connecticut Code / Title 38a / Chapter 704c / Section 38a-943
Sec. 38a-943. (Formerly Sec. 38-461). Secured creditor's claims.
Status: in_force

(b) The determination shall be under the supervision and control of the court with due regard for the recommendation of the liquidator. The amount so determined shall be credited upon the secured claim, and any deficiency shall be treated as an unsecured claim. If the claimant shall surrender his security to the liquidator, the entire claim shall be allowed as if unsecured.
Conn. Gen. Stat. § 38a-544 — Connecticut Code / Title 38a / Chapter 700c / Section 38a-544
Sec. 38a-544. Prescription drug coverage. Mail order pharmacies. Step therapy use.
Status: in_force

(1) Require any person covered under such policy or contract to obtain prescription drugs from a mail order pharmacy as a condition of obtaining benefits for such drugs; or

(2) Require, if such insurance company, hospital service corporation, medical service corporation, health care center or other entity uses step therapy for such drugs, the use of step therapy (A) for any prescribed drug for longer than thirty days, (B) for a prescribed drug for cancer treatment for an insured who has been diagnosed with stage IV metastatic cancer provided such prescribed drug is in compliance with approved federal Food and Drug Administration indications, or (C) for the period commencing January 1, 2024, and ending January 1, 2027, inclusive, for the treatment of schizophrenia, major depressive disorder or bipolar disorder, as defined in the most recent edition of the American Psychiatric Association's “Diagnostic and Statistical Manual of Mental Disorders”.

(3) At the expiration of the time period specified in subparagraph (A) of subdivision (2) of this subsection or for a prescribed drug described in subparagraph (B) or (C) of subdivision (2) of this subsection, an insured's treating health care provider may deem such step therapy drug regimen clinically ineffective for the insured, at which time the insurance company, hospital service corporation, medical service corporation, health care center or other entity shall authorize dispensation of and coverage for the drug prescribed by the insured's treating health care provider, provided such drug is a covered drug under such policy or contract. If such provider does not deem such step therapy drug regimen clinically ineffective or has not requested an override pursuant to subdivision (1) of subsection (b) of this section, such drug regimen may be continued. For purposes of this section, “step therapy” means a protocol or program that establishes the specific sequence in which prescription drugs for a specified medical condition are to be prescribed.

(b) (1) Notwithstanding the sixty-day period set forth in subdivision (2) of subsection (a) of this section, each insurance company, hospital service corporation, medical service corporation, health care center or other entity that uses step therapy for such prescription drugs shall establish and disclose to its health care providers a process by which an insured's treating health care provider may request at any time an override of the use of any step therapy drug regimen. Any such override process shall be convenient to use by health care providers and an override request shall be expeditiously granted when an insured's treating health care provider demonstrates that the drug regimen required under step therapy (A) has been ineffective in the past for treatment of the insured's medical condition, (B) is expected to be ineffective based on the known relevant physical or mental characteristics of the insured and the known characteristics of the drug regimen, (C) will cause or will likely cause an adverse reaction by or physical harm to the insured, or (D) is not in the best interest of the insured, based on medical necessity.

(2) Upon the granting of an override request, the insurance company, hospital service corporation, medical service corporation, health care center or other entity shall authorize dispensation of and coverage for the drug prescribed by the insured's treating health care provider, provided such drug is a covered drug under such policy or contract.

(c) Nothing in this section shall (1) preclude an insured or an insured's treating health care provider from requesting a review under sections 38a-591c to 38a-591g , inclusive, or (2) affect the provisions of section 38a-518i .

See Sec. 38a-510 for similar provisions re individual policies.
Conn. Gen. Stat. § 38a-514e — Connecticut Code / Title 38a / Chapter 700c / Section 38a-514e
Sec. 38a-514e. Coverage for mental health wellness exams.
Status: in_force

(1) “Licensed mental health professional” means: (A) A licensed professional counselor or professional counselor, as defined in section 20-195aa ; (B) a person who is under professional supervision, as defined in section 20-195aa ; (C) a physician licensed pursuant to chapter 370, who is certified in psychiatry by the American Board of Psychiatry and Neurology; (D) an advanced practice registered nurse licensed pursuant to chapter 378, who is certified as a psychiatric and mental health clinical nurse specialist or nurse practitioner by the American Nurses Credentialing Center; (E) a psychologist licensed pursuant to chapter 383; (F) a marital and family therapist licensed pursuant to chapter 383a; (G) a licensed clinical social worker licensed pursuant to chapter 383b; or (H) an alcohol and drug counselor licensed under chapter 376b; and

(2) “Mental health wellness examination” means a screening or assessment that seeks to identify any behavioral or mental health needs and appropriate resources for treatment. The examination may include: (A) Observation; (B) a behavioral health screening; (C) education and consultation on healthy lifestyle changes; (D) referrals to ongoing treatment, mental health services and other necessary supports; (E) discussion of potential options for medication; (F) age-appropriate screenings or observations to understand the mental health history, personal history and mental or cognitive state of the person being examined; and (G) if appropriate, relevant input from an adult through screenings, interviews or questions.

(b) (1) Each group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 and delivered, issued for delivery, renewed, amended or continued in this state on or after January 1, 2023, (A) shall provide coverage for two mental health wellness examinations per year that are performed by a licensed mental health professional, and (B) shall not require prior authorization of such examinations.

(2) The mental health wellness examinations shall be covered with no patient cost sharing.

(c) The provisions of this section shall apply to a high deductible health plan, as that term is used in subsection (f) of section 38a-520 , to the maximum extent permitted by federal law, except if such plan is used to establish a medical savings account or an Archer MSA pursuant to Section 220 of the Internal Revenue Code of 1986, as amended from time to time, or any subsequent corresponding Internal Revenue Code of the United States, as amended from time to time, or a health savings account pursuant to Section 223 of said Internal Revenue Code, as amended from time to time, the provisions of this section shall apply to such plan to the maximum extent that (1) is permitted by federal law, and (2) does not disqualify such account for the deduction allowed under said Section 220 or 223, as applicable.
Conn. Gen. Stat. § 38a-525c — Connecticut Code / Title 38a / Chapter 700c / Section 38a-525c
Sec. 38a-525c. Denial of coverage prohibited for health care services rendered to persons with an elevated blood alcohol content.
Status: in_force

See Sec. 38a-498c for similar provisions re individual policies.
Conn. Gen. Stat. § 38a-702a — Connecticut Code / Title 38a / Chapter 701a / Section 38a-702a
Sec. 38a-702a. Definitions.
Status: in_force

(1) “Agent” or “insurance agent” means an insurance producer appointed by an insurer to act on the insurer's behalf pursuant to section 38a-702m .

(2) “Business entity” means a corporation, association, partnership, limited liability company, limited liability partnership, or other legal entity.

(3) “Commissioner” means the Insurance Commissioner.

(4) “Home state” means any state or territory of the United States, including, but not limited to, the District of Columbia, in which an insurance producer maintains the producer's principal place of residence or principal place of business and is licensed to act as an insurance producer.

(5) “Insurance” means any of the lines of authority contained in this title.

(6) “Insurance producer” or “producer” means a person required to be licensed under the laws of this state to sell, solicit or negotiate insurance.

(7) “Insurer” has the same meaning as provided in section 38a-1 .

(8) “License” means a document issued by the commissioner authorizing a person to act as an insurance producer for the lines of authority specified in the document. The license itself does not create any authority, actual, apparent or inherent, in the holder to represent or commit an insurance carrier.

(9) “Limited line credit insurance” includes credit life, credit disability, credit property, credit unemployment, involuntary unemployment, mortgage life, mortgage guaranty, mortgage disability, guaranteed automobile protection insurance and any other form of insurance offered in connection with an extension of credit that is limited to partially or wholly extinguishing that credit obligation that the commissioner determines should be designated a form of limited line credit insurance.

(10) “Limited line credit insurance producer” means a person who sells, solicits or negotiates one or more forms of limited line credit insurance coverage to individuals through a master, corporate, group or individual policy.

(11) “Limited lines insurance” means credit insurance and travel insurance, or any other line of insurance that the commissioner deems necessary to recognize for the purpose of complying with section 38a-702g .

(12) “Limited lines producer” means a person authorized by the commissioner to sell, solicit or negotiate limited lines insurance.

(13) “Negotiate” means the act of conferring directly with, or offering advice directly to, a purchaser or prospective purchaser of a particular contract of insurance concerning any of the substantive benefits, terms or conditions of the contract, provided the person engaged in that act either sells insurance or obtains insurance from insurers for purchasers.

(14) “Person” means an individual or a business entity.

(15) “Sell” means to exchange a contract of insurance by any means, for money or its equivalent, on behalf of an insurance company.

(16) “Solicit” means attempting to sell insurance or asking or urging a person to apply for a particular kind of insurance from a particular company.

(17) “Terminate” means the cancellation of the relationship between an insurance producer and the insurer or the termination of a producer's authority to transact insurance.

(18) “Uniform business entity application” means the National Association of Insurance Commissioners uniform business entity application for resident and nonresident business entities, as amended from time to time.

(19) “Uniform application” means the National Association of Insurance Commissioners uniform application for resident and nonresident producer licensing, as amended from time to time.
Conn. Gen. Stat. § 38a-92d — Connecticut Code / Title 38a / Chapter 698 / Section 38a-92d
Sec. 38a-92d. Reserves against unpaid losses and loss expense.
Status: in_force

(b) Except as otherwise permitted by the commissioner, no deduction shall be made for anticipated salvage in computing case basis loss reserves, unless that salvage is held by or under the control of the financial guaranty insurance corporation and would qualify as an admitted asset under this title or unless that salvage constitutes or is secured by a letter of credit which is approved by the commissioner or complies with the criteria set forth in subdivision (4) of section 38a-92a .

(c) If the insured principal and interest on a defaulted issue of obligations due and payable during any three years following the date of default exceed ten per cent of the financial guaranty insurance corporation's capital, surplus and contingency reserves, its reserves so established shall be supported by a report from an independent actuarial firm or other source acceptable to the commissioner.
Conn. Gen. Stat. § 38a-604 — Connecticut Code / Title 38a / Chapter 700d / Section 38a-604
Sec. 38a-604. (Formerly Sec. 38-215). Tax exemption.
Status: in_force

Annotation to former section 38-215:

“Office equipment” does not include office supplies, materials and similar fungible items and is therefore exempt from taxation. 36 CS 63.
Conn. Gen. Stat. § 38a-465m — Connecticut Code / Title 38a / Chapter 700b / Section 38a-465m
Sec. 38a-465m. Regulations. Imposition of bond or other mechanism as proof of financial accountability. Conflict of laws.
Status: in_force

(b) Such regulations may establish standards for evaluating reasonableness of payments under life settlement contracts. Such regulations may include, but are not limited to, the regulation of discount rates used to determine the amount paid in exchange for assignment, transfer, sale, devise or bequest of a benefit under a life insurance policy.

(c) Such regulations may establish appropriate licensing requirements and standards for continued licensure for providers and brokers.

(d) The commissioner may require a bond or other mechanism for financial accountability for providers and brokers.

(e) Such regulations may adopt rules governing the relationship and responsibilities of providers, brokers, insurers and their agents, pursuant to the requirements of this part.

(f) If there is more than one owner on a single policy and the owners are residents of different states, the life settlement contract shall be governed by the law of the state in which the owner having the largest percentage ownership resides or, if the owners hold equal ownership, the state of residence of one owner agreed upon in writing by all of the owners. In the event that equal owners fail to agree in writing upon a state of residence for jurisdictional purposes, the law of the state of the insured shall govern.

(g) A provider in this state that enters into a life settlement contract with an owner who is a resident of another state that has enacted statutes or adopted regulations governing life settlement contracts shall be governed in the effectuation of such life settlement contract by the statutes and regulations of the owner's state of residence. If the state in which the owner is a resident has not enacted statutes or regulations governing life settlement contracts, the provider shall provide notice to the owner that neither state regulates the transaction upon which the owner is entering, except that for transactions in such states, the provider shall maintain all records required if the transactions were executed in the owner's state of residence. The forms used in such states need not be approved by the commissioner.

(h) If there is a conflict in the laws that apply to an owner and a provider in any individual transaction, the laws of the state that apply to the owner shall take precedence and the provider shall comply with those laws.
Conn. Gen. Stat. § 38a-513b — Connecticut Code / Title 38a / Chapter 700c / Section 38a-513b
Sec. 38a-513b. Coverage and notice re experimental treatments. Appeals.
Status: in_force

(b) No such health insurance policy may deny a procedure, treatment or the use of any drug as experimental if such procedure, treatment or drug, for the illness or condition being treated, or for the diagnosis for which it is being prescribed, has successfully completed a phase III clinical trial of the federal Food and Drug Administration.

(c) Any person who has been diagnosed with a condition that creates a life expectancy in that person of less than two years and who has been denied an otherwise covered procedure, treatment or drug on the grounds that it is experimental may request an expedited appeal as provided in section 38a-591e and may appeal a denial thereof to the Insurance Commissioner in accordance with the procedures established in section 38a-591g .

See Sec. 38a-483c for similar provisions re individual policies.
Conn. Gen. Stat. § 38a-1088 — Connecticut Code / Title 38a / Chapter 706c / Section 38a-1088
Sec. 38a-1088. State pledge to contractors. Exemption from taxes.
Status: in_force

(b) The exchange shall be exempt from all franchise, corporate business and property taxes levied by the state or any municipality, except that nothing in this subsection shall be construed to exempt from any such taxes, or from any taxes levied in connection with, (1) the manufacture or sale of any products that are the subject of any agreement made by the exchange, or (2) any person entering into any contract with the exchange.
Conn. Gen. Stat. § 38a-478l — Connecticut Code / Title 38a / Chapter 700c / Section 38a-478l
Sec. 38a-478l. Consumer report card required. Content. Data analysis by commissioner.
Status: in_force

(b) (1) The consumer report card shall be known as the “Consumer Report Card on Health Insurance Carriers in Connecticut” and shall include (A) all health care centers licensed pursuant to chapter 698a, (B) the fifteen largest licensed health insurers that use provider networks and that are not included in subparagraph (A) of this subdivision, (C) the state medical loss ratio of each such health care center or licensed health insurer, (D) the federal medical loss ratio of each such health care center or licensed health insurer, (E) the information required under subdivisions (6) and (7) of subsection (a) of section 38a-478c , and (F) information concerning mental health services, as specified in subsection (c) of this section. The insurers selected pursuant to subparagraph (B) of this subdivision shall be selected on the basis of Connecticut direct written health premiums from such network plans.

(2) For the purposes of this section and sections 38a-477c , 38a-478c and 38a-478g :

(A) “State medical loss ratio” means the ratio of incurred claims to earned premiums for the prior calendar year for managed care plans issued in the state. Claims shall be limited to medical expenses for services and supplies provided to enrollees and shall not include expenses for stop loss coverage, reinsurance, enrollee educational programs or other cost containment programs or features;

(B) “Federal medical loss ratio” has the same meaning as provided in, and shall be calculated in accordance with, the Patient Protection and Affordable Care Act, P.L. 111-148, as amended from time to time, and regulations adopted thereunder.

(c) With respect to mental health services, the consumer report card shall include information or measures with respect to the percentage of enrollees receiving mental health services, utilization of mental health and chemical dependence services, inpatient and outpatient admissions, discharge rates and average lengths of stay. Such data shall be collected in a manner consistent with the National Committee for Quality Assurance Health Plan Employer Data and Information Set measures.

(d) The commissioner shall test market a draft of the consumer report card prior to its publication and distribution. As a result of such test marketing, the commissioner may make any necessary modification to its form or substance. The Insurance Department shall prominently display a link to the consumer report card on the department's Internet web site.

(e) The commissioner shall analyze annually the data submitted under subparagraphs (E) and (F) of subdivision (1) of subsection (b) of this section for the accuracy of, trends in and statistically significant differences in such data among the health care centers and licensed health insurers included in the consumer report card. The commissioner may investigate any such differences to determine whether further action by the commissioner is warranted.
Conn. Gen. Stat. § 38a-490 — Connecticut Code / Title 38a / Chapter 700c / Section 38a-490
Sec. 38a-490. (Formerly Sec. 38-174g). Coverage for newly born children. Notification to insurer.
Status: in_force

(b) Coverage for such newly born child shall consist of coverage for injury and sickness including necessary care and treatment of medically diagnosed congenital defects and birth abnormalities within the limits of the policy.

(c) If payment of a specific premium or subscription fee is required to provide coverage for a child, the policy or contract may require that notification of birth of such newly born child and payment of the required premium or fees shall be furnished to the insurer, hospital service corporation, medical service corporation or health care center not later than ninety-one days after the date of birth in order to continue coverage beyond such period, provided failure to furnish such notice or pay such premium or fees shall not prejudice any claim originating within such period.

See Sec. 38a-516 for similar provisions re group policies.
Conn. Gen. Stat. § 38a-91nn — Connecticut Code / Title 38a / Chapter 698 / Section 38a-91nn
Sec. 38a-91nn. Direct premium receipts tax and assumed reinsurance premium receipts tax. Applicability of tax statutes.
Status: in_force

(b) Each captive insurance company shall pay to the Commissioner of Revenue Services, on or before March first of each year, a tax at the rate of (1) two hundred fourteen thousandths of one per cent on the first twenty million dollars, (2) one hundred forty-three thousandths of one per cent on the next twenty million dollars, (3) forty-eight thousandths of one per cent on the next twenty million dollars, and (4) twenty-four thousandths of one per cent on each dollar thereafter, on assumed reinsurance premiums collected or contracted for on policies or contracts of insurance written by the captive insurance company during the year ending December thirty-first next preceding, provided no tax under this subsection shall apply to premiums for risks or portions of risks that are subject to taxation on a direct basis pursuant to subsection (a) of this section. No tax under this subsection shall be payable in connection with the receipt of assets in exchange for the assumption by a captive insurance company of loss reserves and other liabilities of another insurer under common ownership and control, if such transaction is part of a plan to discontinue the operations of such other insurer and if the intent of the parties to such transaction is to renew or maintain such business with the captive insurance company.

(c) (1) The annual minimum aggregate tax to be paid by a captive insurance company, other than a sponsored captive insurance company, calculated under subsection (a) of this section shall be seven thousand five hundred dollars, and the annual maximum aggregate tax calculated under subsections (a) and (b) of this section shall be two hundred thousand dollars. In the case of a branch captive insurance company, the annual aggregate tax to be paid by such company shall apply only to the branch business of such company.

(2) In the case of a sponsored captive insurance company, the annual minimum aggregate tax to be paid by a sponsored captive insurance company shall be seven thousand five hundred dollars and shall apply to such company as a whole and not to each protected cell. The annual maximum tax to be paid by a sponsored captive insurance company shall be the aggregate tax liability, calculated under subsection (a) of this section, of each protected cell.

(d) The provisions of sections 12-204 , 12-204d , 12-204g and 12-205 to 12-208 , inclusive, shall apply to the provisions of sections 38a-91aa to 38a-91tt , inclusive, in the same manner and with the same force and effect as if the language of said sections 12-204 , 12-204d , 12-204g and 12-205 to 12-208 , inclusive, had been incorporated in full into this section and had expressly referred to the tax due under this section, except to the extent that any such language is inconsistent with a provision of said sections 38a-91aa to 38a-91tt , inclusive.

(e) (1) Except as specified in subsection (c) of this section and subdivision (2) of this subsection, two or more captive insurance companies under common ownership and control shall be taxed as though they were a single captive insurance company.

(2) Special purpose financial captive insurance companies shall not be consolidated with other captive insurance companies that are not special purpose financial captive insurance companies for purposes of calculating the tax due under this section.

(f) For the purposes of this section, (1) “common ownership and control” means ownership and control of two or more captive insurance companies by the same person or group of persons, and (2) “ownership and control” means:

(A) In the case of stock insurers, the direct or indirect ownership of eighty per cent or more of the outstanding voting stock of the insurer;

(B) In the case of mutual or nonprofit corporations, the direct or indirect ownership of eighty per cent or more of the surplus and the voting power of the corporation;

(C) In the case of limited liability companies, the direct or indirect ownership of eighty per cent or more of the membership interests in the company; and

(D) In the case of sponsored captive insurance companies, a protected cell shall be treated as a separate captive insurance company owned and controlled by the protected cell's participants.

(g) (1) The tax provided for in this section shall constitute all taxes collectible under the laws of this state from any captive insurance company, and no other occupation tax or other taxes shall be levied or collected from any captive insurance company by the state or any county, city or municipality within this state, except sales and use taxes and ad valorem taxes on real and personal property used in the production of income.

(2) The tax provided for in this section shall be calculated on an annual basis, notwithstanding policies or contracts of insurance or contracts of reinsurance issued on a multiyear basis. In the case of multiyear policies or contracts, the premium shall be prorated for purposes of determining the tax under this section.

(3) A captive insurance company may claim a nonrefundable tax credit of seven thousand five hundred dollars against the aggregate tax imposed under this section for the first calendar year on or after January 1, 2012, in which the company has liability under this section. The Commissioner of Revenue Services shall prescribe the form and manner in which such tax credit may be claimed.

(h) (1) All fees and assessments relating to captive insurance companies received by the Insurance Department shall be deposited in the Insurance Fund established pursuant to section 38a-52a . The Comptroller shall transfer annually to said fund eleven per cent of the tax collected pursuant to this section.

(2) The Comptroller may transfer from the Insurance Department's available appropriation, with the approval of the Secretary of the Office of Policy and Management, an amount equivalent to not more than two per cent of the tax collected pursuant to this section, to the Department of Economic and Community Development for reasonable expenses incurred to promote the captive insurance industry in this state. The Department of Economic and Community Development may also utilize the transferred moneys to collaborate with other entities to promote the captive insurance industry in this state.

(3) No payment for the maintenance of staff or associated expenses, including contractual services as necessary, shall be disbursed until the commissioner receives proper documentation regarding services rendered and expenses incurred. The commissioner shall establish the form and manner of such documentation.
Conn. Gen. Stat. § 38a-202 — Connecticut Code / Title 38a / Chapter 698a / Section 38a-202
Sec. 38a-202. (Formerly Sec. 33-160). Reports and examinations.
Status: in_force

Annotation to former section 33-160:

Section empowers Insurance Commissioner as supervisor of costs of management activities; his determination of administrative costs in a Blue Cross rate increase hearing sustained on appeal. 31 CS 257.
Conn. Gen. Stat. § 38a-479qq — Connecticut Code / Title 38a / Chapter 700c / Section 38a-479qq
Sec. 38a-479qq. Medical discount plans: Definitions, prohibited sales practices, penalties.
Status: in_force

(1) “Affiliate” means a person that directly or indirectly through one or more intermediaries, controls, or is controlled by, or is under common control with, a health insurer, health care center, hospital service corporation, medical service corporation or fraternal benefit society licensed in this state;

(2) “Consumer” means: (A) A person to whom a medical discount plan is marketed or advertised, or (B) a member, as defined in this subsection;

(3) “Marketer” means a person that markets, advertises or sells a medical discount plan, including, but not limited to, an entity that markets, advertises or sells a medical discount plan under its own name;

(4) “Medical discount plan” means a business arrangement or contract in which a person, in exchange for payment, provides access for its members to providers of health care services and the right to receive health care services from those providers at a discount. “Medical discount plan” does not include a product that (A) is otherwise subject to regulation or approval under this title, or (B) costs less than twenty-five dollars, annually, in the aggregate;

(5) “Medical discount plan organization” means a person that (A) establishes a medical discount plan, (B) contracts with providers, provider networks or other medical discount plan organizations to provide health care services at a discount to medical discount plan members, and (C) determines the fees charged to the members for the medical discount plan. “Medical discount plan organization” does not include a health insurer, health care center, hospital service corporation, medical service corporation or fraternal benefit society licensed in this state or any affiliate of such health insurer, health care center, hospital service corporation, medical service corporation or fraternal benefit society;

(6) “Health care services” means any care, service or treatment of an illness or dysfunction of, or injury to, the human body. “Health care services” includes physician care, inpatient care, hospital surgical services, emergency medical services, ambulance services, dental care services, vision care services, mental health care services, substance abuse services, chiropractic services, podiatric services, laboratory test services and the provision of medical equipment or supplies. “Health care services” does not include pharmaceutical supplies or prescriptions;

(7) “Member” means an individual who pays for the right to receive the benefits of a medical discount plan; and

(8) “Person” has the same meaning as provided in section 38a-1 .

(b) No person shall market, advertise or sell to a resident of this state a medical discount plan or any plan material that: (1) Fails to provide to the consumer a clear and conspicuous disclosure that the medical discount plan is not insurance and that the plan only provides for discounted health care services from participating providers within the plan; (2) uses in its marketing materials, advertisements, brochures or member discount cards the term “insurance”, “health plan”, “coverage”, “copay”, “copayments”, “preexisting conditions”, “guaranteed issue”, “premium”, “PPO”, “preferred provider organization” or any other term that could reasonably mislead a person into believing the medical discount plan is insurance, except that such terms may be used as a disclaimer of any relationship between the medical discount plan and insurance; (3) fails to provide the name, address and telephone number of the administrator of the medical discount plan; (4) fails to make available to the consumer through a toll-free telephone number, upon request of the consumer, a complete and accurate list of the participating providers within the plan in the consumer's local area and a list of the services for which the discounts are applicable; (5) fails to make a printed copy of such list available to the consumer upon request commencing with the time the plan is purchased or fails to update the list at least once every six months; (6) fails to use plain language to describe the discounts or access to discounts offered and such failure results in representations of the discounts that are misleading, deceptive or fraudulent; (7) fails to provide the consumer notice of the right to cancel such medical discount plan; (8) offers discounted health care services or products that are not authorized by a contract with each provider listed in conjunction with the medical discount plan; (9) fails to allow a consumer to cancel a medical discount plan not later than thirty days after the date payment is received by the medical discount plan; (10) with respect to a consumer who cancels a medical discount plan pursuant to subdivision (9) of this subsection, fails to guarantee a refund of all membership fees paid to the medical discount plan by the consumer, excluding a reasonable one-time processing fee, not later than thirty days after the member gives timely notification of cancellation of the plan to the medical discount plan organization; or (11) fails to (A) provide at least one member discount card for each member as proof of membership, and (B) prominently display on such member discount card a statement that the medical discount plan is not insurance.

(c) Any person who knowingly operates as a medical discount plan organization in violation of this section shall be fined not more than fifteen thousand dollars. Any person who knowingly aids and abets another that the person knew or reasonably should have known was operating as a medical discount plan organization in violation of this section shall be fined not more than fifteen thousand dollars.

(d) Any person who collects fees for purported membership in a medical discount plan but fails to provide the promised benefits shall be subject to the penalties for larceny under sections 53a-122 to 53a-125b , inclusive, depending on the amount involved. Upon the conviction of such person of larceny, as defined in section 53a-119 , if the court does not order financial restitution pursuant to section 53a-28 , the commissioner may order reimbursement of any membership fees paid by residents of the state who were harmed by such offense.

(e) Any person licensed in this state as a health insurer, health care center, hospital service corporation, medical service corporation or fraternal benefit society, or any affiliate owned or controlled by such health insurer, health care center, hospital service corporation, medical service corporation or fraternal benefit society, may offer medical discount plans in this state pursuant to such licensure.
Conn. Gen. Stat. § 38a-1040 — Connecticut Code / Title 38a / Chapter 706b / Section 38a-1040
Sec. 38a-1040. Definitions.
Status: in_force

(1) “Consumer” means an individual who receives or is attempting to receive services from a managed care organization and is a resident of this state.

(2) “Managed care organization” means an insurer, health care center, hospital service corporation, medical service corporation or other organization delivering, issuing for delivery, renewing or amending any individual or group health managed care plan in this state.

(3) “Managed care plan” means a product offered by a managed care organization that provides for the financing or delivery of health care services to persons enrolled in the plan through: (A) Arrangements with selected providers to furnish health care services; (B) explicit standards for the selection of participating providers; (C) financial incentives for enrollees to use the participating providers and procedures provided for by the plan; or (D) arrangements that share risks with providers, provided the organization offering a plan described under subparagraph (A), (B), (C) or (D) of this subdivision is licensed by the Insurance Department pursuant to chapter 698, 698a or 700 and that the plan includes utilization review, as defined in section 38a-591a .
Conn. Gen. Stat. § 38a-337 — Connecticut Code / Title 38a / Chapter 700 / Section 38a-337
Sec. 38a-337. (Formerly Sec. 14-130). Apportionment of risks.
Status: in_force

Annotations to former section 14-130:

Cited. 143 C. 202; 169 C. 267.

Annotation to present section:

Cited. 36 CA 587.
Conn. Gen. Stat. § 38a-339 — Connecticut Code / Title 38a / Chapter 700 / Section 38a-339
Sec. 38a-339. (Formerly Sec. 38-175t). Comprehensive automobile coverage to include optional coverage for repair or replacement of damaged safety glass without deductible or minimum amount.
Status: in_force

See Sec. 14-151a re filing of police report as condition precedent to settling a motor vehicle theft claim.
Conn. Gen. Stat. § 38a-903 — Connecticut Code / Title 38a / Chapter 704c / Section 38a-903
Sec. 38a-903. (Formerly Sec. 38-421). Short title: Insurers Rehabilitation and Liquidation Act. Interpretation. Applicability.
Status: in_force

(1) Early detection of any potentially dangerous condition in an insurer and prompt application of appropriate corrective measures;

(2) Improved methods for rehabilitating insurers, involving the cooperation and management expertise of the insurance industry;

(3) Enhanced efficiency and economy of liquidation, through clarification of the law, to minimize legal uncertainty and litigation;

(4) Equitable apportionment of any unavoidable loss;

(5) Reducing the problems of interstate rehabilitation and liquidation by facilitating cooperation between states in delinquency proceedings and by extending the scope of personal jurisdiction over debtors of the insurer outside this state;

(6) Regulation of the business of insurance by the impact of the law relating to delinquency procedures and related substantive rules; and

(7) Providing for a comprehensive scheme for the rehabilitation and liquidation of insurance companies and those subject to sections 38a-903 to 38a-961 , inclusive, as part of the regulation of the business of insurance in the state. Proceedings in cases of insurer insolvency and delinquency are deemed an integral aspect of the business of insurance and are of vital public interest and concern.
Conn. Gen. Stat. § 38a-335 — Connecticut Code / Title 38a / Chapter 700 / Section 38a-335
Sec. 38a-335. (Formerly Sec. 38-175b). Minimum coverages. Applicability. Statement of coverage for rented motor vehicle.
Status: in_force

(b) Each automobile liability insurance policy issued, renewed, amended or endorsed on or after October 1, 1988, and covering a private passenger motor vehicle as defined in subsection (e) of section 38a-363 , shall contain or have attached thereto a conspicuous statement specifying whether the policy provides liability, collision or comprehensive coverage for damage to a rented private passenger motor vehicle and, where the policy provides such coverage, the limit of coverage provided and whether any deductible amount applies.

(c) Each automobile liability insurance policy issued, renewed, amended or endorsed on or after April 8, 1974, shall provide that if the provisions of the motor vehicle financial responsibility law or the motor vehicle compulsory insurance law or any similar law of any state, territory or possession of the United States of America or any Province of Canada, require insurance with respect to the operation or use of the motor vehicle in such state, territory, possession or province and such insurance requirements are greater than the insurance provided by the policy, the limits of the company's liability and the kinds of coverage afforded by the policy shall be as set forth in such law, in lieu of the insurance otherwise provided by the policy, but only to the extent required by such law and only with respect to the operation or use of the motor vehicle in such state, territory, possession or province; provided the insurance under this subsection shall be reduced to the extent that there is other valid and collectible insurance under such policy or any other motor vehicle insurance policy. In no event shall any person be entitled to receive duplicate payments for the same element of loss.

(d) With respect to the insured motor vehicle, the coverage afforded under the bodily injury liability and property damage liability provisions in any such policy shall apply to the named insured and relatives residing in such insured's household unless any such relative is specifically excluded by endorsement.

Annotations to former section 38-175b:

Cited. 160 C. 280. Regulations under statute make “other insurance” clauses in conflict with the regulations. 161 C. 169. Cited. 169 C. 502; overruled with respect to holding an uninsured motorist coverage, see 219 C. 371; 171 C. 252; Id., 463; 187 C. 386; 203 C. 45; Id., 258; Id., 305.

Cited. 31 CS 229; 36 CS 256.

Annotations to present section:

Cited. 225 C. 257; 234 C. 182.

Cited. 25 CA 492; judgment reversed, see 222 C. 744; 34 CA 679; 41 CA 632; 45 CA 630.

Subsec. (c):

In action for underinsured motorist benefits, since jury verdict was less than amount insured had already recovered from tortfeasor, insured not entitled to recover any additional damages because to do so would result in impermissible double recovery. 49 CA 306.

Subsec. (d):

Statute is not an absolute prohibition on household exclusions, but merely requires notice and acceptance by insured of an endorsement that specifically excludes relatives residing in the household of the named insured; statute prescribes a process by which such exclusions must be executed to be valid. 282 C. 454. Under 2009 revision, trial court improperly held that exclusion was valid, as that exclusion was not set forth in an endorsement as clearly and unambiguously required by Subsec., but rather, was listed among other exclusions in the body of the policy itself. 320 C. 205.
Conn. Gen. Stat. § 38a-720l — Connecticut Code / Title 38a / Chapter 701a / Section 38a-720l
Sec. 38a-720l. License renewal filing.
Status: in_force

(b) The renewal filing shall include the complete names and addresses of all insurers or other persons with which the third-party administrator had written agreements during the preceding fiscal year.
Conn. Gen. Stat. § 38a-186 — Connecticut Code / Title 38a / Chapter 698a / Section 38a-186
Sec. 38a-186. (Formerly Sec. 33-179n). Disposition of property on termination. Prohibitions re stock transactions and mergers.
Status: in_force

(b) No person may, with respect to a domestic health care center, (1) make a tender for or a request or invitation for tenders of, or enter into an agreement to exchange securities for or acquire in the open market or otherwise, any voting security of such health care center, (2) enter into any other agreement if, after the consummation of such agreement, such person would, directly or indirectly, or by conversion or by exercise of any right to acquire, be in control of such health care center, or (3) enter into an agreement to merge or consolidate with or otherwise to acquire control of such health care center, unless, at the time any offer, request or invitation is made or any agreement is entered into, or prior to the acquisition of the securities if no offer or agreement is involved, the person has complied with the provisions of section 38a-130 .
Conn. Gen. Stat. § 38a-498b — Connecticut Code / Title 38a / Chapter 700c / Section 38a-498b
Sec. 38a-498b. Mandatory coverage for mobile field hospital.
Status: in_force

See Sec. 38a-525b for similar provisions re group policies.
Conn. Gen. Stat. § 38a-516d — Connecticut Code / Title 38a / Chapter 700c / Section 38a-516d
Sec. 38a-516d. Coverage for neuropsychological testing for children diagnosed with cancer.
Status: in_force

See Sec. 38a-492 l for similar provisions re individual policies.
Conn. Gen. Stat. § 38a-586 — Connecticut Code / Title 38a / Chapter 700c / Section 38a-586
Sec. 38a-586. (Formerly Sec. 38-174rr). False or misleading advertising or solicitation and deceptive evidence of coverage prohibited.
Status: in_force

(b) No dental plan organization, unless licensed as an insurer, may use in its name, evidence of coverage or literature any of the words “insurance”, “assurance”, “casualty”, “surety”, “mutual” or any other words descriptive of the insurance, casualty or surety business or deceptively similar to the name or description of any insurer licensed to do business in this state.
Conn. Gen. Stat. § 38a-91uu — Connecticut Code / Title 38a / Chapter 698 / Section 38a-91uu
Sec. 38a-91uu. Dormant captive insurance company. Certificate of dormancy. Capital and surplus.
Status: in_force

(1) “Dormant captive insurance company” means a pure captive insurance company, a sponsored captive insurance company or an industrial insured captive insurance company, each as defined in section 38a-91aa , that has:

(A) Ceased transacting insurance business; and

(B) No liabilities associated with any insurance business that occurred, or insurance policy that was issued, prior to, on or after the filing of its application for a certificate of dormancy under subsection (b) of this section; and

(2) “Insurance business” means the business of insurance, as defined in section 38a-905 .

(b) A dormant captive insurance company that is domiciled in this state may apply to the Insurance Commissioner for a certificate of dormancy. The certificate of dormancy shall be subject to renewal once every five years, and shall be forfeited if the dormant captive insurance company commences transacting insurance business or fails to timely renew such certificate.

(c) A dormant captive insurance company that has been issued a certificate of dormancy shall:

(1) Possess and maintain unimpaired, paid-in capital and surplus of not less than fifteen thousand dollars, provided such dormant captive insurance company shall not be required to add capital upon entering dormancy if such dormant captive insurance company was never capitalized;

(2) Not later than March fifteenth, annually, submit to the commissioner a report on the financial condition of such company, verified by oath of two executive officers of such company, in such form as the commissioner prescribes; and

(3) Pay the license renewal fee specified in section 38a-11 for a captive insurance company.

(d) A dormant captive insurance company shall not be subject to or liable for the payment of any tax under section 38a-91nn .
Conn. Gen. Stat. § 38a-343a — Connecticut Code / Title 38a / Chapter 700 / Section 38a-343a
Sec. 38a-343a. Notice of policy cancellation, addition or issuance and policy information provided to Commissioner of Motor Vehicles.
Status: in_force

(2) Said commissioner may require each insurer that issues policies in this state to provide monthly, on a date specified by said commissioner, the policy information required for purposes of the Online Insurance Verification System, as provided in section 14-112a .

(3) The failure of an insurer to comply with the requirements of this section shall not affect the cancellation or issuance of any policy.

(b) The Commissioner of Motor Vehicles shall receive or accept all notices of policy addition, cancellation and issuance or all policy information from insurers, as required pursuant to subsection (a) of this section. Said commissioner shall review and analyze the addition, cancellation and issuance data or policy information submitted, together with such other information as said commissioner may obtain from the insurers, from the records of the Department of Motor Vehicles, or from any other public or private agency or firm in possession of relevant information, for the purpose of determining whether any registered owner identified in any such notice has failed to continuously maintain insurance coverage in violation of sections 14-12c and 38a-371 . In conducting such an inquiry to determine insured status, said commissioner may contact registered vehicle owners by mail and require that such mail inquiries be answered in not less than thirty days, in a satisfactory manner containing such information and verification of insurance coverage as said commissioner deems necessary and acceptable.

See Sec. 14-12g re cancellation of motor vehicle registrations by the Commissioner of Motor Vehicles.

See Sec. 14-12h re record of motor vehicle registrations cancelled by the Commissioner of Motor Vehicles.

Cited. 234 C. 182.
Conn. Gen. Stat. § 38a-1093 — Connecticut Code / Title 38a / Chapter 706c / Section 38a-1093
Sec. 38a-1093. Subsidiaries.
Status: reserved

(b) Each subsidiary shall have and may exercise the powers of the exchange and such additional powers as are set forth in such resolution, except the powers of the exchange set forth in subdivisions (7), (12), (15), (16), (17) and (21) of subsection (c) of section 38a-1083 shall be reserved to the exchange and shall not be exercisable by any subsidiary of the exchange.

(c) (1) Each subsidiary shall act through a board of directors, at least one-half of which shall be members of the board of directors of the exchange or their designees or officers or employees of the exchange. The provisions of subdivision (2) of subsection (b) of section 38a-1081 and subdivisions (7) and (9) of subsection (c) of section 38a-1081 shall apply to each member of the board of directors of a subsidiary who is not a member of the board of directors of the exchange, an officer of the exchange or an employee of the exchange.

(2) The provisions of section 1-125 shall apply to any member of the board of directors of a subsidiary established under this section. Any such member shall not be personally liable for the debts, obligations or liabilities of any such subsidiary as provided in section 1-125 . Any such subsidiary shall, and the exchange may, save harmless and indemnify any such member as provided in section 1-125 .

(d) (1) Each subsidiary shall be subject to suit, provided its liability shall be limited solely to the assets, revenues and resources of such subsidiary and without recourse to the general funds, revenues or resources or any other assets of the exchange.

(2) Each subsidiary may convey or dispose of its assets and pledge its revenues to secure any borrowing, provided any such borrowing shall be a special obligation of the subsidiary and shall be payable solely from the assets, revenues and resources of the subsidiary.

(3) Each subsidiary or the exchange may take any action necessary to comply with the provisions of the Internal Revenue Code of 1986, or any subsequent corresponding internal revenue code of the United States, as amended from time to time, to qualify and maintain any subsidiary as a corporation exempt from taxation under said code.
Conn. Gen. Stat. § 38a-214 — Connecticut Code / Title 38a / Chapter 698a / Section 38a-214
Sec. 38a-214. (Formerly Sec. 33-168). Definition. Powers. Exemption from insurance laws. Reserves.
Status: in_force

(b) A medical service corporation providing health care benefits to plan subscribers under the provisions of subsection (a) of this section may, upon obtaining the approval of the Insurance Commissioner as provided in section 38a-218 : (1) Contract for the coordination of benefits with other hospital service corporations, medical service corporations or insurance companies to avoid duplication of benefits to be provided to its group subscribers; (2) make loans, grants or provide anything of value to a health care center covering all or part of the cost of health services provided to members; (3) contract with a health care center to provide insurance or similar protection to cover the cost of care provided through health care centers and to provide coverage in the event of the insolvency of the health care center; and (4) establish, maintain, own and operate health care centers as a line of business, provided (A) aggregate investments hereafter made by such corporation shall not exceed ten per cent of such corporation's contingency reserve as of the date of the investment; (B) such investments shall not be repaid or recovered from rates charged by such corporation for its non-health-care-center lines of business; and (C) the commissioner finds, based upon evidence furnished by such corporation, that the financial condition of such corporation and the rates of its non-health-care-center subscribers are not unduly jeopardized by such investment. Subdivision (1) of this subsection shall be subject to such regulations as may be adopted by the Insurance Commissioner, in accordance with the provisions of chapter 54, to establish coordination of benefits clauses in health care benefit contracts.

(c) Each medical service corporation shall maintain reserves equal in amount to its liabilities under all its policy contracts, as the same are computed in accordance with regulations adopted in accordance with the provisions of chapter 54 upon reasonable consideration of ascertained experience for the purpose of adequately protecting the subscriber or securing the solvency of such company. Each such corporation shall maintain a reserve for contingencies that shall not be less than the amount required by companies licensed to transact accident and health insurance, under section 38a-72 . The commissioner may adopt regulations, in accordance with the provisions of chapter 54, prescribing the maximum amount that may be held in the reserve for contingencies, and in adopting such regulations, shall consider the stability, solvency and interests of the corporation, and the interests of the subscribers and other affected persons. On and after October 1, 1974, the commissioner may require a medical service corporation to adjust its reserve for contingencies to comply with the provisions of this section and to adjust its rates or benefits or both to reflect such adjustment in the reserve for contingencies.

See Sec. 38a-504 re insurance policy or contract requirements covering surgical removal of tumors and treatment of leukemia.

Annotations to former section 33-168:

Cited. 184 C. 352.

Cited. 29 CS 474.
Conn. Gen. Stat. § 38a-409 — Connecticut Code / Title 38a / Chapter 700a / Section 38a-409
Sec. 38a-409. Use of reserve on liquidation, dissolution or insolvency.
Status: in_force

(1) Such amount of the assets of such title insurance company equal to the reserve then remaining may be used by or with the written approval of the commissioner to pay for reinsurance of the liability of such title insurer upon all outstanding title insurance policies or reinsurance agreements to the extent for which claims for losses by the holders thereof are not then pending. The balance of such assets, if any, equal to the reserve may then be transferred to the general assets of the title insurer.

(2) The assets net of the reserve shall be available to pay claims for losses sustained by holders of title insurance policies then pending or arising up to the time reinsurance is effected. If claims for losses exceed such other assets of the title insurer such claims, when established, shall be paid pro rata out of the surplus assets attributable to the reserve, to the extent of such surplus, if any.

(b) If reinsurance is not obtained, assets equal to the reserve and assets constituting minimum capital, or so much as remains thereof after outstanding claims have been paid, shall constitute a trust fund to be held and invested by the commissioner for twenty years, out of which claims of policyholders shall be paid as they arise. The balance, if any, of the trust fund shall, at the expiration of twenty years, revert to the general assets of the title insurer.
Conn. Gen. Stat. § 38a-446 — Connecticut Code / Title 38a / Chapter 700b / Section 38a-446
Sec. 38a-446. (Formerly Sec. 38-149). Discrimination in favor of individuals prohibited.
Status: in_force

See Sec. 38a-488 re prohibition against discrimination between individuals of same class with respect to premiums or rates charged.

See Sec. 38a-816 re unfair practices.

See Sec. 38a-825 re prohibition against premium rebate or other special favor.
Conn. Gen. Stat. § 38a-224 — Connecticut Code / Title 38a / Chapter 698a / Section 38a-224
Sec. 38a-224. (Formerly Sec. 33-178). Exemption from taxation.
Status: in_force

Annotations to former section 33-178:

Cited. 184 C. 352.

Cited. 29 CS 474.
Conn. Gen. Stat. § 38a-453 — Connecticut Code / Title 38a / Chapter 700b / Section 38a-453
Sec. 38a-453. (Formerly Sec. 38-161). Rights of creditors of insured against beneficiary.
Status: in_force

(b) If any such policy was procured or any such designation made with the intent, express or implied, to defraud creditors, the proceeds thereof shall become a part of the estate of the insured, and the executor or administrator of the estate shall collect the insurance and use the proceeds thereof so far as it is required for the expenses of administration and the payment of debts and pay over the balance, if any, to the beneficiary of the policy. If any premiums paid on the insurance policy were paid with the intent, express or implied, to defraud creditors, the amount of the premiums so paid, with interest thereon, shall become a part of the estate and shall be dealt with as above provided.

(c) The company issuing the policy shall be discharged of all liability thereunder by payment of the proceeds in accordance with the terms of the policy unless, before such payment, the company has received written notice, from a creditor, executor or administrator of the insured, that the policy was procured or premiums were paid thereon with intent to defraud creditors. That notice may be disregarded by the company unless proper legal proceedings to enforce the claim are begun within three months from the giving of the notice.

(d) This section shall apply to any policy of insurance issued before July 1, 1933, but not to policies which matured by the death of the insured before July 1, 1933.

Annotations to former section 38-161:

Where husband assigned insurance on his life as security for bank loan, joinder by wife in assignment did not defeat her right as beneficiary to excess of proceeds above debt to bank. 120 C. 306.

Cited. 39 CS 470.

Annotation to present section:

Cited. 229 C. 459.
Conn. Gen. Stat. § 38a-217 — Connecticut Code / Title 38a / Chapter 698a / Section 38a-217
Sec. 38a-217. (Formerly Sec. 33-171). Form of contract.
Status: in_force

See Sec. 38a-472 re assignment of insurance proceeds to doctor, hospital or state agency.
Conn. Gen. Stat. § 38a-42 — Connecticut Code / Title 38a / Chapter 698 / Section 38a-42
Sec. 38a-42. (Formerly Sec. 38-20b). Contracts with life, accident or health insurance producers.
Status: in_force

(b) Any insurance company may enter into a contract of remuneration of the kind prohibited in subsection (a) of this section with any such insurance producer if the company has offered to such producer a contract which contains no such contingent provisions as described in subdivisions (1) and (2) of subsection (a) of this section and which provides actuarially equivalent remuneration to the contract containing such contingent provisions.
Conn. Gen. Stat. § 38a-465g — Connecticut Code / Title 38a / Chapter 700b / Section 38a-465g
Sec. 38a-465g. Prerequisites to a life settlement contract wherein insured is terminally or chronically ill. Medical release and confidentiality of medical information. Verification of coverage. Notice to insurer. Change of ownership or beneficiary. Rescission. Escrow agent or trustee. Broker fee calculation and disclosure of compensation. Prohibitions. Exemptions.
Status: in_force

(1) If the owner is the insured, a written statement from a licensed attending physician, physician assistant or advanced practice registered nurse that the owner is of sound mind and under no constraint or undue influence to enter into the settlement contract; and

(2) A document in which the insured consents to the release of the insured's medical records to a provider, broker or insurance producer, and, if the policy was issued less than two years from the date of application for a settlement contract, to the insurance company that issued the policy.

(b) The insurer shall respond to a request for verification of coverage submitted by a provider, broker or life insurance producer on a form approved by the commissioner not later than thirty calendar days after the date the request was received. The insurer shall complete and issue the verification of coverage or indicate in which respects it is unable to respond. In its response, the insurer shall indicate whether, based on the medical evidence and documents provided, the insurer intends to pursue an investigation regarding the validity of the policy.

(c) Prior to or at the time of execution of the settlement contract, the provider shall obtain a witnessed document in which the owner consents to the settlement contract, represents that the owner has a full and complete understanding of the settlement contract, that the owner has a full and complete understanding of the benefits of the policy, acknowledges that the owner is entering into the settlement contract freely and voluntarily and, for persons with a terminal or chronic illness or condition, acknowledges that the insured has a terminal or chronic illness or condition and that the terminal or chronic illness or condition was diagnosed after the life insurance policy was issued.

(d) If a broker or life insurance producer performs any of the activities required of the provider under this section, the provider shall be deemed to have fulfilled the requirements of this section.

(e) The insurer shall not unreasonably delay effecting change of ownership or beneficiary with any life settlement contract lawfully entered into in this state or with a resident of this state.

(f) Not later than twenty days after an owner executes the life settlement contract, the provider shall give written notice to the insurer that issued the policy that the policy has become subject to a life settlement contract. The notice shall be accompanied by a copy of the medical records release required under subdivision (2) of subsection (a) of this section and a copy of the insured's application for the life settlement contract.

(g) All medical information solicited or obtained by any person licensed pursuant to this part shall be subject to applicable provisions of law relating to the confidentiality of medical information.

(h) Each life settlement contract entered into in this state shall provide that the owner may rescind the contract not later than fifteen days from the date it is executed by all parties thereto. Such rescission exercised by the owner shall be effective only if both notice of rescission is given to the provider and the owner repays all proceeds and any premiums, loans and loan interest paid by the provider within the rescission period. A failure to provide written notice of the right of rescission shall toll the period of such right until thirty days after the written notice of the right of rescission has been given. If the insured dies during the rescission period, the contract shall be deemed to have been rescinded, subject to repayment by the owner or the owner's estate of all proceeds and any premiums, loans and loan interest to the provider.

(i) Not later than three business days after the date the provider receives the documents from the owner to effect the transfer of the insurance policy, the provider shall pay or transfer the proceeds of the settlement into an escrow or trust account managed by a trustee or escrow agent in a state or federally chartered financial institution whose deposits are insured by the Federal Deposit Insurance Corporation. Not later than three business days after receiving acknowledgment of the transfer of the insurance policy from the issuer of the policy, said trustee or escrow agent shall pay the settlement proceeds to the owner.

(j) Failure to tender the life settlement contract proceeds to the owner within the time set forth in section 38a-465f shall render the viatical settlement contract voidable by the owner for lack of consideration until the time such consideration is tendered to, and accepted by, the owner.

(k) Any fee paid by a provider, party, individual or an owner to a broker in exchange for services provided to the owner pertaining to a life settlement contract shall be computed as a percentage of the offer obtained and not as a percentage of the face value of the policy. Nothing in this section shall be construed to prohibit a broker from reducing such broker's fee below such percentage.

(l) Each broker shall disclose to the owner anything of value paid or given to such broker in connection with a life settlement contract concerning the owner.

(m) No person at any time prior to, or at the time of, the application for or issuance of a policy, or during a two-year period commencing with the date of issuance of the policy, shall enter into a life settlement contract regardless of the date the compensation is to be provided and regardless of the date the assignment, transfer, sale, devise, bequest or surrender of the policy is to occur. This prohibition shall not apply if the owner certifies to the provider that:

(1) The policy was issued upon the owner's exercise of conversion rights arising out of a group or individual policy, provided the total of the time covered under the conversion policy plus the time covered under the prior policy is not less than twenty-four months. The time covered under a group policy shall be calculated without regard to a change in insurance carriers, provided the coverage has been continuous and under the same group sponsorship; or

(2) The owner submits independent evidence to the provider that one or more of the following conditions have been met within said two-year period: (A) The owner or insured is terminally ill or chronically ill; (B) the owner or insured disposes of the owner or insured's ownership interests in a closely held corporation, pursuant to the terms of a buyout or other similar agreement in effect at the time the insurance policy was initially issued; (C) the owner's spouse dies; (D) the owner divorces his or her spouse; (E) the owner retires from full-time employment; (F) the owner has a physical or mental disability and a physician, a physician assistant or an advanced practice registered nurse determines that the disability prevents the owner from maintaining full-time employment; or (G) a final order, judgment or decree is entered by a court of competent jurisdiction on the application of a creditor of the owner, adjudicating the owner bankrupt or insolvent, or approving a petition seeking reorganization of the owner or appointing a receiver, trustee or liquidator to all or a substantial part of the owner's assets.

(n) Copies of the independent evidence required by subdivision (2) of subsection (m) of this section shall be submitted to the insurer when the provider submits a request to the insurer for verification of coverage. The copies shall be accompanied by a letter of attestation from the provider that the copies are true and correct copies of the documents received by the provider. Nothing in this section shall prohibit an insurer from exercising its right to contest the validity of any policy.

(o) If, at the time the provider submits a request to the insurer to effect the transfer of the policy to the provider, the provider submits a copy of independent evidence of subparagraph (A) of subdivision (2) of subsection (m) of this section, such copy shall be deemed to establish that the settlement contract satisfies the requirements of this section.
Conn. Gen. Stat. § 38a-724 — Connecticut Code / Title 38a / Chapter 701b / Section 38a-724
Sec. 38a-724. Employment contract required. Cancellation. Solicitation prohibition.
Status: in_force

(1) Any such contract signed on or after July 1, 2019, shall contain a provision, prominently displayed on the first page of such contract in not less than twelve-point boldface type, specifying that the insured may cancel the contract, provided such insured notifies the public adjuster at such public adjuster's main office or branch office at the address shown in the contract, by certified mail, return receipt requested or, if agreed between the insured and the public adjuster, by electronic means with proof of a delivery receipt, posted or delivered not later than midnight of the fourth calendar day after the day on which the insured signs the contract, except that if the signing is on a Friday, Saturday or Sunday, the cancellation shall be posted not later than midnight of the Thursday immediately following, and thereafter the contract shall be void ab initio.

(2) Any such contract signed on or after July 1, 2019, that does not display the provision as specified in subdivision (1) of this subsection shall be void ab initio.

(b) No public adjuster shall solicit an insured between the hours of eight o'clock p.m. and eight o'clock a.m. Any public adjuster employment contract that results from a public adjuster's solicitation between such hours shall be void ab initio.
Conn. Gen. Stat. § 38a-720f — Connecticut Code / Title 38a / Chapter 701a / Section 38a-720f
Sec. 38a-720f. Collection of premiums or charges. Payment of claims.
Status: in_force

(b) Each third-party administrator that deposits in a fiduciary account charges or premiums collected on behalf of or for one or more insurers or other persons utilizing the services of the third-party administrator shall keep clear records of the deposits in and withdrawals from the account on behalf of each insurer or other person utilizing the services of the third-party administrator. The third-party administrator shall keep copies of all the records and, upon request by the insurer or other person utilizing the services of the third-party administrator, shall furnish such insurer or other person with a copy of the records of the deposits and withdrawals pertaining to such insurer or other person.

(c) A third-party administrator shall not pay any claim by making withdrawals from a fiduciary account in which premiums or charges are deposited. Withdrawals from the account shall be made as provided in the written agreement set forth in subsection (c) of section 38a-720a .

(d) All claims paid by the third-party administrator from funds collected on behalf of or for an insurer or other person utilizing the services of the third-party administrator shall be paid only by drafts or checks of, and as authorized by, such insurer or other person.
Conn. Gen. Stat. § 38a-518j — Connecticut Code / Title 38a / Chapter 700c / Section 38a-518j
Sec. 38a-518j. Mandatory coverage for ostomy-related supplies.
Status: in_force

See Sec. 38a-492j for similar provisions re individual policies.
Conn. Gen. Stat. § 38a-517 — Connecticut Code / Title 38a / Chapter 700c / Section 38a-517
Sec. 38a-517. Coverage for services performed by dentist in certain instances.
Status: in_force

See Sec. 38a-491 for similar provisions re individual policies.
Conn. Gen. Stat. § 38a-272 — Connecticut Code / Title 38a / Chapter 698d / Section 38a-272
Sec. 38a-272. (Formerly Sec. 38-264). Prohibited acts of an insurance business.
Status: in_force

Annotation to former section 38-264:

Cited. 9 CA 622.
Conn. Gen. Stat. § 38a-525a — Connecticut Code / Title 38a / Chapter 700c / Section 38a-525a
Sec. 38a-525a. Prior authorization prohibited for certain 9-1-1 emergency calls or transporting enrollee to a hospital by ambulance when medically necessary. Denial of payment to ambulance provider responding to 9-1-1 local prehospital emergency medical service system call prohibited on basis that enrollee did not obtain approval prior to calling such system or transporting such enrollee when medically necessary by ambulance to a hospital.
Status: in_force

(b) No insurer or health care center subject to the provisions of subsection (a) of this section shall deny payment to any ambulance provider responding to a 9-1-1 local prehospital emergency medical service system call on the basis that the enrollee did not obtain approval from such insurer or health care center prior to calling such emergency medical service system or prior to transporting such enrollee when medically necessary by ambulance to a hospital.

See Sec. 38a-498a for similar provisions re individual policies.
Conn. Gen. Stat. § 38a-518i — Connecticut Code / Title 38a / Chapter 700c / Section 38a-518i
Sec. 38a-518i. Mandatory coverage for pain management.
Status: in_force

(b) (1) No such policy that provides coverage for prescription drugs shall require an insured to use, prior to using a brand name prescription drug prescribed by a licensed physician for pain treatment, any alternative brand name prescription drugs or over-the-counter drugs.

(2) Such policy may require an insured to use, prior to using a brand name prescription drug prescribed by a licensed physician for pain treatment, a therapeutically equivalent generic drug.

(c) As used in this section, “pain” means a sensation in which a person experiences severe discomfort, distress or suffering due to provocation of sensory nerves, and “pain management specialist” means a physician who is credentialed by the American Academy of Pain Management or who is a board-certified anesthesiologist, physiatrist, neurologist, oncologist or radiation oncologist with additional training in pain management.

See Sec. 38a-492i re individual health insurance coverage for pain management.
Conn. Gen. Stat. § 38a-518q — Connecticut Code / Title 38a / Chapter 700c / Section 38a-518q
Sec. 38a-518q. Mandatory coverage for essential health benefits.
Status: in_force

(1) “Employee” has the same meaning as specified in section 38a-564 .

(2) “Essential health benefits” means health care services and benefits that fall within the following categories:

(A) Ambulatory patient services;

(B) Emergency services;

(C) Hospitalization;

(D) Maternity and newborn health care;

(E) Mental health and substance use disorder services, including, but not limited to, behavioral health treatment;

(F) Prescription drugs;

(G) Rehabilitative and habilitative services and devices;

(H) Laboratory services;

(I) Preventive and wellness services and chronic disease management; and

(J) Pediatric services, including, but not limited to, oral and vision care.

(3) (A) “Small employer” means an employer that employed an average of at least one but not more than fifty employees on business days during the preceding calendar year and employs at least one employee on the first day of the group health insurance policy year. “Small employer” does not include a sole proprietorship that employs only the sole proprietor or the spouse of such sole proprietor.

(B) (i) For the purposes of subparagraph (A) of this subdivision, the number of employees shall be determined by adding (I) the number of full-time employees for each month who work a normal work week of thirty hours or more, and (II) the number of full-time equivalent employees, calculated for each month by dividing by one hundred twenty the aggregate number of hours worked for such month by employees who work a normal work week of less than thirty hours, and averaging such total for the calendar year.

(ii) If an employer was not in existence throughout the preceding calendar year, the number of employees shall be based on the average number of employees that such employer reasonably expects to employ in the current calendar year.

(b) Each group health insurance policy providing, through a small employer, coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, amended, renewed or continued in this state on or after January 1, 2019, shall provide coverage for essential health benefits.

(c) No provision of the general statutes concerning a requirement of the Patient Protection and Affordable Care Act, P.L. 111-148, as amended from time to time, shall be construed to supersede any provision of this section that provides greater protection to an insured, except to the extent this section prevents the application of a requirement of the Affordable Care Act.

(d) The Insurance Commissioner may adopt regulations, in accordance with chapter 54, to carry out the purposes of this section, including, but not limited to, regulations specifying the health care services and benefits that fall within each category set forth in subdivision (2) of subsection (a) of this section.

See Sec. 38a-492q for similar provisions re individual policies.
Conn. Gen. Stat. § 38a-90d — Connecticut Code / Title 38a / Chapter 698 / Section 38a-90d
Sec. 38a-90d. Duties of the insurer.
Status: in_force

(b) If a managing general agent establishes loss reserves, the insurer shall annually obtain the opinion of an actuary attesting to the adequacy of loss reserves established for losses incurred and outstanding on business produced by the managing general agent. This shall be in addition to any other required loss reserve certification.

(c) The insurer shall semiannually conduct an on-site review of the underwriting and claims processing operations of the managing general agent.

(d) Binding authority for all reinsurance contracts or participation in insurance or reinsurance syndicates shall rest with an officer of the insurer, who shall not be affiliated with the managing general agent.

(e) Within thirty days of entering into or termination of a contract with a managing general agent, the insurer shall provide written notification of such appointment or termination to the commissioner. Notices of appointment of a managing general agent shall include a statement of duties which the applicant is expected to perform on behalf of the insurer, the lines of insurance for which the applicant is authorized to act and any other information the commissioner may require.

(f) An insurer shall review its books and records each quarter to determine if any agent has become, by operation of subdivision (2) of section 38a-90a , a managing general agent. If the insurer determines that an agent has become a managing general agent, the insurer shall promptly notify the agent of such determination and the insurer and agent shall fully comply with the provisions of sections 38a-90 to 38a-90h , inclusive, not later than thirty days after such determination.

(g) An insurer shall not appoint to its board of directors an officer, director, employee or controlling shareholder of its managing general agents. This subsection shall not apply to any relationships governed by the Insurance Holding Company Act or, if applicable, the Broker Controlled Insurer Act.
Conn. Gen. Stat. § 38a-842 — Connecticut Code / Title 38a / Chapter 704a / Section 38a-842
Sec. 38a-842. (Formerly Sec. 38-279). Plan of operation.
Status: in_force

(2) If said association fails to submit a suitable plan of operation within ninety days following October 1, 1971, or if at any time thereafter said association fails to submit suitable amendments to the plan, the commissioner shall, after notice and hearing, adopt and promulgate such reasonable regulations as are necessary or advisable to effectuate the provisions of sections 38a-836 to 38a-853 , inclusive. Such regulations shall continue in force until modified by the commissioner or superseded by a plan submitted by said association and approved by the commissioner.

(b) All member insurers shall comply with the plan of operation.

(c) The plan of operation shall: (1) Establish the procedures whereby all the powers and duties of said association under section 38a-841 shall be performed; (2) establish procedures for handling the assets of said association; (3) establish the number, the terms of office and the amount and method of reimbursing members of the board of directors under section 38a-840 ; (4) establish procedures by which claims may be filed with said association and establish acceptable forms of proof of covered claims. Notice of claims to the receiver or liquidator of the insolvent insurer shall be deemed notice to said association or its agent and a list of such claims shall be periodically submitted to said association or similar organization having a like function to that of said association in another state by the receiver or liquidator; (5) establish regular places and times for meetings of the board of directors; (6) establish procedures for records to be kept of all financial transactions of said association, its agents, and the board of directors; (7) provide that any member insurer aggrieved by any final action or decision of said association may appeal to the commissioner within thirty days after such action or decision; (8) establish the procedures whereby selections for the board of directors shall be submitted to the commissioner; (9) contain such additional provisions as may be necessary or proper for the execution of the powers and duties of said association under sections 38a-836 to 38a-853 , inclusive.

(d) The plan of operation may delegate any or all powers and duties of said association, except those under subdivision (3) of subsection (a) of section 38a-841 and subdivision (2) of subsection (b) of section 38a-841 , to a corporation, association, or other organization which performs or will perform functions similar to those of said association, or its equivalent having a like function to that of said association, in two or more states. Such a corporation, association or organization shall be reimbursed by said association as a servicing facility would be reimbursed and shall be paid by said association for its performance of any other functions of said association. Any delegation under this subsection shall take effect only with the approval of both the board of directors and the commissioner, and may be made only to a corporation, association, or organization which extends protection not substantially less favorable and effective than that provided by sections 38a-836 to 38a-853 , inclusive.
Conn. Gen. Stat. § 38a-479hhh — Connecticut Code / Title 38a / Chapter 700c / Section 38a-479hhh
Sec. 38a-479hhh. Investigations and hearings. Powers of commissioner. Appeals.
Status: in_force

(b) Any person aggrieved by an order or decision of the commissioner under sections 38a-479aaa to 38a-479iii , inclusive, may appeal therefrom in accordance with the provisions of section 4-183 .
Conn. Gen. Stat. § 38a-41a — Connecticut Code / Title 38a / Chapter 698 / Section 38a-41a
Sec. 38a-41a. Certificate authorizing formation of insurance company or health care center. Information required by commissioner. Costs.
Status: in_force

(b) All expenses incurred by the commissioner in connection with proceedings under this section shall be paid by the person filing the application.
Conn. Gen. Stat. § 38a-907 — Connecticut Code / Title 38a / Chapter 704c / Section 38a-907
Sec. 38a-907. (Formerly Sec. 38-425). Injunctions, orders and stays.
Status: in_force

(1) An application or petition under sections 38a-912 , 38a-914 , 38a-915 , 38a-918 , 38a-919 and 38a-920 , shall operate as an automatic stay applicable to all persons, other than the receiver, which shall be permanent and survive the entry of an order of conservation, rehabilitation or liquidation, and which shall prohibit: (A) The transaction of further business; (B) the transfer of property; (C) interference with the receiver or with a proceeding under said sections; (D) waste of the insurer's assets; (E) dissipation and transfer of bank accounts; (F) the institution or further prosecution of any actions or proceedings in which the insurer is a party; (G) the obtaining of preferences, judgments, attachments, garnishments, or liens against the insurer, its assets or its policyholders; (H) the levying of execution against the insurer, its assets, or its policyholders; (I) the making of any sale or deed for nonpayment of taxes or assessments that would lessen the value of the assets of the insurer; (J) the withholding from the receiver of books, accounts, documents, or other records relating to the business of the insurer; or (K) any other threatened or contemplated action that might lessen the value of the insurer's assets or prejudice the rights of policyholders, creditors, or shareholders, or the administration of any proceeding under said sections.

(2) Notwithstanding any other provision of law, no bond shall be required of the commissioner as a prerequisite for the issuance of any injunction or restraining order pursuant to this section.

(3) Upon motion of a person subject to the stay, the court, after notice to the receiver and a hearing, may modify or grant relief from the stay, provided said person shall have the burden of proof and shall establish by clear and convincing evidence that such relief should be granted.

(4) All matters that may be stayed, enjoined or barred under this section and all matters involving its interpretation or operation shall remain within the exclusive jurisdiction of the domiciliary receivership court.

(b) The receiver may apply to any court outside of the state for the relief described in subsection (a) of this section.
Conn. Gen. Stat. § 38a-516 — Connecticut Code / Title 38a / Chapter 700c / Section 38a-516
Sec. 38a-516. Coverage for newly born children. Notification to insurer.
Status: in_force

(b) Coverage for such newly born child shall consist of coverage for injury and sickness including necessary care and treatment of medically diagnosed congenital defects and birth abnormalities within the limits of the policy.

(c) If payment of a specific premium fee is required to provide coverage for a child, the policy may require that notification of birth of such newly born child and payment of the required premium or fees shall be furnished to the insurer, hospital service corporation, medical service corporation or health care center not later than ninety-one days after the date of birth in order to continue coverage beyond such period, provided failure to furnish such notice or pay such premium shall not prejudice any claim originating within such period.

See Sec. 38a-490 for similar provisions re individual policies.