reglab/statecodes huggingface dataset:
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698 - Insurers › Section 38a-163. (Formerly Sec. 38-293). - Application for license. Investigation. Hearing on license denial. Issuance or renewal.

(a) Each applicant for an insurance premium finance company license or for any renewal of such license shall file with the commissioner a written application in such manner and form as the commissioner shall prescribe, with the fee specified under section 38a-162.
(b) Upon the filing of an application and payment of the license fee, the commissioner shall investigate the applicant and shall issue an insurance premium finance company license if the applicant is qualified in accordance with the provisions of sections 38a-160 to 38a-170, inclusive. If the commissioner does not find the applicant so qualified, the commissioner shall, not later than thirty days after receipt of the license application and fee, grant the applicant a full hearing, provided such applicant shall have requested such hearing within said period. Any hearing conducted under said sections may be held by the commissioner or any person duly appointed by the commissioner. Any person acting as a hearing officer on behalf of the commissioner shall submit such person's findings and recommendations to the commissioner for the commissioner's decision in the matter.
(c) The commissioner may issue or renew any license under this part when the commissioner is satisfied that the applicant (1) is competent and trustworthy and intends to act in good faith in the capacity of a licensee under the provisions of sections 38a-160 to 38a-170, inclusive, (2) has a good business reputation and has had such experience, training or education so as to qualify the applicant for a license under the provisions of said sections, and (3) if the applicant is a corporation, that it is either incorporated under the laws of this state or, if a foreign corporation, it is authorized to transact business in this state.
(1971, P.A. 425, S. 4; P.A. 96-227, S. 5; P.A. 13-134, S. 8.)
History: Sec. 38-293 transferred to Sec. 38a-163 in 1991; P.A. 96-227 reorganized subsections; P.A. 13-134 made technical changes.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698 - Insurers › Section 38a-165. (Formerly Sec. 38-295). - Records of licensee.

(a) Every licensee under sections 38a-160 to 38a-170, inclusive, shall maintain records of his insurance premium financing transactions and such records shall be open to examination and investigation by the commissioner. The commissioner may at any time require any licensee to bring such records as he may direct to the commissioner's office for examination.
(b) Every licensee shall preserve his records of all such premium financing transactions, including but not limited to cards used in a card system, for at least three years after making the final entry in respect to any insurance premium finance agreement, provided the preservation of such records in photographic form shall constitute compliance with the requirements of this section.
(1971, P.A. 425, S. 6.)
History: Sec. 38-295 transferred to Sec. 38a-165 in 1991.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698 - Insurers › Section 38a-166. (Formerly Sec. 38-296). - Regulations.

The commissioner may promulgate such reasonable regulations as he deems necessary to carry out the provisions of sections 38a-160 to 38a-170, inclusive, and to establish the manner in which licensees under said sections shall conduct their business, provided no such regulation shall be contrary to or inconsistent with any provision of said sections.
(1971, P.A. 425, S. 7.)
History: Sec. 38-296 transferred to Sec. 38a-166 in 1991.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698 - Insurers › Section 38a-167. (Formerly Sec. 38-297). - Insurance premium finance agreement requirements.

(a) Every insurance premium finance agreement shall (1) be dated, signed by or on behalf of the insured, and the printed portion thereof shall be in at least eight-point type; (2) contain the name and place of business of the insurance agent negotiating the related insurance contract, the name and address or the place of business of the insurance premium finance company to which payments are to be made, a description of the insurance contracts involved and the amount of the premium therefor; and (3) set forth the following information when applicable: (A) The total amount of the premiums, (B) the amount of the down payment, (C) the principal balance (being the difference between the total amount of the premiums and the amount of the down payment), (D) the amount of the service charge, (E) the balance payable by the insured (being the sum of the principal balance and the amount of the service charge), and (F) the number of installments required, the amount of each such installment expressed in dollars and the due date or period thereof.
(b) Nothing herein shall be deemed to require that the items set out in subdivision (3) of subsection (a) of this section shall be shown in any insurance premium finance agreement in the sequence or order in which they appear in said subdivision and additional items may be included in any such agreement to explain the computations made in determining the amount to be paid by the insured.
(1971, P.A. 425, S. 8.)
History: Sec. 38-297 transferred to Sec. 38a-167 in 1991.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698 - Insurers › Section 38a-168. (Formerly Sec. 38-298). - Service charge.

(a) No insurance premium finance company shall charge, contract for, receive or collect any service charge in respect of any consumer insurance premium finance agreement except as permitted under the provisions of subsection (b) of this section.
(b) The service charge shall be computed (i) on the balance of the premiums due, after subtracting the down payment made by the insured in accordance with the insurance premium finance agreement, from the effective date of the insurance coverage for which the premiums are being advanced to and including the date when the final installment under the insurance premium finance agreement is payable, and (ii) at a maximum rate of fifteen per cent per annum for such period, plus an additional charge of ten dollars for each insurance premium finance agreement, which additional charge need not be refunded upon cancellation or prepayment of the agreement.
(c) An insurance premium finance company may charge, contract for, receive and collect a service charge of any amount which is agreed to by it and any insured or prospective insured with respect to any insurance premium finance agreement which is not a consumer insurance premium finance agreement.
(1971, P.A. 425, S. 9; P.A. 80-87, S. 1, 2; P.A. 81-346; P.A. 83-110; P.A. 85-48; P.A. 87-151; P.A. 90-38, S. 2, 3.)
History: P.A. 80-87 raised maximum service charge from 12% to 16% “until January 1, 1982,” allowed 18% charge if balance is $2,500 or more and added provision re maximum rate to be charged on and after January 1, 1982, in Subsec. (b); P.A. 81-346 amended Subsec. (b), extending the date within which an insurance premium finance company may compute the maximum rate for service charges from January 1, 1982, to January 1, 1984; P.A. 83-110 amended Subsec. (b) to extend the maximum rate of 16% from January 1, 1984, to January 1, 1986; P.A. 85-48 amended Subsec. (b) to extend the maximum rate of 16% from January 1, 1986, to January 1, 1988; P.A. 87-151 amended Subsec. (b) to set a maximum rate of 15% for service charge; P.A. 90-38 amended Subsec. (a) to require “consumer” insurance premium finance agreements to conform to the requirements of Subsec. (b) and added a new Subsec. (c) re service charge for nonconsumer insurance premium finance agreements; Sec. 38-298 transferred to Sec. 38a-168 in 1991.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698 - Insurers › Section 38a-169. (Formerly Sec. 38-299). - Delinquency charge.

Any insurance premium finance agreement may provide for the payment by the insured of a delinquency charge of not more than five per cent of any installment, due under such agreement, which is delinquent by five days or more after becoming due.
(1971, P.A. 425, S. 10.)
History: Sec. 38-299 transferred to Sec. 38a-169 in 1991.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698 - Insurers › Section 38a-170. (Formerly Sec. 38-300). - Cancellation of insurance contract on default of insured.

(a) When an insurance premium finance agreement contains a power of attorney enabling the insurance premium finance company to cancel any insurance contract or contracts listed in the agreement on account of any default on the part of the insured, the insurance contract or contracts shall not be cancelled by the insurance premium finance company unless such cancellation is effectuated in accordance with the provisions of this section.
(b) Not less than ten days' written notice shall be mailed by first class mail to the insured, at his last-known address, of the intent of the insurance premium finance company to cancel the insurance contract unless the default is cured within such ten-day period.
(c) After expiration of such ten-day period, the insurance premium finance company may request, in the name of the insured, cancellation of such insurance contract or contracts by mailing to the insurer a notice of cancellation, and the insurance contract may be cancelled as if such notice of cancellation had been submitted by the insured himself, but without requiring the return of the insurance contract or contracts. The insurance premium finance company shall also mail, by first class mail, a notice of cancellation to the insured at his last-known address.
(d) All statutory, regulatory, and contractual provisions or restrictions providing that the insurance contract may not be cancelled unless notice is given to a governmental agency, mortgagee, or other third party shall apply where cancellation is effected under the provisions of this section. The insurer shall give the prescribed notice on behalf of itself or the insured to any such governmental agency, mortgagee or other third party on or before the second business day after the day it receives the notice of cancellation from the insurance premium finance company and shall determine the effective date of cancellation taking into consideration the number of days notice required to complete the cancellation.
(e) Whenever an insurance contract is cancelled in accordance with the provisions of this section, the insurer shall return whatever gross unearned premiums are due under the insurance contract to the insurance premium finance company effecting the cancellation for crediting to the account of the insured.
(f) In the event that the crediting of return premiums to the account of the insured results in a surplus over the amount due from the insured to the insurance premium finance company, such company shall refund such excess to the insured, provided no such refund shall be required if the surplus amounts to less than one dollar.
(1971, P.A. 425, S. 11; P.A. 10-32, S. 117.)
History: Sec. 38-300 transferred to Sec. 38a-170 in 1991; P.A. 10-32 made a technical change in Subsec. (d), effective May 10, 2010.
Cited. 239 C. 658.
Cancellation refers to contract and not specific coverage provisions within contract. 54 CA 77.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-177. (Formerly Sec. 33-179c). - Manner of providing health care.

A health care center may provide health care (1) directly or by its employees or contractors licensed by this state to render such services, or by contract or by indemnity arrangement with any hospital, hospital service corporation, medical service corporation or person qualified and licensed to render any health care service or by both methods; or (2) by other methods to the extent permitted under the Federal Health Maintenance Organization Act and the regulations adopted thereunder from time to time unless otherwise determined by the commissioner in regulations adopted in accordance with the provisions of chapter 54. A health care center may also enter into agreements with hospitals or individuals approved by their respective state regulating board, licensed to practice any of the healing arts, for the training of personnel under the direction of persons licensed to practice the profession or healing art. A health care center may also maintain a clinic or clinics for the prevention, study, diagnosis and treatment of human ailments and injuries by licensed persons and to promote medical, surgical, dental or scientific research and learning.
(1971, P.A. 445, S. 3; P.A. 90-68, S. 3, 16; P.A. 16-213, S. 22; P.A. 17-198, S. 5.)
History: P.A. 90-68 added a provision allowing the federal health maintenance organization act through preemption or the insurance commissioner through regulations to establish the method or the manner in which health care is provided; Sec. 33-179c transferred to Sec. 38a-177 in 1991; P.A. 16-213 replaced “Health care may be provided” with “A health care center may provide health care”, redesignated existing Subsecs. (a) and (b) as Subdivs. (1) and (2), replaced “medical, surgical, dental and scientific” with “medical, surgical, dental or scientific” and made a conforming change, effective July 1, 2017; P.A. 17-198 replaced “; and (2)” with “; or (2)” re manner of providing health care and added reference to Ch. 54 re adoption of regulations, effective July 1, 2017.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-178. (Formerly Sec. 33-179e). - Organization.

Persons desiring to form a health care center may organize under the general law of the state governing corporations, partnerships, associations or trusts, subject to the following provisions: (1) The certificate of incorporation or other organizational document of each such organization shall have endorsed thereon or attached thereto the consent of the commissioner if the commissioner finds the same to be in accordance with the provisions of sections 38a-175 to 38a-194, inclusive; and (2) the certificate or other document shall include a statement of the area in which the health care center will operate and the services to be rendered by such organization within this state and in other jurisdictions in which the health care center may be authorized to do business.
(1971, P.A. 445, S. 5; P.A. 77-614, S. 163, 610; P.A. 80-482, S. 226, 348; P.A. 82-415, S. 3, 18; P.A. 90-68, S. 4, 16; P.A. 16-213, S. 4; P.A. 17-198, S. 17.)
History: P.A. 77-614 made insurance department a division within the department of business regulation with commissioner as its head, effective January 1, 1979; P.A. 80-482 restored insurance division as independent department with commissioner as its head and abolished department of business regulation; P.A. 82-415 deleted references to incorporation and substituted references to organization, in addition to making several technical changes; P.A. 90-68 substituted “organization” for “health care center” to reflect the expansion of the definition and the manner of providing health care; Sec. 33-179e transferred to Sec. 38a-178 in 1991; P.A. 16-213 added “within this state and in other jurisdictions in which the health care center may be authorized to do business” and made technical changes, effective July 1, 2016; P.A. 17-198 replaced reference to Sec. 38a-192 with reference to Sec. 38a-194, effective July 1, 2017.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-181. (Formerly Sec. 33-179i). - Acceptance of payments, grants and loans for cost of operation.

A health care center governed by sections 38a-175 to 38a-194, inclusive, may accept from governmental agencies, or from private agencies, corporations, associations, groups or individuals, payments, grants, loans or anything of value concerning all or part of the cost of its operation or agreements entered into between such health care center and its subscribers or other persons to be served by the health care center, or its employees, suppliers or contractors.
(1971, P.A. 445, S. 9; P.A. 17-198, S. 20.)
History: Sec. 33-179i transferred to Sec. 38a-181 in 1991; P.A. 17-198 replaced reference to Sec. 38a-192 with reference to Sec. 38a-194, effective July 1, 2017.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-185. (Formerly Sec. 33-179m). - Appeal from commissioner. Resolution of dispute between community member and corporation.

From any order or decision of the commissioner relating to any health care center governed by sections 38a-175 to 38a-194, inclusive, an appeal may be taken by any person or organization aggrieved thereby in accordance with the provisions of section 4-183, except venue for such appeal shall be in the judicial district of New Britain. Any dispute which arises between a member of the community including subscribers eligible to receive health care from the health care center and each such center shall be referred, at the request of either party to such dispute, to the commissioner, who shall have the power to hear and decide the same, subject to appeal as herein provided.
(1971, P.A. 445, S. 13; 1972, P.A. 108, S. 7; P.A. 76-436, S. 626, 681; P.A. 77-603, S. 23, 125; 77-614, S. 163, 610; P.A. 78-280, S. 5, 127; P.A. 80-482, S. 230, 348; P.A. 82-415, S. 9, 18; P.A. 88-230, S. 1, 12; P.A. 90-68, S. 9, 16; 90-98, S. 1, 2; P.A. 93-142, S. 4, 7, 8; P.A. 95-220, S. 4
–
6; P.A. 99-215, S. 24, 29; P.A. 17-198, S. 24.)
History: 1972 act replaced superior court with court of common pleas, effective September 1, 1972, except that courts with cases pending retain jurisdiction; P.A. 76-436 replaced court of common pleas with superior court, effective July 1, 1978; P.A. 77-603 replaced previous appeal provisions with requirement that appeals be made in accordance with Sec. 4-183 but retained venue in Hartford county; P.A. 77-614 made insurance department a division within the department of business regulation with commissioner as its head, effective January 1, 1979; P.A. 78-280 substituted “judicial district of Hartford-New Britain” for “Hartford county”; P.A. 80-482 restored insurance division as independent department with commissioner as its head and abolished department of business regulation; P.A. 82-415 substituted references to health care centers for references to corporations; P.A. 88-230 replaced “judicial district of Hartford-New Britain” with “judicial district of Hartford”, effective September 1, 1991; P.A. 90-68 made technical changes; P.A. 90-98 changed effective date of P.A. 88-230 from September 1, 1991, to September 1, 1993; Sec. 33-179m transferred to Sec. 38a-185 in 1991; P.A. 93-142 changed the effective date of P.A. 88-230 from September 1, 1993, to September 1, 1996, effective June 14, 1993; P.A. 95-220 changed the effective date of P.A. 88-230 from September 1, 1996, to September 1, 1998, effective July 1, 1995; P.A. 99-215 replaced “judicial district of Hartford” with “judicial district of New Britain”, effective June 29, 1999; P.A. 17-198 replaced reference to Sec. 38a-192 with reference to Sec. 38a-194, effective July 1, 2017.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-186. (Formerly Sec. 33-179n). - Disposition of property on termination. Prohibitions re stock transactions and mergers.

(a) In the event of the dissolution, liquidation or termination of the corporate existence of a domestic health care center that is organized as a nonprofit, nonstock corporation, no part of the property or assets of the health care center shall inure to the benefit of any director, officer, subscriber or employee of the corporation, each of whom by holding such position shall be deemed to have waived and relinquished all rights conferred by statute or otherwise upon subscribers of a corporation without capital stock to share in such assets upon dissolution, liquidation or termination. After the payment of all lawful claims against the corporation, all its remaining assets shall be devoted permanently and exclusively to the purposes for which the corporation is formed, or paid over to an organization organized and operated exclusively for charitable, educational and scientific purposes, and in such amount and proportions, as the board of directors in its discretion shall determine.
(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.
(1971, P.A. 445, S. 14; P.A. 82-415, S. 10, 18; P.A. 16-213, S. 6.)
History: P.A. 82-415 deleted provision requiring center to hold all property and assets in perpetuity, limited the provisions of Subsec. (a) to centers organized as nonprofit, nonstock corporations and listed prohibitions re stock transactions, mergers and consolidations in new Subsec. (b); Sec. 33-179n transferred to Sec. 38a-186 in 1991; P.A. 16-213 amended Subsec. (a) by adding “domestic” re health care center, amended Subsec. (b) by adding “, with respect to a domestic health care center,” and replacing provisions re information required and approval of offer, request, invitation, agreement or acquisition by commissioner with reference to compliance with Sec. 38a-130, and made technical changes, effective July 1, 2016.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-187. (Formerly Sec. 33-179o). - Investments. Use of ancillary equipment and facilities.

A health care center governed by sections 38a-175 to 38a-194, inclusive, may purchase, lease, construct, renovate, operate and maintain medical facilities and equipment ancillary to such facilities and such other property as may be reasonably required for its principal office and for such purposes as may be necessary in the transaction of the business of the health care center, and may otherwise invest in other securities permitted by the general statutes for the investment of trust funds, and in such other securities alone.
(1971, P.A. 445, S. 15; P.A. 90-68, S. 10, 16; P.A. 17-198, S. 25.)
History: P.A. 90-68 allowed the health care centers to purchase, lease, construct, renovate, operate or maintain ancillary equipment or facilities necessary to their operation, replacing provision prohibiting investments in real estate mortgages; Sec. 33-179o transferred to Sec. 38a-187 in 1991; P.A. 17-198 replaced reference to Sec. 38a-192 with reference to Sec. 38a-194, effective July 1, 2017.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-189. (Formerly Sec. 33-179q). - Workers' Compensation Act not affected.

No provision of sections 38a-175 to 38a-194, inclusive, nor any contract for health care by a health care center governed by said sections shall, in any way, affect the operation of the Workers' Compensation Act.
(1971, P.A. 445, S. 17; P.A. 79-376, S. 56; P.A. 17-198, S. 27.)
History: P.A. 79-376 replaced “workmen's compensation” with “workers' compensation”; Sec. 33-179q transferred to Sec. 38a-189 in 1991; P.A. 17-198 replaced reference to Sec. 38a-192 with reference to Sec. 38a-194, effective July 1, 2017.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-190. (Formerly Sec. 33-179r). - Inapplicability of other laws.

Any provisions of the statutes of this state regulating group medical, dental or other professions or occupations dealing with health care which is in conflict with sections 38a-175 to 38a-194, inclusive, shall not apply to a health care center governed by said sections.
(1971, P.A. 445, S. 18; P.A. 17-198, S. 28.)
History: Sec. 33-179r transferred to Sec. 38a-190 in 1991; P.A. 17-198 replaced reference to Sec. 38a-192 with reference to Sec. 38a-194, effective July 1, 2017.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-191. (Formerly Sec. 33-179s). - Authority of insurance companies not affected.

Nothing in sections 38a-175 to 38a-194, inclusive, shall preclude an insurance company authorized to conduct an accident and health insurance business in this state from performing marketing, enrollment, administration and other functions and from providing hospitalization insurance, including but not limited to emergency and out-of-area benefits, in conjunction with a plan providing health care to subscribers under existing provisions of the general statutes.
(1971, P.A. 445, S. 19; P.A. 17-198, S. 29.)
History: Sec. 33-179s transferred to Sec. 38a-191 in 1991; P.A. 17-198 replaced reference to Sec. 38a-192 with reference to Sec. 38a-194, effective July 1, 2017.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-192. (Formerly Sec. 33-179u). - Regulations by Insurance Commissioner.

The commissioner may adopt such regulations, in accordance with the provisions of chapter 54, as shall be necessary to carry out the provisions of sections 38a-175 to 38a-194, inclusive.
(P.A. 86-154, S. 2; P.A. 90-68, S. 12, 16; P.A. 17-198, S. 30.)
History: P.A. 90-68 substituted commissioner for insurance commissioner; Sec. 33-179u transferred to Sec. 38a-192 in 1991; P.A. 17-198 replaced reference to Sec. 38a-192 with reference to Sec. 38a-194, effective July 1, 2017.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-193a. - Uncovered expenditures insolvency deposit by health care center. Requirements. Withdrawal of deposit. Regulations.

Section 38a-193a is repealed, effective July 1, 2019.
(P.A. 07-178, S. 2; P.A. 19-125, S. 15.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-200. (Formerly Sec. 33-158). - Incorporation. Representation of policyholders on board of directors.

Persons desiring to form a hospital service corporation may incorporate under the general law of the state governing corporations, but subject to the following provisions: (1) The certificate of incorporation of each such corporation shall have endorsed thereon or attached thereto the consent of the Insurance Commissioner, if he finds the same to be in accordance with the provisions of sections 38a-199 to 38a-209, inclusive; and (2) said certificate shall include a statement of the territory in which the corporation will operate, the services to be rendered by the corporation and the rates currently to be charged therefor and shall be accompanied by two copies of the contract for services which the corporation proposes to make with subscribers and two copies of the type of contract which such corporation proposes to make with member hospitals. Such corporation shall include in its bylaws provision for the election of at least three of its policyholders to its board of directors by its members, and failure to include such a provision in such bylaws or to abide by such provision shall be grounds for disapproval by the Insurance Commissioner of any contract it may enter into during the period of such noncompliance.
(1949 Rev., S. 5270; 1959, P.A. 559; P.A. 77-614, S. 163, 610; P.A. 80-482, S. 215, 348.)
History: 1959 act required corporation to include in its bylaws provision for election of at least three policyholders to board of directors; P.A. 77-614 made insurance department a division within the department of business regulation with the commissioner as its head, effective January 1, 1979; P.A. 80-482 restored insurance division as independent department with commissioner as its head and deleted reference to abolished department of business regulation; Sec. 33-158 transferred to Sec. 38a-200 in 1991.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-201. (Formerly Sec. 33-159). - Form of contract.

No contract between any such corporation and subscribers shall entitle more than one person to services, except that such contract may be issued for service to a subscriber and spouse, to a subscriber and family, to a subscriber and dependent or dependents related by blood, marriage or adoption or to a subscriber and ward. Such contract with a subscriber shall be in writing and a copy thereof furnished to each subscriber. Each such contract shall contain the following provisions: (1) A statement of the amount payable to the corporation by the subscriber and the manner in which such amount is payable; (2) a statement of the nature of the services to be furnished and the period during which they will be furnished, and, if there are any services to be excepted, a detailed statement of such exceptions; (3) a statement of terms and conditions upon which the contract may be cancelled or otherwise terminated at the option of either party; (4) a statement that the contract includes the endorsement thereon and attached papers, if any, and contains the entire contract; (5) a statement that no statement by the subscriber in the subscriber's application for a contract shall void the contract or be used in any legal proceeding thereunder, unless such application or an exact copy thereof is included in or attached to such contract; (6) a statement of the period of grace that will be allowed the subscriber for making any payment due under the contract, which period shall not be less than ten days; and (7) a statement that no action at law based upon or arising out of the physician-patient relationship shall be maintained against a nonprofit hospital service corporation.
(1949 Rev., S. 5271; 1969, P.A. 686, S. 2; P.A. 14-235, S. 46.)
History: 1969 act required that contract contain statement that no action at law concerning physician-patient relationship shall be maintained against nonprofit hospital service corporation; Sec. 33-159 transferred to Sec. 38a-201 in 1991; P.A. 14-235 made technical changes.
See Sec. 38a-472 re assignment of insurance proceeds to doctor, hospital or state agency.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-202. (Formerly Sec. 33-160). - Reports and examinations.

Each such corporation shall annually, on or before March first, file in the office of the Insurance Commissioner a statement, verified by at least two of its principal officers, showing its condition on the thirty-first day of December then next preceding, which shall be in such form and contain such information as said commissioner prescribes. Examination of the financial condition of each such corporation by the Insurance Commissioner or his representatives shall be made at least once in every five years. Said commissioner, or any deputy or examiner or any other person whom he appoints, shall have the power of visitation and examination into the affairs of any such corporation and free access to all of the books, papers and documents that relate to the business of the corporation, and may summon and qualify as witnesses under oath, for the purpose of examination, its officers, agents or employees or other persons in relation to the affairs, transactions and conditions of the corporation. All costs of acquisition and of management activities shall be under the supervision of the Insurance Commissioner.
(1949 Rev., S. 5273; 1953, S. 2596d; P.A. 77-614, S. 163, 610; P.A. 80-482, S. 216, 348; P.A. 81-101, S. 2.)
History: P.A. 77-614 made insurance department a division within the department of business regulation with commissioner as its head, effective January 1, 1979; P.A. 80-482 restored division as independent department with commissioner as its head and deleted reference to abolished department of business regulation; P.A. 81-101 required that insurance commissioner examine financial condition of each hospital service corporation every five years, rather than biennially; Sec. 33-160 transferred to Sec. 38a-202 in 1991.
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.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-203. (Formerly Sec. 33-161). - Investments.

Such corporations shall not invest in real estate mortgages, but may invest in other securities permitted by the general statutes for the investment of trust funds, and in such other securities alone.
(1949 Rev., S. 5274.)
History: Sec. 33-161 transferred to Sec. 38a-203 in 1991.
Annotation to former section 33-161:
Cited. 184 C. 352.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-204. (Formerly Sec. 33-162). - Liquidation or rehabilitation. Mergers.

Each such corporation shall be subject to liquidation, dissolution or rehabilitation, and such proceeding shall be under the supervision of the Insurance Commissioner, who shall have such powers hereunder as he possesses in reference to domestic insurance corporations. Any hospital service corporation may merge with any other hospital service corporation or corporations, subject to the approval of the Insurance Commissioner and may consolidate or merge with any medical service corporation organized under sections 38a-214 to 38a-225, inclusive, subject to the approval of the Insurance Commissioner. The new corporation resulting from such consolidation or the surviving corporation resulting from such merger may exercise all of the powers and perform all of the functions of hospital service corporations organized pursuant to sections 38a-199 to 38a-209, inclusive, and medical service corporations organized pursuant to sections 38a-214 to 38a-225, inclusive, and shall be subject to the provisions of said sections. Prior to such approval, the commissioner shall hold a hearing or hearings, in accordance with the procedures of chapter 54 to determine that the terms and conditions of the proposed merger or consolidation are fair and reasonable and that the interests of all parties, subscribers and affected persons are adequately protected. The consolidation or merger shall become effective upon the filing with the Secretary of the State of a certificate of consolidation or merger, endorsed as approved by the Insurance Commissioner.
(1949 Rev., S. 5275; P.A. 74-7, S. 1; P.A. 77-614, S. 163, 610; P.A. 80-482, S. 217, 348.)
History: P.A. 74-7 added provisions re merger and consolidation of medical service corporations and hospital service corporations; P.A. 77-614 made insurance department a division within the department of business regulation with commissioner as its head, effective January 1, 1979; P.A. 80-482 restored insurance division as independent department and abolished department of business regulation; Sec. 33-162 transferred to Sec. 38a-204 in 1991.
Annotation to former section 33-162:
Cited. 184 C. 352.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-205. (Formerly Sec. 33-163). - Workers' compensation law not affected.

No provision of sections 38a-199 to 38a-209, inclusive, nor any contract for hospital or other health service by any such corporation shall, in any way, affect the operation of the Workers' Compensation Act.
(1949 Rev., S. 5276; 1969, P.A. 686, S. 3; P.A. 79-376, S. 54.)
History: 1969 act included reference to health service other than hospital service; P.A. 79-376 replaced “workmen's compensation” with “workers' compensation”; Sec. 33-163 transferred to Sec. 38a-205 in 1991.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-206. (Formerly Sec. 33-164). - Fraternal benefit societies and life or accident insurance companies not affected.

Fraternal benefit societies and life and accident insurance companies or accident insurance companies shall not be affected by any provision of sections 38a-199 to 38a-209, inclusive.
(1949 Rev., S. 5278.)
History: Sec. 33-164 transferred to Sec. 38a-206 in 1991.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-207. (Formerly Sec. 33-165). - Exemption from taxation.

All property of any such corporation shall be exempt from state, district and municipal taxes.
(1949 Rev., S. 5279.)
History: Sec. 33-165 transferred to Sec. 38a-207 in 1991.
Annotation to former section 33-165:
Cited. 184 C. 352.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-208. (Formerly Sec. 33-166). - Approval of rates to be paid by subscribers and contracts.

(a) No such corporation shall enter into any contract with subscribers unless and until it has filed with the Insurance Commissioner a full schedule of the rates to be paid by the subscribers and has obtained said commissioner's approval thereof. Such filing shall include an actuarial memorandum that includes, but is not limited to, pricing assumptions and claims experience, and premium rates and loss ratios from the inception of the contract. The commissioner may refuse such approval if the commissioner finds such rates to be excessive, inadequate or discriminatory. As used in this subsection, “loss ratio” means the ratio of incurred claims to earned premiums by the number of years of policy duration for all combined durations.
(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.
(1949 Rev., S. 5272; P.A. 77-614, S. 163, 610; P.A. 80-482, S. 218, 348; P.A. 15-247, S. 3; P.A. 18-43, S. 4.)
History: P.A. 77-614 made insurance department a division within the department of business regulation with commissioner as its head, effective January 1, 1979; P.A. 80-482 restored insurance division as independent department with commissioner as its head and abolished department of business regulation; Sec. 33-166 transferred to Sec. 38a-208 in 1991; P.A. 15-247 designated existing provisions re filing and approval of rates to be paid by subscribers as Subsec. (a) and amended same by adding provision re information to be included with such filing and definition of “loss ratio”, added Subsecs. (b) and (c) re rates offered to individuals and small employers, respectively, designated existing provisions re filing and approval of contract with subscribers as Subsec. (d), and made technical changes, effective July 10, 2015; P.A. 18-43 added “and special enrollment periods” in Subsec. (b), effective January 1, 2019.
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.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-209. (Formerly Sec. 33-167). - Appeal.

From any order or decision of the Insurance Commissioner, an appeal may be taken by any person or corporation aggrieved thereby in accordance with the provisions of section 4-183. Any dispute which arises between a subscriber and a hospital plan corporation or between a member hospital and the hospital plan corporation, or between two or more hospital plan corporations, shall be referred, at the request of any party to such dispute, to the Insurance Commissioner, who shall have the power to hear and decide the same, subject to appeal in accordance with the provisions of section 4-183, except venue for such appeal shall be in the judicial district of New Britain.
(1949 Rev., S. 5280; 1971, P.A. 870, S. 90; P.A. 76-436, S. 624, 681; P.A. 77-603, S. 19, 125; 77-614, S. 163, 610; P.A. 78-280, S. 5, 127; P.A. 80-482, S. 219, 348; P.A. 88-230, S. 1, 12; P.A. 90-98, S. 1, 2; P.A. 93-142, S. 4, 7, 8; P.A. 95-220, S. 4
–
6; P.A. 99-215, S. 24, 29.)
History: 1971 act replaced superior court with court of common pleas effective September 1, 1971, except that courts with cases pending retain jurisdiction unless pending matters deemed transferable; P.A. 76-436 replaced court of common pleas with superior court, effective July 1, 1978; P.A. 77-603 required that appeals be made in accordance with Sec. 4-183, replacing previous appeal provision; P.A. 77-614 made insurance department a division within the department of business regulation with commissioner as its head, effective January 1, 1979; P.A. 78-280 substituted “judicial district of Hartford-New Britain” for “Hartford county”; P.A. 80-482 restored insurance division as independent department with commissioner as its head and abolished department of business regulation; P.A. 88-230 replaced “judicial district of Hartford-New Britain” with “judicial district of Hartford”, effective September 1, 1991; P.A. 90-98 changed the effective date of P.A. 88-230 from September 1, 1991, to September 1, 1993; Sec. 33-167 transferred to Sec. 38a-209 in 1991; P.A. 93-142 changed the effective date of P.A. 88-230 from September 1, 1993, to September 1, 1996, effective June 14, 1993; P.A. 95-220 changed the effective date of P.A. 88-230 from September 1, 1996, to September 1, 1998, effective July 1, 1995; P.A. 99-215 replaced “judicial district of Hartford” with “judicial district of New Britain”, effective June 29, 1999.
Annotations to former section 33-167:
Cited. 3 CA 627.
Appeals by Blue Cross from rate increase decision of Insurance Commissioner under this section and Sec. 4-183(b), heard and decided together. 31 CS 257.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-215. (Formerly Sec. 33-169). - Formation.

Any number of persons not less than seven, all of whom shall be residents of this state, may form a corporation, under and in conformity with the provisions of sections 38a-214 to 38a-225, inclusive, for the purpose of establishing, maintaining and operating a nonprofit medical service corporation. The Connecticut State Medical Society, the Fairfield County Medical Association, the Hartford County Medical Association, the Litchfield County Medical Association, the Middlesex County Medical Association, the New Haven County Medical Association, the New London County Medical Association, the Tolland County Medical Association and the Windham County Medical Association may jointly or severally incorporate for the purposes of operating a medical service corporation.
(1949 Rev., S. 5281.)
History: Sec. 33-169 transferred to Sec. 38a-215 in 1991.
Annotation to former section 33-169:
Cited. 29 CS 474.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-216. (Formerly Sec. 33-170). - Incorporation. Representation of policyholders on board of directors.

A medical association desiring to form a medical service corporation may incorporate under the general laws of the state governing corporations, but subject to the following provisions: (1) The certificate of incorporation of each such corporation shall have endorsed thereon, or attached thereto, the consent of the Insurance Commissioner, if the commissioner finds the same to be in accordance with sections 38a-214 to 38a-225, inclusive, and in the public interest, provided security guaranteeing the performance of the obligations of such corporation shall be furnished in form and amount, not less than five thousand dollars, as the commissioner determines; and (2) such certificate shall include a statement of the territory in which the corporation will operate, the services to be rendered by the corporation and the rates currently to be charged therefor and shall be accompanied by two copies of the contract that the corporation proposes to make with the subscribers. Such corporation shall include in its bylaws provision for the election of at least three of its policyholders to its board of directors by its members, and failure to include such a provision in such bylaws or to abide by such provision shall be grounds for disapproval by the Insurance Commissioner of any contract it may enter into during the period of such noncompliance.
(1949 Rev., S. 5283; 1959, P.A. 511; P.A. 77-614, S. 163, 610; P.A. 80-482, S. 221, 348; P.A. 14-235, S. 3.)
History: 1959 act required that corporation include in bylaws provision for election of at least three policyholders to board of directors; P.A. 77-614 made insurance department a division within the department of business regulation with commissioner as its head, effective January 1, 1979; P.A. 80-482 restored insurance division as independent department with commissioner as its head and abolished department of business regulation; Sec. 33-170 transferred to Sec. 38a-216 in 1991; P.A. 14-235 made technical changes.
Annotation to former section 33-170:
Cited. 29 CS 474.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 698a - Health Care and Related Service Groups › Section 38a-217. (Formerly Sec. 33-171). - Form of contract.

No single contract between any such corporation and its subscribers shall entitle more than one person to indemnity, except that a single contract may be issued to subscriber and spouse, to subscriber and family by marriage or adoption or to subscriber and ward. Such contract shall be in writing and a copy thereof shall be furnished to each subscriber and shall contain the following provisions: (1) A statement of the amount payable to the corporation by the subscriber and the manner in which such amount is payable; (2) a statement of the amount of indemnity to be furnished and the period during which it will be furnished, and, if there are to be exceptions, a detailed statement of such exceptions; (3) a statement of terms and conditions upon which the contract may be cancelled or otherwise terminated at the option of either party; (4) a statement that the contract includes the endorsements thereon and attached papers, if any, and contains the entire contract; (5) a statement that no statements by the subscriber in the subscriber's application for a contract shall void the contract or be used in any legal proceeding thereunder, unless such application or an exact copy thereof is included in or attached to such contract; (6) a statement of the period of grace that will be allowed the subscriber for making any payment due under the contract, which period shall not be less than ten days; and (7) a statement that no action at law based upon or arising out of the physician-patient relationship shall be maintained against a nonprofit medical service corporation.
(1949 Rev., S. 5284; P.A. 14-235, S. 47.)
History: Sec. 33-171 transferred to Sec. 38a-217 in 1991; P.A. 14-235 made technical changes.
See Sec. 38a-472 re assignment of insurance proceeds to doctor, hospital or state agency.