reglab/statecodes huggingface dataset:
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 705 - Connecticut Insurance Information and Privacy Protection Act › Section 38a-992. (Formerly Sec. 38-517). - Commissioner to prepare findings.

(a) If, after a hearing pursuant to section 38a-990, the commissioner determines that the insurance institution, agent or insurance-support organization charged has engaged in conduct or practices in violation of sections 38a-975 to 38a-998, inclusive, the commissioner shall reduce the findings to writing and shall issue and cause to be served upon such institution, agent or organization a copy of such findings and an order requiring such institution, agent or organization to cease and desist from engaging in such conduct or practices.
(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.
(P.A. 81-368, S. 18, 25; P.A. 99-284, S. 22, 60.)
History: Sec. 38-517 transferred to Sec. 38a-992 in 1991; P.A. 99-284 substituted “the commissioner” for “he” and “the findings” for “his findings” and made a technical change, effective July 1, 2000.
Annotation to former section 38-517:
Cited. 215 C. 277.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 705 - Connecticut Insurance Information and Privacy Protection Act › Section 38a-993. (Formerly Sec. 38-518). - Penalties.

(a) In any case where a hearing pursuant to section 38a-990 results in the finding of a negligent 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 two thousand dollars for each violation but not to exceed twenty thousand dollars in the aggregate for multiple violations.
(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.
(P.A. 81-368, S. 19, 25; P.A. 97-99, S. 23; P.A. 99-284, S. 23, 60.)
History: Sec. 38-518 transferred to Sec. 38a-993 in 1991; P.A. 97-99 amended Subsec. (a) to increase penalty from $500 to $2,000 and limit maximum to $20,000 rather than $10,000; P.A. 99-284 amended Subsec. (a) to substitute “a negligent violation” for “an intentional violation” re sections 38a-975 to 38a-998, inclusive, inserted new Subdiv. (b)(1) re an intentional violation of said sections, inserted new Subdiv. (b)(2) re an intentional violation of Sec. 38a-988a, redesignated former Subsec. (b) as (c), amended Subdiv. (c)(1) to substitute $20,000 for $10,000 re penalty for each violation and amended Subdiv. (c)(2) to substitute $100,000 for $50,000 re penalty for violations that indicate a general business practice, effective July 1, 2000.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 705 - Connecticut Insurance Information and Privacy Protection Act › Section 38a-994. (Formerly Sec. 38-519). - Appeals from orders.

(a) Any person aggrieved by an order of the commissioner issued pursuant to sections 38a-975 to 38a-998, inclusive, 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.
(b) No order or report of the commissioner under sections 38a-975 to 38a-998, inclusive, or order of a court to enforce the same shall in any way relieve or absolve any person affected by such order or report from any liability under any other laws of this state.
(P.A. 81-368, S. 20, 25; 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; 99-215, S. 24, 29; P.A. 99-284, S. 24, 60.)
History: 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. 38-519 transferred to Sec. 38a-994 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” in Subsec. (a), effective June 29, 1999; P.A. 99-284 made a technical change, effective July 1, 2000.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 705 - Connecticut Insurance Information and Privacy Protection Act › Section 38a-995. (Formerly Sec. 38-520). - Individual remedies.

(a) If an insurance institution, agent or insurance-support organization fails to comply with section 38a-983, 38a-984 or 38a-985 with respect to the rights granted under those sections, any person whose rights are violated may bring an action for equitable relief.
(b) An insurance institution, agent or insurance-support organization that discloses information in violation of section 38a-988 shall be liable for damages sustained by the individual concerning whom the information relates, except that no individual shall be entitled to a monetary award that exceeds the actual damages sustained by such individual as a result of a violation of section 38a-988.
(c) In any action brought pursuant to this section, the court may award costs and reasonable attorney's fees to the prevailing party.
(d) No action under this section shall be brought but within two years from the date the alleged violation is or should have been discovered.
(e) Except as specifically provided in this section, there shall be no remedy available to individuals, in law or in equity, for occurrences constituting a violation of any provision of sections 38a-975 to 38a-998, inclusive.
(P.A. 81-368, S. 21, 25; P.A. 17-15, S. 94.)
History: Sec. 38-520 transferred to Sec. 38a-995 in 1991; P.A. 17-15 made technical changes in Subsec. (b).
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 705 - Connecticut Insurance Information and Privacy Protection Act › Section 38a-996. (Formerly Sec. 38-521). - Immunity.

Any person who discloses personal or privileged information in accordance with sections 38a-975 to 38a-998, inclusive, or who furnishes such information to an insurance institution, agent or insurance-support organization, shall be immune from any civil liability on account of such act, unless such person disclosed or furnished false information with malice or wilful intent to injure any person.
(P.A. 81-368, S. 22, 25.)
History: Sec. 38-521 transferred to Sec. 38a-996 in 1991.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 705 - Connecticut Insurance Information and Privacy Protection Act › Section 38a-997. (Formerly Sec. 38-522). - Obtaining information under false pretenses. Fine.

Any person who knowingly and wilfully obtains information concerning an individual from an insurance institution, agent or insurance-support organization under false pretenses shall be fined not more than twenty thousand dollars.
(P.A. 81-368, S. 23, 25; P.A. 08-178, S. 49.)
History: Sec. 38-522 transferred to Sec. 38a-997 in 1991; P.A. 08-178 increased maximum fine from $10,000 to $20,000.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 705 - Connecticut Insurance Information and Privacy Protection Act › Section 38a-998. (Formerly Sec. 38-523). - Severability.

If any provision of sections 38a-975 to 38a-998, inclusive, or the application thereof to any person or circumstance is for any reason held to be invalid, the remainder of said sections and the application of such provision to other persons or circumstances shall not be affected thereby.
(P.A. 81-368, S. 24, 25.)
History: Sec. 38-523 transferred to Sec. 38a-998 in 1991.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 705 - Connecticut Insurance Information and Privacy Protection Act › Section 38a-999. - Written policies, standards and procedures re medical record information.

(a) An insurance institution, agent or insurance support organization that regularly collects, uses or discloses medical record information, as defined in section 38a-976, shall develop and implement written policies, standards and procedures for the management, transfer and security of medical record information, including policies, standards and procedures to guard against the unauthorized collection, use or disclosure of medical record information by the insurance institution, agent or insurance support organization or any employee or agent thereof. Such policies, standards and procedures shall include:
(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.
(P.A. 99-284, S. 25, 60; P.A. 14-235, S. 10.)
History: P.A. 99-284 effective July 1, 2000; P.A. 14-235 made a technical change in Subsec. (a).
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 705 - Connecticut Insurance Information and Privacy Protection Act › Section 38a-999a. - Disclosure of individually identifiable medical record information with malicious intent prohibited. Penalty.

(a) No person shall disclose individually identifiable medical record information, as defined in subsection (r) of section 38a-976, with the malicious intent to damage an individual's reputation or character.
(b) Any person who violates subsection (a) of this section shall be fined not more than five hundred dollars or imprisoned not more than three months or both for the first offense and shall be fined not more than two thousand dollars or imprisoned not more than one year or both for each subsequent offense.
(P.A. 99-284, S. 26, 60.)
History: P.A. 99-284 effective July 1, 2000.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 705 - Connecticut Insurance Information and Privacy Protection Act › Section 38a-999b. - Comprehensive information security program to safeguard personal information. Certification. Notice requirements for actual or suspected breach. Penalty.

Section 38a-999b is repealed, effective October 1, 2021.
(P.A. 15-142, S. 5; P.A. 19-117, S. 401; 19-196, S. 9.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706 - Private Employer Workers' Compensation Group Self-Insurance › Section 38a-1000. - Applicability.

The provisions of subsection (e) of section 31-288 and sections 31-289b, 31-316, 31-345 and 38a-1000 to 38a-1023, inclusive, shall apply to workers' compensation self-insurance groups here and after formed in accordance with said sections. Subsection (e) of section 31-288 and sections 31-289b, 31-316, 31-345 and 38a-1000 to 38a-1023, inclusive, shall not apply to public employees or governmental entities. Groups which are issued a certificate of approval by the commissioner shall be subject to the provisions of sections 38a-14 and 38a-17 but shall not be deemed to be insurers or insurance companies and shall not be subject to the provisions of this title and any regulations issued pursuant to this title except as otherwise provided.
(P.A. 96-267, S. 1.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706 - Private Employer Workers' Compensation Group Self-Insurance › Section 38a-1001. - Definitions.

As used in subsection (e) of section 31-288 and sections 31-289b, 31-316, 31-345 and 38a-1000 to 38a-1023, inclusive:
(1) “Administrator” means an individual, partnership or corporation engaged by a workers' compensation self-insurance group's board of trustees to carry out the policies established by the group's board of trustees and to provide day-to-day management of the group.
(2) “Commissioner” means the Insurance Commissioner.
(3) “Insolvent” or “insolvency” means the inability of a workers' compensation self-insurance group to pay its outstanding lawful obligations as they mature in the regular course of business, as may be shown either by an excess of its required reserves and other liabilities over its assets or by its not having sufficient assets to reinsure all of its outstanding liabilities after paying all accrued claims owed by it.
(4) “Net premium” means premium derived from standard premium adjusted by any advance premium discounts.
(5) “Service company” means a person or entity which provides services not provided by the administrator, including but not limited to: (A) Claims adjustment; (B) safety engineering; (C) compilation of statistics and the preparation of premium, loss and tax reports; (D) preparation of other required self-insurance reports; (E) development of members' assessments and fees; and (F) administration of a claim fund.
(6) “Standard premium” means the premium derived from the manual rates adjusted by experience modification factors but before advance premium discounts.
(7) “Workers' compensation”, when used as a modifier of “benefits”, “liabilities” or “obligations”, includes both workers' compensation and employers' liability.
(8) “Workers' compensation self-insurance group” or “group” means a not-for-profit association consisting of fifteen or more employers who are engaged in the same or similar type of business, who are members of the same bona fide trade or professional association which has been in existence for not less than five years, and who enter into agreements to pool their liabilities for workers' compensation benefits and employers' liability.
(P.A. 96-267, S. 2.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706 - Private Employer Workers' Compensation Group Self-Insurance › Section 38a-1004. - Duration and termination of certificate of approval.

(a) The certificate of approval issued by the commissioner to a workers' compensation self-insurance group shall authorize the group to provide workers' compensation benefits. The certificate of approval shall remain in effect until terminated at the request of the group or revoked by the commissioner, pursuant to the provisions of section 38a-1021, or any other provision of this title.
(b) The commissioner shall not grant the request of any group to terminate its certificate of approval unless such group has insured or reinsured all incurred workers' compensation obligations with an authorized insurer under an agreement filed with and approved, in writing, by the commissioner. Such obligations shall include both known claims and expenses associated therewith and claims incurred but not reported and expenses associated therewith.
(c) Subject to the approval of the commissioner, any group may merge with another group engaged in the same or similar type of business only if the resulting group assumes in full all obligations of the merging groups. The commissioner may hold a hearing on the merger and shall do so if any party, including any member of any of the merging groups, requests it.
(P.A. 96-267, S. 5.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706 - Private Employer Workers' Compensation Group Self-Insurance › Section 38a-1005. - Examination of group. Costs.

The commissioner may examine the affairs, transactions, accounts, records, assets and liabilities of each group if said commissioner has reasonable cause to believe that such examination is necessary. The expense of such examinations shall be assessed against the group in the same manner that insurers are assessed for examinations.
(P.A. 96-267, S. 6.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706 - Private Employer Workers' Compensation Group Self-Insurance › Section 38a-1006. - Group board of trustees.

Each group shall be operated by a board of trustees which shall consist of not less that five persons whom the members of a group elect for stated terms of office. At least two-thirds of the trustees shall be employees, officers or directors of members of the group. The group's service company or any owner, officer, employee of, or any other person affiliated with such service company shall not serve on the board of trustees of the group. All trustees shall be residents of this state or officers of corporations authorized to do business in this state. The board of trustees of each group shall ensure that all claims are paid promptly and take all necessary precautions to safeguard the assets of the group, including all of the following:
(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.
(P.A. 96-267, S. 7.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706 - Private Employer Workers' Compensation Group Self-Insurance › Section 38a-1007. - Requirements for an employer to join group after its approval. Termination of membership. Insolvency or bankruptcy of member.

(a) An employer joining a workers' compensation self-insurance group after the group has been issued a certificate of approval shall: (1) Submit an application for membership to the board of trustees or its administrator; and (2) enter into the indemnity agreement required by subparagraph (B) of subdivision (5) of subsection (b) of section 38a-1003. Membership takes effect no earlier than each member's date of approval. The application for membership and its approval shall be maintained as permanent records of the board of trustees.
(b) Individual members of a group shall be subject to cancellation by the group pursuant to the bylaws of the group. In addition, individual members may elect to terminate their participation in the group. The group shall notify the Commissioner and chairman of the Workers' Compensation Commission of a termination or cancellation of a member within ten days and shall maintain coverage of each cancelled or terminated member for thirty days after notice, at the terminating member's expense, unless the group is notified sooner by the Workers' Compensation Commission that the cancelled or terminated member has procured workers' compensation insurance, has become an approved self-insurer or has become a member of another group.
(c) The group shall pay all workers' compensation benefits for which each member incurs liability during its period of membership. A member who elects to terminate its membership or is cancelled by a group remains jointly and severely liable for workers' compensation obligations of the group and its members which were incurred during the cancelled or terminated member's period of membership.
(d) A group member shall not be relieved of its workers' compensation liabilities incurred during its period of membership except through payment by the group or the member of required workers' compensation benefits.
(e) The insolvency or bankruptcy of a member shall not relieve the group or any other member of liability for the payment of any workers' compensation benefits incurred during the insolvent or bankrupt member's period of membership.
(P.A. 96-267, S. 8.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706 - Private Employer Workers' Compensation Group Self-Insurance › Section 38a-1008. - Service company and administrator to be mutually disinterested.

(a) No service company or its employees, officers or directors shall be an employee, officer or director of, or have either a direct or indirect financial interest in, an administrator. No administrator or its employees, officers or directors shall be an employee, officer or director of, or have either a direct or indirect financial interest in, a service company.
(b) The service contract shall state that unless the commissioner permits otherwise the service company shall handle, to its conclusion, all claims and other obligations incurred during the contract period.
(P.A. 96-267, S. 9.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706 - Private Employer Workers' Compensation Group Self-Insurance › Section 38a-1009. - Nonemployee soliciting group membership must be licensed.

Except for a salaried employee of a group, its administrator or its service company, any person soliciting membership for a workers' compensation self-insurance group shall be licensed pursuant to chapter 702.
(P.A. 96-267, S. 10.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706 - Private Employer Workers' Compensation Group Self-Insurance › Section 38a-1010. - Annual statement of financial condition required. Untrue statement prohibited.

(a) Each group shall submit to the commissioner a statement of financial condition audited by an independent certified public accountant on or before the last day of the sixth month following the end of the group's fiscal year. The financial statement shall be in a form prescribed by the commissioner and shall include, but not be limited to, actuarially appropriate reserves for: (1) Known claims and any associated expenses; (2) claims incurred but not reported and any associated expenses; (3) unearned premiums; and (4) bad debts, which shall be shown as liabilities.
(b) An actuarial opinion regarding reserves for: (1) Known claims and any associated expenses; and (2) claims incurred but not reported and any associated expenses shall be included in the audited financial statement. The actuarial opinion shall be prepared (A) by an independent person with a designation of Fellow of the Casualty Actuarial Society (FCAS), (B) by a member of the American Academy of Actuaries (MAAA) with experience in preparing such opinions, or (C) by any other qualified loss reserve specialist in accordance with the provisions of section 38a-14.
(c) No person shall make any untrue statement of a material fact, or omit to state a material fact necessary in order to make the statement made, in light of the circumstances under which it is made, not misleading, in connection with the solicitation of membership in a group.
(d) The commissioner may prescribe the format and frequency of other reports which may include, but shall not be limited to, payroll audit reports, summary loss reports and quarterly financial statements and make any regulations necessary to carry out the provisions of subsection (e) of section 31-288 and sections 31-289b, 31-316, 31-345 and 38a-1000 to 38a-1023, inclusive.
(P.A. 96-267, S. 11; P.A. 12-145, S. 40.)
History: P.A. 12-145 made technical changes in Subsec. (b), effective June 15, 2012.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706 - Private Employer Workers' Compensation Group Self-Insurance › Section 38a-1011. - Taxes.

Each workers' compensation self-insurance group, as defined in section 38a-1001, shall pay a tax to the Commissioner of Revenue Services for the calendar year commencing on January 1, 1997, and annually thereafter, at the rate of one and three-quarters per cent of the total net premium received on any new or renewal contract or policy by such group during each such calendar year, which shall be in addition to any other payment required under sections 31-345, 31-354 and 38a-48. The provisions of chapter 207 pertaining to the filing of returns, declarations, installment payments, assessments and collection of taxes, penalties, administrative hearings and appeals imposed on domestic insurance companies shall apply with respect to the charge imposed under this section.
(P.A. 96-267, S. 12.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706 - Private Employer Workers' Compensation Group Self-Insurance › Section 38a-1012. - Misrepresentation and omission in membership solicitation prohibited.

No person shall make a material misrepresentation or omission of a material fact in connection with the solicitation of membership of a group.
(P.A. 96-267, S. 13.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706 - Private Employer Workers' Compensation Group Self-Insurance › Section 38a-1014. - Classifications and rating. Premium contributions. Audits. Hearings.

(a) Every workers' compensation self-insurance group shall adhere to the uniform classification system, uniform experience rating plan and manual rules filed with the commissioner.
(b) Premium contributions to the group shall be determined by applying the manual rates and rules to the appropriate classification of each member which shall be adjusted by each member's experience credit or debit. Subject to approval by the commissioner, any premium contributions may also be reduced by an advance premium discount factor reflecting the groups expense levels and loss experience.
(c) Notwithstanding the provisions of subsection (b) of this section, a group may apply to the commissioner for permission to utilize its own rates. Such rates shall be based on at least five years of experience of the members of the group.
(d) Each group shall be audited at least annually by an auditor acceptable to the commissioner to verify proper classifications, experience rating, payroll and rates. A report of the audit shall be filed with the commissioner in a form acceptable to the commissioner. A group or any member thereof may request a hearing on any objections to the classifications. If the commissioner determines that as a result of an improper classification, a member's premium contribution is insufficient, he shall order the group to assess that member in an amount equal to the deficiency. If the commissioner determines that as a result of an improper classification a member's premium is excessive, he shall order the group to refund to the member the excess collected. Any audit shall be at the expense of the group.
(P.A. 96-267, S. 15.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706 - Private Employer Workers' Compensation Group Self-Insurance › Section 38a-1015. - Excess moneys refundable. Refund plan. Notice.

(a) Any moneys for a fund year in excess of the amount necessary to fund all obligations for that fund year may be declared to be refundable by the board of trustees not less than twelve months after the end of the fund year.
(b) Each member shall be given a written description of the refund plan at the time of application for membership. A refund for any fund year shall be paid only to those employers who remain participants in the group for the entire fund year. Payment of a refund based on a previous fund year shall not be contingent on continued membership in the group after that fund year.
(P.A. 96-267, S. 16.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706 - Private Employer Workers' Compensation Group Self-Insurance › Section 38a-1016. - Premium payment plan required. Loss reserves. Bad debt reserves.

(a) Each group shall establish to the satisfaction of the commissioner a premium payment plan which shall include: (1) An initial payment by each member of at least twenty-five per cent of that member's annual premium before the start of the group's fund year; and (2) payment of the balance of each member's annual premium in monthly or quarterly installments.
(b) Each group shall establish and maintain actuarially appropriate loss reserves which shall include reserves for: (1) Known claims and any associated expenses; and (2) Claims incurred but not reported and any associated expenses.
(c) Each group shall establish and maintain bad debt reserves based on the historical experience of the group or other groups or such other data as the commissioner may determine.
(P.A. 96-267, S. 17.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706 - Private Employer Workers' Compensation Group Self-Insurance › Section 38a-1017. - Deficiencies. Insolvency. Liquidation and assessment.

(a) If the assets of a group are at any time insufficient to enable the group to discharge its legal liabilities and other obligations and to maintain the reserves required of it under the provisions of subsection (e) of section 31-288 and sections 31-289b, 31-316, 31-345 and 38a-1000 to 38a-1023, inclusive, after consideration of present value of investment interest and income, it shall make up the deficiency or levy an assessment upon its members for the amount needed to make up the deficiency.
(b) In the event of a deficiency as determined in subsection (a) of this section, in any fund year, the deficiency shall be made up from: (1) Surplus from a fund year other than the current fund year; (2) administrative funds; (3) assessment of the membership, if ordered by the group; or (4) such alternate method as the commissioner may approve or direct. The commissioner shall be notified prior to any transfer of surplus funds from one fund year to another.
(c) If the group fails to assess its members or to otherwise make up such deficit within thirty days, the commissioner shall order it to do so.
(d) If the group fails to make the required assessment of its members within thirty days after the commissioner so orders, or if the deficiency is not fully made up within sixty days after the date on which the assessment is made, or within such longer period of time as may be specified by the commissioner, the group shall be deemed to be insolvent.
(e) The commissioner shall proceed against an insolvent group in the same manner as the commissioner would proceed against an insolvent domestic insurer in this state as prescribed in sections 38a-903 to 38a-961, inclusive. The commissioner shall have the same powers and limitations in such proceedings as are provided under the provisions of said sections 38a-903 to 38a-961, inclusive, except as provided in subsection (e) of section 31-288 and sections 31-289b, 31-316, 31-345 and 38a-1000 to 38a-1023, inclusive.
(f) In the event of the liquidation of a group, the commissioner shall levy an assessment upon its members for such an amount as the commissioner determines to be necessary to discharge all liabilities of the group, including the reasonable cost of liquidation.
(P.A. 96-267, S. 18.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706 - Private Employer Workers' Compensation Group Self-Insurance › Section 38a-1018. - Penalties.

After notice and opportunity for a hearing, the commissioner may impose a monetary penalty on any person or group found to be in violation of any provision of subsection (e) of section 31-288 or section 31-289b, 31-316, 31-345 or 38a-1000 to 38a-1023, inclusive, or of any rules or regulations adopted pursuant to said provisions. Such monetary penalty shall not exceed one thousand dollars for each act or violation and shall not exceed an aggregate of ten thousand dollars. The amount of any monetary penalty shall be paid to the commissioner for deposit in the General Fund.
(P.A. 96-267, S. 19.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706 - Private Employer Workers' Compensation Group Self-Insurance › Section 38a-1019. - Cease and desist orders. Violations. Penalties. License and certificate revocation.

(a) After notice and opportunity for a hearing, the commissioner may issue an order requiring a person or group to cease and desist from engaging in an act or practice found to be in violation of any provision of subsection (e) of section 31-288 or section 31-289b, 31-316, 31-345 or 38a-1000 to 38a-1023, inclusive, or of any rules or regulations adopted pursuant to said sections.
(b) Upon a finding, after notice and opportunity for a hearing, that any person or group has violated any cease and desist order, the commissioner may do either or both of the following: (1) Impose a monetary penalty of not more than ten thousand dollars for each and every act or violation of the order not to exceed an aggregate monetary penalty of one hundred thousand dollars; or (2) revoke the group's certificate of approval for the group or any insurance license held by the person.
(P.A. 96-267, S. 20.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706 - Private Employer Workers' Compensation Group Self-Insurance › Section 38a-1020. - Revocation of certificate of approval.

(a) After notice and opportunity for a hearing, the commissioner may revoke a group's certificate of approval if it: (1) Is found to be insolvent; (2) fails to pay any premium tax, regulatory fee or assessment or special fund contribution imposed upon it; or (3) fails to comply with any of the provisions of subsection (e) of section 31-288, 31-289b, 31-316, 31-345 or 38a-1000 to 38a-1023, inclusive, with any rules adopted pursuant to said sections, or with any lawful order of the commissioner within the time prescribed.
(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.
(P.A. 96-267, S. 21.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706 - Private Employer Workers' Compensation Group Self-Insurance › Section 38a-1021. - Additional provisions.

The provisions of sections 38a-16, 38a-132, 38a-140 and 38a-815 to 38a-819, inclusive, shall be additional to any other powers to enforce any penalties, fines or forfeitures authorized by law.
(P.A. 96-267, S. 22.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706 - Private Employer Workers' Compensation Group Self-Insurance › Section 38a-1022. - Regulations.

The commissioner shall adopt such reasonable regulations as he deems necessary to carry out the provisions of subsection (e) of section 31-288 and sections 31-289b, 31-316, 31-345 and 38a-1000 to 38a-1023, inclusive.
(P.A. 96-267, S. 23.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706 - Private Employer Workers' Compensation Group Self-Insurance › Section 38a-1023. - Severability.

If any provision of subsection (e) of section 31-288 or section 31-289b, 31-316, 31-345 or 38a-1000 to 38a-1023, inclusive, or the application thereof to any person or circumstance is subsequently held to be invalid, such invalidity shall not affect other provisions or applications of said sections.
(P.A. 96-267, S. 24.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706a - Charitable Gift Annuities › Section 38a-1030. - Definitions.

As used in sections 38a-1030 to 38a-1034, inclusive:
(1) “Charitable gift annuity” means a transfer of cash or other property by a donor to a charitable organization in return for an annuity payable over one or two lives, under which the actuarial value of the annuity is less than the value of the cash or other property transferred and the difference in value constitutes a charitable deduction for federal tax purposes.
(2) “Charitable organization” means an entity described in: (A) Section 501(c)(3) of the Internal Revenue Code of 1986, or any subsequent corresponding internal revenue code of the United States, as from time to time amended (26 USC Section 501(c)(3)); or (B) Section 170(c) of said Internal Revenue Code (26 USC Section 170(c)).
(3) “Qualified charitable gift annuity” means a charitable gift annuity described in Section 501(m)(5) of said Internal Revenue Code (26 USC Section 501(m)(5)), and Section 514(c)(5) of said Internal Revenue Code (26 USC Section 514(c)(5)), that is issued by a charitable organization that on the date of the annuity agreement: (A) Has a minimum of three hundred thousand dollars in unrestricted cash, cash equivalents or publicly traded securities, exclusive of the assets funding the annuity agreement; and (B) has been in continuous operation for at least three years or is a successor or affiliate of a charitable organization that has been in continuous operation for at least three years.
(P.A. 99-52, S. 1.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706a - Charitable Gift Annuities › Section 38a-1031. - Issuance of charitable gift annuity does not constitute engaging in the business of insurance.

(a) The issuance of a qualified charitable gift annuity shall not constitute engaging in the business of insurance in this state.
(b) A charitable gift annuity issued before October 1, 1999, is a qualified charitable gift annuity for the purposes of sections 38a-1030 to 38a-1034, inclusive, and the issuance of that charitable gift annuity shall not constitute engaging in the business of insurance in this state.
(P.A. 99-52, S. 2.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706a - Charitable Gift Annuities › Section 38a-1032. - Written disclosures.

(a) When entering into an agreement for a qualified charitable gift annuity, the charitable organization shall disclose to the donor in writing in the annuity agreement that a qualified charitable gift annuity is not insurance under the laws of this state and is not subject to regulation by the Insurance Commissioner or protected by an insurance guaranty association.
(b) The notice provisions required by this section shall be in a separate paragraph in a print size no smaller than that employed in the annuity agreement generally.
(P.A. 99-52, S. 3.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706a - Charitable Gift Annuities › Section 38a-1033. - Notice to commissioner.

(a) A charitable organization that issues qualified charitable gift annuities shall notify the Insurance Commissioner, in writing, by the latter of January 1, 2000, or the date on which it enters into the organization's first qualified charitable gift annuity agreement. The notice shall: (1) Be signed by an officer or director of the organization; (2) identify the organization; and (3) certify that: (A) The organization is a charitable organization; and (B) the annuities issued by the organization are qualified charitable gift annuities.
(b) The organization shall not be required to submit additional information except to determine appropriate penalties that may be applicable under section 38a-1034.
(P.A. 99-52, S. 4.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706a - Charitable Gift Annuities › Section 38a-1034. - Failure to comply with notice requirements. Validity of charitable gift annuity after failure to give notice. Penalties.

The failure of a charitable organization to comply with the notice requirements imposed under section 38a-1032 or 38a-1033 shall not prevent a charitable gift annuity that otherwise meets the requirements of sections 38a-1030 to 38a-1034, inclusive, from constituting a qualified charitable gift annuity. The Insurance Commissioner may enforce performance of the requirements of sections 38a-1032 and 38a-1033 by sending a letter by certified mail, return receipt requested, demanding that the charitable organization comply with the requirements of sections 38a-1032 and 38a-1033. The commissioner may fine the charitable organization in an amount not to exceed one thousand dollars per qualified charitable gift annuity agreement issued until such time as the charitable organization complies with the requirements of sections 38a-1032 and 38a-1033.
(P.A. 99-52, S. 5.)
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706b - Office of the Healthcare Advocate › Section 38a-1040. - Definitions.

As used in sections 38a-1040 to 38a-1050, inclusive:
(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.
(P.A. 99-284, S. 1; P.A. 11-58, S. 86; P.A. 15-118, S. 24.)
History: P.A. 11-58 replaced reference to Secs. 38a-226 to 38a-226d with “as defined in section 38a-591a” in Subdiv. (3), effective July 1, 2011; P.A. 15-118 made a technical change in Subdiv. (2).
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706b - Office of the Healthcare Advocate › Section 38a-1043. - Access to information.

(a) Each managed care organization shall, when presented with the written consent of the consumer or the consumer's guardian or legal representative, provide to the Office of the Healthcare Advocate access to records relating to such consumer.
(b) Any records provided pursuant to this section to the Office of the Healthcare Advocate shall be exempt from disclosure under the Freedom of Information Act, as defined in section 1-200.
(P.A. 99-284, S. 4; P.A. 05-102, S. 10.)
History: P.A. 05-102 renamed the Office of Managed Care Ombudsman the Office of the Healthcare Advocate.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706b - Office of the Healthcare Advocate › Section 38a-1044. - State agency information and assistance.

All state agencies shall comply with reasonable requests of the Office of the Healthcare Advocate for information and assistance.
(P.A. 99-284, S. 5; P.A. 05-102, S. 11.)
History: P.A. 05-102 renamed the Office of Managed Care Ombudsman the Office of the Healthcare Advocate.
2023 Connecticut General Statutes › Title 38a - Insurance › Chapter 706b - Office of the Healthcare Advocate › Section 38a-1045. - Confidentiality of consumer identity.

In the absence of the written consent of a consumer utilizing the services of the Office of the Healthcare Advocate or such consumer's guardian or legal representative or of a court order, the Office of the Healthcare Advocate, its employees and agents, shall not disclose the identity of the consumer.
(P.A. 99-284, S. 6; P.A. 05-102, S. 12.)
History: P.A. 05-102 renamed the Office of Managed Care Ombudsman the Office of the Healthcare Advocate.