2023 Connecticut General Statutes › Title 19a - Public Health and Well-Being › Chapter 368a - Department of Public Health › Section 19a-7p. - Public health fee. Annual reporting requirement. Appeal. Penalties. Overpayment.

(a) Not later than September first, annually, the Secretary of the Office of Policy and Management, in consultation with the Commissioner of Public Health, shall (1) determine the amounts appropriated for the syringe services program, AIDS services, breast and cervical cancer detection and treatment, x-ray screening and tuberculosis care, sexually transmitted disease control and children's health initiatives; and (2) inform the Insurance Commissioner of such amounts.
(b) (1) As used in this section: (A) “Health insurance” means health insurance of the types specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469; and (B) “health care center” has the same meaning as provided in section 38a-175.
(2) Each domestic insurer or domestic health care center doing health insurance business in this state shall annually pay to the Insurance Commissioner, for deposit in the Insurance Fund established under section 38a-52a, a public health fee assessed by the Insurance Commissioner pursuant to this section.
(3) (A) Not later than September first, annually, each such insurer or health care center shall report to the Insurance Commissioner, in the form and manner prescribed by the commissioner, the number of insured or enrolled lives in this state as of May first immediately preceding the date for which such insurer or health care center is providing health insurance that provides coverage of the types specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469. Such number shall not include lives enrolled in Medicare, any medical assistance program administered by the Department of Social Services, workers' compensation insurance or Medicare Part C plans. The commissioner may require each such insurer or health care center or any other person to submit to the commissioner any records that are in such insurer's, health care center's or other person's possession if such records were used to prepare such insurer's or health care center's annual report submitted pursuant to this subparagraph.
(B) Each such insurer or health care center that fails to timely submit an annual report pursuant to subparagraph (A) of this subdivision shall pay to the Insurance Commissioner, in the form and manner prescribed by the commissioner, a late filing fee of one hundred dollars per day for each day from the date that the annual report was due.
(C) If the Insurance Commissioner determines that there is a discrepancy, other than a good faith discrepancy, between the number of insured or enrolled lives that the insurer or health care center reported to the commissioner pursuant to subparagraph (A) of this subdivision and the number of such lives that the insurer or health care center should have reported to the commissioner pursuant to said subparagraph (A), the insurer or health care center shall be liable for a civil penalty of not more than fifteen thousand dollars.
(c) Not later than November first, annually, the Insurance Commissioner shall determine the fee to be assessed for the current fiscal year against each such insurer and health care center. Such fee shall be calculated by multiplying the number of lives reported to said commissioner pursuant to subparagraph (A) of subdivision (3) of subsection (b) of this section by a factor, determined annually by said commissioner as set forth in this subsection, to fully fund the aggregate amount determined under subsection (a) of this section. The Insurance Commissioner shall determine the factor by dividing the aggregate amount by the total number of lives reported to said commissioner pursuant to subparagraph (A) of subdivision (3) of subsection (b) of this section.
(d) Not later than December first, annually, the Insurance Commissioner shall submit a statement to each such insurer and health care center that includes the proposed fee, identified on such statement as the “Public Health fee”, for the insurer or health care center, calculated in accordance with this section. Not later than December twentieth, annually, any insurer or health care center may submit an objection to the Insurance Commissioner concerning the proposed public health fee. The Insurance Commissioner, after making any adjustment that said commissioner deems necessary, shall, not later than January first, annually, submit a final statement to each insurer and health care center that includes the final fee for the insurer or health care center. Each such insurer and health care center shall pay such fee to the Insurance Commissioner not later than February first, annually.
(e) Any such insurer or health care center aggrieved by an assessment levied under this section may appeal therefrom in the same manner as provided for appeals under section 38a-52.
(f) (1) The Insurance Commissioner shall apply an overpayment of the public health fee by an insurer or health care center for any fiscal year as a credit against the public health fee due from such insurer or health care center for the succeeding fiscal year, subject to an adjustment under subsection (c) of this section, if: (A) The amount of the overpayment exceeds five thousand dollars; and (B) on or before June first of the calendar year of the overpayment, the insurer or health care center (i) notifies the commissioner of the amount of the overpayment, and (ii) provides the commissioner with evidence sufficient to prove the amount of the overpayment.
(2) Not later than ninety days following receipt of notice and supporting evidence under subdivision (1) of this subsection, the commissioner shall (A) determine whether the insurer or health care center made an overpayment, and (B) notify the insurer or health care center of such determination.
(3) Failure of an insurer or health care center to notify the commissioner of the amount of an overpayment within the time prescribed in subdivision (1) of this subsection constitutes a waiver of any demand of the insurer or health care center against the state on account of such overpayment.
(4) Nothing in this subsection shall be construed to prohibit or limit the right of an insurer or health care center to appeal pursuant to subsection (e) of this section.
(June Sp. Sess. P.A. 15-5, S. 345; P.A. 16-213, S. 9; P.A. 17-6, S. 4; 17-198, S. 32; P.A. 18-168, S. 26; P.A. 19-117, S. 72; P.A. 21-157, S. 1.)
History: June Sp. Sess. P.A. 15-5 effective July 1, 2015; P.A. 16-213 amended Subsec. (b)(2) by adding “domestic” in provision re health care center, effective July 1, 2016; P.A. 17-6 amended Subsec. (a) by replacing “needle and syringe exchange program” with “syringe services program”, effective July 1, 2017; P.A. 17-198 added Subsec. (f) re overpayment of public health fee, effective June 30, 2017, and applicable to any public health fee due on or after February 1, 2017; P.A. 18-168 amended Subsec. (a) by replacing “venereal” with “sexually transmitted” in Subdiv. (1); P.A. 19-117 amended Subsec. (a)(1) by adding reference to children's health initiatives, effective July 1, 2019; P.A. 21-157 amended Subsec. (b)(3) by designating existing provisions as Subpara. (A) and amended same to add provision re commissioner may require submission of records used to prepare annual report and adding Subpara. (B) re late filing fee and Subpara. (C) re civil penalty, amended Subsec. (c) by adding “subparagraph (A) of” and made a technical change, effective July 1, 2021.