All Roll Calls
Yes: 275 • No: 155
ConnecticutSB 000102025 Regular SessionSenateWALLET
AN ACT CONCERNING HEALTH INSURANCE AND PATIENT PROTECTION.
Sponsored By: Insurance and Real Estate Committee
Signed by Governor
Summary
To: (1) Establish (A) certain reporting requirements and enforcement provisions concerning compliance with mental health and substance use disorder benefit laws, and (B) the parity advancement account; (2) require health carriers to bear the burden of proving that certain health care services under adverse determination or utilization review are not medically necessary; (3) establish certain prohibitions on the use of step therapy for prescription drugs; (4) require health carriers to include certain provisions in contracts with health care providers regarding reimbursement for certain covered health benefits; (5) establish certain requirements concerning stop loss insurance policies for health care or medical benefits under any self-funded employee health benefit plan; (6) establish certain health insurance rate filing requirements and require that the Insurance Commissioner adopt regulations concerning affordability in rate filing; (7) prohibit the use of artificial intelligence to make an adverse determination based on medical necessity; and (8) prohibit any individual or group health insurance policy from imposing (A) arbitrary time limits on reimbursement for general anesthesia services, or (B) unilateral arbitrary limitations on reimbursement for medically necessary ancillary services.
insurance and real estate
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Bill Overview
Analyzed Economic Effects
5 provisions identified: 5 benefits, 0 costs, 0 mixed.
Anesthesia payments protected from time limits
Beginning January 1, 2026, affected individual and group health policies cannot impose arbitrary time limits on general anesthesia payments. Insurers cannot deny, reduce, stop, or withhold payment solely because care exceeded an insurer-set time limit. The protection applies to specified policy types that cover general anesthesia during medically necessary procedures.
Fewer drug hurdles for covered patients
Beginning January 1, 2026, plans with prescription coverage cannot require patients with multiple sclerosis or rheumatoid arthritis to try other drugs first. This applies when the prescribed drug meets FDA-approved uses, and the same protection remains for stage IV metastatic cancer. The law removes the January 1, 2027 end date for protections covering schizophrenia, major depressive disorder, and bipolar disorder. Providers can request a step-therapy exception at any time. Insurers must grant it quickly when the required drug failed, is expected to fail or cause harm, or is not medically best for the patient.
Premium review may lower requested rates
Beginning January 1, 2027, Connecticut's Insurance Commissioner may lower affected carriers' requested premium rates, including small-group rates for small employers. The reduction can be up to two percentage points of the filed premium rate. It applies when approved average premium increases exceeded the state's health care cost-growth benchmark in each of the two latest plan years with available data. A reduction is not required, and the law does not guarantee lower premiums for any household or employer.
Stronger enforcement of hospital fee limits
Beginning January 1, 2026, violating the specified hospital facility-fee collection restrictions also counts as an unfair trade practice. This adds an enforcement consequence for hospitals, health systems, and hospital-based facilities that break those restrictions. It does not create a new patient fee or set a reimbursement amount.
Stronger oversight of mental health coverage
Beginning October 1, 2025, Connecticut strengthens enforcement of mental health and substance use coverage rules. Carriers must review their practices annually and certify compliance or list failures and planned fixes. The first certification is due March 1, 2026, covering 2025; later certifications cover the prior calendar year. Annual state reports may publicly name carriers and contractors. Reports go to the insurance committee, Attorney General, Healthcare Advocate, and Commissioner of Health Strategy. After a hearing opportunity, carriers face fines up to $100 per covered person, capped at $625,000 per carrier annually. The Commissioner may waive fines for reasonable cause without willful neglect, or correction within 30 days after certifying noncompliance. Missing filings trigger $100 daily fees, capped at $625,000 per carrier; incomplete filings trigger fees after notice and a deadline. Fines and late fees go to the General Fund. The Commissioner may also order payment of reasonable, necessary enforcement expenses, with no fixed amount; that money supports parity enforcement.
Sponsors & Cosponsors
Sponsor
Insurance and Real Estate Committee
Affiliation unavailable
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
Senate vote • 5/12/2025
APP Vote Tally Sheet (Joint Favorable)
Yes: 37 • No: 11
Senate vote • 5/6/2025
JUD Vote Tally Sheet (Joint Favorable)
Yes: 28 • No: 11
House vote • 1/21/2025
House Roll Call Vote 272 AS AMENDED
Yes: 122 • No: 26
Senate vote • 1/21/2025
INS Vote Tally Sheet (Joint Favorable Substitute)
Yes: 10 • No: 3
Senate vote • 1/21/2025
Senate Roll Call Vote 211
Yes: 31 • No: 5
Senate vote • 1/21/2025
INS Vote Tally Sheet-A
Yes: 0 • No: 0
House vote • 1/21/2025
House Roll Call Vote 271 HOUSE AMD A
Yes: 47 • No: 99
Senate vote • 1/21/2025
INS Vote Tally Sheet (Vote to Draft)
Yes: 0 • No: 0
Actions Timeline
Signed by the Governor
6/24/2025legislatureTransmitted by Secretary of the State to Governor
6/23/2025legislatureTransmitted to the Secretary of State
6/23/2025legislaturePublic Act 25-94
6/11/2025legislatureIn Concurrence
6/2/2025legislatureHouse Passed as Amended by Senate Amendment Schedule A
6/2/2025HouseHouse Adopted Senate Amendment Schedule A
6/2/2025HouseHouse Rejected House Amendment Schedule A 10230
6/2/2025HouseHouse Calendar Number 632
5/23/2025HouseFavorable Report, Tabled for the Calendar, House
5/23/2025HouseSenate Passed as Amended by Senate Amendment Schedule A
5/21/2025SenateSenate Adopted Senate Amendment Schedule A 8995
5/21/2025SenateFavorable Report, Tabled for the Calendar, Senate
5/13/2025SenateNo New File by Committee on Appropriations
5/13/2025legislatureReported Out of Legislative Commissioners' Office
5/13/2025legislatureFiled with Legislative Commissioners' Office
5/13/2025legislatureJoint Favorable
5/12/2025legislatureImmediate Transmittal
5/8/2025legislatureReferred by Senate to Committee on Appropriations
5/8/2025SenateFavorable Report, Tabled for the Calendar, Senate
5/7/2025SenateNo New File by Committee on Judiciary
5/7/2025legislatureReported Out of Legislative Commissioners' Office
5/7/2025legislatureFiled with Legislative Commissioners' Office
5/6/2025legislatureJoint Favorable
5/6/2025legislatureReferred by Senate to Committee on Judiciary
5/1/2025Senate
Bill Text
Public Act No. 25-94
6/11/2025
File No. 419
4/2/2025
APP Joint Favorable
3/13/2025
Committee Bill
3/13/2025
INS Joint Favorable Substitute
3/13/2025
JUD Joint Favorable
3/13/2025
Proposed Bill
1/8/2025
APP Joint Fav. Rpt
APP Vote Tally Sheet (Joint Favorable)
Bill Analysis For File Copy 419
Bill Analysis for SB-10, as amended by Senate "A"
Fiscal Note For File Copy 419
Fiscal Note for Amendment LCO 10230 (No Fiscal Impact)
Fiscal Note for Amendment LCO 8138 (See Fiscal Note Details)
Fiscal Note for Amendment LCO 8638 (See Fiscal Note Details)
Fiscal Note for Amendment LCO 8927 (See Fiscal Note Details)
Fiscal Note for Amendment LCO 8930 (See Fiscal Note Details)
Fiscal Note for Amendment LCO 8932 (See Fiscal Note Details)
Fiscal Note for Amendment LCO 8934 (Eliminates Fiscal Impact in Bill)
Fiscal Note for Amendment LCO 8935 (See Fiscal Note Details)
Fiscal Note for Amendment LCO 8937 (No Fiscal Impact)
Fiscal Note for Amendment LCO 8938 (Eliminates Fiscal Impact in Bill)
Fiscal Note for Amendment LCO 8939 (Reduces Cost In Bill)
Fiscal Note for Amendment LCO 8940 (See Fiscal Note Details)
Fiscal Note for Amendment LCO 8941 (See Fiscal Note Details)
Fiscal Note for Amendment LCO 8943 (Eliminates Fiscal Impact in Bill)
Fiscal Note for Amendment LCO 8944 (Savings)
Fiscal Note for Amendment LCO 8951 (Eliminates Fiscal Impact in Bill)
Fiscal Note for Amendment LCO 8953 (Savings)
Fiscal Note for Amendment LCO 8980 (Reduces Cost In Bill)
Fiscal Note for Amendment LCO 8995 (See Fiscal Note Details)
Fiscal Note for SB-10, As Amended by Senate "A" (LCO 8995)
House Roll Call Vote 271 HOUSE AMD A
House Roll Call Vote 272 AS AMENDED
House Schedule A LCO# 10230 (R)
INS Joint Fav. Rpt
INS Vote Tally Sheet (Joint Favorable Substitute)
INS Vote Tally Sheet (Vote to Draft)
INS Vote Tally Sheet-A
JUD Joint Fav. Rpt
JUD Vote Tally Sheet (Joint Favorable)
Senate LCO Amendment #8138 (D)
Senate LCO Amendment #8638 (D)
Senate LCO Amendment #8927 (R)
Senate LCO Amendment #8930 (R)
Senate LCO Amendment #8932 (R)
Senate LCO Amendment #8934 (R)
Senate LCO Amendment #8935 (R)
Senate LCO Amendment #8937 (R)
Senate LCO Amendment #8938 (R)
Senate LCO Amendment #8939 (R)
Senate LCO Amendment #8940 (R)
Senate LCO Amendment #8941 (R)
Senate LCO Amendment #8943 (R)
Senate LCO Amendment #8944 (R)
Senate LCO Amendment #8951 (R)
Senate LCO Amendment #8953 (R)
Senate LCO Amendment #8980 (R)
Senate Roll Call Vote 211
Senate Schedule A LCO# 8995 (D)
Summary for Public Act No. 25-94
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