Connecticut Administrative Code

Regulations of Connecticut State AgenciesSec. 38a-459-6. Purchase of annuities from segregated account assetsFor group annuity contracts, which make available to the contract holder the purchase of immediate or deferred annuities for the benefit of individual members of the group…

Regulations of Connecticut State AgenciesSec. 38a-459-7. Unilateral synthetic guaranteed investment contract terminationsA contract subject to sections 38a-459-1 to 38a-459-9, inclusive, of the Regulations of Connecticut State Agencies shall allow the insurance company to unilate…

Regulations of Connecticut State AgenciesSec. 38a-459-8. Reserves for synthetic guaranteed investment contracts(a) An insurance company, at all times, shall hold minimum reserves in the general account or one or more separate accounts, as appropriate, equal to the excess, if any,…

Regulations of Connecticut State AgenciesSec. 38a-459-9. SeverabilityIf any provision of sections 38a-459-1 to 38a-459-9, inclusive, of the Regulations of Connecticut State Agencies or its application to any person or circumstance is held to be invalid, the remainder of the regul…

Regulations of Connecticut State AgenciesSec. 38a-465-1. Definitions (Repealed) Repealed June 27, 2013.(Adopted effective November 9, 1998; Amended March 1, 2000; Repealed June 27, 2013) AUTHORITY: Conn. Gen. Stat. § 38a-465 AUTHORITY: Conn. Gen. Stat. § 38a-465

Regulations of Connecticut State AgenciesSec. 38a-465-10. Disclosure requirementsA disclosure document containing the disclosures required in section 38a-465f of the Connecticut General Statutes and sections 38a-465-2 to 38a-465-10, inclusive, of the Regulations of Connecticut St…

Regulations of Connecticut State AgenciesSec. 38a-465-2. Annual statement reporting requirementsEach provider shall file with the Commissioner on or before March 1 each year, an annual statement containing the following information regarding business transacted in this state for …

Regulations of Connecticut State AgenciesSec. 38a-465-3. Verification of license status of providersEach licensed broker shall file on or before March 1 of each year, a notarized statement, signed under oath or affirmation, verifying that each provider from which such broker rece…

Regulations of Connecticut State AgenciesSec. 38a-465-4. Confidentiality of identity of insured's informationExcept as otherwise permitted under Section 38a-465d of the Connecticut General Statutes:(a) No person may submit the report required by Section 38a-465-2 in such a manner…

Regulations of Connecticut State AgenciesSec. 38a-465-5. Evaluation standards for reasonable payments(a) A broker or provider shall not enter into a life settlement contract that provides payment to the owner that is unreasonable, unjust or inequitable. In determining whether a p…

Regulations of Connecticut State AgenciesSec. 38a-465-6. Amounts payable to owner(a) Payment of the proceeds of a life settlement contract shall be made by means of wire transfer to the account of the owner or by certified check or cashier’s check. (b) Payment of the proceeds to …

Regulations of Connecticut State AgenciesSec. 38a-465-7. Prohibited practices(a) A life insurance producer, broker or provider shall not discriminate in the creation or solicitation of a life settlement contract on the basis of race, color, age, sex, national origin, ancestry, cr…

Regulations of Connecticut State AgenciesSec. 38a-465-8. Advertising practices(a) Advertising related to the life settlement contract shall be truthful and not misleading by fact or implication. (b) If the advertiser references the speed with which the settlement will occur, the …

Regulations of Connecticut State AgenciesSec. 38a-465-9. Interest retained by owner(a) If a provider enters a life settlement contract that allows the owner to retain an interest in the policy, the life settlement contract shall contain the following provisions: (1) A provision t…

Regulations of Connecticut State AgenciesSec. 38a-472f-1. Policy DefinitionsFor purposes of sections 38a-472f-2 to 38a-472f-5, inclusive, of the Regulations of Connecticut State Agencies: (1) \"Ancillary service\" means a health care service that is not provided as part of an off…

Regulations of Connecticut State AgenciesSec. 38a-472f-2. Health insurance carrier standards and responsibilitiesEach health carrier that delivers, issues for delivery, renews, amends or continues any individual or group health insurance policy or certificate in this state that u…

Regulations of Connecticut State AgenciesSec. 38a-472f-3. Minimum Standards for Network Adequacy(a) Each health carrier that delivers, issues for delivery, renews, amends or continues any individual or group health insurance policy or certificate in this state that uses a provide…

Regulations of Connecticut State AgenciesSec. 38a-472f-4. Minimum Standards for Provider DirectoriesEach health carrier that delivers, issues for delivery, renews, amends or continues any individual or group health insurance policy or certificate in this state that uses a provide…

Regulations of Connecticut State AgenciesSec. 38a-472f-5. Annual Filing RequirementsEach health carrier that delivers, issues for delivery, renews, amends or continues any individual or group health insurance policy or certificate in this state that uses a provider network shall …

Regulations of Connecticut State AgenciesSec. 38a-472f-6. SeparabilityIf any provision of sections 38a-472f-1 to 38a-472f-5, inclusive, of the Regulations of Connecticut State Agencies or the application thereof to any person or circumstances, is for any reason held to be invalid…

Regulations of Connecticut State AgenciesSec. 38a-474-1. DefinitionsAs used in Sections 38a-474-1 to 38a-474-4, inclusive, of the regulations of Connecticut state agencies: (1) \"Commissioner\" means the Insurance Commissioner.(2) \"Insurer\" means insurance company, fraternal be…

Regulations of Connecticut State AgenciesSec. 38a-474-2. Rate submission requirements(a) Each insurer shall submit the rates on every Medicare supplement policy form for initial approval by the Commissioner and annually thereafter. (b) An insurer seeking to change rates on a Medi…

Regulations of Connecticut State AgenciesSec. 38a-474-2a. Electronic filing(a) Any insurer filing rates with the commissioner in accordance with section 38a-474-2 of the Regulations of Connecticut State Agencies may submit such filing electronically using software known as the Sy…

Regulations of Connecticut State AgenciesSec. 38a-474-3. Rate review standards(a) The commissioner shall not approve a rate for a Medicare supplement policy that is excessive, inadequate, unreasonable in relation to the benefits provided or unfairly discriminatory. (b) Rates for …

Regulations of Connecticut State AgenciesSec. 38a-474-4. SeparabilityIf any provision of sections 38a-474-1 to 38a-474-3, inclusive, of the regulations of Connecticut state agencies or the application thereof to any person or circumstance is for any reason held to be invalid, the…

Regulations of Connecticut State AgenciesSec. 38a-475-1. Applicability and scopeSections 38a-475-1 to 38a-475-6, inclusive, apply to any long-term care insurance policy or certificate form which the insurance department is requested to precertify in accordance with section 38a-47…

Regulations of Connecticut State AgenciesSec. 38a-475-2. DefinitionsAs used in sections 38a-475-1 to 38a-475-6, inclusive:(a) \"Connecticut Partnership for Long-Term Care\" means the program authorized in section 17b-252 of the general statutes. (b) \"Long-Term Care Insurance Pol…

Regulations of Connecticut State AgenciesSec. 38a-475-3. Partnership-approval of long-term care policiesNo long-term care insurance policy shall be precertified as partnership-approved for purposes of the Connecticut Partnership for Long-Term Care, unless the requirements of sect…

Regulations of Connecticut State AgenciesSec. 38a-475-4. Conditions for partnership-approval(a) No long-term care insurance policy shall be advertised, solicited, or issued for delivery in this state as a partnership-approved long-term care policy which does not meet the followin…

Regulations of Connecticut State AgenciesSec. 38a-475-5. Insurer documentation and reportingUnless otherwise noted, the requirements of subsections (a) to (f), inclusive, of this section refer to insurer documentation and reporting requirements for partnership-approved policies. …

Regulations of Connecticut State AgenciesSec. 38a-475-6. SeparabilityIf any provision of sections 38a-475-1 to 38a-475-6, inclusive, or the application thereof to any person or circumstance is for any reason held to be invalid, the remainder of these regulations and the applicati…

Regulations of Connecticut State AgenciesSec. 38a-478m-1. (Repealed) Repealed September 4, 2012. AUTHORITY: Conn. Gen. Stat. § 38a-478m AUTHORITY: Conn. Gen. Stat. § 38a-478m

Regulations of Connecticut State AgenciesSec. 38a-478n-1—38a-478n-5. (Repealed) Repealed September 4, 2012. AUTHORITY: Conn. Gen. Stat. § 38a-478n

Regulations of Connecticut State AgenciesSec. 38a-478u-1. Applicability and scopeNothing in Sections 38a-478u-1 to 38a-478u-7, inclusive, shall be construed to apply to the arrangements of managed care organizations offered to individuals covered under self-insured employee welfa…

Regulations of Connecticut State AgenciesSec. 38a-478u-2. DefinitionsAs used in Sections 38a-478u-1 to 38a-478u-7, inclusive, of the Regulations ofConnecticut State Agencies:(1) ‘‘Commissioner” means the Insurance Commissioner of the State of Connecticut;(2) ‘‘Enrollee’’ means a …

Regulations of Connecticut State AgenciesSec. 38a-478u-3. Annual filing requirementsEach managed care organization shall file annually the information specified below.(1) Quality Assurance Reports(A) A summary report on its quality assurance plan inclusive of, but not limited to,…

Regulations of Connecticut State AgenciesSec. 38a-478u-4. Notification of primary care physician terminationEach managed care organization shall send written notice to each affected enrollee at his last known address no later than thirty days after sending or receiving notice of …

Regulations of Connecticut State AgenciesSec. 38a-478u-5. Medical loss ratioFor the purposes of reporting and disclosure in accordance with Sections 4 and 8 of Public Act 97-99 as amended by Public Act 97-8, June 18 Special Session, \"medical loss ratio\" means the ratio of incur…

Regulations of Connecticut State AgenciesSec. 38a-478u-6. Prior certificationEach managed care plan that requires preauthorization procedures may require enrollees to obtain prior certification or preauthorization for covered services provided (1) such services are clearly identi…

Regulations of Connecticut State AgenciesSec. 38a-478u-7. SeparabilityIf any provision of sections 38a-478u-1 to 38a-478u-7, inclusive, of the Regulations of Connecticut State Agencies or the application thereof to any person or circumstance is for any reason held to be invalid, …

Regulations of Connecticut State AgenciesSec. 38a-479aaa-1. DefinitionsAs used in section 38a-479aaa-1 to Section 38a-479aaa-5, inclusive, of the Regulations of Connecticut State Agencies: (1) \"Commissioner\" means the Insurance Commissioner;(2) \"Material modification\" means a…

Regulations of Connecticut State AgenciesSec. 38a-479aaa-2. Timing of application and registration(a) Each person acting as a pharmacy benefits manager on January 1, 2008 shall obtain a certificate of registration from the commissioner on or before April 1, 2008, after completion…

Regulations of Connecticut State AgenciesSec. 38a-479aaa-3. Contents of application(a) The filing required from a pharmacy benefits manager shall include the following information: (1) The identity of the pharmacy benefits manager and any company or organization controlling the o…

Regulations of Connecticut State AgenciesSec. 38a-479aaa-4. Contents of exemption formA pharmacy benefits manager seeking exemption from registration pursuant to section 38a-479bbb of the Connecticut General Statutes shall notify the commissioner and include the following informa…

Regulations of Connecticut State AgenciesSec. 38a-479aaa-5. Timing of exemption request(a) For pharmacy benefits managers doing business on January 1, 2008, as set forth in subsection (d) of section 38a-479bbb of the Connecticut General Statutes, the health insurer, health care c…

Regulations of Connecticut State AgenciesSec. 38a-480-1. Purpose and scope(a) Purpose. The purpose of this regulation is to adopt a group coordination of benefits regulation. This regulation is intended to establish uniformity in the permissive use of overinsurance provisions and…

Regulations of Connecticut State AgenciesSec. 38a-480-10. Policy form approval(a) Within fifteen (15) days of receipt of a form filed with the Commissioner for approval pursuant to Section 38a-480 (a) (2) of the General Statutes, the Insurance Department shall determine a filing …