Connecticut Administrative Code

Regulations of Connecticut State AgenciesSec. 38a-495a-17. Appropriateness of recommended purchase and excessive insurance(a) In recommending the purchase or replacement of any Medicare supplement policy or certificate an agent shall make reasonable efforts to determine the appro…

Regulations of Connecticut State AgenciesSec. 38a-495a-18. Reporting of multiple policies(a) On or before March 1 of each year, an issuer shall report to the commissioner the following information for every individual resident of this state for which the issuer has in force more …

Regulations of Connecticut State AgenciesSec. 38a-495a-19. Prohibition against preexisting conditions, waiting periods, elimination periods and probationary periods in replacement policies or certificates(a) If a Medicare supplement policy or certificate replaces another Medicare…

Regulations of Connecticut State AgenciesSec. 38a-495a-19a. Prohibition against use of genetic information. Requests for genetic testingThis section applies to all policies with policy years beginning on or after May 21, 2009. (a) For the purposes of this section only: (1) \"Issu…

Regulations of Connecticut State AgenciesSec. 38a-495a-2. DefinitionsAs used in sections 38a-495a-1 to 38a-495a-20, inclusive, of the Regulations of Connecticut State Agencies: (1) \"Applicant\" means: (A) In the case of an individual Medicare supplement policy, the person who se…

Regulations of Connecticut State AgenciesSec. 38a-495a-20. SeparabilityIf any provision of this regulation or the application thereof to any person or circumstance is for any reason held to be invalid, the remainder of the regulation and the application of such provision to other…

Regulations of Connecticut State AgenciesSec. 38a-495a-21. Effective date Sections 38a-495a-1 to 38a-495a-21, inclusive, of the Regulations of Connecticut State Agencies shall be effective when posted to the eRegulations System website by the Secretary of the State. (Effective Ju…

Regulations of Connecticut State AgenciesSec. 38a-495a-3. Policy definitions and termsNo policy or certificate may be advertised, solicited or issued for delivery in this state as a Medicare supplement policy or certificate unless such policy or certificate contains definitions o…

Regulations of Connecticut State AgenciesSec. 38a-495a-4. Policy provisions(a) Except for permitted preexisting condition clauses as described in sections 38a-495a-4a(a)(1), 38a-495a-5(a)(1), and 38a-495a-5a(a)(1) of the Regulations of Connecticut State Agencies, no policy or cer…

Regulations of Connecticut State AgenciesSec. 38a-495a-5. Benefit standards for policies or certificates issued or delivered on or after July 30, 1992 and with an effective date for coverage prior to June 2010The following standards are applicable to all Medicare supplement polic…

Regulations of Connecticut State AgenciesSec. 38a-495a-5a. Benefit standards for 2010 standardized Medicare supplement benefit plan policies or certificates issued for delivery with an effective date for coverage on or after June 1, 2010The standards established in this section a…

Regulations of Connecticut State AgenciesSec. 38a-495a-6. Standard Medicare supplement benefit plans for 1992 standardized Medicare supplement benefit plan policies or certificates issued for delivery on or after July 30, 1992 and with an effective date for coverage prior to June…

Regulations of Connecticut State AgenciesSec. 38a-495a-6a. Standard Medicare supplement benefit plans for 2010 standardized Medicare supplement benefit plan policies or certificates with an effective date for coverage on or after June 1, 2010.(a) The following standards are appli…

Regulations of Connecticut State AgenciesSec. 38a-495a-6b. Standard Medicare Supplement Benefit Plans for 2020 Standardized Medicare Supplement Benefits Plan Policies or Certificates Issued for Delivery to Individuals Newly Eligible for Medicare on or After January 1, 2020The Med…

Regulations of Connecticut State AgenciesSec. 38a-495a-7. Medicare select policies and certificates(a) (1) This section shall apply to Medicare Select policies and certificates, as defined in this section. (2) No policy or certificate may be advertised as a Medicare Select policy…

Regulations of Connecticut State AgenciesSec. 38a-495a-8. Open enrollment(a) No issuer shall deny or condition the issuance or effectiveness of any Medicare supplement policy or certificate available for sale in this state, nor discriminate in the pricing of such a policy or cert…

Regulations of Connecticut State AgenciesSec. 38a-495a-8a. Guaranteed issue for eligible persons(a) Guaranteed Issue(1) Eligible persons are those individuals described in subsection (b) of this section who seek to enroll under the policy during the period specified in subsection…

Regulations of Connecticut State AgenciesSec. 38a-495a-9. Standards for claims payment(a) An issuer shall comply with section 1882(c) (3) of the Social Security Act (as enacted by section 4081(b) (2) (C) of the Omnibus Budget Reconciliation Act of 1987 (OBRA) 1987, Pub. L. No. 10…

Regulations of Connecticut State AgenciesSec. 38a-501-10. Policy definitions and termsNo insurance policy or subscriber contract may be advertised, solicited or issued for delivery to any resident of this state as a long-term care policy unless the terms used in such policy or su…

Regulations of Connecticut State AgenciesSec. 38a-501-11. Minimum standardsNo individual insurance policy or subscriber contract shall be advertised, solicited or issued for delivery in this state as a long-term care policy which does not meet the following minimum standards. The…

Regulations of Connecticut State AgenciesSec. 38a-501-12. Prohibition against pre-existing conditions and probationary periods in replacement policiesIf a long-term care policy replaces another long-term care policy or certificate, the replacing insurer shall waive any time perio…

Regulations of Connecticut State AgenciesSec. 38a-501-13. Required disclosure provisions(a) Renewability. Individual long-term care insurance policies shall contain a renewability provision. Such provision shall be appropriately captioned, shall appear on the first page of the po…

Regulations of Connecticut State AgenciesSec. 38a-501-14. Prohibition against post claims underwriting(a) All applications for long-term care insurance policies except those which are guaranteed issue shall contain clear and unambiguous questions designed to ascertain the health …

Regulations of Connecticut State AgenciesSec. 38a-501-15. Filing requirements(a) All filings of rates and rating schedules shall be accompanied by an actuarial certification demonstrating that expected claims in relation to premiums comply with the loss ratio required by subsecti…

Regulations of Connecticut State AgenciesSec. 38a-501-16. Standards for marketing(a) Every insurer, fraternal benefit society, hospital service corporation, medical service corporation or health care center marketing long-term care insurance coverage in this state, directly or th…

Regulations of Connecticut State AgenciesSec. 38a-501-17. Suitability of recommended purchase(a) An agent who recommends the purchase or replacement of a long-term care policy or certificate shall have reasonable grounds for believing that the recommendation is suitable for the a…

Regulations of Connecticut State AgenciesSec. 38a-501-18. Requirement to deliver shopper's guideA long-term care insurance shopper's guide approved by the Commissioner shall be provided to all prospective applicants for a long-term care insurance policy. (a) In the case of agent …

Regulations of Connecticut State AgenciesSec. 38a-501-19. Requirement to offer a non-forfeiture benefitNo insurer shall offer for sale a long-term care insurance policy unless the insurer also offers the applicant the option to purchase a policy that provides a non-forfeiture ben…

Regulations of Connecticut State AgenciesSec. 38a-501-1—38a-501-7. (Repealed) Repealed September 30, 1994. AUTHORITY: Conn. Gen. Stat. § 38a-501

Regulations of Connecticut State AgenciesSec. 38a-501-20. Requirement to offer inflation protection(a) No insurer shall offer for sale a long-term care insurance policy unless the insurer also offers the applicant the option to purchase a policy that provides for meaningful perio…

Regulations of Connecticut State AgenciesSec. 38a-501-21. Standard format outline of coverage(a) No long-term care policy shall be delivered or issued for delivery to any resident of this state unless an appropriate outline of coverage in the format prescribed herein is completed…

Regulations of Connecticut State AgenciesSec. 38a-501-22. Replacement(a) Application forms shall include the following questions designed to elicit information as to whether, as of the date of the application, the applicant has another long-term care insurance policy or certifica…

Regulations of Connecticut State AgenciesSec. 38a-501-23. Reporting requirements(a) Every insurer shall report annually by June 30 the number of policies lapsed in the previous calendar year, the average total number of policies in force during the preceding calendar year, and th…

Regulations of Connecticut State AgenciesSec. 38a-501-24. Effective date; separability(a) The effective date of Sections 38a-501-8 to 38a-501-24, inclusive, shall be September 30, 1994. (b) If any provision of Sections 38a-501-8 to 38a-501-24, inclusive, or the application thereo…

Regulations of Connecticut State AgenciesSec. 38a-501-8. Applicability and scopeExcept as otherwise specifically provided, Sections 38a-501-8 to 38a-501-24, inclusive, apply to all individual long-term care insurance policies delivered or issued for delivery in this state on or a…

Regulations of Connecticut State AgenciesSec. 38a-501-9. DefinitionsAs used in Sections 38a-501-8 to 38a-501-24, inclusive:(a) \"Long-term care policy\" means any individual health insurance policy, or any individual subscriber contract, or any amendment, endorsement or rider to …

Regulations of Connecticut State AgenciesSec. 38a-501a-1. Applicability and scopeExcept as otherwise specifically provided, Sections 38a-501a-1 to 38a-501a-16, inclusive, of the Regulations of Connecticut State Agencies apply to all individual short term care insurance policies d…

Regulations of Connecticut State AgenciesSec. 38a-501a-10. Suitability of recommended purchase(a) A producer who recommends the purchase or replacement of a short term care policy or certificate shall have reasonable grounds for believing that the recommendation is suitable for t…

Regulations of Connecticut State AgenciesSec. 38a-501a-11. Non-forfeiture of benefitsAn insurer may offer the option to purchase a policy that provides a non-forfeiture benefit in the form of a return of premium, full benefits for a reduced benefit period, reduced benefits for th…

Regulations of Connecticut State AgenciesSec. 38a-501a-12. Inflation protection(a) An insurer shall offer the option to purchase a policy that provides for meaningful periodic benefit level increases to account for reasonably anticipated increases in the costs of short term care …

Regulations of Connecticut State AgenciesSec. 38a-501a-13. Standard format outline of coverage(a) No short term care policy shall be delivered or issued for delivery to any resident of this state unless an appropriate outline of coverage in the format prescribed in this section i…

Regulations of Connecticut State AgenciesSec. 38a-501a-14. Replacement(a) Application forms shall include the following questions designed to elicit information as to whether, as of the date of the application, the applicant has another short term care or long term care policy or…

Regulations of Connecticut State AgenciesSec. 38a-501a-15. Reporting requirements(a) Every insurer shall report annually by June 30 the number of policies lapsed in the previous calendar year, the average total number of policies in force during the preceding calendar year, and t…

Regulations of Connecticut State AgenciesSec. 38a-501a-16. SeverabilityIf any provision of sections 38a-501a-1 to 38a-501a-15 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 remain…

Regulations of Connecticut State AgenciesSec. 38a-501a-2. DefinitionsAs used in Sections 38a-501a-1 to 38a-501a-15, inclusive, of the Regulations of Connecticut State Agencies: (a) \"Short term care policy\" means any individual health insurance policy, or any individual subscrib…

Regulations of Connecticut State AgenciesSec. 38a-501a-3. Policy definitions and termsNo insurance policy or subscriber contract may be advertised, solicited or issued for delivery to any resident of this state as a short term care policy unless the terms used in such policy or s…

Regulations of Connecticut State AgenciesSec. 38a-501a-4. Minimum standardsNo individual insurance policy or subscriber contract shall be advertised, solicited or issued for delivery in this state as a short term care policy that does not meet the following minimum standards. The…