Connecticut Administrative Code

Regulations of Connecticut State AgenciesSec. 38a-554-5. Facility of paymentWhenever payments which should have been made under this plan in accordance with this provision have been made under any other plans, the company shall have the right, exercisable alone and in its sole di…

Regulations of Connecticut State AgenciesSec. 38a-554-6. Right of recoveryWhenever payments have been made by the company with respect to Allowable Expenses in a total amount which is, at any time, in excess of the maximum amount of payment necessary at that time to satisfy the i…

Regulations of Connecticut State AgenciesSec. 38a-591-1. Utilization review company licenses(a) No utilization review company shall conduct utilization review in this state unless it has been licensed by the commissioner in accordance with section 38a-591j of the Connecticut Gene…

Regulations of Connecticut State AgenciesSec. 38a-591-10. Independent review organizations(a) The commissioner shall enter into agreements for external review services with as many independent review organizations as he deems necessary. The agreements shall set forth all terms wh…

Regulations of Connecticut State AgenciesSec. 38a-591-11. SeverabilityIf any provision of sections 38a-591-1 to 38a-591-11, 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, t…

Regulations of Connecticut State AgenciesSec. 38a-591-2. Compensation based on certification denials – prohibited(a) No staff member, officer or consultant of a utilization review company or a health carrier shall receive any financial incentive based on the number of denials of …

Regulations of Connecticut State AgenciesSec. 38a-591-3. Confidentiality(a) Each utilization review company shall comply with the provisions of this section as well as all applicable federal and state laws to protect the confidentiality of patient medical records. Each utilizatio…

Regulations of Connecticut State AgenciesSec. 38a-591-4. RecordkeepingWith respect to all utilization reviews, urgent care or expedited utilization reviews, grievances of adverse determinations, and expedited reviews of adverse determinations, each utilization review company shal…

Regulations of Connecticut State AgenciesSec. 38a-591-5. Statistical reporting to the commissioner(a) Each health carrier shall file annually with the commissioner, on or before March 1, a summary report of its utilization review program activities in the calendar year immediatel…

Regulations of Connecticut State AgenciesSec. 38a-591-6. Examinations(a) The commissioner may undertake a compliance examination of any utilization review company licensed and conducting business in this state. In conducting the examination, the commissioner or his designee may e…

Regulations of Connecticut State AgenciesSec. 38a-591-7. Grievance procedures(a) Each health carrier shall file with the commissioner a copy of the written procedures, including all forms used to process requests, for (1) the review of grievances of adverse determinations that we…

Regulations of Connecticut State AgenciesSec. 38a-591-8. Notice to enrollees(a) Each health carrier that submits notices to a covered person or the covered person's authorized representative pursuant to section 38a-591d of the Connecticut General Statutes, including adverse deter…

Regulations of Connecticut State AgenciesSec. 38a-591-9. Rescission noticeHealth carriers shall provide advance written notice, consistent with 45 C.F.R. 136, to each covered person who would be affected before coverage may be rescinded regardless of whether the rescission applie…

Regulations of Connecticut State AgenciesSec. 38a-640-1. DefinitionsAs used in Sections 38a-640-1 to 38a-640-4, inclusive, of the Regulations of Connecticut State Agencies: (a) ‘‘Commissioner’’ means the Insurance Commissioner of the State of Connecticut.(b) ‘‘Form’’ means a cert…

Regulations of Connecticut State AgenciesSec. 38a-640-2. Filing procedureAny society required pursuant to Section 38a-640 of the Connecticut General Statutes to file a copy of a form with the Commissioner for approval, shall comply with the following standards: (a) Filing. (1) Fi…

Regulations of Connecticut State AgenciesSec. 38a-640-3. Policy form approval(a) Each filing shall be state specific. Only filings with state specific language will be approved. (b) Unless otherwise provided by law, the Insurance Department shall review all forms filed with the I…

Regulations of Connecticut State AgenciesSec. 38a-640-3a. Electronic filingFilings shall be considered received by the Commissioner when received at the Insurance Department. Filings received on a weekend or legal holiday shall be deemed received on the next business day. An elec…

Regulations of Connecticut State AgenciesSec. 38a-640-4. SeverabilityIf any provision of this regulation or 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 perso…

Regulations of Connecticut State AgenciesSec. 38a-651-1. DefinitionsAs used in Sections 38a-651-1 to 38a-651-4, inclusive, of the Regulations of Connecticut State Agencies: (a) ‘‘Commissioner’’ means the Insurance Commissioner of the State of Connecticut.(b) ‘‘Form’’ means a cred…

Regulations of Connecticut State AgenciesSec. 38a-651-2. Filing procedureAny insurer required pursuant to Section 38a-651 of the Connecticut General Statutes to file a copy of a form with the Commissioner for approval, shall comply with the following standards: (a) Filing. (1) Fi…

Regulations of Connecticut State AgenciesSec. 38a-651-3. Policy form approval(a) Each filing shall be state specific. Only filings with state specific language will be approved. (b) Unless otherwise provided by law, the Insurance Department shall review all forms filed with the I…

Regulations of Connecticut State AgenciesSec. 38a-651-3a. Electronic filingFilings shall be considered received by the Commissioner when received at the Insurance Department. Filings received on a weekend or legal holiday shall be deemed received on the next business day. An elec…

Regulations of Connecticut State AgenciesSec. 38a-651-4. SeverabilityIf any provision of this regulation or 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 perso…

Regulations of Connecticut State AgenciesSec. 38a-660-1. Definitions (Repealed) Repealed June 11, 2014.(Adopted effective March 21, 1997; Amended February 1, 2000; Amended December 6, 2000; Repealed June 11, 2014)Notes: For 2014 repeal, see Sec. 54 of Public Act 14-187. (June 11,…

Regulations of Connecticut State AgenciesSec. 38a-660-2. Initial application (Repealed) Repealed June 11, 2014.(Adopted effective March 21, 1997; Amended February 1, 2000; Repealed June 11, 2014)Notes: For 2014 repeal, see Sec. 54 of Public Act 14-187. (June 11, 2014) AUTHORITY: …

Regulations of Connecticut State AgenciesSec. 38a-660-3. Renewal application (Repealed) Repealed June 11, 2014.(Adopted effective March 21, 1997; Amended February 1, 2000; Repealed June 11, 2014)Notes: For 2014 repeal, see Sec. 54 of Public Act 14-187. (June 11, 2014) AUTHORITY: …

Regulations of Connecticut State AgenciesSec. 38a-660-4. Company appointment (Repealed) Repealed June 11, 2014.(Adopted effective March 21, 1997; Amended February 1, 2000; Repealed June 11, 2014)Notes: For 2014 repeal, see Sec. 54 of Public Act 14-187. (June 11, 2014) AUTHORITY: …

Regulations of Connecticut State AgenciesSec. 38a-660-5. Additional insurer appointments (Repealed) Repealed June 11, 2014.(Adopted effective March 21, 1997; Amended February 1, 2000; Repealed June 11, 2014)Notes: For 2014 repeal, see Sec. 54 of Public Act 14-187. (June 11, 2014)…

Regulations of Connecticut State AgenciesSec. 38a-660-6. Disqualification (Repealed) Repealed June 11, 2014.(Adopted effective March 21, 1997; Amended February 1, 2000; Amended December 6, 2000; Repealed June 11, 2014)Notes: For 2014 repeal, see Sec. 54 of Public Act 14-187. (Jun…

Regulations of Connecticut State AgenciesSec. 38a-660-7. Convictions (Repealed) Repealed June 11, 2014.(Adopted effective March 21, 1997; Amended February 1, 2000; Amended December 6, 2000; Repealed June 11, 2014)Notes: For 2014 repeal, see Sec. 54 of Public Act 14-187. (June 11,…

Regulations of Connecticut State AgenciesSec. 38a-676-1. DefinitionsAs used in Sections 38a-676-1 through 38a-676-3, inclusive:(a) \"Commissioner\" means the Insurance Commissioner of this state.(b) \"Form\" means any insurance policy or contract, other than fidelity, surety or g…

Regulations of Connecticut State AgenciesSec. 38a-676-2. Filing procedureAny insurer required pursuant to Section 38a-676 of the General Statutes to file a copy of a form with the Commissioner shall comply with the following standards: (a) All filings of proposed policies, forms,…

Regulations of Connecticut State AgenciesSec. 38a-676-3. Policy form acceptance(a) Within fifteen (15) calendar days of receipt of a form filed with the Commissioner pursuant to Section 38a-676 of the General Statutes, the Insurance Department shall determine a filing to be compl…

Regulations of Connecticut State AgenciesSec. 38a-683-1. PurposeSection 38a-683-2, section 38a-683-4, section 38a-683-6 and section 38a-683-7 of the Regulations of Connecticut State Agencies are intended to comply with section 38a-683(b) and 38a-683 (c) of the Connecticut General…

Regulations of Connecticut State AgenciesSec. 38a-683-2. DefinitionsTerms used in this regulation shall have the following meanings:(1) ‘‘Commissioner’’ means the Commissioner of Motor Vehicles.(2) ‘‘School’’ means an organization or agency that conducts an accident prevention co…

Regulations of Connecticut State AgenciesSec. 38a-683-3. (Repealed) Repealed May 8, 2006. AUTHORITY: Conn. Gen. Stat. § 38a-683 AUTHORITY: Conn. Gen. Stat. § 38a-683

Regulations of Connecticut State AgenciesSec. 38a-683-4. Classroom accident prevention course approvalTo be approved, an accident prevention course offered in a classroom setting for operators who have attained the age of sixty (60) years shall meet the following minimum requirem…

Regulations of Connecticut State AgenciesSec. 38a-683-4a. Internet accident prevention course approvalAn accident prevention course offered on the Internet for operators who have attained the age of sixty (60) years shall be submitted to the commissioner for approval. To be appro…

Regulations of Connecticut State AgenciesSec. 38a-683-5. (Repealed) Repealed May 8, 2006. AUTHORITY: Conn. Gen. Stat. § 38a-683 AUTHORITY: Conn. Gen. Stat. § 38a-683

Regulations of Connecticut State AgenciesSec. 38a-683-6. Certificate of accident prevention course completion(a) Each participant successfully completing an approved accident prevention course shall be issued a certificate of course completion, which shall include the following i…

Regulations of Connecticut State AgenciesSec. 38a-683-7. Withdrawal of approvalAny approval may be withdrawn or denied in the event the minimum requirements of sections 38a-683-1 to 38a-683-7, inclusive, of the Regulations of Connecticut State Agencies are not maintained. No appr…

Regulations of Connecticut State AgenciesSec. 38a-686-1. DefinitionsAs used in Sections 38a-686-1 to 38a-686-3, inclusive, of the Regulations of Connecticut State Agencies: (1) \"Adopted statewide rate level change\" means the premium weighted average of all base rate level chang…

Regulations of Connecticut State AgenciesSec. 38a-686-2. Private passenger nonfleet automobile insurance rate filings(a) Standards for the Establishment of Territorial Classifications. In order to create a classification system for rating private passenger nonfleet automobile ins…

Regulations of Connecticut State AgenciesSec. 38a-686-3. Private passenger nonfleet automobile rate filing submission requirements(a) Supporting Information. An insurer, rating organization or advisory organization shall make a private passenger nonfleet automobile rate filing wi…

Regulations of Connecticut State AgenciesSec. 38a-693-1. PurposeThe purpose of the regulations is to establish a Statistical Data Monitoring System (SDMS) to provide procedures to insure accuracy and reliability of private passenger automobile insurance statistical data. Such pro…

Regulations of Connecticut State AgenciesSec. 38a-693-2. Description(a) The SDMS will be comprised of six elements: (1) Systems Descriptions and Procedural Control Checklists.(2) Statistical Sampling Procedures (Detail Data Verification).(3) Reasonability Test Procedures (Detail …

Regulations of Connecticut State AgenciesSec. 38a-693-3. ApplicabilitySections 38a-693-1 through Section 38a-693-6 shall be applicable to:(a) all insurers writing private passenger automobile insurance in this State; and(b) all statistical agents reporting private passenger autom…

Regulations of Connecticut State AgenciesSec. 38a-693-4. StandardsExcept to the extent that it may be modified by state statutes, each insurer and statistical agent shall be guided by the Statistical Data Monitoring System promulgated by the Insurance Department of the State of N…

Regulations of Connecticut State AgenciesSec. 38a-693-5. Implementation(a) Each insurer and statistical agent shall monitor private passenger automobile statistical data in accordance with the provisions of the SDMS as required by the Insurance Department. However, the Insurance …

Regulations of Connecticut State AgenciesSec. 38a-693-6. Effective dates(a) The system to implement the Reconciliation of Statistical Data to Financial Statements is required to begin in January, 1985. The first reconciliation will cover the statistical and financial data of 1985…