Title 38a — Title 38a: Insurance
33 chapters · 1,393 sections in this title.
Conn. Gen. Stat. § 38a-479rrr Annual certification by health carriers.
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Sec. 38a-479rrr. Annual certification by health carriers. Beginning on March 1, 2022, and annually thereafter, each health carrier shall submit to the commissioner, in a form and manner prescribed by the commissioner, a written certification for the immediately preceding calendar…
Conn. Gen. Stat. §§ 38a-479ss to 38a-479zz 38a-479ss to 38a-479zz
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Secs. 38a-479ss to 38a-479zz. Reserved for future use. PART Id HEALTH INSURANCE: PHARMACY BENEFITS MANAGERS
Conn. Gen. Stat. § 38a-479sss Annual report by commissioner to the General Assembly re outpatient prescription drug costs.
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Sec. 38a-479sss. Annual report by commissioner to the General Assembly re outpatient prescription drug costs. Not later than March 1, 2022, and annually thereafter, the commissioner shall submit a report, in accordance with section 11-4a, to the joint standing committee of the Ge…
Conn. Gen. Stat. § 38a-479ttt Annual report by commissioner to the General Assembly re prescription drug rebates.
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Sec. 38a-479ttt. Annual report by commissioner to the General Assembly re prescription drug rebates. Not later than March 1, 2021, and annually thereafter, the commissioner shall prepare a report, for the immediately preceding calendar year, describing the rebate practices of hea…
Conn. Gen. Stat. § 38a-480 (Formerly Sec. 38-174). Applicability of statutes to certain policies and contracts.
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Sec. 38a-480. (Formerly Sec. 38-174). Applicability of statutes to certain policies and contracts. (a) Nothing in sections 38a-481 to 38a-488, inclusive, shall apply to or affect (1) any policy of liability or workers' compensation insurance; (2) any group health insurance policy…
Conn. Gen. Stat. § 38a-481 (Formerly Sec. 38-165). Filing of policy form, application, classification of risks and rates. Approval of rates. Prescription drug rebates. Medicare supplement policies: Age, gender, previous claim or medical history rating prohibited. Reduction of payments on basis of Medicare eligibility. Optional life insurance rider. Treatment of health insurance issued to association or certain other insurance arrangements. Special enrollment periods. Grandfathered and nongrandfathered plans.
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Sec. 38a-481. (Formerly Sec. 38-165). Filing of policy form, application, classification of risks and rates. Approval of rates. Prescription drug rebates. Medicare supplement policies: Age, gender, previous claim or medical history rating prohibited. Reduction of payments on basi…
Conn. Gen. Stat. § 38a-482 (Formerly Sec. 38-166). Form of policy.
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Sec. 38a-482. (Formerly Sec. 38-166). Form of policy. No individual health insurance policy shall be delivered or issued for delivery to any person in this state unless: (1) The entire money and other considerations therefor are expressed therein; (2) the time at which the insura…
Conn. Gen. Stat. § 38a-482a Individual health insurance policy to contain definition of “medically necessary” or “medical necessity”.
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Sec. 38a-482a. Individual health insurance policy to contain definition of “medically necessary” or “medical necessity”. (a) No insurer, health care center, hospital service corporation, medical service corporation or other entity delivering, issuing for delivery, renewing, conti…
Conn. Gen. Stat. § 38a-482b Individual health insurance policy providing limited coverage to include disclosure. Limited coverage defined.
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Sec. 38a-482b. Individual health insurance policy providing limited coverage to include disclosure. Limited coverage defined. (a) Each individual health insurance policy, subscriber contract or certificate of coverage delivered or issued for delivery in this state on or after Jan…
Conn. Gen. Stat. § 38a-482c Annual and lifetime limits.
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Sec. 38a-482c. Annual and lifetime limits. (a) No individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, amended, renewed or continued in this state shall include …
Conn. Gen. Stat. § 38a-483 (Formerly Sec. 38-167). Standard provisions of individual health policy.
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Sec. 38a-483. (Formerly Sec. 38-167). Standard provisions of individual health policy. (a) Except as provided in subsection (c) of this section, each individual health insurance policy delivered or issued for delivery to any person in this state shall contain the provisions speci…
Conn. Gen. Stat. § 38a-483a Exclusionary riders for individual health insurance policies. Regulations.
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Sec. 38a-483a. Exclusionary riders for individual health insurance policies. Regulations. Notwithstanding the provisions of section 38a-476, the Insurance Commissioner may adopt regulations, in accordance with the provisions of chapter 54, to allow exclusionary riders to be issue…
Conn. Gen. Stat. § 38a-483b Time limits for coverage determinations. Notice requirements.
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Sec. 38a-483b. Time limits for coverage determinations. Notice requirements. Section 38a-483b is repealed, effective October 1, 2015. (P.A. 99-284, S. 12; P.A. 10-24, S. 1; P.A. 11-19, S. 23; P.A. 15-118, S. 71.)
Conn. Gen. Stat. § 38a-483c Coverage and notice re experimental treatments. Appeals.
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Sec. 38a-483c. Coverage and notice re experimental treatments. Appeals. (a) Each individual health insurance policy delivered, issued for delivery, renewed, amended or continued in this state shall define the extent to which it provides coverage for experimental treatments. (b) N…
Conn. Gen. Stat. § 38a-484 (Formerly Sec. 38-168). Policy provisions not to be less favorable than standard. Validity of policy issued in violation of law.
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Sec. 38a-484. (Formerly Sec. 38-168). Policy provisions not to be less favorable than standard. Validity of policy issued in violation of law. (a) No policy provision which is not subject to section 38a-483 shall make a policy, or any portion thereof, less favorable in any respec…
Conn. Gen. Stat. § 38a-485 (Formerly Sec. 38-169). Copy of application to be part of new policy or to be furnished with renewal. Alteration of application.
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Sec. 38a-485. (Formerly Sec. 38-169). Copy of application to be part of new policy or to be furnished with renewal. Alteration of application. (a) The insured shall not be bound by any statement made in an application for an individual health insurance policy unless a copy of suc…
Conn. Gen. Stat. § 38a-486 (Formerly Sec. 38-170). Certain acts not to operate as waiver of rights.
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Sec. 38a-486. (Formerly Sec. 38-170). Certain acts not to operate as waiver of rights. The acknowledgment by any insurer of the receipt of notice given under any individual health insurance policy, or the furnishing of forms for filing proofs of loss, or the acceptance of such pr…
Conn. Gen. Stat. § 38a-487 (Formerly Sec. 38-171). Coverage after termination date of policy.
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Sec. 38a-487. (Formerly Sec. 38-171). Coverage after termination date of policy. If any individual health insurance policy contains a provision establishing, as an age limit or otherwise, a date after which the coverage provided by the policy will not be effective, and if such da…
Conn. Gen. Stat. § 38a-488 (Formerly Sec. 38-172). Discrimination.
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Sec. 38a-488. (Formerly Sec. 38-172). Discrimination. Discrimination between individuals of the same class in the amount of premiums or rates charged for any individual health insurance policy, or in the benefits payable thereon, or in any of the terms or conditions of such polic…
Conn. Gen. Stat. § 38a-488a Mandatory coverage for the diagnosis and treatment of mental or nervous conditions. Exceptions. Benefits payable re type of provider or facility. State's claim against proceeds. Direct reimbursement for certain covered services rendered by certain out-of-network providers.
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Sec. 38a-488a. Mandatory coverage for the diagnosis and treatment of mental or nervous conditions. Exceptions. Benefits payable re type of provider or facility. State's claim against proceeds. Direct reimbursement for certain covered services rendered by certain out-of-network pr…
Conn. Gen. Stat. § 38a-488b Coverage for autism spectrum disorder therapies.
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Sec. 38a-488b. Coverage for autism spectrum disorder therapies. (a) As used in this section: (1) “Applied behavior analysis” means the design, implementation and evaluation of environmental modifications, using behavioral stimuli and consequences, including the use of direct obse…
Conn. Gen. Stat. § 38a-488c Mental health and substance use disorder benefits. Nonquantitative treatment limitations.
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Sec. 38a-488c. Mental health and substance use disorder benefits. Nonquantitative treatment limitations. No individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, …
Conn. Gen. Stat. § 38a-488d Coverage for substance abuse services provided pursuant to court order.
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Sec. 38a-488d. Coverage for substance abuse services provided pursuant to court order. No individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 that is delivered, issued for delivery, renewed, a…
Conn. Gen. Stat. § 38a-488e Coverage for mental health wellness examinations.
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Sec. 38a-488e. Coverage for mental health wellness examinations. (a) For the purposes of this section: (1) “Licensed mental health professional” means: (A) A licensed professional counselor or professional counselor, both as defined in section 20-195aa; (B) a person who is under …
Conn. Gen. Stat. § 38a-488f Coverage for services provided under the Collaborative Care Model.
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Sec. 38a-488f. Coverage for services provided under the Collaborative Care Model. (a) For the purposes of this section: (1) “Collaborative Care Model” means the integrated delivery of behavioral health and primary care services by a primary care team that includes a primary care …
Conn. Gen. Stat. § 38a-488g Acute inpatient psychiatric coverage. Prior authorization not required.
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Sec. 38a-488g. Acute inpatient psychiatric coverage. Prior authorization not required. (a) No individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amend…
Conn. Gen. Stat. § 38a-489 (Formerly Sec. 38-174e). Continuation of coverage of mentally or physically handicapped children.
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Sec. 38a-489. (Formerly Sec. 38-174e). Continuation of coverage of mentally or physically handicapped children. (a) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (10), (11) and (12) of section 38a-469, delivered, i…
Conn. Gen. Stat. § 38a-490 (Formerly Sec. 38-174g). Coverage for newly born children. Notification to insurer.
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Sec. 38a-490. (Formerly Sec. 38-174g). Coverage for newly born children. Notification to insurer. (a) Each individual health insurance policy delivered, issued for delivery, renewed, amended or continued in this state providing coverage of the type specified in subdivisions (1), …
Conn. Gen. Stat. § 38a-490a Coverage for birth-to-three program.
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Sec. 38a-490a. Coverage for birth-to-three program. (a) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state sha…
Conn. Gen. Stat. § 38a-490b Coverage for hearing aids.
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Sec. 38a-490b. Coverage for hearing aids. Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state shall provide cov…
Conn. Gen. Stat. § 38a-490c Coverage for craniofacial disorders.
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Sec. 38a-490c. Coverage for craniofacial disorders. Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, amended, renewed or continued in this state on or a…
Conn. Gen. Stat. § 38a-490d Mandatory coverage for blood lead screening and risk assessment.
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Sec. 38a-490d. Mandatory coverage for blood lead screening and risk assessment. Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, amended, renewed or con…
Conn. Gen. Stat. § 38a-491 (Formerly Sec. 38-174h). Coverage for services performed by dentists in certain instances.
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Sec. 38a-491. (Formerly Sec. 38-174h). Coverage for services performed by dentists in certain instances. Whenever the term “physician” or “doctor” is used in any individual health insurance policy delivered, issued for delivery or renewed in this state on or after October 1, 1975…
Conn. Gen. Stat. § 38a-491a Coverage for in-patient, outpatient or one-day dental services in certain instances.
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Sec. 38a-491a. Coverage for in-patient, outpatient or one-day dental services in certain instances. (a) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery,…
Conn. Gen. Stat. § 38a-491b Assignment of benefits to a dentist or oral surgeon.
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Sec. 38a-491b. Assignment of benefits to a dentist or oral surgeon. No insurer, health care center, hospital service corporation, medical service corporation or other entity delivering, issuing for delivery, renewing, continuing or amending any individual health insurance policy …
Conn. Gen. Stat. § 38a-492 (Formerly Sec. 38-174i). Coverage for accidental ingestion or consumption of controlled drugs. Benefits prescribed.
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Sec. 38a-492. (Formerly Sec. 38-174i). Coverage for accidental ingestion or consumption of controlled drugs. Benefits prescribed. No individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (6), (10) and (11) of section 38a-469 sh…
Conn. Gen. Stat. § 38a-492a Mandatory coverage for hypodermic needles and syringes.
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Sec. 38a-492a. Mandatory coverage for hypodermic needles and syringes. Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (6), (10), (11) and (12) of section 38a-469, delivered, issued for delivery, renewed, amended or …
Conn. Gen. Stat. § 38a-492b Coverage for certain off-label drug prescriptions.
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Sec. 38a-492b. Coverage for certain off-label drug prescriptions. (a)(1) Each individual health insurance policy delivered, issued for delivery, renewed, amended or continued in this state, that provides coverage for prescription drugs approved by the federal Food and Drug Admini…
Conn. Gen. Stat. § 38a-492c Coverage for low protein modified food products, amino acid modified preparations and specialized formulas.
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Sec. 38a-492c. Coverage for low protein modified food products, amino acid modified preparations and specialized formulas. (a) For purposes of this section: (1) “Inherited metabolic disease” includes (A) a disease for which newborn screening is required under section 19a-55; and …
Conn. Gen. Stat. § 38a-492d Mandatory coverage for diabetes screening, testing and treatment.
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Sec. 38a-492d. Mandatory coverage for diabetes screening, testing and treatment. (a) For the purposes of this section: (1) “Diabetes device” has the same meaning as provided in section 20-616; (2) “Diabetic ketoacidosis device” has the same meaning as provided in section 20-616; …
Conn. Gen. Stat. § 38a-492e Mandatory coverage for diabetes outpatient self-management training.
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Sec. 38a-492e. Mandatory coverage for diabetes outpatient self-management training. (a) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed or cont…
Conn. Gen. Stat. § 38a-492f Mandatory coverage for certain prescription drugs removed from formulary.
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Sec. 38a-492f. Mandatory coverage for certain prescription drugs removed from formulary. Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amend…
Conn. Gen. Stat. § 38a-492g Mandatory coverage for prostate cancer screening and treatment.
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Sec. 38a-492g. Mandatory coverage for prostate cancer screening and treatment. Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or cont…
Conn. Gen. Stat. § 38a-492h Mandatory coverage for certain Lyme disease treatments.
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Sec. 38a-492h. Mandatory coverage for certain Lyme disease treatments. Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed or continued in this sta…
Conn. Gen. Stat. § 38a-492i Mandatory coverage for pain management.
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Sec. 38a-492i. Mandatory coverage for pain management. (a) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (10), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this …
Conn. Gen. Stat. § 38a-492j Mandatory coverage for ostomy-related supplies.
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Sec. 38a-492j. Mandatory coverage for ostomy-related supplies. Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this st…
Conn. Gen. Stat. § 38a-492k Mandatory coverage for colorectal cancer screening.
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Sec. 38a-492k. Mandatory coverage for colorectal cancer screening. (a) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, amended, renewed or continued in…
Conn. Gen. Stat. § 38a-492l Mandatory coverage for neuropsychological testing for children diagnosed with cancer.
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Sec. 38a-492l. Mandatory coverage for neuropsychological testing for children diagnosed with cancer. Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, am…
Conn. Gen. Stat. § 38a-492m Mandatory coverage for certain renewals of prescription eye drops.
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Sec. 38a-492m. Mandatory coverage for certain renewals of prescription eye drops. Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, amended, renewed or c…
Conn. Gen. Stat. § 38a-492n Mandatory coverage for certain wound-care supplies.
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Sec. 38a-492n. Mandatory coverage for certain wound-care supplies. Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 that is delivered, issued for delivery, renewed, amended or continue…