Title 38a, Title 38a: Insurance

Sec. 38a-1007. Requirements for an employer to join group after its approval. Termination of membership. Insolvency or bankruptcy of member. (a) An employer joining a workers' compensation self-insurance group after the group has been issued a certificate of approval shall: (1) S…

Sec. 38a-1008. Service company and administrator to be mutually disinterested. (a) No service company or its employees, officers or directors shall be an employee, officer or director of, or have either a direct or indirect financial interest in, an administrator. No administrato…

Sec. 38a-1009. Nonemployee soliciting group membership must be licensed. Except for a salaried employee of a group, its administrator or its service company, any person soliciting membership for a workers' compensation self-insurance group shall be licensed pursuant to chapter 70…

Sec. 38a-1010. Annual statement of financial condition required. Untrue statement prohibited. (a) Each group shall submit to the commissioner a statement of financial condition audited by an independent certified public accountant on or before the last day of the sixth month foll…

Sec. 38a-1011. Taxes. Each workers' compensation self-insurance group, as defined in section 38a-1001, shall pay a tax to the Commissioner of Revenue Services for the calendar year commencing on January 1, 1997, and annually thereafter, at the rate of one and three-quarters per c…

Sec. 38a-1012. Misrepresentation and omission in membership solicitation prohibited. No person shall make a material misrepresentation or omission of a material fact in connection with the solicitation of membership of a group. (P.A. 96-267, S. 13.)

Sec. 38a-1013. Investments. Funds not needed for current obligations may be invested by the board of trustees in accordance with sections 38a-102 to 38a-102h, inclusive. (P.A. 96-267, S. 14.)

Sec. 38a-1014. Classifications and rating. Premium contributions. Audits. Hearings. (a) Every workers' compensation self-insurance group shall adhere to the uniform classification system, uniform experience rating plan and manual rules filed with the commissioner. (b) Premium con…

Sec. 38a-1015. Excess moneys refundable. Refund plan. Notice. (a) Any moneys for a fund year in excess of the amount necessary to fund all obligations for that fund year may be declared to be refundable by the board of trustees not less than twelve months after the end of the fun…

Sec. 38a-1016. Premium payment plan required. Loss reserves. Bad debt reserves. (a) Each group shall establish to the satisfaction of the commissioner a premium payment plan which shall include: (1) An initial payment by each member of at least twenty-five per cent of that member…

Sec. 38a-1017. Deficiencies. Insolvency. Liquidation and assessment. (a) If the assets of a group are at any time insufficient to enable the group to discharge its legal liabilities and other obligations and to maintain the reserves required of it under the provisions of subsecti…

Sec. 38a-1018. Penalties. After notice and opportunity for a hearing, the commissioner may impose a monetary penalty on any person or group found to be in violation of any provision of subsection (e) of section 31-288 or section 31-289b, 31-316, 31-345 or 38a-1000 to 38a-1023, in…

Sec. 38a-1019. Cease and desist orders. Violations. Penalties. License and certificate revocation. (a) After notice and opportunity for a hearing, the commissioner may issue an order requiring a person or group to cease and desist from engaging in an act or practice found to be i…

Sec. 38a-1020. Revocation of certificate of approval. (a) After notice and opportunity for a hearing, the commissioner may revoke a group's certificate of approval if it: (1) Is found to be insolvent; (2) fails to pay any premium tax, regulatory fee or assessment or special fund …

Sec. 38a-1021. Additional provisions. The provisions of sections 38a-16, 38a-132, 38a-140 and 38a-815 to 38a-819, inclusive, shall be additional to any other powers to enforce any penalties, fines or forfeitures authorized by law. (P.A. 96-267, S. 22.)

Sec. 38a-1022. Regulations. The commissioner shall adopt such reasonable regulations as he deems necessary to carry out the provisions of subsection (e) of section 31-288 and sections 31-289b, 31-316, 31-345 and 38a-1000 to 38a-1023, inclusive. (P.A. 96-267, S. 23.)

Sec. 38a-1023. Severability. If any provision of subsection (e) of section 31-288 or section 31-289b, 31-316, 31-345 or 38a-1000 to 38a-1023, inclusive, or the application thereof to any person or circumstance is subsequently held to be invalid, such invalidity shall not affect o…

Sec. 38a-1030. Definitions. As used in sections 38a-1030 to 38a-1034, inclusive: (1) “Charitable gift annuity” means a transfer of cash or other property by a donor to a charitable organization in return for an annuity payable over one or two lives, under which the actuarial valu…

Sec. 38a-1031. Issuance of charitable gift annuity does not constitute engaging in the business of insurance. (a) The issuance of a qualified charitable gift annuity shall not constitute engaging in the business of insurance in this state. (b) A charitable gift annuity issued bef…

Sec. 38a-1032. Written disclosures. (a) When entering into an agreement for a qualified charitable gift annuity, the charitable organization shall disclose to the donor in writing in the annuity agreement that a qualified charitable gift annuity is not insurance under the laws of…

Sec. 38a-1033. Notice to commissioner. (a) A charitable organization that issues qualified charitable gift annuities shall notify the Insurance Commissioner, in writing, by the latter of January 1, 2000, or the date on which it enters into the organization's first qualified chari…

Sec. 38a-1034. Failure to comply with notice requirements. Validity of charitable gift annuity after failure to give notice. Penalties. The failure of a charitable organization to comply with the notice requirements imposed under section 38a-1032 or 38a-1033 shall not prevent a c…

Sec. 38a-1040. Definitions. As used in sections 38a-1040 to 38a-1050, inclusive: (1) “Consumer” means an individual who receives or is attempting to receive services from a managed care organization and is a resident of this state. (2) “Managed care organization” means an insurer…

Sec. 38a-1041. Office of the Healthcare Advocate established. Duties. (a) There is established an Office of the Healthcare Advocate which shall be within the Insurance Department for administrative purposes only. (b) The Office of the Healthcare Advocate may: (1) Assist health in…

Sec. 38a-1042. Appointment. (a) The Office of the Healthcare Advocate shall be under the direction of the Healthcare Advocate who shall be appointed by the Governor, with the approval of the General Assembly. The Healthcare Advocate shall be an elector of the state with expertise…

Sec. 38a-1043. Access to information. (a) Each managed care organization shall, when presented with the written consent of the consumer or the consumer's guardian or legal representative, provide to the Office of the Healthcare Advocate access to records relating to such consumer…

Sec. 38a-1044. State agency information and assistance. All state agencies shall comply with reasonable requests of the Office of the Healthcare Advocate for information and assistance. (P.A. 99-284, S. 5; P.A. 05-102, S. 11.) History: P.A. 05-102 renamed the Office of Managed Ca…

Sec. 38a-1045. Confidentiality of consumer identity. In the absence of the written consent of a consumer utilizing the services of the Office of the Healthcare Advocate or such consumer's guardian or legal representative or of a court order, the Office of the Healthcare Advocate,…

Sec. 38a-1046. Employers required to post advocate services. Each employer that provides health insurance or health care benefits to employees shall obtain from the Healthcare Advocate and post, in a conspicuous location, a notice concerning the services that the Healthcare Advoc…

Sec. 38a-1047. Conflicts of interest. (a) No Healthcare Advocate or person employed by the Office of the Healthcare Advocate may: (1) Have a direct involvement in the licensing, certification or accreditation of a managed care organization; (2) Have a direct ownership or investme…

Sec. 38a-1048. Acceptance of gifts and grants. Separate account established. (a) The Office of the Healthcare Advocate may apply for and accept grants, gifts and bequests of funds from other states, federal and interstate agencies and independent authorities and private firms, in…

Sec. 38a-1049. Advisory committee established. Annual evaluation. (a) There is established an advisory committee to the Office of the Healthcare Advocate which shall meet four times a year with the Healthcare Advocate and the staff of the Office of the Healthcare Advocate to revi…

Sec. 38a-1050. Report required by advocate. Contents. The Healthcare Advocate shall submit, not later than March first of each year, a report to the Governor and the joint standing committees of the General Assembly having cognizance of matters relating to public health and insur…

Sec. 38a-1051. Commission on Health Equity. Membership. Duties. Report to Governor and General Assembly. Section 38a-1051 is repealed, effective July 1, 2016. (P.A. 08-171, S. 1; P.A. 09-232, S. 9; Sept. Sp. Sess. P.A. 09-3, S. 38; P.A. 15-118, S. 59; May Sp. Sess. P.A. 16-3, S. …

Sec. 38a-1052. Office of the Cannabis Ombudsman established. Duties. (a) For the purposes of this section: (1) “Caregiver” has the same meaning as provided in section 21a-408; (2) “Marijuana” has the same meaning as provided in section 21a-240; (3) “Palliative use” has the same m…

Sec. 38a-1060. Office of the Behavioral Health Advocate established. Duties. (a) There is established an Office of the Behavioral Health Advocate which shall be within the Insurance Department for administrative purposes only. (b) The Office of the Behavioral Health Advocate may:…

Sec. 38a-1061. Behavioral Health Advocate appointment. (a) The Office of the Behavioral Health Advocate shall be under the direction of the Behavioral Health Advocate who shall be appointed by the Governor, with the approval of the General Assembly. The Behavioral Health Advocate…

Sec. 38a-1062. Advisory committee to the Office of the Behavioral Health Advocate established. Annual evaluation. (a) There is established an advisory committee to the Office of the Behavioral Health Advocate which shall meet four times a year with the Behavioral Health Advocate …

Sec. 38a-1080. Definitions. For purposes of sections 38a-1080 to 38a-1093, inclusive: (1) “Board” means the board of directors of the Connecticut Health Insurance Exchange; (2) “Commissioner” means the Insurance Commissioner; (3) “Exchange” means the Connecticut Health Insurance …

Sec. 38a-1081. Connecticut Health Insurance Exchange. Board of directors. Chief executive officer. Employees. (a) There is hereby created as a body politic and corporate, constituting a public instrumentality and political subdivision of the state created for the performance of a…

Sec. 38a-1082. Written procedures. Audits. (a) The board of directors of the exchange shall adopt written procedures, in accordance with the provisions of section 1-121, for: (1) Adopting an annual budget and plan of operations, including a requirement of board approval before th…

Sec. 38a-1083. Powers of exchange. Commissioner's authority to enforce payment of assessments or user fees. (a) For purposes of sections 38a-1080 to 38a-1093, inclusive, “purposes of the exchange” means the purposes of and the pursuit of the goals of the exchange expressed in and…

Sec. 38a-1084. Duties of exchange. The exchange shall: (1) Administer the exchange for both qualified individuals and qualified employers; (2) Commission surveys of individuals, small employers and health care providers on issues related to health care and health care coverage; (…

Sec. 38a-1084a. Consumer health information Internet web site. Reports to be provided to exchange. Hospital disclosures to patients. Commissioner of Social Services to submit Medicaid data to exchange. Section 38a-1084a is repealed, effective October 31, 2017. (P.A. 15-146, S. 2;…

Sec. 38a-1085. Qualified health plans. (a) The exchange shall make qualified health plans available to qualified individuals and qualified employers for coverage beginning on or before January 1, 2014. (b) (1) The exchange shall not make available any health benefit plan that is …

Sec. 38a-1086. Certification of health benefit plans. (a) The exchange may certify a health benefit plan as a qualified health plan if: (1) The plan includes, at a minimum, essential benefits as determined under the Affordable Care Act and the coverage requirements under chapter …