Title 38a, Title 38a: Insurance

Sec. 38a-460. Accumulation fund arrangements. Definition. (a) Any domestic life insurance company may provide accumulation fund arrangements in connection with the making of any life insurance contract or annuity contract, including any contract that makes life insurance or annui…

Secs. 38a-461 to 38a-463. Reserved for future use. PART II BURIAL CONTRACTS

Sec. 38a-464. (Formerly Sec. 38-32). Burial contracts; license from Insurance Commissioner. A “burial contract” or “burial certificate”, within the meaning of this section, is any instrument in writing whereby any person, firm, corporation or association, in consideration of the …

Sec. 38a-465. Definitions. As used in sections 38a-465 to 38a-465q, inclusive, and subdivision (21) of section 38a-816: (1) “Advertisement” means any written, electronic or printed communication or any communication by means of recorded telephone messages or transmitted on radio,…

Sec. 38a-465a. Licensing of life settlement providers and brokers. (a) Except as otherwise provided in this part, no person shall act as a provider or broker until the person is licensed by the commissioner pursuant to this section. (b) Any applicant for a license as a provider o…

Sec. 38a-465b. Denial, suspension or revocation of license. Refusal to renew license. Appeals. (a) The commissioner may deny a license application, or suspend, revoke or refuse to renew the license of any licensee if the commissioner determines that: (1) There was a material misr…

Sec. 38a-465c. Contract form and disclosure statements. Filing and approval requirements. Disclosure of life settlement contract availability and lawful assignment not to be prohibited. (a) No person shall use any form of life settlement contract or disclosure statement in this s…

Sec. 38a-465d. Annual statements. Penalty. Confidentiality of insured's information. Reasons for disclosure of insured's identity. (a) On or before March first of each year, each provider shall file with the commissioner an annual statement containing such information as the comm…

Sec. 38a-465e. Examination of licensees and applicants. Commissioner's access to records. Retention of records. Expenses of examination. Confidentiality of examination workpapers and reports. (a) When the commissioner deems it reasonably necessary to protect the interests of the …

Sec. 38a-465f. Required disclosures. (a) The provider or broker shall provide, in writing, in a separate document that is signed by the owner and provider, the following disclosures to the owner not later than the date the life settlement contract is signed by all parties. The di…

Sec. 38a-465g. Prerequisites to a life settlement contract wherein insured is terminally or chronically ill. Medical release and confidentiality of medical information. Verification of coverage. Notice to insurer. Change of ownership or beneficiary. Rescission. Escrow agent or tr…

Sec. 38a-465h. Premium finance loans. Disclosures and certifications. (a) Without limiting the ability of an insurer to assess the insurability of a policy applicant and in addition to other questions an insurance company may lawfully pose to a life insurance applicant, an insura…

Sec. 38a-465i. Violations. (a) It shall be a violation of this part for any person to: (1) Enter into a life settlement contract if such person knows or reasonably should have known that the life insurance policy was obtained by means of a false, deceptive or misleading applicati…

Sec. 38a-465j. Fraudulent life settlement acts prohibited. Confidentiality of documents and evidence. Antifraud plans. (a)(1) A person shall not commit a fraudulent life settlement act. (2) “Fraudulent life settlement act” includes, but is not limited to: (A) Acts or omissions co…

Sec. 38a-465k. Injunctions. Cease and desist orders. Damages. (a) In addition to the penalties and other enforcement provisions of this part, if any person violates this part or any regulation implementing this part, the commissioner may seek an injunction in a court of competent…

Sec. 38a-465l. Penalties. (a) It shall be a violation of this part for any person, provider, broker or any other party related to the business of life settlements to commit a fraudulent life settlement act. (b) A person that commits a fraudulent life settlement act is guilty of c…

Sec. 38a-465m. Regulations. Imposition of bond or other mechanism as proof of financial accountability. Conflict of laws. (a) The commissioner may adopt regulations, in accordance with the provisions of chapter 54, to implement the provisions of sections 38a-465 to 38a-465l, incl…

Sec. 38a-465n. Life settlement advertisements. (a) Each person licensed pursuant to this part may conduct or participate in advertisements within this state. Such advertisements shall be accurate, truthful and not misleading in fact or by implication. (b) No person or trust shall…

Sec. 38a-465o. Life settlement broker deemed to represent only the owner. Fiduciary duty to owner. Notwithstanding the manner in which the life settlement broker is compensated, a life settlement broker is deemed to represent only the owner and owes a fiduciary duty to the owner …

Sec. 38a-465p. Provider or broker lawfully transacting business in the state or person lawfully negotiating life settlement contracts prior to October 1, 2008. (a) Any provider or broker lawfully transacting business in this state prior to October 1, 2008, may continue to do so p…

Sec. 38a-465q. Related provider trusts. A related provider trust shall have a written agreement with the licensed provider under which the licensed provider is responsible for ensuring compliance with all statutory and regulatory requirements and under which the trust agrees to m…

Sec. 38a-469. Definitions. As used in this title, unless the context otherwise requires or a different meaning is specifically prescribed, “health insurance” policy means insurance providing benefits due to illness or injury, resulting in loss of life, loss of earnings, or expens…

Sec. 38a-470. (Formerly Sec. 38-174n). Lien on workers' compensation awards for insurers. Notice of lien. (a) For purposes of this section, “controverted claim” means any claim in which compensation is denied either in whole or in part by the workers' compensation carrier or the …

Sec. 38a-471. (Formerly Sec. 38-174o). Third party prescription programs. Notice of cancellation. Applicability of section. (a) As used in this section, a “third party prescription program” means a system of providing for reimbursement for the cost of drugs or pharmaceutical serv…

Sec. 38a-472. (Formerly Sec. 38-174a). Assignment of insurance proceeds to doctor, hospital or state agency. Lien for state care. Notice of lien. (a) Whenever a contract by a third party agency provides for payment to a beneficiary under the contract on account of bills incurred …

Sec. 38a-472a. Medical provider indemnification agreements prohibited. No contract between a managed care company, other organization or insurer authorized to do business in this state and a medical provider practicing in this state for the provision of services may require that …

Sec. 38a-472b. Medical provider indemnification contracts. Professional actions and related liability. Notwithstanding the provisions of section 38a-472a, every medical provider participating in a contract pursuant to said section shall be responsible for his professional actions…

Sec. 38a-472c. Dental policies. Estimate of reimbursement. Material adjustments to fee schedules for in-network providers. Notice. (a) For any policy delivered, issued for delivery, renewed, amended or continued in this state that provides coverage for inpatient or outpatient den…

Sec. 38a-472d. Public education outreach program re health insurance availability and eligibility requirements. (a) Not later than January 1, 2006, the Insurance Commissioner, in consultation with the Commissioner of Social Services and the Healthcare Advocate, shall develop a co…

Sec. 38a-472e. Health insurer. Requirements re offer to contract with a school-based health center. Each health insurer licensed to do business in this state shall, at the request of any school-based health center or group of school-based health centers, offer to contract with su…

Sec. 38a-472f. Network adequacy. Health carrier duties and responsibilities. Access plan filing. (a) As used in this section: (1) “Authorized representative” means (A) an individual to whom a covered person has given express written consent to represent the covered person, (B) an…

Sec. 38a-472g. Restrictions applicable to prior authorization or precertification. (a)(1) No insurer, health care center, fraternal benefit society, hospital service corporation or medical service corporation or other entity, delivering, issuing for delivery, renewing, amending o…

Sec. 38a-472h. Fees charged by dentists, optometrists and ophthalmologists for noncovered benefits. Notice and posting required. (a) No insurer, health care center, fraternal benefit society, hospital service corporation, medical service corporation or other entity delivering, is…

Sec. 38a-472i. Payment amount of professional services component of covered colonoscopy or endoscopic services. Each insurer, health care center, hospital service corporation, medical service corporation or fraternal benefit society that delivers, issues for delivery, renews, ame…

Sec. 38a-472j. Restrictions applicable to cost-sharing for covered benefits. Regulations. (a) Notwithstanding any provision of the general statutes and to the maximum extent permitted by federal law, no individual or group health insurance policy delivered, issued for delivery, r…

Sec. 38a-472k. Disability income policies. Discretionary clauses prohibited. Regulations. No insurer, health care center, fraternal benefit society, hospital service corporation, medical service corporation or other entity delivering, issuing for delivery, renewing, amending or c…

Sec. 38a-472l. Participating dental provider contracts. Third-party access. Restrictions. Exceptions. (a) For the purposes of this section: (1) “Covered person” means a policyholder, subscriber, enrollee or other individual participating in a network dental benefit plan; (2) “Den…

Sec. 38a-473. Medicare supplement expense factors. Age, gender, previous claim or medical history rating prohibited. (a) No insurance company, fraternal benefit society, hospital service corporation, medical service corporation, health care center or other entity that delivers or…

Sec. 38a-474. Medicare supplement policy rate increases: Procedure. Age, gender, previous claim or medical history rating prohibited. (a) Any insurance company, fraternal benefit society, hospital service corporation, medical service corporation, health care center or other entit…

Sec. 38a-475. Precertification of long-term care policies under the Connecticut Partnership for Long-Term Care. Regulations. The Insurance Department shall only precertify long-term care insurance policies that (1) alert the purchaser to the availability of consumer information a…

Sec. 38a-475a. Minimum set of affordable benefit options for long-term care policies. Regulations. (a) For the purposes of this section, “long-term care policy” has the same meaning as provided in section 38a-501 or section 38a-528, as applicable. (b) The commissioner shall, afte…

Sec. 38a-476. Preexisting condition coverage. (a) For the purposes of this section: (1) “Health insurance plan” means any hospital and medical expense incurred policy, hospital or medical service plan contract and health care center subscriber contract. “Health insurance plan” do…

Sec. 38a-476a. Compliance with the Health Insurance Portability and Accountability Act. Guaranteed renewability. Discrimination based on health status, newborns' and mothers' health prohibited. Parity of mental health benefits. Disclosure of information for employers. Constructio…

Sec. 38a-476b. Standards re psychotropic drug availability in health plans. Notwithstanding any provision of the general statutes or the regulations of Connecticut state agencies, no mental health care benefit provided under state law, or with state funds or to state employees ma…

Sec. 38a-476c. Policies and contracts with variable network and enrollee cost-sharing. Approval. Limitations. (a) The Insurance Commissioner shall approve any health insurance policy or contract, including, but not limited to, a policy or contract filed by a health care center, t…

Sec. 38a-477. Standardized claim forms. Information necessary for filing a claim. Regulations. (a) Except where there is an agreement to the contrary between a third-party payer and the health care provider, as defined in section 19a-17b, all health care providers shall submit al…