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Connecticut Statutes, Title 38a

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Connecticut/Statutes

← All Connecticut coverage

Title 38a, Title 38a: Insurance

33 chapters · 1,357 sections in this title.

All chapters in Title 38a1,357 Ch 700c, Chapter 700c: Health Insurance364 Ch 698, Chapter 698: Insurers206 Ch 700, Chapter 700: Property and Casualty I…100 Ch 704c, Chapter 704c: Insurers Rehabilitatio…75 Ch 700b, Chapter 700b: Life Insurance, Annuit…55 Ch 701a, Chapter 701a: Insurance Producers, A…55 Ch 704a, Chapter 704a: Insurance Guaranty Funds48 Ch 698a, Chapter 698a: Health Care and Relate…47 Ch 700d, Chapter 700d: Fraternal Benefit Soci…44 Ch 701, Chapter 701: Personal and Commercial…39 Ch 697, Chapter 697: General Provisions32 Ch 702, Chapter 702: Licensing30 Ch 705, Chapter 705: Connecticut Insurance I…28 Ch 700a, Chapter 700a: Title Insurance27

1,357 sections·Filtered byTitle 38a✕

Conn. Gen. Stat. § 38a-479b Material changes to fee schedules. Return of payment by provider. Appeals. Filing of claim by provider under other applicable insurance coverage. Certain clauses, covenants and agreements prohibited. Exception.
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Sec. 38a-479b. Material changes to fee schedules. Return of payment by provider. Appeals. Filing of claim by provider under other applicable insurance coverage. Certain clauses, covenants and agreements prohibited. Exception. (a) No contracting health organization shall make mate…
Conn. Gen. Stat. § 38a-479bb Requirements for managed care organizations that contract with preferred provider networks. Requirements for preferred provider networks.
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Sec. 38a-479bb. Requirements for managed care organizations that contract with preferred provider networks. Requirements for preferred provider networks. (a) On and after May 1, 2004, no managed care organization may enter into or renew a contractual relationship with a preferred…
Conn. Gen. Stat. § 38a-479bbb Registration of pharmacy benefits managers required. Application for registration. Fee. Surety bond. Exemption from registration.
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Sec. 38a-479bbb. Registration of pharmacy benefits managers required. Application for registration. Fee. Surety bond. Exemption from registration. (a) Except as provided in subsection (d) of this section, no person shall act as a pharmacy benefits manager in this state without fi…

Showing 601–650 of 1,357

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Conn. Gen. Stat. §§ 38a-479c to 38a-479z 38a-479c to 38a-479z

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Secs. 38a-479c to 38a-479z. Reserved for future use. PART Ib HEALTH INSURANCE: PREFERRED PROVIDER NETWORKS

Conn. Gen. Stat. § 38a-479cc Duties of a preferred provider network when providing services pursuant to a contract with a managed care organization.

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Sec. 38a-479cc. Duties of a preferred provider network when providing services pursuant to a contract with a managed care organization. (a) Whenever a preferred provider network is providing services pursuant to a contract with a managed care organization, the preferred provider …

Conn. Gen. Stat. § 38a-479ccc Certificate of registration; when issued or refused. Suspension, revocation or refusal to issue or renew registration; grounds.

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Sec. 38a-479ccc. Certificate of registration; when issued or refused. Suspension, revocation or refusal to issue or renew registration; grounds. (a) Upon receipt of a completed application, evidence of a surety bond and fee, the commissioner shall: (1) Issue and deliver to the ap…

Conn. Gen. Stat. § 38a-479dd Preferred provider network examination of outstanding amounts. Notice. Commissioner's duties.

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Sec. 38a-479dd. Preferred provider network examination of outstanding amounts. Notice. Commissioner's duties. Each preferred provider network shall examine its outstanding amounts in each quarter and if the preferred provider network determines that the outstanding amounts in a q…

Conn. Gen. Stat. § 38a-479ddd Hearing on denial of certificate. Subsequent application.

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Sec. 38a-479ddd. Hearing on denial of certificate. Subsequent application. (a) Upon refusal to issue or renew a certificate, the commissioner shall notify the applicant of the denial and of the applicant's right to request a hearing within ten days from the date of receipt of the…

Conn. Gen. Stat. § 38a-479ee Violations. Penalties. Investigations and staffing. Grievances. Referrals from Healthcare Advocate.

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Sec. 38a-479ee. Violations. Penalties. Investigations and staffing. Grievances. Referrals from Healthcare Advocate. (a) If the Insurance Commissioner determines that a preferred provider network or managed care organization, or both, has not complied with any applicable provision…

Conn. Gen. Stat. § 38a-479eee Claims payment to be made by electronic funds transfer upon written request.

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Sec. 38a-479eee. Claims payment to be made by electronic funds transfer upon written request. Upon written request from a pharmacy, a pharmacy benefits manager shall pay claims to such pharmacy by electronic funds transfer. Any such payments shall be made within the time periods …

Conn. Gen. Stat. § 38a-479ff Adverse action or threat of adverse action against complainant prohibited. Exception. Civil actions by aggrieved persons.

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Sec. 38a-479ff. Adverse action or threat of adverse action against complainant prohibited. Exception. Civil actions by aggrieved persons. No health insurer, health care center, utilization review company, as defined in section 38a-591a, or preferred provider network, as defined i…

Conn. Gen. Stat. § 38a-479fff Expiration of certificates of registration. Renewal. Fees.

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Sec. 38a-479fff. Expiration of certificates of registration. Renewal. Fees. (a) All certificates of registration issued under section 38a-479ccc shall expire annually on December thirty-first. (b) Any person seeking to renew a certificate of registration shall apply to the commis…

Conn. Gen. Stat. § 38a-479gg Regulations.

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Sec. 38a-479gg. Regulations. The Insurance Commissioner may adopt regulations, in accordance with chapter 54, to implement the provisions of this part. (P.A. 03-169, S. 7.)

Conn. Gen. Stat. § 38a-479ggg Regulations.

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Sec. 38a-479ggg. Regulations. The commissioner shall adopt regulations, in accordance with chapter 54, to implement the provisions of sections 38a-479aaa to 38a-479hhh, inclusive. Such regulations shall specify the contents of the application form and any other form or report req…

Conn. Gen. Stat. §§ 38a-479hh to 38a-479pp 38a-479hh to 38a-479pp

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Secs. 38a-479hh to 38a-479pp. Reserved for future use. PART Ic HEALTH INSURANCE: MEDICAL DISCOUNT PLANS

Conn. Gen. Stat. § 38a-479hhh Investigations and hearings. Powers of commissioner. Appeals.

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Sec. 38a-479hhh. Investigations and hearings. Powers of commissioner. Appeals. (a) The commissioner may conduct investigations and hold hearings on any matter under the provisions of sections 38a-479aaa to 38a-479iii, inclusive. The commissioner may issue subpoenas, administer oa…

Conn. Gen. Stat. § 38a-479iii Pharmacy audits.

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Sec. 38a-479iii. Pharmacy audits. (a) As used in this section: (1) “Extrapolation” means the practice of inferring a frequency of dollar amount of overpayments, underpayments, nonvalid claims or other errors on any portion of claims submitted, based on the frequency or dollar amo…

Conn. Gen. Stat. § 38a-479jjj Contract with 340B covered entity. Prohibited provisions. Reimbursement rates. Regulations.

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Sec. 38a-479jjj. Contract with 340B covered entity. Prohibited provisions. Reimbursement rates. Regulations. (a) For purposes of this section and section 19a-649: (1) “340B covered entity” means an entity authorized to participate in the federal 340B Drug Pricing Program under 42…

Conn. Gen. Stat. §§ 38a-479kkk to 38a-479nnn 38a-479kkk to 38a-479nnn

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Secs. 38a-479kkk to 38a-479nnn. Reserved for future use. PART Ie HEALTH INSURANCE: PRESCRIPTION DRUG COSTS

Conn. Gen. Stat. § 38a-479ooo Definitions.

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Sec. 38a-479ooo. Definitions. For the purposes of this part: (1) “Commissioner” means the Insurance Commissioner. (2) “Department” means the Insurance Department. (3) “Drug” has the same meaning as provided in section 21a-92. (4) “Health care plan” means an individual or a group …

Conn. Gen. Stat. § 38a-479ppp Annual report by pharmacy benefits managers. Standardized form. Confidentiality of information. Penalty. Regulations. Commissioner's report to the General Assembly.

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Sec. 38a-479ppp. Annual report by pharmacy benefits managers. Standardized form. Confidentiality of information. Penalty. Regulations. Commissioner's report to the General Assembly. (a) Not later than February 1, 2025, and annually thereafter, each pharmacy benefits manager shall…

Conn. Gen. Stat. § 38a-479qq Medical discount plans: Definitions, prohibited sales practices, penalties.

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Sec. 38a-479qq. Medical discount plans: Definitions, prohibited sales practices, penalties. (a) As used in this section and section 38a-479rr: (1) “Affiliate” means a person that directly or indirectly through one or more intermediaries, controls, or is controlled by, or is under…

Conn. Gen. Stat. § 38a-479qqq Annual report by health carriers. Regulations.

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Sec. 38a-479qqq. Annual report by health carriers. Regulations. (a) Each health carrier that delivers, issues for delivery, renews, amends or continues a health care plan on or after January 1, 2021, shall submit the following information and data to the commissioner, for such he…

Conn. Gen. Stat. § 38a-479rr Medical discount plan organizations: Licensure. List of authorized marketers. Provider agreements. Minimum net worth. Suspension of authority and revocation or nonrenewal of license. Reinstatement of license. Maintenance of information. Regulations. Penalties. Advertising and marketing materials. Investigations.

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Sec. 38a-479rr. Medical discount plan organizations: Licensure. List of authorized marketers. Provider agreements. Minimum net worth. Suspension of authority and revocation or nonrenewal of license. Reinstatement of license. Maintenance of information. Regulations. Penalties. Adv…

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…