Title 38a — Title 38a: Insurance
33 chapters · 1,393 sections in this title.
Conn. Gen. Stat. § 38a-494 (Formerly Sec. 38-174l). Home health care by recognized nonmedical systems.
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Sec. 38a-494. (Formerly Sec. 38-174l). Home health care by recognized nonmedical systems. Notwithstanding the provisions of section 38a-493, no insurer, health care center or issuer of any service plan contract for hospital or medical expense delivered, issued for delivery or ren…
Conn. Gen. Stat. § 38a-495 (Formerly Sec. 38-174m). Medicare supplement policies. Coverage of home health aide services and mammography. Prescription drug riders.
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Sec. 38a-495. (Formerly Sec. 38-174m). Medicare supplement policies. Coverage of home health aide services and mammography. Prescription drug riders. (a) As used in this section, “Medicare” means the Health Insurance for the Aged Act, Title XVIII of the Social Security Amendments…
Conn. Gen. Stat. § 38a-495a Medicare supplement policies and certificates. Minimum required policy benefits and standards. Regulations.
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Sec. 38a-495a. Medicare supplement policies and certificates. Minimum required policy benefits and standards. Regulations. (a) As used in this section: (1) “Applicant” means (A) in the case of an individual Medicare supplement policy, a person who seeks to contract for insurance …
Conn. Gen. Stat. § 38a-495b Medicare supplement policies and certificates. Definitions.
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Sec. 38a-495b. Medicare supplement policies and certificates. Definitions. (a) As used in sections 38a-473, 38a-474 and 38a-481, subsection (l) of section 38a-495a, sections 38a-495c and 38a-513 and this section, “Medicare” means the Health Insurance for the Aged Act, Title XVIII…
Conn. Gen. Stat. § 38a-495c Medicare supplement premium rates charged on a community rate basis. Age, gender, previous claim or medical history rating prohibited. Preexisting conditions. Coverage for the disabled and qualified Medicare beneficiaries. Exception. Regulations.
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Sec. 38a-495c. Medicare supplement premium rates charged on a community rate basis. Age, gender, previous claim or medical history rating prohibited. Preexisting conditions. Coverage for the disabled and qualified Medicare beneficiaries. Exception. Regulations. (a) Each insurance…
Conn. Gen. Stat. § 38a-495d Refund of prepaid premium for Medicare supplement policies.
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Sec. 38a-495d. Refund of prepaid premium for Medicare supplement policies. Each insurance company, fraternal benefit society, hospital service corporation, medical service corporation, health care center or other entity which delivers or issues for delivery, continues or renews i…
Conn. Gen. Stat. § 38a-496 (Formerly Sec. 38-174q). Coverage for occupational therapy.
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Sec. 38a-496. (Formerly Sec. 38-174q). Coverage for occupational therapy. (a) For the purposes of this section: (1) “Occupational therapy” means services provided by a licensed occupational therapist in accordance with a plan of care established and approved in writing by a physi…
Conn. Gen. Stat. § 38a-497 (Formerly Sec. 38-174r). Termination of coverage of child, stepchild, or other dependent child in individual policies. Dental or vision coverage.
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Sec. 38a-497. (Formerly Sec. 38-174r). Termination of coverage of child, stepchild, or other dependent child in individual policies. Dental or vision coverage. (a) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (10)…
Conn. Gen. Stat. § 38a-497a Group coverage and benefits of a noncustodial parent. National Medical Support Notice. Notification of new employer by IV-D agency. Notification to parent. Enrollment of child.
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Sec. 38a-497a. Group coverage and benefits of a noncustodial parent. National Medical Support Notice. Notification of new employer by IV-D agency. Notification to parent. Enrollment of child. (a) As used in this section (1) “insurer” has the same meaning as “insurer”, as defined …
Conn. Gen. Stat. § 38a-498 (Formerly Sec. 38-174t). Mandatory coverage for medically necessary ambulance services. Direct payment to ambulance provider.
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Sec. 38a-498. (Formerly Sec. 38-174t). Mandatory coverage for medically necessary ambulance services. Direct payment to ambulance provider. (a) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (6), (10), (11) and (12)…
Conn. Gen. Stat. § 38a-498a Prior authorization prohibited for certain 9-1-1 emergency calls or transporting enrollee to a hospital by ambulance when medically necessary. Denial of payment to ambulance provider responding to 9-1-1 local prehospital emergency medical service system call prohibited on basis that enrollee did not obtain approval prior to calling such system or transporting such enrollee when medically necessary by ambulance to a hospital.
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Sec. 38a-498a. Prior authorization prohibited for certain 9-1-1 emergency calls or transporting enrollee to a hospital by ambulance when medically necessary. Denial of payment to ambulance provider responding to 9-1-1 local prehospital emergency medical service system call prohib…
Conn. Gen. Stat. § 38a-498b Mandatory coverage for mobile field hospital.
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Sec. 38a-498b. Mandatory coverage for mobile field hospital. Each individual health insurance policy providing coverage of the type specified in subdivisions (1) to (13), inclusive, of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state sha…
Conn. Gen. Stat. § 38a-498c Denial of coverage prohibited for health care services rendered to persons with an elevated blood alcohol content.
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Sec. 38a-498c. Denial of coverage prohibited for health care services rendered to persons with an elevated blood alcohol content. No individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 deliver…
Conn. Gen. Stat. § 38a-499 (Formerly Sec. 38-174v). Coverage for services of physician assistants and certain nurses.
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Sec. 38a-499. (Formerly Sec. 38-174v). Coverage for services of physician assistants and certain nurses. (a) For the purposes of this section: (1) “Advanced practice registered nurse” means any advanced practice registered nurse licensed under the provisions of chapter 378; (2) “…
Conn. Gen. Stat. § 38a-499a Coverage for telehealth services.
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Sec. 38a-499a. Coverage for telehealth services. (a) As used in this section, (1) “telehealth” has the same meaning as provided in section 19a-906, and (2) “telehealth provider” means any physician licensed under chapter 370, physical therapist licensed under chapter 376, chiropr…
Conn. Gen. Stat. § 38a-500 (Formerly Sec. 38-174w). Mandatory coverage for partners, sole proprietors and corporate officers for work-related injuries. Subrogation rights.
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Sec. 38a-500. (Formerly Sec. 38-174w). Mandatory coverage for partners, sole proprietors and corporate officers for work-related injuries. Subrogation rights. (a) Notwithstanding any other provision of the general statutes, no individual health insurance policy providing coverage…
Conn. Gen. Stat. § 38a-501 (Formerly Sec. 38-174x). Individual long-term care policies. Insurers authorized. Disclosures. Premium rate increases of twenty per cent or more. Disclosure of premium rate increase and minimum set of affordable benefit options.
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Sec. 38a-501. (Formerly Sec. 38-174x). Individual long-term care policies. Insurers authorized. Disclosures. Premium rate increases of twenty per cent or more. Disclosure of premium rate increase and minimum set of affordable benefit options. (a)(1) As used in this section and se…
Conn. Gen. Stat. § 38a-501a Individual short-term care policies. Approval of rates and forms. Disclosures. Regulations.
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Sec. 38a-501a. Individual short-term care policies. Approval of rates and forms. Disclosures. Regulations. (a) As used in this section, “short-term care policy” means any individual health insurance policy delivered or issued for delivery to any resident of this state that is des…
Conn. Gen. Stat. § 38a-502 (Formerly Sec. 38-174ff). Mandatory coverage for services provided by the Healthcare Center maintained by the Department of Veterans Affairs.
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Sec. 38a-502. (Formerly Sec. 38-174ff). Mandatory coverage for services provided by the Healthcare Center maintained by the Department of Veterans Affairs. No individual health insurance policy delivered, issued for delivery or renewed in this state on or after October 1, 1988, m…
Conn. Gen. Stat. § 38a-503 (Formerly Sec. 38-174gg). Mandatory coverage for diagnostic and screening mammography, diagnostic and screening breast ultrasound, diagnostic and screening magnetic resonance imaging, breast biopsies, prophylactic mastectomies and breast reconstructive surgery. Breast density information included in report.
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Sec. 38a-503. (Formerly Sec. 38-174gg). Mandatory coverage for diagnostic and screening mammography, diagnostic and screening breast ultrasound, diagnostic and screening magnetic resonance imaging, breast biopsies, prophylactic mastectomies and breast reconstructive surgery. Brea…
Conn. Gen. Stat. § 38a-503a Mandatory coverage for breast cancer survivors.
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Sec. 38a-503a. Mandatory coverage for breast cancer survivors. Section 38a-503 is repealed, effective January 1, 2020. (P.A. 96-177, S. 4; P.A. 17-15, S. 57; P.A. 19-134, S. 2.)
Conn. Gen. Stat. § 38a-503b Carriers to permit direct access to obstetrician-gynecologist.
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Sec. 38a-503b. Carriers to permit direct access to obstetrician-gynecologist. (a) As used in this section, “carrier” means each insurer, health care center, hospital service corporation, medical service corporation or other entity delivering, issuing for delivery, renewing, amend…
Conn. Gen. Stat. § 38a-503c Mandatory coverage for maternity care. Interhospital transfer of newborn infant and mother.
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Sec. 38a-503c. Mandatory coverage for maternity care. Interhospital transfer of newborn infant and mother. (a) As used in this section, “carrier” means each insurer, health care center, hospital service corporation, medical service corporation or other entity delivering, issuing …
Conn. Gen. Stat. § 38a-503d Mandatory coverage for mastectomy care. Termination of provider contract prohibited.
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Sec. 38a-503d. Mandatory coverage for mastectomy care. Termination of provider contract prohibited. (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 del…
Conn. Gen. Stat. § 38a-503e Mandatory coverage for contraceptives and sterilization.
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Sec. 38a-503e. Mandatory coverage for contraceptives and sterilization. (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 continu…
Conn. Gen. Stat. § 38a-503f Mandatory coverage for certain health benefits and services for women, infants, children and adolescents and certain evidence-based items or services for individuals.
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Sec. 38a-503f. Mandatory coverage for certain health benefits and services for women, infants, children and adolescents and certain evidence-based items or services for individuals. (a)(1) Except as provided in subdivision (2) of this subsection, each individual health insurance …
Conn. Gen. Stat. § 38a-503g Mandatory coverage for ovarian cancer screening and monitoring.
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Sec. 38a-503g. Mandatory coverage for ovarian cancer screening and monitoring. (a) For purposes of this section: (1) “At risk for ovarian cancer” means: (A) Having a family history: (i) With one or more first degree blood relatives, including a parent, sibling or child, or one or…
Conn. Gen. Stat. § 38a-504 (Formerly Sec. 38-262i). Mandatory coverage for treatment of tumors and leukemia. Mandatory coverage for reconstructive surgery, prosthesis, chemotherapy and wigs. Orally administered anticancer medications.
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Sec. 38a-504. (Formerly Sec. 38-262i). Mandatory coverage for treatment of tumors and leukemia. Mandatory coverage for reconstructive surgery, prosthesis, chemotherapy and wigs. Orally administered anticancer medications. (a) Each insurance company, hospital service corporation, …
Conn. Gen. Stat. § 38a-504a Coverage for routine patient care costs associated with certain clinical trials.
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Sec. 38a-504a. Coverage for routine patient care costs associated with certain clinical trials. 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…
Conn. Gen. Stat. § 38a-504b Clinical trial criteria.
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Sec. 38a-504b. Clinical trial criteria. A clinical trial for the prevention of cancer shall be eligible for coverage only if it involves a therapeutic intervention, is a phase III clinical trial approved by one of the entities identified in this section, and is conducted at multi…
Conn. Gen. Stat. § 38a-504c Evidence and information re eligibility for clinical trial. No coverage required for otherwise reimbursable costs.
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Sec. 38a-504c. Evidence and information re eligibility for clinical trial. No coverage required for otherwise reimbursable costs. In order to be eligible for coverage of routine patient care costs, as defined in section 38a-504d, the insurer, health care center or plan administra…
Conn. Gen. Stat. § 38a-504d Clinical trials: Routine patient care costs.
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Sec. 38a-504d. Clinical trials: Routine patient care costs. (a) For purposes of sections 38a-504a to 38a-504g, inclusive, “routine patient care costs” means: (1) Medically necessary health care services that are incurred as a result of the treatment being provided to the insured …
Conn. Gen. Stat. § 38a-504e Clinical trials: Billing. Payments.
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Sec. 38a-504e. Clinical trials: Billing. Payments. (a) Providers, hospitals and institutions that provide routine patient care services as set forth in subsection (a) of section 38a-504d as part of a clinical trial that meets the requirements of sections 38a-504a to 38a-504g, inc…
Conn. Gen. Stat. § 38a-504f Clinical trials: Standardized forms. Time frame for coverage determinations. Appeals. Regulations.
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Sec. 38a-504f. Clinical trials: Standardized forms. Time frame for coverage determinations. Appeals. Regulations. (a)(1) For purposes of cancer clinical trials, the Insurance Department, in cooperation with the Connecticut Oncology Association, the American Cancer Society, the Co…
Conn. Gen. Stat. § 38a-504g Clinical trials: Submission and certification of policy forms.
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Sec. 38a-504g. Clinical trials: Submission and certification of policy forms. (a) Any insurer or health care center with coverage policies for care in clinical trials shall submit such policies to the Insurance Department for evaluation and approval. The department shall certify …
Conn. Gen. Stat. § 38a-505 (Formerly Sec. 38-378). Insurance Commissioner's powers concerning comprehensive health care plans. Disclosures.
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Sec. 38a-505. (Formerly Sec. 38-378). Insurance Commissioner's powers concerning comprehensive health care plans. Disclosures. In order to provide reasonable simplification of terms and coverages of individual health insurance policies, to facilitate public understanding and comp…
Conn. Gen. Stat. § 38a-506 (Formerly Sec. 38-173). Penalty.
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Sec. 38a-506. (Formerly Sec. 38-173). Penalty. Any insurer, hospital service corporation, medical service corporation, health care center or fraternal benefit society, or any officer or agent thereof, delivering or issuing for delivery to any person in this state any policy in vi…
Conn. Gen. Stat. § 38a-507 Coverage for services performed by chiropractors.
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Sec. 38a-507. Coverage for services performed by chiropractors. Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (6) and (11) of section 38a-469, delivered, issued for delivery, renewed, amended or continued in this s…
Conn. Gen. Stat. § 38a-508 Coverage for adopted children.
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Sec. 38a-508. Coverage for adopted 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, issued for delivery, amended, renewed or continued in this state shal…
Conn. Gen. Stat. § 38a-509 Mandatory coverage for infertility diagnosis and treatment. Limitations.
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Sec. 38a-509. Mandatory coverage for infertility diagnosis and treatment. Limitations. (a) Subject to the limitations set forth in subsection (b) of this section and except as provided in subsection (c) of this section, each individual health insurance policy providing coverage o…
Conn. Gen. Stat. § 38a-510 Prescription drug coverage. Mail order pharmacies. Step therapy use.
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Sec. 38a-510. Prescription drug coverage. Mail order pharmacies. Step therapy use. (a) No insurance company, hospital service corporation, medical service corporation, health care center or other entity delivering, issuing for delivery, renewing, amending or continuing an individ…
Conn. Gen. Stat. § 38a-510a Prescription drug coverage. Synchronized refills.
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Sec. 38a-510a. Prescription drug coverage. Synchronized refills. No individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11), (12) and (16) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in t…
Conn. Gen. Stat. § 38a-510b Prescription drug coverage. Prior authorization for naloxone hydrochloride or similar drug not required.
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Sec. 38a-510b. Prescription drug coverage. Prior authorization for naloxone hydrochloride or similar drug not required. No individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11), (12) and (16) of section 38a-469 delivered, …
Conn. Gen. Stat. § 38a-510c Coverage for investigational drug, biological product or device for insureds with terminal illnesses. Liability of health carrier.
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Sec. 38a-510c. Coverage for investigational drug, biological product or device for insureds with terminal illnesses. Liability of health carrier. (a) As used in this section, “health carrier” means an insurance company, health care center, hospital service corporation, medical se…
Conn. Gen. Stat. § 38a-511 Copayments re in-network imaging services.
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Sec. 38a-511. Copayments re in-network imaging services. (a) No health insurer, health care center, hospital service corporation, medical service corporation or fraternal benefit society that provides coverage under an individual health insurance policy or contract for magnetic r…
Conn. Gen. Stat. § 38a-511a Copayments re in-network physical therapy services and in-network occupational therapy services.
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Sec. 38a-511a. Copayments re in-network physical therapy services and in-network occupational therapy services. 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 del…
Conn. Gen. Stat. § 38a-512 Applicability of statutes to certain major medical expense policies.
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Sec. 38a-512. Applicability of statutes to certain major medical expense policies. Any policy providing major medical expense coverage that is written to complement underlying hospital, medical and surgical expense coverage shall not be required, unless otherwise specifically pro…
Conn. Gen. Stat. § 38a-512a Continuation of coverage.
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Sec. 38a-512a. Continuation of coverage. (a)(1) Each insurer, health care center, hospital service corporation, medical service corporation, fraternal benefit society or other entity delivering, issuing for delivery, renewing, amending or continuing a group health insurance polic…
Conn. Gen. Stat. § 38a-512b Termination of coverage of child, stepchild or other dependent child in group policies. Dental or vision coverage.
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Sec. 38a-512b. Termination of coverage of child, stepchild or other dependent child in group policies. Dental or vision coverage. (a) Each group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (10), (11) and (12) of section 38a-469 …
Conn. Gen. Stat. § 38a-512c Annual and lifetime limits.
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Sec. 38a-512c. Annual and lifetime limits. (a) No group 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 an an…