Title 38a — Title 38a: Insurance
33 chapters · 1,393 sections in this title.
Conn. Gen. Stat. § 38a-519 (Formerly Sec. 38-174j). Offset proviso prohibited in certain policies. Required disclosures for group long-term disability policies.
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Sec. 38a-519. (Formerly Sec. 38-174j). Offset proviso prohibited in certain policies. Required disclosures for group long-term disability policies. (a) No group health insurance policy that provides disability income protection coverage, delivered, issued for delivery, renewed, a…
Conn. Gen. Stat. § 38a-520 Mandatory coverage for home health care. Deductibles. Exception from deductible limits for medical savings accounts. Archer MSAs and health savings accounts.
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Sec. 38a-520. Mandatory coverage for home health care. Deductibles. Exception from deductible limits for medical savings accounts. Archer MSAs and health savings accounts. (a) Each group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4…
Conn. Gen. Stat. § 38a-521 Home health care by recognized nonmedical systems.
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Sec. 38a-521. Home health care by recognized nonmedical systems. Notwithstanding the provisions of section 38a-520, no insurer, health care center or issuer of any service plan contract for hospital or medical expense delivered, issued for delivery or renewed in this state shall …
Conn. Gen. Stat. § 38a-522 Medicare supplement policies. Coverage of home health aide service.
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Sec. 38a-522. Medicare supplement policies. Coverage of home health aide service. (a) As used in this section, “Medicare” means the Health Insurance for the Aged Act, Title XVIII of the Social Security Amendments of 1965, as amended (Title I, Part I of P.L. 89-97); “Medicare supp…
Conn. Gen. Stat. § 38a-523 (Formerly Sec. 38-174p). Group hospital or medical insurance coverage for comprehensive rehabilitation services.
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Sec. 38a-523. (Formerly Sec. 38-174p). Group hospital or medical insurance coverage for comprehensive rehabilitation services. (a) For the purposes of this section: (1) “Comprehensive rehabilitation services” shall consist of the following when provided in a comprehensive rehabil…
Conn. Gen. Stat. § 38a-524 Coverage for occupational therapy.
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Sec. 38a-524. 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 physician licensed in accordan…
Conn. Gen. Stat. § 38a-525 Mandatory coverage for medically necessary ambulance services. Direct payment to ambulance provider.
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Sec. 38a-525. Mandatory coverage for medically necessary ambulance services. Direct payment to ambulance provider. (a) Each group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (6), (11) and (12) of section 38a-469 delivered, issue…
Conn. Gen. Stat. § 38a-525a 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-525a. 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-525b Mandatory coverage for mobile field hospital.
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Sec. 38a-525b. Mandatory coverage for mobile field hospital. Each group 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 shall pr…
Conn. Gen. Stat. § 38a-525c Denial of coverage prohibited for health care services rendered to persons with an elevated blood alcohol content.
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Sec. 38a-525c. Denial of coverage prohibited for health care services rendered to persons with an elevated blood alcohol content. No group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, i…
Conn. Gen. Stat. § 38a-526 Coverage for services of physician assistants and certain nurses.
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Sec. 38a-526. Coverage for services of physician assistants and certain nurses. (a) For the purposes of this section: (1) “Certified nurse practitioner” means any registered nurse licensed under chapter 378 who has completed a formal educational nurse practitioner program and is …
Conn. Gen. Stat. § 38a-526a Coverage for telehealth services.
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Sec. 38a-526a. 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-527 Mandatory coverage for partners, sole proprietors and corporate officers for work-related injuries.
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Sec. 38a-527. Mandatory coverage for partners, sole proprietors and corporate officers for work-related injuries. (a) Notwithstanding any other provision of the general statutes, no group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (…
Conn. Gen. Stat. § 38a-528 Group 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-528. Group 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 section 38a-475a, “long-term car…
Conn. Gen. Stat. § 38a-528a Group short-term care policies. Approval of rates and forms. Disclosures. Regulations.
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Sec. 38a-528a. Group short-term care policies. Approval of rates and forms. Disclosures. Regulations. (a) As used in this section, “short-term care policy” means any group health insurance policy or certificate delivered or issued for delivery to any resident of this state that i…
Conn. Gen. Stat. § 38a-529 Mandatory coverage for services provided by the Healthcare Center maintained by the Department of Veterans Affairs.
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Sec. 38a-529. Mandatory coverage for services provided by the Healthcare Center maintained by the Department of Veterans Affairs. No group health insurance policy delivered, issued for delivery or renewed in this state on or after October 1, 1988, may exclude coverage for service…
Conn. Gen. Stat. § 38a-530 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-530. 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 inc…
Conn. Gen. Stat. § 38a-530a Mandatory coverage for breast cancer survivors.
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Sec. 38a-530a. Mandatory coverage for breast cancer survivors. Section 38a-530a is repealed, effective January 1, 2020. (P.A. 96-177, S. 3; P.A. 17-15, S. 68; P.A. 19-134, S. 3.)
Conn. Gen. Stat. § 38a-530b Carriers to permit direct access to obstetrician-gynecologist.
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Sec. 38a-530b. 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-530c Mandatory coverage for maternity care. Interhospital transfer of newborn infant and mother.
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Sec. 38a-530c. 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-530d Mandatory coverage for mastectomy care. Termination of provider contract prohibited.
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Sec. 38a-530d. Mandatory coverage for mastectomy care. Termination of provider contract prohibited. (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 delivered, issued for delivery…
Conn. Gen. Stat. § 38a-530e Mandatory coverage for contraceptives and sterilization.
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Sec. 38a-530e. Mandatory coverage for contraceptives and sterilization. (a) Each 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, renewed, amended or continued in…
Conn. Gen. Stat. § 38a-530f 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-530f. 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 group health insurance polic…
Conn. Gen. Stat. § 38a-530g Mandatory coverage for ovarian cancer screening and monitoring.
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Sec. 38a-530g. 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-531 (Formerly Sec. 38-174hh). Mandatory coverage for employees of certain employers. Approval of policy forms.
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Sec. 38a-531. (Formerly Sec. 38-174hh). Mandatory coverage for employees of certain employers. Approval of policy forms. (a) For purposes of this section: (1) “Employer” means any person, firm, corporation, limited liability company, partnership or association engaged in business…
Conn. Gen. Stat. § 38a-532 (Formerly Sec. 38-262a). Assignment of incidents of ownership under group life, health or accident policy.
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Sec. 38a-532. (Formerly Sec. 38-262a). Assignment of incidents of ownership under group life, health or accident policy. Any person who is insured under any policy of group health insurance may make an assignment of all or any part of such insured's incidents of ownership in such…
Conn. Gen. Stat. § 38a-533 (Formerly Sec. 38-262b). Mandatory coverage for the treatment of medical complications of alcoholism.
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Sec. 38a-533. (Formerly Sec. 38-262b). Mandatory coverage for the treatment of medical complications of alcoholism. (a) Except as provided in subsection (c) of this section, each group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4),…
Conn. Gen. Stat. § 38a-534 Coverage for services performed by chiropractors.
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Sec. 38a-534. Coverage for services performed by chiropractors. Each group 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 state …
Conn. Gen. Stat. § 38a-535 Mandatory coverage for preventive pediatric care and blood lead screening and risk assessment.
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Sec. 38a-535. Mandatory coverage for preventive pediatric care and blood lead screening and risk assessment. (a) For purposes of this section, “preventive pediatric care” means the periodic review of a child's physical and emotional health from birth through six years of age by o…
Conn. Gen. Stat. § 38a-535a Notification of individual coverage and benefits of a noncustodial parent to a custodial parent, when. Regulations.
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Sec. 38a-535a. Notification of individual coverage and benefits of a noncustodial parent to a custodial parent, when. Regulations. Section 38a-535a is repealed, effective July 1, 1995. (May Sp. Sess. P.A. 94-5, S. 5, 30; P.A. 95-305, S. 5, 6.)
Conn. Gen. Stat. § 38a-536 Mandatory coverage for infertility diagnosis and treatment. Limitations.
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Sec. 38a-536. 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 group health insurance policy providing coverage of the…
Conn. Gen. Stat. § 38a-537 (Formerly Sec. 38-262c). Notice of cancellation or discontinuation to covered employees. Fine. Notice of transfer of coverage. Failure to procure coverage.
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Sec. 38a-537. (Formerly Sec. 38-262c). Notice of cancellation or discontinuation to covered employees. Fine. Notice of transfer of coverage. Failure to procure coverage. (a) Any individual, partnership, corporation or unincorporated association providing group health insurance co…
Conn. Gen. Stat. § 38a-538 (Formerly Sec. 38-262d). Continuation of benefits under group employee health plans.
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Sec. 38a-538. (Formerly Sec. 38-262d). Continuation of benefits under group employee health plans. Section 38a-538 is repealed, effective July 10, 2015. (P.A. 75-417; P.A. 82-340; P.A. 87-274, S. 1; P.A. 90-243, S. 119; P.A. 92-158; May Sp. Sess. P.A. 92-11, S. 69, 70; P.A. 97-26…
Conn. Gen. Stat. § 38a-539 (Formerly Sec. 38-262f). Group hospital or medical expense insurance policy coverage for treatment of alcoholism on an outpatient basis.
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Sec. 38a-539. (Formerly Sec. 38-262f). Group hospital or medical expense insurance policy coverage for treatment of alcoholism on an outpatient basis. Section 38a-539 is repealed, effective January 1, 2000. (P.A. 77-237; 77-614, S. 323, 610; P.A. 79-610, S. 32; P.A. 90-102, S. 2;…
Conn. Gen. Stat. § 38a-540 (Formerly Sec. 38-262g). Duplication of coverage under group health insurance policies.
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Sec. 38a-540. (Formerly Sec. 38-262g). Duplication of coverage under group health insurance policies. In any case in which spouses are employed by the same employer and, by reason of their employment, are both eligible for coverage under the terms of any health insurance policy i…
Conn. Gen. Stat. § 38a-541 (Formerly Sec. 38-262h). Group health policy to allow spouse coverage as both employee and dependent, when. Effect of collective bargaining agreements.
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Sec. 38a-541. (Formerly Sec. 38-262h). Group health policy to allow spouse coverage as both employee and dependent, when. Effect of collective bargaining agreements. Every health insurance policy issued under a group insurance plan and by an insurance company, hospital service co…
Conn. Gen. Stat. § 38a-542 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-542. 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, medical service corporati…
Conn. Gen. Stat. § 38a-542a Coverage for routine patient care costs associated with certain clinical trials.
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Sec. 38a-542a. Coverage for routine patient care costs associated with certain clinical trials. Each 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, renewed, ame…
Conn. Gen. Stat. § 38a-542b Clinical trial criteria.
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Sec. 38a-542b. 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-542c Evidence and information re eligibility for clinical trial. No coverage required for otherwise reimbursable costs.
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Sec. 38a-542c. 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-542d, the insurer, health care center or plan administra…
Conn. Gen. Stat. § 38a-542d Clinical trials: Routine patient care costs.
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Sec. 38a-542d. Clinical trials: Routine patient care costs. (a) For purposes of sections 38a-542a to 38a-542g, 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-542e Clinical trials: Billing. Payments.
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Sec. 38a-542e. Clinical trials: Billing. Payments. (a) Providers, hospitals and institutions that provide routine patient care services as set forth in subsection (a) of section 38a-542d as part of a clinical trial that meets the requirements of sections 38a-542a to 38a-542g, inc…
Conn. Gen. Stat. § 38a-542f Clinical trials: Standardized forms. Time frame for coverage determinations. Appeals. Regulations.
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Sec. 38a-542f. 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-542g Clinical trials: Submission and certification of policy forms.
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Sec. 38a-542g. 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-543 (Formerly Sec. 38-262j). Reduction of payments on basis of Medicare eligibility.
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Sec. 38a-543. (Formerly Sec. 38-262j). Reduction of payments on basis of Medicare eligibility. No group health insurance policy delivered, issued for delivery, renewed, amended or continued in this state shall include any provision that reduces payments on the basis that an indiv…
Conn. Gen. Stat. § 38a-544 Prescription drug coverage. Mail order pharmacies. Step therapy use.
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Sec. 38a-544. 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 a group he…
Conn. Gen. Stat. § 38a-544a Prescription drug coverage. Synchronized refills.
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Sec. 38a-544a. Prescription drug coverage. Synchronized refills. No group 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 this s…
Conn. Gen. Stat. § 38a-544b Prescription drug coverage. Prior authorization for naloxone hydrochloride or similar drug not required.
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Sec. 38a-544b. Prescription drug coverage. Prior authorization for naloxone hydrochloride or similar drug not required. No group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11), (12) and (16) of section 38a-469 delivered, issue…
Conn. Gen. Stat. § 38a-545 (Formerly Sec. 38-262k). Group dental health insurance plans. Alternative coverage option.
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Sec. 38a-545. (Formerly Sec. 38-262k). Group dental health insurance plans. Alternative coverage option. Any employer or other organization which had twenty-five or more employees or members at all times during the preceding calendar year and which contributes to a group health i…
Conn. Gen. Stat. § 38a-546 (Formerly Sec. 38-379). Discontinuation and replacement of group health insurance policy. Regulations.
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Sec. 38a-546. (Formerly Sec. 38-379). Discontinuation and replacement of group health insurance policy. Regulations. (a) In any case of the discontinuance of a group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (3), (4), (11) and (12)…