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Connecticut Statutes, Title 38a

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Connecticut/Statutes

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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-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 Section 38a-530a is repealed, effective January 1, 2020.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)…

Conn. Gen. Stat. § 38a-547 Termination of policy or contract due to insurer ceasing to offer health insurance in this state; maternity benefits to continue for six weeks following termination of the pregnancy, when.

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Sec. 38a-547. Termination of policy or contract due to insurer ceasing to offer health insurance in this state; maternity benefits to continue for six weeks following termination of the pregnancy, when. As used in this section, the term “employer” means any individual, partnershi…

Conn. Gen. Stat. § 38a-548 Penalty.

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Sec. 38a-548. 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 violation of any of the pr…

Conn. Gen. Stat. § 38a-549 Coverage for adopted children.

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Sec. 38a-549. Coverage for adopted children. (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, amended, renewed or continued in this state shall pro…

Conn. Gen. Stat. § 38a-550 Copayments re in-network imaging services.

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Sec. 38a-550. 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 a group health insurance policy or contract for magnetic resonan…

Conn. Gen. Stat. § 38a-550a Copayments re in-network physical therapy services and in-network occupational therapy services.

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Sec. 38a-550a. Copayments re in-network physical therapy services and in-network occupational therapy services. 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…

Conn. Gen. Stat. § 38a-551 (Formerly Sec. 38-371). Definitions.

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Sec. 38a-551. (Formerly Sec. 38-371). Definitions. For the purposes of this section and sections 38a-552 and 38a-556 to 38a-559, inclusive, the following terms have the following meanings: (1) “Health insurance” or “health care plan” means hospital and medical expenses incurred p…

Conn. Gen. Stat. § 38a-552 (Formerly Sec. 38-372). Provision of service to certain low-income individuals.

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Sec. 38a-552. (Formerly Sec. 38-372). Provision of service to certain low-income individuals. No individual or organization that provides medical advice, diagnosis, care or treatment of a type covered under a special health care plan shall provide such service to any person in th…

Conn. Gen. Stat. §§ 38a-553 to 38a-555 (Formerly Secs. 38-373 to 38-375). Minimum standard benefits of comprehensive health care plans; optional and excludable benefits; preexisting conditions; use of managed care plans. Additional requirements and eligibility under group comprehensive health care plans; coverage for stepchildren; continuation of benefits under group plans; Insurance Commissioner's authority to coordinate benefits. Additional requirements for individual comprehensive health care plans; carrier obligations concerning termination of coverage.

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Secs. 38a-553 to 38a-555. (Formerly Secs. 38-373 to 38-375). Minimum standard benefits of comprehensive health care plans; optional and excludable benefits; preexisting conditions; use of managed care plans. Additional requirements and eligibility under group comprehensive health…

Conn. Gen. Stat. § 38a-556 (Formerly Sec. 38-376). Health Reinsurance Association. Board of directors. Powers and authority. Rates. Net loss assessment. Immunity from liability.

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Sec. 38a-556. (Formerly Sec. 38-376). Health Reinsurance Association. Board of directors. Powers and authority. Rates. Net loss assessment. Immunity from liability. (a) There is hereby created a nonprofit legal entity to be known as the Health Reinsurance Association. All insurer…

Conn. Gen. Stat. § 38a-556a Connecticut Clearinghouse.

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Sec. 38a-556a. Connecticut Clearinghouse. Section 38a-556a is repealed, effective June 6, 2024. (P.A. 10-4, S. 3; P.A. 11-44, S. 138; P.A. 13-234, S. 87; P.A. 15-69, S. 40; P.A. 24-138, S. 18.)

Conn. Gen. Stat. § 38a-557 (Formerly Sec. 38-377). Hospital service corporations and medical service corporations. Residual market mechanism. Insurance Commissioner's powers concerning such mechanisms.

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Sec. 38a-557. (Formerly Sec. 38-377). Hospital service corporations and medical service corporations. Residual market mechanism. Insurance Commissioner's powers concerning such mechanisms. (a) Hospital service corporations and medical service corporations may participate in the H…

Conn. Gen. Stat. § 38a-558 (Formerly Sec. 38-380). Office of Health Care Access.

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Sec. 38a-558. (Formerly Sec. 38-380). Office of Health Care Access. Section 38a-558 is repealed, effective May 14, 2018. (P.A. 75-616, S. 10, 12; P.A. 77-118; P.A. 95-257, S. 39, 58; P.A. 18-91, S. 80; 18-168, S. 85.)

Conn. Gen. Stat. § 38a-559 (Formerly Sec. 38-381). Commissioner of Social Services. Contract authority concerning Medicaid programs.

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Sec. 38a-559. (Formerly Sec. 38-381). Commissioner of Social Services. Contract authority concerning Medicaid programs. The Commissioner of Social Services may enter into contractual agreements with any carrier or with the Health Reinsurance Association or a residual market mecha…

Conn. Gen. Stat. § 38a-560 Small employer grouping for health insurance coverage.

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Sec. 38a-560. Small employer grouping for health insurance coverage. Small employers, as defined in section 38a-564, may group together solely for the purpose of securing group health insurance coverage. (P.A. 93-69.)

Conn. Gen. Stat. §§ 38a-561 to 38a-563 38a-561 to 38a-563

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Secs. 38a-561 to 38a-563. Reserved for future use. PART V BLUE RIBBON HEALTH CARE PLANS

Conn. Gen. Stat. § 38a-564 Definitions.

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Sec. 38a-564. Definitions. As used in this section and sections 38a-566, 38a-567, 38a-569 and 38a-574: (1) “Pool” means the Connecticut Small Employer Health Reinsurance Pool, established under section 38a-569. (2) “Board” means the board of directors of the pool. (3) “Employee” …