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General Assembly Raised Bill No. 843
January Session, 2021
LCO No. 2689
Referred to Committee on INSURANCE AND REAL ESTATE
Introduced by:
(INS)
AN ACT CONCERNING TH E REGULATION OF INSURANCE IN THIS
STATE.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 38a-495c of the general statutes is repealed and the 1
following is substituted in lieu thereof (Effective July 1, 2021): 2
(a) Each insurance company, fraternal benefit society, hospital service 3
corporation, medical service corporation, health care center or other 4
entity in this state that delivers, issues for delivery, continues or renews 5
any Medicare supplement insurance policies or certificates shall base 6
the premium rates charged on a community rate. Such rate shall not be 7
based on age, gender, previous claims history or the medical condition 8
of the person covered by such policy or certificate. Except as provided 9
in subsection (c) of this section, coverage shall not be denied on the basis 10
of age, gender, previous claim history or the medical condition of the 11
person covered by such policy or certificate. 12
(b) Nothing in this section shall prohibit an insurance company, 13
fraternal benefit society, hospital service corporation, medical service 14
corporation, health care center or other entity in this state issuing 15 Raised Bill No. 843
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Medicare supplement insurance policies or certificates from using its 16
usual and customary underwriting procedures, provided no such 17
company, society, corporation, center or other entity shall issue a 18
Medicare supplement policy or certificate based on the age, gender, 19
previous claims history or the medical condition of the applicant. 20
(c) Nothing in this section shall prohibit an insurance company, 21
fraternal benefit society, hospital service corporation, medical service 22
corporation, health care center or other entity in this state when granting 23
coverage under a Medicare supplement policy or certificate from 24
excluding benefits for losses incurred within six months from the 25
effective date of coverage based on a preexisting condition, in 26
accordance with section 38a-495a and the regulations adopted pursuant 27
to section 38a-495a. 28
(d) Each insurance company, fraternal benefit society, hospital 29
service corporation, medical service corporation, health care center or 30
other entity in the state issuing Medicare supplement policies or 31
certificates for plan "A", "B", [or] "C" or "D", or any combination thereof, 32
to persons eligible for Medicare by reason of age, shall offer for sale the 33
same such policies or certificates to persons eligible for Medicare by 34
reason of disability, except no such company, society, corporation, 35
center or other entity issuing any Medicare supplement policy or 36
certificate for plan "C" shall be required to offer for sale such policy or 37
certificate to any person who is a newly eligible Medicare beneficiary, 38
as defined in 42 USC 1395ss(z)(2). 39
(e) To the extent permissible by federal law, each insurance company, 40
fraternal benefit society, hospital service corporation, medical service 41
corporation, health care center or other entity in the state issuing 42
Medicare supplement policies or certificates for plan "A", "B", [or] "C" or 43
"D", or any combination thereof, may deliver or issue for delivery such 44
policy to a qualified Medicare beneficiary, as defined in 42 USC 45
1396d(p). 46
(f) Each insurance company, fraternal benefit society, hospital service 47 Raised Bill No. 843
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corporation, medical service corporation, health care center or other 48
entity in the state issuing Medicare supplement policies or certificates 49
shall make all necessary arrangements with the Medicare Part B carrier 50
and all Medicare Part A intermediaries to allow for the forwarding, to 51
the issuing entity, of all Medicare claims containing the name of the 52
entity issuing a Medicare supplement policy or certificate and the 53
identification number of an insured. The entity issuing the Medicare 54
supplement policy or certificate shall process all benefits available to an 55
insured from a Medicare claim so forwarded, without requiring any 56
additional action on the part of the insured. 57
(g) The Insurance Commissioner may adopt regulations, in 58
accordance with chapter 54, to implement this section. 59
Sec. 2. Subsection (a) of section 38a-688a of the general statutes is 60
repealed and the following is substituted in lieu thereof (Effective June 61
30, 2021): 62
(a) Notwithstanding the requirements of sections 38a-389 and 38a-688 63
with respect to personal risk insurance with the exception of residual 64
market rates, and on and after July 1, 2006, and until July 1, [2021] 2025, 65
an insurer may file a rate with the Insurance Commissioner pursuant to 66
this section and such rate shall take effect the date it is filed provided 67
the rate provides for an overall state-wide rate increase or decrease of 68
not more than six per cent in the aggregate [and not more than a fifteen 69
per cent increase in any individual territory] for all coverages that are 70
subject to the filing. Such percentage [limits] limit shall not apply on an 71
individual insured basis. Not more than one filing may be made by an 72
insurer pursuant to this section within any twelve-month period unless 73
the filing, when combined with one or more filings made by the insurer 74
within the preceding twelve months, does not result in an overall state-75
wide increase or decrease of more than six per cent in the aggregate [and 76
not more than a fifteen per cent increase in any individual territory] for 77
all coverages that are subject to the filing.78 Raised Bill No. 843
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This act shall take effect as follows and shall amend the following
sections:
Section 1 July 1, 2021 38a-495c
Sec. 2 June 30, 2021 38a-688a(a)
Statement of Purpose:
To: (1) Provide that certain health carriers (A) shall offer Medicare
supplement insurance policies and certificates for plan "D" to persons
eligible for Medicare by reason of disability, and (B) may deliver
Medicare supplement insurance policies and certificates for plan "D" to
qualified Medicare beneficiaries; (2) amend certain provisions of the
general statutes to more closely conform to the Medicare Access and
CHIP Reauthorization Act of 2015, P.L. 114-10; (3) extend the sunset date
for personal risk insurance rate filings; and (4) eliminate the territorial
cap on increases for personal risk insurance rate filings.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
underlined.]