Connecticut 2021 Regular Session

Connecticut Senate Bill SB01005 Compare Versions

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Version 2 (New)

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7		-	General Assembly ~~Substitute~~ Bill No. 1005
	5	+	General Assembly Raised Bill No. 1005
8	6		January Session, 2021
	7	+	LCO No. 3712
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	9	+
	10	+	Referred to Committee on INSURANCE AND REAL ESTATE
	11	+
	12	+
	13	+	Introduced by:
	14	+	(INS)
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13		-
14		-	~~AN ACT CONCERNING RE QUIRED~~ HEALTH ~~INSURA NCE~~
15		-	~~COVERAGE FOR NEWBORN CHILDREN~~.
	19	+	AN ACT REQUIRING CER TAIN HEALTH INSURERS TO
	20	+	AUTOMATICALLY PROVID E HEALTH INSURANCE COVERAGE FOR
	21	+	CERTAIN NEWBORNS.
16	22		Be it enacted by the Senate and House of Representatives in General
17	23		Assembly convened:
18	24
19		-	Section 1. Section 38a-~~490~~ of the general statutes is repealed and the 1
	25	+	Section 1. Section 38a-1 of the general statutes is repealed and the 1
20	26		following is substituted in lieu thereof (Effective January 1, 2022): 2
21		-	(a) Each individual health insurance policy delivered, issued for 3
22		-	delivery, renewed, amended or continued in this state providing 4
23		-	coverage of the type specified in subdivisions (1), (2), (4), (6), (10), (11) 5
24		-	and (12) of section 38a-469 for a family member of the insured or 6
25		-	subscriber shall, as to such family member's coverage, also provide that 7
26		-	the health insurance benefits applicable for children shall be payable 8
27		-	with respect to a newly born child of the insured or subscriber from the 9
28		-	moment of birth. 10
29		-	(b) Coverage for such newly born child shall consist of coverage for 11
30		-	injury and sickness including necessary care and treatment of medically 12
31		-	diagnosed congenital defects and birth abnormalities within the limits 13
32		-	of the policy. 14
33		-	(c) If payment of a specific premium or subscription fee is required to 15
34		-	provide coverage for a child, the policy or contract may require that 16
35		-	notification of birth of such newly born child and payment of the 17 Substitute Bill No. 1005
	27	+	Terms used in this title and section 2 of this act, unless it appears from 3
	28	+	the context to the contrary, shall have a scope and meaning as set forth 4
	29	+	in this section. 5
	30	+	(1) "Affiliate" or "affiliated" means a person that directly, or indirectly 6
	31	+	through one or more intermediaries, controls, is controlled by or is 7
	32	+	under common control with another person. 8
	33	+	(2) "Alien insurer" means any insurer that has been chartered by or 9
	34	+	organized or constituted within or under the laws of any jurisdiction or 10
	35	+	country without the United States. 11
	36	+	(3) "Annuities" means all agreements to make periodical payments 12 Raised Bill No. 1005
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42		-	required premium or fees shall be furnished to the insurer, hospital 18
43		-	service corporation, medical service corporation or health care center 19
44		-	not later than [sixty-one] one hundred twenty-one days after the date of 20
45		-	birth or the date of discharge from the hospital, whichever is later, in 21
46		-	order to continue coverage beyond such [sixty-one-day] period, 22
47		-	provided failure to furnish such notice or pay such premium or fees 23
48		-	shall not prejudice any claim originating within such [sixty-one-day] 24
49		-	period. 25
50		-	Sec. 2. Section 38a-516 of the general statutes is repealed and the 26
51		-	following is substituted in lieu thereof (Effective January 1, 2022): 27
52		-	(a) Each group health insurance policy delivered, issued for delivery, 28
53		-	renewed, amended or continued in this state providing coverage of the 29
54		-	type specified in subdivisions (1), (2), (4), (6), (11) and (12) of section 38a-30
55		-	469 for a family member of the insured or subscriber shall, as to such 31
56		-	family member's coverage, also provide that the health insurance 32
57		-	benefits applicable for children shall be payable with respect to a newly 33
58		-	born child of the insured or subscriber from the moment of birth. 34
59		-	(b) Coverage for such newly born child shall consist of coverage for 35
60		-	injury and sickness including necessary care and treatment of medically 36
61		-	diagnosed congenital defects and birth abnormalities within the limits 37
62		-	of the policy. 38
63		-	(c) If payment of a specific premium fee is required to provide 39
64		-	coverage for a child, the policy may require that notification of birth of 40
65		-	such newly born child and payment of the required premium or fees 41
66		-	shall be furnished to the insurer, hospital service corporation, medical 42
67		-	service corporation or health care center not later than [sixty-one] one 43
68		-	hundred twenty-one days after the date of birth or the date of discharge 44
69		-	from the hospital, whichever is later, in order to continue coverage 45
70		-	beyond such [sixty-one-day] period, provided failure to furnish such 46
71		-	notice or pay such premium shall not prejudice any claim originating 47
72		-	within such [sixty-one-day] period. 48 Substitute Bill No. 1005
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	42	+	where the making or continuance of all or some of the series of the 13
	43	+	payments, or the amount of the payment, is dependent upon the 14
	44	+	continuance of human life or is for a specified term of years. This 15
	45	+	definition does not apply to payments made under a policy of life 16
	46	+	insurance. 17
	47	+	(4) "Commissioner" means the Insurance Commissioner. 18
	48	+	(5) "Control", "controlled by" or "under common control with" means 19
	49	+	the possession, direct or indirect, of the power to direct or cause the 20
	50	+	direction of the management and policies of a person, whether through 21
	51	+	the ownership of voting securities, by contract other than a commercial 22
	52	+	contract for goods or nonmanagement services, or otherwise, unless the 23
	53	+	power is the result of an official position with the person. 24
	54	+	(6) "Domestic insurer" means any insurer that has been chartered by, 25
	55	+	incorporated, organized or constituted within or under the laws of this 26
	56	+	state. 27
	57	+	(7) "Domestic surplus lines insurer" means any domestic insurer that 28
	58	+	has been authorized by the commissioner to write surplus lines 29
	59	+	insurance. 30
	60	+	(8) "Foreign country" means any jurisdiction not in any state, district 31
	61	+	or territory of the United States. 32
	62	+	(9) "Foreign insurer" means any insurer that has been chartered by or 33
	63	+	organized or constituted within or under the laws of another state or a 34
	64	+	territory of the United States. 35
	65	+	(10) "Insolvency" or "insolvent" means, for any insurer, that it is 36
	66	+	unable to pay its obligations when they are due, or when its admitted 37
	67	+	assets do not exceed its liabilities plus the greater of: (A) Capital and 38
	68	+	surplus required by law for its organization and continued operation; 39
	69	+	or (B) the total par or stated value of its authorized and issued capital 40
	70	+	stock. For purposes of this subdivision "liabilities" shall include but not 41
	71	+	be limited to reserves required by statute or by regulations adopted by 42 Raised Bill No. 1005
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	77	+	the commissioner in accordance with the provisions of chapter 54 or 43
	78	+	specific requirements imposed by the commissioner upon a subject 44
	79	+	company at the time of admission or subsequent thereto. 45
	80	+	(11) "Insurance" means any agreement to pay a sum of money, 46
	81	+	provide services or any other thing of value on the happening of a 47
	82	+	particular event or contingency or to provide indemnity for loss in 48
	83	+	respect to a specified subject by specified perils in return for a 49
	84	+	consideration. In any contract of insurance, an insured shall have an 50
	85	+	interest which is subject to a risk of loss through destruction or 51
	86	+	impairment of that interest, which risk is assumed by the insurer and 52
	87	+	such assumption shall be part of a general scheme to distribute losses 53
	88	+	among a large group of persons bearing similar risks in return for a 54
	89	+	ratable contribution or other consideration. 55
	90	+	(12) "Insurer" or "insurance company" includes any person or 56
	91	+	combination of persons doing any kind or form of insurance business 57
	92	+	other than a fraternal benefit society, and shall include a receiver of any 58
	93	+	insurer when the context reasonably permits. 59
	94	+	(13) "Insured" means a person to whom or for whose benefit an 60
	95	+	insurer makes a promise in an insurance policy. The term includes 61
	96	+	policyholders, subscribers, members and beneficiaries. This definition 62
	97	+	applies only to the provisions of this title and does not define the 63
	98	+	meaning of this word as used in insurance policies or certificates. 64
	99	+	(14) "Life insurance" means insurance on human lives and insurances 65
	100	+	pertaining to or connected with human life. The business of life 66
	101	+	insurance includes granting endowment benefits, granting additional 67
	102	+	benefits in the event of death by accident or accidental means, granting 68
	103	+	additional benefits in the event of the total and permanent disability of 69
	104	+	the insured, and providing optional methods of settlement of proceeds. 70
	105	+	Life insurance includes burial contracts to the extent provided by 71
	106	+	section 38a-464. 72
	107	+	(15) "Mutual insurer" means any insurer without capital stock, the 73
	108	+	managing directors or officers of which are elected by its members. 74 Raised Bill No. 1005
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	113	+
	114	+	(16) "Person" means an individual, a corporation, a partnership, a 75
	115	+	limited liability company, an association, a joint stock company, a 76
	116	+	business trust, an unincorporated organization or other legal entity. 77
	117	+	(17) "Policy" means any document, including attached endorsements 78
	118	+	and riders, purporting to be an enforceable contract, which 79
	119	+	memorializes in writing some or all of the terms of an insurance 80
	120	+	contract. 81
	121	+	(18) "State" means any state, district, or territory of the United States. 82
	122	+	(19) "Subsidiary" of a specified person means an affiliate controlled 83
	123	+	by the person directly, or indirectly through one or more intermediaries. 84
	124	+	(20) "Unauthorized insurer" or "nonadmitted insurer" means an 85
	125	+	insurer that has not been granted a certificate of authority by the 86
	126	+	commissioner to transact the business of insurance in this state or an 87
	127	+	insurer transacting business not authorized by a valid certificate. 88
	128	+	(21) "United States" means the United States of America, its territories 89
	129	+	and possessions, the Commonwealth of Puerto Rico and the District of 90
	130	+	Columbia. 91
	131	+	Sec. 2. (NEW) (Effective January 1, 2022) (a) Notwithstanding any 92
	132	+	provision of the general statutes, each insurer, health care center, 93
	133	+	hospital service corporation, medical service corporation, fraternal 94
	134	+	benefit society or other entity that delivers, issues for delivery, renews, 95
	135	+	amends or continues an individual or group health insurance policy in 96
	136	+	this state on or after January 1, 2022, that provides coverage of the type 97
	137	+	specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 of 98
	138	+	the general statutes shall, not later than thirty days after a newborn child 99
	139	+	is born during any policy year, provide coverage under such policy for 100
	140	+	the newborn child for such policy year if an insured is the parent of such 101
	141	+	newborn child. 102
	142	+	(b) The commissioner may adopt regulations, in accordance with the 103
	143	+	provisions of chapter 54 of the general statutes, to implement the 104 Raised Bill No. 1005
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	147	+	LCO No. 3712 5 of 5
	148	+
	149	+	provisions of this section. 105
79	150		This act shall take effect as follows and shall amend the following
80	151		sections:
81	152
82		-	Section 1 January 1, 2022 38a-~~490~~
83		-	Sec. 2 January 1, 2022 ~~38a-516~~
	153	+	Section 1 January 1, 2022 38a-1
	154	+	Sec. 2 January 1, 2022 New section
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85		-	INS Joint Favorable Subst.
	156	+	Statement of Purpose:
	157	+	To require certain health insurers to automatically provide health
	158	+	insurance coverage for certain newborns.
	159	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
	160	+	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
	161	+	underlined.]
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