Connecticut 2023 Regular Session

Connecticut House Bill HB06710 Compare Versions

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Version 2 (New)

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7	7		General Assembly Substitute Bill No. 6710
8	8		January Session, 2023
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14	14		AN ACT CONCERNING ASSOCIATION HEALTH PLANS AND
15	15		ESTABLISHING A TASK FORCE TO STUDY STOP -LOSS
16	16		INSURANCE.
17	17		Be it enacted by the Senate and House of Representatives in General
18	18		Assembly convened:
19	19
20	20		Section 1. (NEW) (Effective October 1, 2023) For the purposes of this 1
21	21		section and sections 2, 3 and 5 of this act: 2
22	22		(1) "Commissioner" means the Insurance Commissioner; 3
23	23		(2) "Employer member" means an entity in this state that is part of a 4
24	24		sponsoring association, conducts business in this state and employs 5
25	25		individuals in this state; 6
26	26		(3) "ERISA" means the Employee Retirement Income Security Act of 7
27	27		1974, as amended from time to time; 8
28	28		(4) "Fully insured multiple employer welfare arrangement" means 9
29	29		any health benefit plan offered by a sponsoring association for the 10
30	30		purpose of providing insurance to participating employees of a 11
31	31		sponsoring association that is funded through a policy of insurance 12
32	32		issued by a licensed insurance company in this state; 13
33	33		(5) "Health enhancement program" means any health benefit 14
34	34		program that ensures access and removes barriers to essential, high-15 Substitute Bill No. 6710
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41	41		value clinical services; 16
42	42		(6) "Preexisting conditions provision" has the same meaning as 17
43	43		provided in section 38a-476 of the general statutes; 18
44	44		(7) "Self-funded multiple employer welfare arrangement" means any 19
45	45		health benefit plan offered by a sponsoring association, that is not fully 20
46	46		insured by a licensed insurance company in this state, for the purpose 21
47	47		of providing insurance to participating employer members of a 22
48	48		sponsoring association; 23
49	49		(8) "Sponsoring association" means any industry trade group or any 24
50	50		other trade group with employer members representing multiple trades 25
51	51		incorporated in this state that (A) is organized and has a written 26
52	52		constitution or bylaws, (B) has not less than fifty employer members, 27
53	53		and (C) has been maintained in good faith for not less than the 28
54	54		immediately preceding five years for purposes other than obtaining or 29
55	55		providing insurance; and 30
56	56		(9) "Value-based insurance design" means any material term in a 31
57	57		health insurance policy that is designed to increase the quality of 32
58	58		covered benefits or health care services while reducing the cost of such 33
59	59		policy, benefits or health care services. 34
60	60		Sec. 2. (NEW) (Effective October 1, 2023) (a) No self-funded multiple 35
61	61		employer welfare arrangement shall issue any health benefit plan in this 36
62	62		state unless such self-funded multiple employer welfare arrangement 37
63	63		first obtains a license from the commissioner. 38
64	64		(b) Any health benefit plan issued by a self-funded multiple 39
65	65		employer welfare arrangement that covers one or more employees of 40
66	66		one or more participating employer members of a sponsoring 41
67	67		association shall: 42
68	68		(1) Provide coverage for (A) essential health benefits as defined in the 43
69	69		Patient Protection and Affordable Care Act, P.L. 111-148, as amended 44
70	70		from time to time, or regulations adopted thereunder, and (B) the state 45 Substitute Bill No. 6710
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76	76
77	77		mandated coverage requirements under chapter 700c of the general 46
78	78		statutes; 47
79	79		(2) Offer a minimum level of coverage designed to provide health 48
80	80		benefits that are actuarially equivalent to not less than sixty per cent of 49
81	81		the full actuarial value of the benefits provided under the health benefit 50
82	82		plan and include coverage for inpatient hospital services and physician 51
83	83		services; 52
84	84		(3) Not limit or exclude coverage for any individual by imposing any 53
85	85		preexisting conditions provision on such individual; 54
86	86		(4) Not establish discriminatory rules based on the health status of an 55
87	87		individual related to health benefit plan eligibility, or premium or 56
88	88		contribution requirements; 57
89	89		(5) Establish base rates formed on an actuarially sound, modified 58
90	90		community rating methodology that considers the pooling of all 59
91	91		participants' claims; 60
92	92		(6) Utilize each employer member's risk profile to determine 61
93	93		premiums by actuarially adjusting above or below established base 62
94	94		rates, and utilize pooling or reinsurance of individual large claimants to 63
95	95		reduce the adverse impact on any specific employer member's 64
96	96		premiums; 65
97	97		(7) Make any health benefit plan available to all employer members 66
98	98		of a sponsoring association regardless of any factor relating to the health 67
99	99		status of such employer members or individuals eligible for coverage 68
100	100		through any employer member; 69
101	101		(8) Implement value-based insurance design and value-based 70
102	102		contracting by administering programs, which may include, but are not 71
103	103		limited to, centers of excellence, wellness programs, health 72
104	104		enhancement programs, alternative payment models, chronic disease 73
105	105		navigation, patient-centered medical homes and advanced primary 74
106	106		care; and 75 Substitute Bill No. 6710
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112	112
113	113		(9) Comply with the notification requirements to covered persons set 76
114	114		forth in sections 38a-591d, 38a-591e and 38a-591f of the general statutes 77
115	115		with respect to utilization review and benefit determinations of a benefit 78
116	116		request or claim. 79
117	117		(c) Any sponsoring association shall form a trust that shall establish 80
118	118		and maintain any health benefit plans for such sponsoring association. 81
119	119		Such trust shall be authorized to sell health benefit plans to employer 82
120	120		members of the sponsoring association by meeting the following 83
121	121		conditions: 84
122	122		(1) The trust shall be subject to ERISA and any regulations or 85
123	123		standards prescribed by the United States Department of Labor to 86
124	124		enforce multiple employer welfare arrangements; 87
125	125		(2) A Form M-1 shall be filed each year with the United States 88
126	126		Department of Labor. For purposes of this subdivision, "Form M-1" 89
127	127		means an annual report required by the United States Department of 90
128	128		Labor for multiple employer welfare arrangements that includes, but is 91
129	129		not limited to, the following: (A) Identification of the sponsoring 92
130	130		association and trust establishing a self-funded multiple employer 93
131	131		welfare arrangement; and (B) a description of any health benefit plans 94
132	132		offered through the trust as a self-funded multiple employer welfare 95
133	133		arrangement; 96
134	134		(3) Any organizational documents for a trust shall: 97
135	135		(A) State that such trust is sponsored by the sponsoring association; 98
136	136		(B) State that the purpose of such trust is to provide health care 99
137	137		benefits, including, but not limited to, medical, prescription drug, dental 100
138	138		and vision benefits, to participating employees of the sponsoring 101
139	139		association or its members, and the dependents of such participating 102
140	140		employees or members, through health benefit plans; 103
141	141		(C) Provide that trust funds shall be used for the benefit of 104
142	142		participating employees of the sponsoring association and the 105 Substitute Bill No. 6710
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149	149		dependents of such participating employees, through (i) self-funding of 106
150	150		claims or the purchase of reinsurance, or any combination thereof, and 107
151	151		(ii) defraying the costs and expenses of administering and operating 108
152	152		such trust and any health benefit plan; 109
153	153		(D) Limit participation in any health benefit plan to participating 110
154	154		employees of the sponsoring association and such sponsoring 111
155	155		association's employer members; 112
156	156		(E) Establish and maintain a board of trustees, composed of not less 113
157	157		than five trustees, that shall have fiscal control over such self-funded 114
158	158		multiple employer welfare arrangement. Any board of trustees shall 115
159	159		have the authority to (i) approve applications of association employer 116
160	160		members for participation in the self-funded multiple employer welfare 117
161	161		arrangement, and (ii) contract with any licensed administrator or service 118
162	162		company to administer the daily operations of the self-funded multiple 119
163	163		employer welfare arrangement; 120
164	164		(F) Implement a process for the election of trustees to the board of 121
165	165		trustees; and 122
166	166		(G) Require each trustee to discharge such trustee's duties in 123
167	167		accordance with generally accepted fiduciary standards, as determined 124
168	168		by the commissioner, in accordance with the provisions of chapter 54 of 125
169	169		the general statutes; 126
170	170		(4) The trust shall establish and maintain reserves calculated in 127
171	171		accordance with the accounting requirements of the National 128
172	172		Association of Insurance Commissioners Accounting Practices and 129
173	173		Procedures Manual, version effective January 1, 2001, and subsequent 130
174	174		revisions, and in accordance with any financial and solvency 131
175	175		regulations adopted by the commissioner, in accordance with the 132
176	176		provisions of chapter 54 of the general statutes; 133
177	177		(5) The trust shall purchase and maintain an insurance policy 134
178	178		providing coverage for stop-loss insurance with retention levels 135
179	179		determined in accordance with actuarial principles from insurers 136 Substitute Bill No. 6710
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186	186		licensed to transact the business of insurance in this state; 137
187	187		(6) The trust shall purchase and maintain commercially reasonable 138
188	188		fiduciary liability insurance from insurers licensed to transact the 139
189	189		business of insurance in this state; 140
190	190		(7) The trust shall purchase and maintain a bond in an amount and 141
191	191		form approved by the commissioner; and 142
192	192		(8) No trust shall include in its name, the words "insurance", 143
193	193		"insurer", "underwriter", "mutual", or any other word or term or 144
194	194		combination of words or terms that is descriptive of an insurance 145
195	195		company or insurance business, unless the context of such words or 146
196	196		terms indicate that such trust is not an insurance company and is not 147
197	197		transacting the business of insurance. 148
198	198		(d) Any board of trustees established pursuant to subsection (c) of 149
199	199		this section shall: 150
200	200		(1) Operate any health benefit plans in accordance with generally 151
201	201		accepted fiduciary standards, as established in regulations adopted by 152
202	202		the commissioner, in accordance with the provisions of chapter 54 of the 153
203	203		general statutes; and 154
204	204		(2) Have the authority to collect special assessments against employer 155
205	205		members and enforce the collection of such special assessments. 156
206	206		(e) Each employer member shall be liable for such employer 157
207	207		member's allocated share of the liabilities of the sponsoring association 158
208	208		under any health benefit plan, as determined by the board of trustees. 159
209	209		(f) Health benefit plan documents issued by any such self-funded 160
210	210		multiple employer welfare arrangement shall have the following 161
211	211		statement printed on the first page in fourteen-point boldface type: "This 162
212	212		coverage is not insurance and is not offered through an insurance 163
213	213		company. This coverage is not required to comply with certain federal 164
214	214		market requirements for health insurance, and is not required to comply 165 Substitute Bill No. 6710
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221	221		with certain state laws for health insurance. Each employer member 166
222	222		shall be liable for such employer member's allocated share of the 167
223	223		liabilities of the sponsoring association under the health benefit plans as 168
224	224		determined by the board of trustees. Each employer member may be 169
225	225		responsible for paying an additional sum if the annual premiums 170
226	226		present a deficit of funds for the trust. The trust's financial documents 171
227	227		shall be made available upon request by a participant in the health 172
228	228		benefit plan". 173
229	229		(g) This section shall not apply to any fully insured multiple 174
230	230		employer welfare arrangement that offers or provides any health benefit 175
231	231		plan that is fully insured by any insurer authorized to transact the 176
232	232		business of insurance in this state. 177
233	233		(h) The commissioner shall adopt regulations, in accordance with the 178
234	234		provisions of chapter 54 of the general statutes, to implement the 179
235	235		provisions of this section, including, but not limited to, the requirements 180
236	236		of self-funded multiple employer welfare arrangements for: (1) 181
237	237		Licensing; (2) financial condition and actuarial standards; (3) solvency 182
238	238		and insolvency, including, but not limited to, the use of trust deposits 183
239	239		and security bonds; (4) transparency and reporting; and (5) filings. 184
240	240		Sec. 3. (NEW) (Effective October 1, 2023) (a) Any sponsoring 185
241	241		association that sponsors any fully insured multiple employer welfare 186
242	242		arrangement shall have a written constitution and bylaws that require: 187
243	243		(1) The sponsoring association to hold regular meetings not less than 188
244	244		once annually to further the purposes of such sponsoring association's 189
245	245		participating employers; and 190
246	246		(2) The sponsoring association to collect dues or solicit contributions 191
247	247		from such sponsoring association's participating employers. 192
248	248		(b) Any health benefit plan issued by any fully insured multiple 193
249	249		employer welfare arrangement shall: 194
250	250		(1) Comply with regulations or standards prescribed by the United 195 Substitute Bill No. 6710
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257	257		States Department of Labor pertaining to multiple employer welfare 196
258	258		arrangements; 197
259	259		(2) Qualify as a large group market plan subject to (A) all coverage 198
260	260		mandates under chapter 700c of the general statutes applicable to a large 199
261	261		group market plan offered in this state, and (B) the large group market 200
262	262		insurance regulations pursuant to the Public Health Service Act, 42 USC 201
263	263		2791, as amended from time to time; 202
264	264		(3) Adhere to the group health plan coverage requirements under the 203
265	265		Patient Protection and Affordable Care Act, P.L. 111-148, as amended 204
266	266		from time to time; 205
267	267		(4) Not limit or exclude coverage for any individual by imposing any 206
268	268		preexisting conditions provision on such individual; 207
269	269		(5) Provide coverage for (A) essential health benefits as defined in the 208
270	270		Patient Protection and Affordable Care Act, P.L. 111-148, as amended 209
271	271		from time to time, or regulations adopted thereunder, and (B) the state 210
272	272		mandated coverage requirements under chapter 700c of the general 211
273	273		statutes; 212
274	274		(6) Offer a minimum level of coverage designed to provide benefits 213
275	275		that are actuarially equivalent to not less than sixty per cent of the full 214
276	276		actuarial value of the benefits provided under the health benefit plan; 215
277	277		and 216
278	278		(7) Be available only to participating employers of the fully insured 217
279	279		multiple employer welfare arrangement. 218
280	280		Sec. 4. Section 38a-567 of the general statutes is repealed and the 219
281	281		following is substituted in lieu thereof (Effective October 1, 2023): 220
282	282		Health insurance plans [, associations of small employers] and other 221
283	283		insurance arrangements covering small employers and insurers and 222
284	284		producers marketing such plans and arrangements shall be subject to 223
285	285		the following provisions: 224 Substitute Bill No. 6710
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292	292		(1) (A) Any such plan or arrangement shall be offered on a 225
293	293		guaranteed issue basis with respect to all eligible employees or 226
294	294		dependents of such employees, at the option of the small employer, 227
295	295		policyholder or contractholder, as the case may be. 228
296	296		(B) Any such plan or arrangement shall be renewable with respect to 229
297	297		all eligible employees or dependents at the option of the small employer, 230
298	298		policyholder or contractholder, as the case may be, except: (i) For 231
299	299		nonpayment of the required premiums by the small employer, 232
300	300		policyholder or contractholder; (ii) for fraud or misrepresentation of the 233
301	301		small employer, policyholder or contractholder or, with respect to 234
302	302		coverage of individual insured, the insureds or their representatives; 235
303	303		(iii) for noncompliance with plan or arrangement provisions; (iv) when 236
304	304		the number of insureds covered under the plan or arrangement is less 237
305	305		than the number of insureds or percentage of insureds required by 238
306	306		participation requirements under the plan or arrangement; or (v) when 239
307	307		the small employer, policyholder or contractholder is no longer actively 240
308	308		engaged in the business in which it was engaged on the effective date of 241
309	309		the plan or arrangement. 242
310	310		(C) Renewability of coverage may be effected by either continuing in 243
311	311		effect a plan or arrangement covering a small employer or by 244
312	312		substituting upon renewal for the prior plan or arrangement the plan or 245
313	313		arrangement then offered by the carrier that most closely corresponds 246
314	314		to the prior plan or arrangement and is available to other small 247
315	315		employers. Such substitution shall only be made under conditions 248
316	316		approved by the commissioner. A carrier may substitute a plan or 249
317	317		arrangement as set forth in this subparagraph only if the carrier effects 250
318	318		the same substitution upon renewal for all small employers previously 251
319	319		covered under the particular plan or arrangement, unless otherwise 252
320	320		approved by the commissioner. The substitute plan or arrangement 253
321	321		shall be subject to the rating restrictions specified in this section on the 254
322	322		same basis as if no substitution had occurred, except for an adjustment 255
323	323		based on coverage differences. 256
324	324		(D) Any such plan or arrangement shall provide special enrollment 257 Substitute Bill No. 6710
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331	331		periods (i) to all eligible employees or dependents as set forth in 45 CFR 258
332	332		147.104, as amended from time to time, and (ii) for coverage under such 259
333	333		plan or arrangement ordered by a court for a spouse or minor child of 260
334	334		an eligible employee where request for enrollment is made not later than 261
335	335		thirty days after the issuance of such court order. 262
336	336		(2) (A) As used in this subdivision, "grandfathered plan" has the same 263
337	337		meaning as "grandfathered health plan" as provided in the Patient 264
338	338		Protection and Affordable Care Act, P.L. 111-148, as amended from time 265
339	339		to time. 266
340	340		(B) With respect to grandfathered plans issued to small employers, 267
341	341		the premium rates charged or offered shall be established on the basis 268
342	342		of a single pool of all grandfathered plans, adjusted to reflect one or 269
343	343		more of the following classifications: 270
344	344		(i) Age, provided age brackets of less than five years shall not be 271
345	345		utilized; 272
346	346		(ii) Gender; 273
347	347		(iii) Geographic area, provided an area smaller than a county shall 274
348	348		not be utilized; 275
349	349		(iv) Industry, provided the rate factor associated with any industry 276
350	350		classification shall not vary from the arithmetic average of the highest 277
351	351		and lowest rate factors associated with all industry classifications by 278
352	352		greater than fifteen per cent of such average, and provided further, the 279
353	353		rate factors associated with any industry shall not be increased by more 280
354	354		than five per cent per year; 281
355	355		(v) Group size, provided the highest rate factor associated with group 282
356	356		size shall not vary from the lowest rate factor associated with group size 283
357	357		by a ratio of greater than 1.25 to 1.0; 284
358	358		(vi) Administrative cost savings resulting from the administration of 285
359	359		an association group plan or a plan written pursuant to section 5-259, 286 Substitute Bill No. 6710
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366	366		provided the savings reflect a reduction to the small employer carrier's 287
367	367		overall retention that is measurable and specifically realized on items 288
368	368		such as marketing, billing or claims paying functions taken on directly 289
369	369		by the plan administrator or association, except that such savings may 290
370	370		not reflect a reduction realized on commissions; 291
371	371		(vii) Savings resulting from a reduction in the profit of a carrier that 292
372	372		writes small business plans or arrangements for an association group 293
373	373		plan or a plan written pursuant to section 5-259, provided any loss in 294
374	374		overall revenue due to a reduction in profit is not shifted to other small 295
375	375		employers; and 296
376	376		(viii) Family composition, provided the small employer carrier shall 297
377	377		utilize only one or more of the following billing classifications: (I) 298
378	378		Employee; (II) employee plus family; (III) employee and spouse; (IV) 299
379	379		employee and child; (V) employee plus one dependent; and (VI) 300
380	380		employee plus two or more dependents. 301
381	381		(C) (i) With respect to nongrandfathered plans issued to small 302
382	382		employers, the premium rates charged or offered shall be established on 303
383	383		the basis of a single pool of all nongrandfathered plans, adjusted to 304
384	384		reflect one or more of the following classifications: 305
385	385		(I) Age, in accordance with a uniform age rating curve established by 306
386	386		the commissioner; or 307
387	387		(II) Geographic area, as defined by the commissioner. 308
388	388		(ii) Total premium rates for family coverage for nongrandfathered 309
389	389		plans shall be determined by adding the premiums for each individual 310
390	390		family member, except that with respect to family members under 311
391	391		twenty-one years of age, the premiums for only the three oldest covered 312
392	392		children shall be taken into account in determining the total premium 313
393	393		rate for such family. 314
394	394		(iii) Premium rates for employees and dependents for 315
395	395		nongrandfathered plans shall be calculated for each covered individual 316 Substitute Bill No. 6710
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402	402		and premium rates for the small employer group shall be calculated by 317
403	403		totaling the premiums attributable to each covered individual. 318
404	404		(iv) Premium rates for any given plan may vary by (I) actuarially 319
405	405		justified differences in plan design, and (II) actuarially justified amounts 320
406	406		to reflect the policy's provider network and administrative expense 321
407	407		differences that can be reasonably allocated to such policy. 322
408	408		(3) No small employer carrier or producer shall, directly or indirectly, 323
409	409		engage in the following activities: 324
410	410		(A) Encouraging or directing small employers to refrain from filing 325
411	411		an application for coverage with the small employer carrier because of 326
412	412		the health status, claims experience, industry, occupation or geographic 327
413	413		location of the small employer, except the provisions of this 328
414	414		subparagraph shall not apply to information provided by a small 329
415	415		employer carrier or producer to a small employer regarding the carrier's 330
416	416		established geographic service area or a restricted network provision of 331
417	417		a small employer carrier; or 332
418	418		(B) Encouraging or directing small employers to seek coverage from 333
419	419		another carrier because of the health status, claims experience, industry, 334
420	420		occupation or geographic location of the small employer. 335
421	421		(4) No small employer carrier shall, directly or indirectly, enter into 336
422	422		any contract, agreement or arrangement with a producer that provides 337
423	423		for or results in the compensation paid to a producer for the sale of a 338
424	424		health benefit plan to be varied because of the health status, claims 339
425	425		experience, industry, occupation or geographic area of the small 340
426	426		employer. A small employer carrier shall provide reasonable 341
427	427		compensation, as provided under the plan of operation of the program, 342
428	428		to a producer, if any, for the sale of a health care plan. No small 343
429	429		employer carrier shall terminate, fail to renew or limit its contract or 344
430	430		agreement of representation with a producer for any reason related to 345
431	431		the health status, claims experience, occupation, or geographic location 346
432	432		of the small employers placed by the producer with the small employer 347 Substitute Bill No. 6710
433	433
434	434
435	435		LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2023HB-06710-
436		-	~~R02~~-HB.docx }
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437	437		13 of 16
438	438
439	439		carrier. 348
440	440		(5) No small employer carrier or producer shall induce or otherwise 349
441	441		encourage a small employer to separate or otherwise exclude an 350
442	442		employee from health coverage or benefits provided in connection with 351
443	443		the employee's employment. 352
444	444		(6) No small employer carrier or producer shall disclose (A) to a small 353
445	445		employer the fact that any or all of the eligible employees of such small 354
446	446		employer have been or will be reinsured with the pool, or (B) to any 355
447	447		eligible employee or dependent the fact that he has been or will be 356
448	448		reinsured with the pool. 357
449	449		(7) If a small employer carrier enters into a contract, agreement or 358
450	450		other arrangement with another party to provide administrative, 359
451	451		marketing or other services related to the offering of health benefit plans 360
452	452		to small employers in this state, the other party shall be subject to the 361
453	453		provisions of this section. 362
454	454		(8) The commissioner may adopt regulations, in accordance with the 363
455	455		provisions of chapter 54, setting forth additional standards to provide 364
456	456		for the fair marketing and broad availability of health benefit plans to 365
457	457		small employers. 366
458	458		(9) Any violation of subdivisions (3) to (7), inclusive, of this section 367
459	459		and of any regulations established under subdivision (8) of this section 368
460	460		shall be an unfair and prohibited practice under sections 38a-815 to 38a-369
461	461		830, inclusive. 370
462	462		Sec. 5. (Effective from passage) (a) For the purposes of this section: 371
463	463		(1) "Stop-loss insurance plan" means any insurance policy purchased 372
464	464		by any employer, insurer, multiple employer welfare arrangement or 373
465	465		other provider of fully insured or self-funded small group health 374
466	466		coverage in this state that limits the financial risk of medical costs for 375
467	467		such employer, insurer, multiple employer welfare arrangement or 376
468	468		other provider of fully insured or self-funded small group health 377 Substitute Bill No. 6710
469	469
470	470
471	471		LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2023HB-06710-
472		-	~~R02~~-HB.docx }
	472	+	R01-HB.docx }
473	473		14 of 16
474	474
475	475		coverage; and 378
476	476		(2) "Small group" means any employer or other purchaser of a stop-379
477	477		loss insurance plan with not more than one hundred employees or 380
478	478		members. 381
479	479		(b) There is established a task force to study the structure of stop-loss 382
480	480		insurance plans and any impact that such plans may have on (1) small 383
481	481		groups and such groups' enrollees, and (2) medical spending in this 384
482	482		state. 385
483	483		(c) The task force shall make recommendations concerning: (1) 386
484	484		Measures to ensure access to affordable health care services to 387
485	485		purchasers of stop-loss insurance plans and such purchasers' enrollees 388
486	486		in health coverage utilizing stop-loss insurance plans; (2) any financial 389
487	487		impact that stop-loss insurance plans may have on (A) small groups in 390
488	488		this state, (B) enrollees and such enrollees' family members, and (C) the 391
489	489		fully insured health insurance market in this state; (3) the appropriate 392
490	490		role of stop-loss insurance plans in this state; and (4) consumer 393
491	491		protections for small groups, such small groups' enrollees and such 394
492	492		enrollees' family members covered by stop-loss insurance plans in this 395
493	493		state. 396
494	494		(d) The task force shall consist of the following members: 397
495	495		(1) Two appointed by the speaker of the House of Representatives, 398
496	496		one of whom shall be a representative of a small group in this state 399
497	497		utilizing a stop-loss insurance plan, and one of whom shall be a 400
498	498		representative of a small group in this state offering health coverage that 401
499	499		does not utilize a stop-loss insurance plan; 402
500	500		(2) Two appointed by the president pro tempore of the Senate, one of 403
501	501		whom shall have experience in managing employee benefits and be 404
502	502		knowledgeable with respect to stop-loss insurance in this state, and one 405
503	503		of whom shall be an insurance producer licensed in this state and be 406
504	504		knowledgeable with respect to stop-loss insurance in this state; 407 Substitute Bill No. 6710
505	505
506	506
507	507		LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2023HB-06710-
508		-	~~R02~~-HB.docx }
	508	+	R01-HB.docx }
509	509		15 of 16
510	510
511	511		(3) One appointed by the majority leader of the House of 408
512	512		Representatives, who shall be a physician licensed pursuant to chapter 409
513	513		370 of the general statutes; 410
514	514		(4) One appointed by the majority leader of the Senate, who shall be 411
515	515		a representative of an advocacy organization focused on health equity; 412
516	516		(5) One appointed by the minority leader of the House of 413
517	517		Representatives, who shall be a representative of the Connecticut 414
518	518		Association of Health Plans; 415
519	519		(6) One appointed by the minority leader of the Senate, who shall be 416
520	520		a representative of the Connecticut Business and Industry Association; 417
521	521		(7) The Healthcare Advocate, or the Healthcare Advocate's designee; 418
522	522		and 419
523	523		(8) Three persons appointed by the Governor, one of whom shall be 420
524	524		a representative of a labor organization, one of whom shall be a 421
525	525		representative of an insurance carrier licensed to issue stop-loss 422
526	526		insurance plans in this state and one of whom shall be a representative 423
527	527		of a consumer advocacy organization. 424
528	528		(e) All initial appointments to the task force shall be made not later 425
529	529		than thirty days after the effective date of this section. Any vacancy shall 426
530	530		be filled by the appointing authority. 427
531	531		(f) The members of the task force shall select one or two chairpersons 428
532	532		of the task force from among the members of the task force. Such 429
533	533		chairperson or chairpersons shall schedule the first meeting of the task 430
534	534		force, which shall be held not later than sixty days after the effective date 431
535	535		of this section. 432
536	536		(g) The administrative staff of the joint standing committee of the 433
537	537		General Assembly having cognizance of matters relating to insurance 434
538	538		shall serve as administrative staff of the task force. 435 Substitute Bill No. 6710
539	539
540	540
541	541		LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2023HB-06710-
542		-	~~R02~~-HB.docx }
	542	+	R01-HB.docx }
543	543		16 of 16
544	544
545	545		(h) Not later than February 1, 2024, the task force shall submit a report 436
546	546		on its findings and recommendations to the joint standing committee of 437
547	547		the General Assembly having cognizance of matters relating to 438
548	548		insurance, in accordance with the provisions of section 11-4a of the 439
549	549		general statutes. The task force shall terminate on the date that it 440
550	550		submits such report or February 1, 2024, whichever is later. 441
551	551		This act shall take effect as follows and shall amend the following
552	552		sections:
553	553
554	554		Section 1 October 1, 2023 New section
555	555		Sec. 2 October 1, 2023 New section
556	556		Sec. 3 October 1, 2023 New section
557	557		Sec. 4 October 1, 2023 38a-567
558	558		Sec. 5 from passage New section
559	559
	560	+	Statement of Legislative Commissioners:
	561	+	In Section 1, the definitions were reordered for consistency with
	562	+	standard drafting conventions.
560	563
561	564		INS Joint Favorable Subst.
562		-	APP Joint Favorable
563	565