Substitute Senate Bill No. 1039
Public Act No. 23-127
AN ACT CONCERNING THE INSURANCE DEPARTMENT'S
RECOMMENDATIONS REGARDING FINANCIAL REGULATION,
LIFE INSURANCE AND INSURANCE LICENSING REQUIREMENTS
AND TECHNICAL CORRECTIONS AND REVISIONS TO THE LIFE
AND HEALTH INSURANCE STATUTES.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 38a-11 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2023):
(a) The commissioner shall demand and receive the following fees:
(1) For the annual fee for each license issued to a domestic insurance
company, two hundred dollars; (2) for receiving and filing annual
reports of domestic insurance companies, fifty dollars; (3) for filing all
documents prerequisite to the issuance of a license to an insurance
company, two hundred twenty dollars, except that the fee for such
filings by any health care center, as defined in section 38a-175, shall be
one thousand three hundred fifty dollars; (4) for filing any additional
paper required by law, thirty dollars; (5) for each certificate of valuation,
organization, reciprocity or compliance, forty dollars; (6) for each
certified copy of a license to a company, forty dollars; (7) for each
certified copy of a report or certificate of condition of a company to be
filed in any other state, forty dollars; (8) for amending a certificate of
authority, two hundred dollars; (9) for each license issued to a rating Substitute Senate Bill No. 1039
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organization, two hundred dollars. In addition, insurance companies
shall pay any fees imposed under section 12-211; (10) a filing fee of fifty
dollars for each initial application for a license made pursuant to section
38a-769, as amended by this act; (11) with respect to insurance agents'
appointments: (A) A filing fee of fifty dollars for each request for any
agent appointment, except that no filing fee shall be payable for a
request for agent appointment by an insurance company domiciled in a
state or foreign country which does not require any filing fee for a
request for agent appointment for a Connecticut insurance company; (B)
a fee of one hundred dollars for each appointment issued to an agent of
a domestic insurance company or for each appointment continued; and
(C) a fee of eighty dollars for each appointment issued to an agent of any
other insurance company or for each appointment continued, except
that (i) no fee shall be payable for an appointment issued to an agent of
an insurance company domiciled in a state or foreign country which
does not require any fee for an appointment issued to an agent of a
Connecticut insurance company, and (ii) the fee shall be twenty dollars
for each appointment issued or continued to an agent of an insurance
company domiciled in a state or foreign country with a premium tax
rate below Connecticut's premium tax rate; (12) with respect to
insurance producers: (A) An examination fee of fifteen dollars for each
examination taken, except when a testing service is used, the testing
service shall pay a fee of fifteen dollars to the commissioner for each
examination taken by an applicant; (B) a fee of eighty dollars for each
license issued; (C) a fee of eighty dollars per year, or any portion thereof,
for each license renewed; and (D) a fee of eighty dollars for any license
renewed under the transitional process established in section 38a-784;
(13) with respect to public adjusters: (A) An examination fee of fifteen
dollars for each examination taken, except when a testing service is
used, the testing service shall pay a fee of fifteen dollars to the
commissioner for each examination taken by an applicant; and (B) a fee
of two hundred fifty dollars for each license issued or renewed; (14) with
respect to casualty claims adjusters: (A) An examination fee of twenty Substitute Senate Bill No. 1039
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dollars for each examination taken, except when a testing service is
used, the testing service shall pay a fee of twenty dollars to the
commissioner for each examination taken by an applicant; (B) a fee of
eighty dollars for each license issued or renewed; and (C) the expense of
any examination administered outside the state shall be the
responsibility of the entity making the request and such entity shall pay
to the commissioner two hundred dollars for such examination and the
actual traveling expenses of the examination administrator to
administer such examination; (15) with respect to motor vehicle
physical damage appraisers: (A) An examination fee of eighty dollars
for each examination taken, except when a testing service is used, the
testing service shall pay a fee of eighty dollars to the commissioner for
each examination taken by an applicant; (B) a fee of eighty dollars for
each license issued or renewed; and (C) the expense of any examination
administered outside the state shall be the responsibility of the entity
making the request and such entity shall pay to the commissioner two
hundred dollars for such examination and the actual traveling expenses
of the examination administrator to administer such examination; (16)
with respect to certified insurance consultants: (A) An examination fee
of twenty-six dollars for each examination taken, except when a testing
service is used, the testing service shall pay a fee of twenty-six dollars to
the commissioner for each examination taken by an applicant; (B) a fee
of two hundred fifty dollars for each license issued; and (C) a fee of two
hundred fifty dollars for each license renewed; (17) with respect to
surplus lines brokers: (A) An examination fee of twenty dollars for each
examination taken, except when a testing service is used, the testing
service shall pay a fee of twenty dollars to the commissioner for each
examination taken by an applicant; and (B) a fee of six hundred twenty-
five dollars for each license issued or renewed; (18) with respect to
fraternal agents, a fee of eighty dollars for each license issued or
renewed; (19) a fee of twenty-six dollars for each license certificate
requested, whether or not a license has been issued; (20) with respect to
domestic and foreign benefit societies shall pay: (A) For service of Substitute Senate Bill No. 1039
Public Act No. 23-127 4 of 19
process, fifty dollars for each person or insurer to be served; (B) for filing
a certified copy of its charter or articles of association, fifteen dollars; (C)
for filing an annual statement or report, twenty dollars; and (D) for filing
any additional paper required by law, fifteen dollars; (21) with respect
to foreign benefit societies: (A) For each certificate of organization or
compliance, fifteen dollars; (B) for each certified copy of permit, fifteen
dollars; and (C) for each copy of a report or certificate of condition of a
society to be filed in any other state, fifteen dollars; (22) with respect to
reinsurance intermediaries, a fee of six hundred twenty-five dollars for
each license issued or renewed; (23) with respect to life settlement
providers: (A) A filing fee of twenty-six dollars for each initial
application for a license made pursuant to section 38a-465a; and (B) a
fee of forty dollars for each license issued or renewed; (24) with respect
to life settlement brokers: (A) A filing fee of twenty-six dollars for each
initial application for a license made pursuant to section 38a-465a; and
(B) a fee of forty dollars for each license issued or renewed; (25) with
respect to preferred provider networks, a fee of two thousand seven
hundred fifty dollars for each license issued or renewed; (26) with
respect to rental companies, as defined in section 38a-799, a fee of eighty
dollars for each permit issued or renewed; (27) with respect to medical
discount plan organizations licensed under section 38a-479rr, a fee of six
hundred twenty-five dollars for each license issued or renewed; (28)
with respect to pharmacy benefits managers, an application fee of one
hundred dollars for each registration issued or renewed; (29) with
respect to captive insurance companies, as defined in section 38a-91aa,
a fee of three hundred seventy-five dollars for each license issued or
renewed; (30) with respect to each duplicate license issued a fee of fifty
dollars for each license issued; (31) with respect to surety bail bond
agents, as defined in section 38a-660, (A) a filing fee of one hundred fifty
dollars for each initial application for a license, and (B) a fee of one
hundred dollars for each license issued or renewed; (32) with respect to
third-party administrators, as defined in section 38a-720, (A) a fee of five
hundred dollars for each license issued, and (B) a fee of four hundred Substitute Senate Bill No. 1039
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fifty dollars for each license renewed; (33) with respect to portable
electronics insurance licenses under section 38a-397, (A) a filing fee of
one hundred dollars for each initial application for a license, (B) a fee of
five hundred dollars for each license issued, and (C) a fee of four
hundred fifty dollars for each license renewed; [and] (34) with respect
to limited lines travel insurance producer licenses under section 38a-398,
(A) a filing fee of one hundred dollars for each initial application for a
license, (B) a fee of six hundred fifty dollars for each license issued, and
(C) a fee of six hundred fifty dollars for each license renewed; (35) with
respect to certified reinsurers, as certified by the commissioner pursuant
to regulations adopted pursuant to section 38a-85, a fee of two thousand
dollars for each certificate issued and renewed; and (36) with respect to
reciprocal jurisdiction reinsurers, as defined in regulations adopted
pursuant to section 38a-85, a fee of two thousand dollars for each
certificate issued and renewed.
(b) If any state imposes fees upon domestic fraternal benefit societies
greater than are fixed by this section or sections 38a-595 to 38a-626,
inclusive, 38a-631 to 38a-640, inclusive, or 38a-800, the commissioner
shall collect from each fraternal benefit society incorporated by or
organized under the laws of such other state and admitted to transact
business in this state, the same fees as are imposed upon similar
domestic societies and organizations by such other state. The expense of
any examination or inquiry made outside the state shall be borne by the
society so examined.
(c) Each unauthorized insurer declared to be an eligible surplus lines
insurer shall pay to the Insurance Commissioner, on or before May first
of each year, an annual fee of one hundred twenty-six dollars in order
to remain on the list of eligible surplus lines insurers.
(d) For service of process on the commissioner, the commissioner
shall demand and receive a fee of fifty dollars for each person or insurer
to be served. The commissioner shall also collect, for each hospital or Substitute Senate Bill No. 1039
Public Act No. 23-127 6 of 19
ambulance lien filed, fifty dollars, and for each small claims notice filed,
fifteen dollars, each of which shall be paid by the plaintiff at the time of
service, the same to be recovered by him as part of the taxable costs if he
prevails in the suit.
(e) Each insurance company depositing any security with the
Treasurer pursuant to section 38a-83 shall pay to the commissioner three
hundred fifteen dollars, annually. In case of an examination or appraisal
made outside the office of the Treasurer, and in such case the company
in whose behalf such examination or appraisal has been made shall pay
to the commissioner two hundred dollars for such examination and the
actual traveling expenses of the officer making such examination or
appraisal.
(f) Notwithstanding any provision of the general statutes, the
commissioner may require that any person required by any provision
of this title to pay a fee to the commissioner pay such fee to the
commissioner by electronic means. Such person may submit a request
to the commissioner for an exception to the electronic fee requirement.
The commissioner shall grant such request for an exception, provided
the commissioner determines that (1) compliance with the electronic fee
requirement is impractical or reasonably causes such person to suffer
undue hardship, or (2) good cause exists to grant such requested
exception.
Sec. 2. Section 38a-769 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2023):
(a) Any person, partnership, association or corporation that is
resident in this state, [or has its principal place of business in this state,]
or a nonresident of this state who is not licensed in any other state that
offers the type of license sought in this state and maintains a principal
place of business in this state, desiring to act within this state as a public
adjuster, casualty adjuster, motor vehicle physical damage appraiser, Substitute Senate Bill No. 1039
Public Act No. 23-127 7 of 19
certified insurance consultant, surplus lines broker or desiring to engage
in any insurance-related occupation for which a license is deemed
necessary by the commissioner, other than an occupation as an
insurance producer, shall make a written application to the
commissioner for a resident license. Any other person, partnership,
association or corporation desiring to so act or to engage in any
insurance-related occupation for which a license is deemed necessary
by the commissioner, other than an occupation as an insurance
producer, shall make a written application to the commissioner for a
nonresident license. [No]
(b) Except as provided in subsection (c) of this section, no application
for a nonresident license shall be granted unless the applicant holds an
equivalent license from any other state. Any application for a resident
or nonresident license shall be made for each name or designation under
which such business shall be conducted, in such form as the
commissioner prescribes, stating the line or lines of insurance for which
the applicant desires such license and any other business which the
applicant desires also to transact. All initial applications shall be
accompanied by a nonrefundable filing fee specified in section 38a-11.
The commissioner shall cause to be made such inquiry and examination
as to the qualifications of each such applicant as the commissioner
deems necessary.
(c) Any person, partnership, association or corporation residing in a
state that does not offer the type of license sought by such person,
partnership, association or corporation in this state may make a written
application to the commissioner for a nonresident license and designate
this state as such person's, association's or corporation's home state.
[(b)] (d) Each application for a license shall be signed by: The
applicant, if the application is for an individual; a licensed officer, if the
application is for a corporation; a licensed partner, if the application is
for a partnership; and a licensed principal, if the application is for any Substitute Senate Bill No. 1039
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other applicant.
[(c)] (e) Each applicant for a license shall furnish satisfactory evidence
to the commissioner that the applicant is a person of good moral
character and that the applicant is financially responsible. In order to
determine the trustworthiness and competency of an applicant the
commissioner shall subject the applicant to personal written
examination as to the applicant's competency to act as a licensee for each
line of insurance for which the applicant desires to be licensed. The
commissioner may, at the commissioner's discretion, designate an
independent testing service to prepare and administer such
examination, provided any examination fees charged by such service
shall be paid by the applicant. The commissioner shall collect the
appropriate examination fee as specified in section 38a-11, as amended
by this act, which shall entitle the applicant to take the examination for
the license desired, except that when a testing service is used, the testing
service shall pay such fee to the commissioner for each examination
taken by an applicant. In either case, each such examination shall be as
the commissioner prescribes and shall be of sufficient scope to test the
applicant's knowledge of insurance, the duties and responsibilities of a
licensee and the laws of this state applicable to insurance. The
commissioner may require a waiting period not exceeding six months,
before reexamining any applicant who has failed to pass any such
examination.
[(d)] (f) Upon finding that an applicant meets the licensing
requirements of this title and is in all respects properly qualified and
trustworthy and that the granting of such license is not against the
public interest, the commissioner may issue to such applicant the license
applied for, in such form as the commissioner may adopt, to act within
this state to the extent therein specified.
[(e)] (g) The commissioner may adopt regulations, in accordance with
chapter 54, concerning the approval of schools offering courses in Substitute Senate Bill No. 1039
Public Act No. 23-127 9 of 19
insurance, the content of such courses and the advertising to the public
of the services of these schools.
[(f)] (h) To further the enforcement of this section and to determine
the eligibility of any licensee, the commissioner may, as often as the
commissioner deems necessary, examine the books and records of any
such licensee.
[(g)] (i) A license may, in the discretion of the commissioner, be
renewed or continued upon payment of the appropriate fee as specified
in section 38a-11, as amended by this act, without the resubmittal of the
detailed information required in the original application.
(j) The provisions of subsections (b) to (i), inclusive, of this section
shall be applicable to any licensee or applicant for a license, including,
but not limited to, such licensee engaged in, or such applicant who seeks
to become licensed to engage in, the occupation of insurance producer.
Sec. 3. Section 38a-489 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2023):
(a) Each individual health insurance policy providing coverage of the
type specified in subdivisions (1), (2), (4), [(6),] (10), (11) and (12) of
section 38a-469, delivered, issued for delivery, renewed, amended or
continued in this state that provides that coverage of a dependent child
shall terminate upon attainment of the limiting age for dependent
children specified in the policy shall also provide in substance that
attainment of the limiting age shall not operate to terminate the
coverage of the child if at such date the child is and continues thereafter
to be both (1) incapable of self-sustaining employment by reason of
mental or physical handicap, as certified by the child's physician,
physician assistant or advanced practice registered nurse on a form
provided by the insurer, hospital service corporation, medical service
corporation or health care center, and (2) chiefly dependent upon the Substitute Senate Bill No. 1039
Public Act No. 23-127 10 of 19
policyholder or subscriber for support and maintenance.
(b) Proof of the incapacity and dependency shall be furnished to the
insurer, hospital service corporation, medical service corporation or
health care center by the policyholder or subscriber within thirty-one
days of the child's attainment of the limiting age. The insurer,
corporation or health care center may at any time require proof of the
child's continuing incapacity and dependency. After a period of two
years has elapsed following the child's attainment of the limiting age the
insurer, corporation or health care center may require periodic proof of
the child's continuing incapacity and dependency but in no case more
frequently than once every year.
Sec. 4. Subsection (a) of section 38a-490 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October
1, 2023):
(a) Each individual health insurance policy delivered, issued for
delivery, renewed, amended or continued in this state providing
coverage of the type specified in subdivisions (1), (2), (4), [(6),] (10), (11)
and (12) of section 38a-469 for a family member of the insured or
subscriber shall, as to such family member's coverage, also provide that
the health insurance benefits applicable for children shall be payable
with respect to a newly born child of the insured or subscriber from the
moment of birth.
Sec. 5. Subsection (a) of section 38a-497 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October
1, 2023):
(a) Each individual health insurance policy providing coverage of the
type specified in subdivisions (1), (2), (4), [(6),] (10), (11) and (12) of
section 38a-469 delivered, issued for delivery, amended, renewed or
continued in this state shall provide that coverage of a child, stepchild Substitute Senate Bill No. 1039
Public Act No. 23-127 11 of 19
or other dependent child shall terminate not earlier than the policy
anniversary date after the date on which the child, stepchild or other
dependent child attains the age of twenty-six.
Sec. 6. Subsection (a) of section 38a-508 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October
1, 2023):
(a) Each individual health insurance policy providing coverage of the
type specified in subdivisions (1), (2), (4), [(6),] (10), (11) and (12) of
section 38a-469 delivered, issued for delivery, amended, renewed or
continued in this state shall provide coverage for a child legally placed
for adoption with the insured or subscriber who is an adoptive parent
or a prospective adoptive parent, even though the adoption has not been
finalized, provided the child lives in the household of such insured or
subscriber and the child is dependent upon such person for support and
maintenance.
Sec. 7. Subsection (a) of section 38a-512b of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October
1, 2023):
(a) Each group health insurance policy providing coverage of the type
specified in subdivisions (1), (2), (4), [(6),] (10), (11) and (12) of section
38a-469 delivered, issued for delivery, amended, renewed or continued
in this state shall provide that coverage of a child, stepchild or other
dependent child shall terminate not earlier than the policy anniversary
date after the date on which the child, stepchild or other dependent
child attains the age of twenty-six.
Sec. 8. Subsection (a) of section 38a-515 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October
1, 2023):
(a) Each group health insurance policy providing coverage of the type Substitute Senate Bill No. 1039
Public Act No. 23-127 12 of 19
specified in subdivisions (1), (2), (4), [(6),] (11) and (12) of section 38a-
469 delivered, issued for delivery, renewed, amended or continued in
this state that provides that coverage of a dependent child of an
employee or other member of the covered group shall terminate upon
attainment of the limiting age for dependent children specified in the
policy shall also provide in substance that attainment of the limiting age
shall not operate to terminate the coverage of the child if at such date
the child is and continues thereafter to be both (1) incapable of self-
sustaining employment by reason of mental or physical handicap, as
certified by the child's physician, physician assistant or advanced
practice registered nurse on a form provided by the insurer, hospital
service corporation, medical service corporation or health care center,
and (2) chiefly dependent upon such employee or member for support
and maintenance.
Sec. 9. Subsection (a) of section 38a-516 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October
1, 2023):
(a) Each group health insurance policy delivered, issued for delivery,
renewed, amended or continued in this state providing coverage of the
type specified in subdivisions (1), (2), (4), [(6),] (11) and (12) of section
38a-469 for a family member of the insured or subscriber shall, as to such
family member's coverage, also provide that the health insurance
benefits applicable for children shall be payable with respect to a newly
born child of the insured or subscriber from the moment of birth.
Sec. 10. Subsection (a) of section 38a-549 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October
1, 2023):
(a) Each group health insurance policy providing coverage of the type
specified in subdivisions (1), (2), (4), [(6),] (10), (11) and (12) of section
38a-469 delivered, issued for delivery, amended, renewed or continued Substitute Senate Bill No. 1039
Public Act No. 23-127 13 of 19
in this state shall provide coverage for a child legally placed for
adoption with an employee or other member of the covered group who
is an adoptive parent or a prospective adoptive parent, even though the
adoption has not been finalized, provided the child lives in the
household of such employee or member and the child is dependent
upon such employee or member for support and maintenance.
Sec. 11. Section 38a-509 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2023):
(a) Subject to the limitations set forth in subsection (b) of this section
and except as provided in subsection (c) of this section, each individual
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, amended, renewed or continued in this state on or
after January 1, 2018, shall provide coverage for the medically necessary
expenses [of] for the diagnosis and treatment of infertility, including,
but not limited to, ovulation induction, intrauterine insemination, in-
vitro fertilization, uterine embryo lavage, embryo transfer, gamete intra-
fallopian transfer, zygote intra-fallopian transfer and low tubal ovum
transfer. For purposes of this section, "infertility" means the condition of
an individual who is unable to conceive or produce conception or
sustain a successful pregnancy during a one-year period or such
treatment is medically necessary.
(b) Such policy may:
[(1) Limit such coverage to an individual until the date of such
individual's fortieth birthday;]
[(2)] (1) Limit such coverage for ovulation induction to a lifetime
maximum benefit of four cycles;
[(3)] (2) Limit such coverage for intrauterine insemination to a
lifetime maximum benefit of three cycles; Substitute Senate Bill No. 1039
Public Act No. 23-127 14 of 19
[(4)] (3) Limit such coverage for lifetime benefits to a maximum of
two cycles, with not more than two embryo implantations per cycle, for
in-vitro fertilization, gamete intra-fallopian transfer, zygote intra-
fallopian transfer or low tubal ovum transfer, provided each such
fertilization or transfer shall be credited toward such maximum as one
cycle;
[(5)] (4) Limit coverage for in-vitro fertilization, gamete intra-
fallopian transfer, zygote intra-fallopian transfer and low tubal ovum
transfer to those individuals who have been unable to conceive or
produce conception or sustain a successful pregnancy through less
expensive and medically viable infertility treatment or procedures
covered under such policy. Nothing in this subdivision shall be
construed to deny the coverage required by this section to any
individual who foregoes a particular infertility treatment or procedure
if the individual's physician determines that such treatment or
procedure is likely to be unsuccessful; and
[(6)] (5) Require that covered infertility treatment or procedures be
performed at facilities that conform to the standards and guidelines
developed by the American Society of Reproductive Medicine or the
Society of Reproductive Endocrinology and Infertility. [;]
[(7) Limit coverage to individuals who have maintained coverage
under such policy for at least twelve months; and
(8) Require disclosure by the individual seeking such coverage to
such individual's existing health insurance carrier of any previous
infertility treatment or procedures for which such individual received
coverage under a different health insurance policy. Such disclosure shall
be made on a form and in the manner prescribed by the Insurance
Commissioner.]
(c) (1) Any insurance company, hospital service corporation, medical Substitute Senate Bill No. 1039
Public Act No. 23-127 15 of 19
service corporation or health care center may issue to a religious
employer an individual health insurance policy that excludes coverage
for methods of diagnosis and treatment of infertility that are contrary to
the religious employer's bona fide religious tenets.
(2) Upon the written request of an individual who states in writing
that methods of diagnosis and treatment of infertility are contrary to
such individual's religious or moral beliefs, any insurance company,
hospital service corporation, medical service corporation or health care
center may issue to or on behalf of the individual a policy or rider
thereto that excludes coverage for such methods.
(d) Any health insurance policy issued pursuant to subsection (c) of
this section shall provide written notice to each insured or prospective
insured that methods of diagnosis and treatment of infertility are
excluded from coverage pursuant to said subsection. Such notice shall
appear, in not less than ten-point type, in the policy, application and
sales brochure for such policy.
(e) As used in this section, "religious employer" means an employer
that is a "qualified church-controlled organization", as defined in 26 USC
3121 or a church-affiliated organization.
(f) Except as provided in subsections (c) to (e), inclusive, of this
section, no individual 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, amended, renewed or continued in this
state on or after January 1, 2024, may make any distinction or
discrimination between persons on the basis of gender identity or
expression, sexual orientation or age with respect to health insurance
coverage for the medically necessary expenses for the diagnosis and
treatment of infertility, except that such policy may consider age as a
factor on the basis of a determination of medical necessity, using
professional guidelines published by the American Society for Substitute Senate Bill No. 1039
Public Act No. 23-127 16 of 19
Reproductive Medicine, its successor organization or a comparable
organization. For purposes of this subsection, "gender identity or
expression" has the same meaning as provided in section 1-1n.
Sec. 12. Section 38a-536 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2023):
(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 type specified in
subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered,
issued for delivery, amended, renewed or continued in this state on or
after January 1, 2018, shall provide coverage for the medically necessary
expenses [of] for the diagnosis and treatment of infertility, including,
but not limited to, ovulation induction, intrauterine insemination, in-
vitro fertilization, uterine embryo lavage, embryo transfer, gamete intra-
fallopian transfer, zygote intra-fallopian transfer and low tubal ovum
transfer. For purposes of this section, "infertility" means the condition of
an individual who is unable to conceive or produce conception or
sustain a successful pregnancy during a one-year period or such
treatment is medically necessary.
(b) Such policy may:
[(1) Limit such coverage to an individual until the date of such
individual's fortieth birthday;]
[(2)] (1) Limit such coverage for ovulation induction to a lifetime
maximum benefit of four cycles;
[(3)] (2) Limit such coverage for intrauterine insemination to a
lifetime maximum benefit of three cycles;
[(4)] (3) Limit such coverage for lifetime benefits to a maximum of
two cycles, with not more than two embryo implantations per cycle, for Substitute Senate Bill No. 1039
Public Act No. 23-127 17 of 19
in-vitro fertilization, gamete intra-fallopian transfer, zygote intra-
fallopian transfer or low tubal ovum transfer, provided each such
fertilization or transfer shall be credited toward such maximum as one
cycle;
[(5)] (4) Limit coverage for in-vitro fertilization, gamete intra-
fallopian transfer, zygote intra-fallopian transfer and low tubal ovum
transfer to those individuals who have been unable to conceive or
produce conception or sustain a successful pregnancy through less
expensive and medically viable infertility treatment or procedures
covered under such policy. Nothing in this subdivision shall be
construed to deny the coverage required by this section to any
individual who foregoes a particular infertility treatment or procedure
if the individual's physician determines that such treatment or
procedure is likely to be unsuccessful; and
[(6)] (5) Require that covered infertility treatment or procedures be
performed at facilities that conform to the standards and guidelines
developed by the American Society of Reproductive Medicine or the
Society of Reproductive Endocrinology and Infertility. [;]
[(7) Limit coverage to individuals who have maintained coverage
under such policy for at least twelve months; and
(8) Require disclosure by the individual seeking such coverage to
such individual's existing health insurance carrier of any previous
infertility treatment or procedures for which such individual received
coverage under a different health insurance policy. Such disclosure shall
be made on a form and in the manner prescribed by the Insurance
Commissioner.]
(c) (1) Any insurance company, hospital service corporation, medical
service corporation or health care center may issue to a religious
employer a group health insurance policy that excludes coverage for Substitute Senate Bill No. 1039
Public Act No. 23-127 18 of 19
methods of diagnosis and treatment of infertility that are contrary to the
religious employer's bona fide religious tenets.
(2) Upon the written request of an individual who states in writing
that methods of diagnosis and treatment of infertility are contrary to
such individual's religious or moral beliefs, any insurance company,
hospital service corporation, medical service corporation or health care
center may issue to or on behalf of the individual a policy or rider
thereto that excludes coverage for such methods.
(d) Any health insurance policy issued pursuant to subsection (c) of
this section shall provide written notice to each insured or prospective
insured that methods of diagnosis and treatment of infertility are
excluded from coverage pursuant to said subsection. Such notice shall
appear, in not less than ten-point type, in the policy, application and
sales brochure for such policy.
(e) As used in this section, "religious employer" means an employer
that is a "qualified church-controlled organization", as defined in 26 USC
3121 or a church-affiliated organization.
(f) Except as provided in subsections (c) to (e), inclusive, of this
section, 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, amended, renewed or continued in this
state on or after January 1, 2024, may make any distinction or
discrimination between persons on the basis of gender identity or
expression, sexual orientation or age with respect to health insurance
coverage for the medically necessary expenses for the diagnosis and
treatment of infertility, except that such policy may consider age as a
factor on the basis of a determination of medical necessity, using
professional guidelines published by the American Society for
Reproductive Medicine, its successor organization or a comparable
organization. For purposes of this subsection, "gender identity or Substitute Senate Bill No. 1039
Public Act No. 23-127 19 of 19
expression" has the same meaning as provided in section 1-1n.