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OLR Bill Analysis
sSB 1039 (File 385, as amended by Senate "A")*
AN ACT CONCERNING THE INSURANCE DEPARTMENT'S
RECOMMENDATIONS REGARDING FINANCIAL REGULATION,
LIFE INSURANCE AND INSURANCE LICENSING REQUIREMENTS
AND TECHNICAL CORRECTIONS TO THE LIFE AND HEALTH
INSURANCE STATUTES.
SUMMARY
This bill prohibits certain health insurance policies, beginning
January 1, 2024, from discriminating between people on the basis of
gender identity or expression, sexual orientation, or age with respect to
health insurance coverage for medically necessary infertility diagnosis
and treatment. It also revises the allowed parameters for a policy to
cover infertility-related expenses to conform to the federal Affordable
Care Act (§§ 11 & 12).
This bill also makes a number of unrelated changes to the insurance
statutes. Specifically, it does the following:
1. authorizes the insurance commissioner to require people and
entities required to pay fees to the Insurance Department to do
so electronically and establishes a waiver process for the
requirement (§ 1);
2. requires certified reinsurers and reciprocal jurisdiction reinsurers
to pay the Insurance Department a fee of $2,000 for each
regulatory certificate issued and renewed (§ 1);
3. allows a non-resident persons or entities to get a nonresident
state license here in Connecticut and designate it as their home
state if their resident state does not offer the same or equivalent
license (§ 2);
4. makes explicit that certain provisions of the general licensing 2023SB-01039-R01-BA.DOCX
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statute apply to any licensee or license applicant, including an
insurance producer licensee or applicant (§ 2); and
5. makes technical corrections to the applicability of the health
insurance statutes requiring dependent coverage, specifically by
removing applicability to accident-only policies, which do not
cover a dependent’s illness-related expenses (§§ 3-10).
*Senate Amendment “A” prohibits insurers from discriminating on
the basis of sexual orientation, instead of on the basis of sex as in the
underlying bill, when providing coverage for infertility treatment. It
also makes technical changes.
EFFECTIVE DATE: October 1, 2023
§ 1 — STATUTORY INSURANCE FEES
Electronic Payment
The bill authorizes the insurance commissioner to require people and
entities that must pay fees to the Insurance Department under state law
to pay them electronically. However, the commissioner must waive this
requirement for any person or entity that requests it if he determines
that (1) compliance is impractical or causes undue hardship or (2) good
cause otherwise exists.
Reinsurer Fees
The bill adds two fees to the list of statutory insurance fees.
Specifically, it requires certified reinsurers and reciprocal jurisdiction
reinsurers to pay the Insurance Department $2,000 for each certificate
issued and renewed. State law and regulations require these reinsurers
to apply to the department for certification.
§ 2 — INSURANCE LICENSURE REQUIREMENTS
Non-Resident Licenses
The bill specifies requirements for people or entities who are eligible
to get certain non-resident licenses from the Insurance Department. It
allows non-resident persons or entities to apply for and get a
nonresident state license here and designate Connecticut as their home 2023SB-01039-R01-BA.DOCX
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state if their resident state does not offer the same or equivalent resident
license and they maintain a principal place of business in Connecticut.
This applies to the following licenses: public adjuster, casualty
adjuster, motor vehicle physical damage appraiser, certified insurance
consultant, surplus lines broker, or any insurance-related occupation for
which a license is deemed necessary by the commissioner, other than an
insurance producer.
Insurance Producers
In 2014, a Connecticut court ruled that because the legislature
adopted specific insurance producer requirements in 2001 (PA 01-113),
the general licensing statute does not apply to insurance producers
(Lagueux v. Leonardi, 148 Conn. App. 234 (2014)). The bill makes explicit
that certain provisions of the general insurance licensing statute (i.e.,
CGS § 38a-769(b)-(i)) apply to any licensee or license applicant,
including an insurance producer licensee or applicant. By law, this
includes the requirement that the applicant prove to the commissioner
that he or she is financially responsible and of sound moral character.
§§ 11 & 12 — MANDATED HEALTH INSURANCE COVERAGE F OR
INFERTILITY DIAGNOSIS AND TREATMENT
Changes to Conform to Federal Law
By law, certain individual and group health insurance policies must
cover the medically necessary costs of diagnosing and treating
infertility. Current law allows insurers to impose certain limits on the
coverage (e.g., number of attempts, among other things). The bill
eliminates the ability of a policy to (1) limit infertility coverage to those
(a) under age 40 and (b) who had coverage under the policy for at least
12 months and (2) require an insured to disclose any previous infertility
treatment covered under a different policy.
These changes generally conform the coverage provision to the
federal Affordable Care Act and codify the Insurance Department’s
Bulletin HC-104 (2015).
The law, unchanged by the act, allows religious employers and 2023SB-01039-R01-BA.DOCX
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individuals to exclude infertility coverage from their policies if it is
contrary to their religious tenets.
By law, “infertility” means being unable to conceive or produce
conception or sustain a successful pregnancy during a one-year period
or the treatment is medically necessary.
Nondiscrimination Provision
The bill prohibits certain individual and group health insurance
policies from discriminating between people on the basis of gender
identity or expression, sexual orientation, or age with respect to health
insurance coverage for medically necessary infertility diagnosis and
treatment. However, a policy may consider age as a factor when
determining medical necessity, using guidelines from the American
Society for Reproductive Medicine or a comparable organization.
Under the bill, this nondiscrimination provision does not apply when
a religious employer or individual excludes infertility coverage from a
policy due to their religious tenets.
The law defines “gender identity or expression” as a person’s gender-
related identity, appearance, or behavior, whether or not it differs from
that traditionally associated with the person’s physiology or assigned
sex at birth. The definition specifies that gender-related identity can be
shown by providing evidence in various ways, including (1) medical
history; (2) care or treatment of the gender-related identity; (3)
consistent and uniform assertion of the identity; or (4) any other
evidence that the identity is sincerely held, part of a person’s core
identity, or not asserted for an improper purpose.
Applicability
The bill applies the federal law to conforming changes to policies
delivered, issued, renewed, amended, or continued in Connecticut on
and after October 1, 2023, that cover (1) basic hospital expenses; (2) basic
medical-surgical expenses; (3) major medical expenses; or (4) hospital or
medical services, including those provided under an HMO plan. It
applies the nondiscrimination provision to these policies that are 2023SB-01039-R01-BA.DOCX
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delivered, issued, renewed, amended, or continued in Connecticut on
and after January 1, 2024.
Because of the federal Employee Retirement Income Security Act,
state insurance benefit mandates do not apply to self-insured benefit
plans.
BACKGROUND
Related Bill
sHB 6617 (File 710), favorably reported by the Appropriations and
Human Services committees, repeals the infertility treatment coverage
mandate and replaces it with coverage requirements for fertility care.
COMMITTEE ACTION
Insurance and Real Estate Committee
Joint Favorable Substitute
Yea 11 Nay 1 (03/16/2023)