Substitute House Bill No. 5503
Public Act No. 24-138
AN ACT CONCERNING INSURANCE MARKET CONDUCT AND
INSURANCE LICENSING, THE INSURANCE DEPARTMENT'S
TECHNICAL CORRECTIONS AND OTHER REVISIONS TO THE
INSURANCE STATUTES AND CAPTIVE INSURANCE.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Subsection (a) of section 38a-8 of the 2024 supplement to
the general statutes is repealed and the following is substituted in lieu
thereof (Effective October 1, 2024):
(a) The commissioner shall see that all laws respecting insurance
companies and health care centers are faithfully executed and shall
administer and enforce the provisions of this title. The commissioner
shall have all powers specifically granted, and all further powers that
are reasonable and necessary to enable the commissioner to protect the
public interest in accordance with the duties imposed by this title,
including, but not limited to, the power to order restitution of any sums
obtained in violation of any provision of this title, or any regulation or
order adopted or issued pursuant to this title by the commissioner, plus
interest at the rate set forth in section 37-3a. The commissioner shall pay
to the Treasurer all the fees that the commissioner receives. The
commissioner may administer oaths in the discharge of the
commissioner's duties. Substitute House Bill No. 5503
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Sec. 2. Section 38a-702k of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2024):
(a) The commissioner may place on probation, suspend, revoke or
refuse to issue or renew an insurance producer's license or may levy a
civil penalty in accordance with the provisions of this title, or may take
any combination of such actions, for any one or more of the following
causes: (1) Providing incorrect, misleading, incomplete or materially
untrue information in the license application; (2) violating any insurance
laws, or violating any regulation, subpoena or order of the
commissioner or of another state's commissioner; (3) obtaining or
attempting to obtain a license through misrepresentation or fraud; (4)
improperly withholding, misappropriating or converting any moneys
or properties received in the course of doing an insurance business; (5)
intentionally misrepresenting the terms of an actual or proposed
insurance contract or application for insurance; (6) having been
convicted of a felony; (7) having admitted or been found to have
committed any insurance unfair trade practice or fraud; (8) using
fraudulent, coercive or dishonest practices, or demonstrating
incompetence, untrustworthiness or financial irresponsibility in the
conduct of business in this state or elsewhere; (9) having an insurance
producer license, or its equivalent, denied, suspended or revoked in any
other state, province, district or territory; (10) forging another's name to
an application for insurance or to any document related to an insurance
transaction; (11) improperly using notes or any other reference material
to complete an examination for an insurance license; (12) knowingly
accepting insurance business from an individual who is not licensed;
(13) failing to comply with an administrative or court order imposing a
child support obligation; or (14) failing to pay state income tax or
comply with any administrative or court order directing payment of
state income tax.
(b) If the action by the commissioner is to nonrenew a license or to Substitute House Bill No. 5503
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deny an application for a license, the commissioner shall notify the
applicant or licensee and advise, in writing, the applicant or licensee of
the reason for the denial or nonrenewal of the applicant's or licensee's
license. The applicant or licensee may make written demand upon the
commissioner, not later than thirty days after the notice, for a hearing
before the commissioner to determine the reasonableness of the
commissioner's action. The hearing shall be held not later than twenty
days after receipt of such request and shall be held pursuant to section
38a-19.
(c) The license of a business entity may be suspended, revoked or
refused if the commissioner finds, after hearing, that an individual
licensee's violation was known or should have been known by one or
more of the partners, officers or managers acting on behalf of the
partnership or corporation and the violation was neither reported to the
commissioner nor corrective action taken.
(d) In addition to or in lieu of any applicable denial, suspension or
revocation of a license, a person may, after hearing, be subject to a civil
fine pursuant to section 38a-774.
(e) The commissioner shall retain the authority to enforce the
provisions of, and impose any penalty or remedy authorized by, this
title against any person who is under investigation for or charged with
a violation of this title even if the person's license or registration has
been surrendered, revoked or has lapsed by operation of law.
(f) Unless otherwise provided in the provisions of this title, the
Attorney General may, at the request of the commissioner, apply to the
Superior Court for an order: (1) Temporarily or permanently restraining
and enjoining any person from violating any provision of this title, (2)
enforcing any order, penalty or remedy imposed by the commissioner,
or (3) providing restitution against any person for any sums shown by
the commissioner to have been obtained by such person in violation of Substitute House Bill No. 5503
Public Act No. 24-138 4 of 34
any such provision of this title.
Sec. 3. Section 38a-16 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2024):
(a) (1) The Insurance Commissioner or the commissioner's authorized
representative may, as often as the commissioner deems necessary,
conduct investigations and hearings in aid of any investigation on any
matter under the provisions of this title. Pursuant to any such
investigation or hearing, the commissioner or the commissioner's
authorized representative may issue data calls, subpoenas, administer
oaths, compel testimony, order the production of books, records, papers
and documents, and examine books and records. Any person in receipt
of an order from the commissioner or the commissioner's authorized
representative for the production of books, records, papers or
documents shall comply with the order not later than thirty calendar
days after the date of such order. If any person refuses to allow the
examination of books and records, to appear, to testify or to produce
any book, record, paper or document when so ordered, a judge of the
Superior Court, upon application of the commissioner or the
commissioner's authorized representative, may make such order as may
be appropriate to aid in the enforcement of this section.
(2) Data provided in response to a data call under this section shall
not be subject to disclosure under section 1-210.
(b) The Attorney General, at the request of the commissioner, is
authorized to apply in the name of the state of Connecticut to the
Superior Court for an order temporarily or permanently restraining and
enjoining any person from violating any provision of this title.
Sec. 4. Subsection (a) of section 38a-790 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October
1, 2024): Substitute House Bill No. 5503
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(a) No person shall act as an appraiser for motor vehicle physical
damage claims on behalf of any insurance company or firm or
corporation engaged in the adjustment or appraisal of motor vehicle
claims unless such person has first secured a license from the Insurance
Commissioner, and has paid the license fee specified in section 38a-11,
for each two-year period or fraction thereof. The license shall be applied
for as provided in section 38a-769. The commissioner may waive the
requirement for examination in the case of any applicant for a motor
vehicle physical damage appraiser's license who is a nonresident of this
state and who holds an equivalent license from any other state. Any
[such license issued by the commissioner shall be in force until the
thirtieth day of June in each odd-numbered year] initial license issued
by the commissioner to an appraiser for motor vehicle physical damage
claims shall expire two years after the date of the licensee's birthday that
preceded the date the license was issued unless sooner revoked or
suspended. The license may, in the discretion of the commissioner, be
renewed biennially upon payment of the fee specified in section 38a-11.
The commissioner may adopt reasonable regulations concerning
standards for qualification, suspension or revocation of such licenses
and the methods by which licensees shall conduct their business.
Sec. 5. Subsection (a) of section 38a-792 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October
1, 2024):
(a) (1) No person may act as an adjuster of casualty claims for any
insurance company or firm or corporation engaged in the adjustment of
casualty claims unless such person has first secured a license from the
commissioner, and has paid the license fee specified in section 38a-11,
for each two-year period or fraction thereof. Application for such license
shall be made as provided in section 38a-769. Any [such license issued
by the commissioner shall be in force until June thirtieth in each odd-
numbered year] initial license issued to an adjuster of casualty claims Substitute House Bill No. 5503
Public Act No. 24-138 6 of 34
shall expire two years after the date of the licensee's birthday that
preceded the date the license was issued unless sooner revoked or
suspended. The [person] licensee may, at the discretion of the
commissioner, renew the license biennially thereafter upon payment of
the fee specified in section 38a-11.
(2) The commissioner may waive the examination required under
section 38a-769, in the case of any applicant for a casualty claims
adjuster's license that (A) is a nonresident of this state or has its principal
place of business in another state, and holds an equivalent license from
any other state, or (B) at any time within two years next preceding the
date of application has been licensed in this state under a license of the
same type as the license applied for.
Sec. 6. Section 38a-48 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2024):
(a) On or before June thirtieth, annually, the Commissioner of
Revenue Services shall render to the Insurance Commissioner a
statement certifying the amount of taxes or charges imposed on each
domestic insurance company or other domestic entity under chapter 207
on business done in this state during the preceding calendar year. The
statement for local domestic insurance companies shall set forth the
amount of taxes and charges before any tax credits allowed as provided
in subsection (a) of section 12-202.
(b) On or before July thirty-first, annually, the Insurance
Commissioner [and the Office of the Healthcare Advocate] shall render
to each domestic insurance company or other domestic entity liable for
payment under section 38a-47: (1) A statement that includes (A) the
amount appropriated to the Insurance Department, the Office of the
Healthcare Advocate and the Office of Health Strategy from the
Insurance Fund established under section 38a-52a for the fiscal year
beginning July first of the same year, (B) the cost of fringe benefits for Substitute House Bill No. 5503
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department and office personnel for such year, as estimated by the
Comptroller, (C) the estimated expenditures on behalf of the
department and the offices from the Capital Equipment Purchase Fund
pursuant to section 4a-9 for such year, not including such estimated
expenditures made on behalf of the Health Systems Planning Unit of the
Office of Health Strategy, and (D) the amount appropriated to the
Department of Aging and Disability Services for the fall prevention
program established in section 17a-859 from the Insurance Fund for the
fiscal year; (2) a statement of the total taxes imposed on all domestic
insurance companies and domestic insurance entities under chapter 207
on business done in this state during the preceding calendar year; and
(3) the proposed assessment against that company or entity, calculated
in accordance with the provisions of subsection (c) of this section,
provided for the purposes of this calculation the amount appropriated
to the Insurance Department, the Office of the Healthcare Advocate and
the Office of Health Strategy from the Insurance Fund plus the cost of
fringe benefits for department and office personnel and the estimated
expenditures on behalf of the department and [the office] such offices
from the Capital Equipment Purchase Fund pursuant to section 4a-9,
not including such expenditures made on behalf of the Health Systems
Planning Unit of the Office of Health Strategy shall be deemed to be the
actual expenditures of the department and [the office] such offices, and
the amount appropriated to the Department of Aging and Disability
Services from the Insurance Fund for the fiscal year for the fall
prevention program established in section 17a-859 shall be deemed to
be the actual expenditures for the program.
(c) (1) The proposed assessments for each domestic insurance
company or other domestic entity shall be calculated by (A) allocating
twenty per cent of the amount to be paid under section 38a-47 among
the domestic entities organized under sections 38a-199 to 38a-209,
inclusive, and 38a-214 to 38a-225, inclusive, in proportion to their
respective shares of the total taxes and charges imposed under chapter Substitute House Bill No. 5503
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207 on such entities on business done in this state during the preceding
calendar year, and (B) allocating eighty per cent of the amount to be paid
under section 38a-47 among all domestic insurance companies and
domestic entities other than those organized under sections 38a-199 to
38a-209, inclusive, and 38a-214 to 38a-225, inclusive, in proportion to
their respective shares of the total taxes and charges imposed under
chapter 207 on such domestic insurance companies and domestic
entities on business done in this state during the preceding calendar
year, provided if there are no domestic entities organized under sections
38a-199 to 38a-209, inclusive, and 38a-214 to 38a-225, inclusive, at the
time of assessment, one hundred per cent of the amount to be paid
under section 38a-47 shall be allocated among such domestic insurance
companies and domestic entities.
(2) When the amount any such company or entity is assessed
pursuant to this section exceeds twenty-five per cent of the actual
expenditures of the Insurance Department, the Office of the Healthcare
Advocate and the Office of Health Strategy from the Insurance Fund,
such excess amount shall not be paid by such company or entity but
rather shall be assessed against and paid by all other such companies
and entities in proportion to their respective shares of the total taxes and
charges imposed under chapter 207 on business done in this state during
the preceding calendar year, except that for purposes of any assessment
made to fund payments to the Department of Public Health to purchase
vaccines, such company or entity shall be responsible for its share of the
costs, notwithstanding whether its assessment exceeds twenty-five per
cent of the actual expenditures of the Insurance Department, the Office
of the Healthcare Advocate and the Office of Health Strategy from the
Insurance Fund. The provisions of this subdivision shall not be
applicable to any corporation [which] that has converted to a domestic
mutual insurance company pursuant to section 38a-155 upon the
effective date of any public act [which] that amends said section to
modify or remove any restriction on the business such a company may Substitute House Bill No. 5503
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engage in, for purposes of any assessment due from such company on
and after such effective date.
(d) For purposes of calculating the amount of payment under section
38a-47, as well as the amount of the assessments under this section, the
"total taxes imposed on all domestic insurance companies and other
domestic entities under chapter 207" shall be based upon the amounts
shown as payable to the state for the calendar year on the returns filed
with the Commissioner of Revenue Services pursuant to chapter 207;
with respect to calculating the amount of payment and assessment for
local domestic insurance companies, the amount used shall be the taxes
and charges imposed before any tax credits allowed as provided in
subsection (a) of section 12-202.
[(e) On or before September thirtieth, annually, for each fiscal year
ending prior to July 1, 1990, the Insurance Commissioner and the
Healthcare Advocate, after receiving any objections to the proposed
assessments and making such adjustments as in their opinion may be
indicated, shall assess each such domestic insurance company or other
domestic entity an amount equal to its proposed assessment as so
adjusted. Each domestic insurance company or other domestic entity
shall pay to the Insurance Commissioner on or before October thirty-
first an amount equal to fifty per cent of its assessment adjusted to reflect
any credit or amount due from the preceding fiscal year as determined
by the commissioner under subsection (g) of this section. Each domestic
insurance company or other domestic entity shall pay to the Insurance
Commissioner on or before the following April thirtieth, the remaining
fifty per cent of its assessment.]
[(f)] (e) On or before September first, annually, for each fiscal year,
[ending after July 1, 1990,] the Insurance Commissioner, [and the
Healthcare Advocate,] after receiving any objections to the proposed
assessments and making such adjustments as in [their] the
commissioner's opinion may be indicated, shall assess each such Substitute House Bill No. 5503
Public Act No. 24-138 10 of 34
domestic insurance company or other domestic entity an amount equal
to its proposed assessment as so adjusted. Each domestic insurance
company or other domestic entity shall pay to the Insurance
Commissioner (1) [on or before June 30, 1990, and] on or before June
thirtieth, annually, [thereafter,] an estimated payment against its
assessment for the following year equal to twenty-five per cent of its
assessment for the fiscal year ending such June thirtieth, (2) on or before
September thirtieth, annually, twenty-five per cent of its assessment
adjusted to reflect any credit or amount due from the preceding fiscal
year as determined by the commissioner under subsection [(g)] (f) of this
section, and (3) on or before the following December thirty-first and
March thirty-first, annually, each domestic insurance company or other
domestic entity shall pay to the Insurance Commissioner the remaining
fifty per cent of its proposed assessment to the department in two equal
installments.
[(g)] (f) If the actual expenditures for the fall prevention program
established in section 17a-859 are less than the amount allocated, the
Commissioner of Aging and Disability Services shall notify the
Insurance Commissioner. [and the Healthcare Advocate.] Immediately
following the close of the fiscal year, the Insurance Commissioner [and
the Healthcare Advocate] shall recalculate the proposed assessment for
each domestic insurance company or other domestic entity in
accordance with subsection (c) of this section using the actual
expenditures made during the fiscal year by the Insurance Department,
the Office of the Healthcare Advocate and the Office of Health Strategy
from the Insurance Fund, the actual expenditures made on behalf of the
department and the offices from the Capital Equipment Purchase Fund
pursuant to section 4a-9, not including such expenditures made on
behalf of the Health Systems Planning Unit of the Office of Health
Strategy, and the actual expenditures for the fall prevention program.
On or before July thirty-first, annually, the Insurance Commissioner
[and the Healthcare Advocate] shall render to each such domestic Substitute House Bill No. 5503
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insurance company and other domestic entity a statement showing the
difference between their respective recalculated assessments and the
amount they have previously paid. On or before August thirty-first, the
Insurance Commissioner, [and the Healthcare Advocate,] after
receiving any objections to such statements, shall make such
adjustments which in their opinion may be indicated, and shall render
an adjusted assessment, if any, to the affected companies. Any such
domestic insurance company or other domestic entity may pay to the
Insurance Commissioner the entire assessment required under this
subsection in one payment when the first installment of such assessment
is due.
[(h)] (g) If any assessment is not paid when due, a penalty of twenty-
five dollars shall be added thereto, and interest at the rate of six per cent
per annum shall be paid thereafter on such assessment and penalty.
[(i)] (h) The Insurance Commissioner shall deposit all payments
made under this section with the State Treasurer. On and after June 6,
1991, the moneys so deposited shall be credited to the Insurance Fund
established under section 38a-52a and shall be accounted for as expenses
recovered from insurance companies.
Sec. 7. Subsection (a) of section 38a-53 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October
1, 2024):
(a) (1) Each domestic insurance company or domestic health care
center shall, annually, on or before the first day of March, submit to the
commissioner, [and] by electronically [to] filing with the National
Association of Insurance Commissioners, a true and complete report,
signed and sworn to by its president or a vice president, and secretary
or an assistant secretary, of its financial condition on the thirty-first day
of December next preceding, prepared in accordance with the National
Association of Insurance Commissioners annual statement instructions Substitute House Bill No. 5503
Public Act No. 24-138 12 of 34
handbook and following those accounting procedures and practices
prescribed by the National Association of Insurance Commissioners
accounting practices and procedures manual, subject to any deviations
in form and detail as may be prescribed by the commissioner. An
electronically filed report in accordance with section 38a-53a that is
timely submitted to the National Association of Insurance
Commissioners shall [not exempt a domestic insurance company or
domestic health care center from timely filing a true and complete paper
copy with the commissioner] be deemed to have been submitted to the
commissioner in accordance with the provisions of this section.
(2) Each accredited reinsurer, as defined in subdivision (1) of
subsection (c) of section 38a-85, and assuming insurance company, as
provided in section 38a-85, shall file an annual report in accordance with
the provisions of section 38a-85.
Sec. 8. Subsection (a) of section 38a-54 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October
1, 2024):
(a) Each domestic insurance company, domestic health care center or
domestic fraternal benefit society doing business in this state shall have
an annual audit conducted by an independent certified public
accountant and shall annually file an audited financial report with the
commissioner, and electronically to the National Association of
Insurance Commissioners on or before the first day of June for the year
ending the preceding December thirty-first. An electronically filed true
and complete report timely submitted to the National Association of
Insurance Commissioners [does not exempt a domestic insurance
company or a domestic health care center from timely filing a true and
complete paper copy to the commissioner] shall be deemed to have been
submitted to the commissioner in accordance with the provisions of this
section. Substitute House Bill No. 5503
Public Act No. 24-138 13 of 34
Sec. 9. Section 38a-297 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2024):
(a) For the purposes of sections 38a-295 to 38a-300, inclusive, a policy
shall be deemed readable if: (1) The text achieves a minimum score of
forty-five on the Flesch reading ease test as computed in section 38a-298
or an equivalent score on any other test comparable in result and
approved by the commissioner, (2) it is printed, except for specification
pages, schedules and tables, in not less than ten-point type, one-point
leaded, of a height and style specified by the commissioner in
regulations adopted in accordance with the provisions of chapter 54, (3)
it uses layout and spacing which separate the paragraphs from each
other and from the border of the paper, (4) it has section titles captioned
in boldface type or which otherwise stand out significantly from the
text, (5) it avoids the use of unnecessarily long, complicated or obscure
words, sentences, paragraphs or constructions, (6) the style,
arrangement and overall appearance of the policy give no undue
prominence to any portion of the text of the policy or to any
endorsements or riders and (7) it contains a table of contents or an index
of the principal sections of the policy, if the policy has more than three
thousand words or if the policy has more than three pages. To be
deemed readable, each policy of individual health insurance shall
include a separate outline of coverage showing the major coverage,
benefit, exclusion and renewal provisions of the policy in readily
understandable terms, provided the policy shall take precedence over
the outline of coverage.
(b) The commissioner may authorize a lower score than the Flesch
reading ease score required in subsection (a) whenever [he] the
commissioner finds that a lower score (1) will provide a more accurate
reflection of the readability of a policy form; (2) is warranted by the
nature of a particular policy form or type or class of policy forms; or (3)
is the result of language which is used to conform to the requirements Substitute House Bill No. 5503
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of any state or federal law, regulation or governmental agency.
(c) Filings subject to this section shall be accompanied by a
certification signed by an officer of the insurer stating that it meets the
requirements of subsection (a) of this section. Such certification shall
state that the policy meets the minimum reading ease score on the test
used or that the score is lower than the minimum required but should
be approved in accordance with subsection (b) of this section. The
commissioner may require the submission of further information to
verify any certification.
(d) Filings subject to this section may be filed with the commissioner
in any language. Any non-English-language policy shall be deemed to
be in compliance with subsection (a) of this section if the insurer certifies
that such policy [is translated from an English-language policy that]
complies with [said] subsection (a) of this section or is translated from a
policy that complies with subsection (a) of this section.
(e) The commissioner may engage the services of any translation
service, as needed, to review any non-English-language policy filed
with the commissioner pursuant to this section, the cost of which shall
be borne by the insurer that submits such filing.
(f) (1) For any insurer that files a non-English-language policy with
the commissioner, the commissioner may require that such insurer
either (A) provide an English translated copy of such policy and a
certification as to the accuracy of such translated copy of such policy, or
(B) pay all costs associated with the translation of such policy in
accordance with the provisions of subsection (e) of this section.
(2) Any insurer shall accept all risk associated with any translation of
such insurer's non-English-language policy in accordance with
subdivision (1) of this subsection and subsection (e) of this section.
(g) The commissioner may adopt regulations, in accordance with the Substitute House Bill No. 5503
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provisions of chapter 54, to implement the provisions of this section.
Sec. 10. Section 38a-479ppp of the general statutes is repealed and the
following is substituted in lieu thereof (Effective January 1, 2025):
(a) Not later than [March 1, 2021] February 1, 2025, and annually
thereafter, each pharmacy benefits manager shall file a report with the
commissioner for the immediately preceding calendar year. The report
shall contain the following information for health carriers that
delivered, issued for delivery, renewed, amended or continued health
care plans that included a pharmacy benefit managed by the pharmacy
benefits manager during such calendar year:
(1) The aggregate dollar amount of all rebates concerning drug
formularies used by such health carriers that such manager collected
from pharmaceutical manufacturers that manufactured outpatient
prescription drugs that (A) were covered by such health carriers during
such calendar year, and (B) are attributable to patient utilization of such
drugs during such calendar year; and
(2) The aggregate dollar amount of all rebates, excluding any portion
of the rebates received by such health carriers, concerning drug
formularies that such manager collected from pharmaceutical
manufacturers that manufactured outpatient prescription drugs that (A)
were covered by such health carriers during such calendar year, and (B)
are attributable to patient utilization of such drugs by covered persons
under such health care plans during such calendar year.
(b) The commissioner shall establish a standardized form for
reporting information pursuant to subsection (a) of this section after
consultation with pharmacy benefits managers. The form shall be
designed to minimize the administrative burden and cost of reporting
on the department and pharmacy benefits managers.
(c) All information submitted to the commissioner pursuant to Substitute House Bill No. 5503
Public Act No. 24-138 16 of 34
subsection (a) of this section shall be exempt from disclosure under the
Freedom of Information Act, as defined in section 1-200, except to the
extent such information is included on an aggregated basis in the report
required by subsection (d) of this section. The commissioner shall not
disclose information submitted pursuant to subdivision (1) of
subsection (a) of this section, or information submitted pursuant to
subdivision (2) of said subsection in a manner that (1) is likely to
compromise the financial, competitive or proprietary nature of such
information, or (2) would enable a third party to identify a health care
plan, health carrier, pharmacy benefits manager, pharmaceutical
manufacturer, or the value of a rebate provided for a particular
outpatient prescription drug or therapeutic class of outpatient
prescription drugs.
(d) Not later than [March 1, 2022] March 1, 2025, and annually
thereafter, the commissioner shall submit a report, in accordance with
section 11-4a, to the joint standing committee of the General Assembly
having cognizance of matters relating to insurance. The report shall
contain (1) an aggregation of the information submitted to the
commissioner pursuant to subsection (a) of this section for the
immediately preceding calendar year, and (2) such other information as
the commissioner, in the commissioner's discretion, deems relevant for
the purposes of this section. Not later than [February 1, 2022, and
annually thereafter] ten days prior to the submission of the annual
report pursuant to the provisions of this subsection, the commissioner
shall provide each pharmacy benefits manager and any third party
affected by submission of [a] such report required by this subsection
with a written notice describing the content of the report.
(e) The commissioner may impose a penalty of not more than seven
thousand five hundred dollars on a pharmacy benefits manager for each
violation of this section.
(f) The commissioner may adopt regulations, in accordance with the Substitute House Bill No. 5503
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provisions of chapter 54, to implement the provisions of this section.
Sec. 11. Subdivision (4) of section 38a-564 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October
1, 2024):
(4) (A) "Small employer" means (i) prior to January 1, 2016, an
employer that employed an average of at least one but not more than
fifty employees on business days during the preceding calendar year
and employs at least one employee on the first day of the group health
insurance plan year, [and] (ii) on and after January 1, 2016, and prior to
January 1, 2025, an employer that employed an average of at least one
but not more than one hundred employees on business days during the
preceding calendar year and employs at least one employee on the first
day of the group health insurance plan year, except the commissioner
may postpone said January 1, 2016, date to be consistent with any such
postponement made by the Secretary of the United States Department
of Health and Human Services under the Patient Protection and
Affordable Care Act, P.L. 111-148, as amended from time to time, and
(iii) on and after January 1, 2025, an employer that employed an average
of at least one but not more than fifty employees on business days
during the preceding calendar year and employs at least one employee
on the first day of the group health insurance plan year. "Small
employer" does not include a sole proprietorship that employs only the
sole proprietor or the spouse of such sole proprietor.
(B) (i) For purposes of subparagraph (A) of this subdivision, the
number of employees shall be determined by adding (I) the number of
full-time employees for each month who work a normal work week of
thirty hours or more, and (II) the number of full-time equivalent
employees, calculated for each month by dividing by one hundred
twenty the aggregate number of hours worked for such month by
employees who work a normal work week of less than thirty hours, and
averaging such total for the calendar year. Substitute House Bill No. 5503
Public Act No. 24-138 18 of 34
(ii) If an employer was not in existence throughout the preceding
calendar year, the number of employees shall be based on the average
number of employees that such employer reasonably expects to employ
in the current calendar year.
(C) All persons treated as a single employer under Section 414 of the
Internal Revenue Code of 1986, or any subsequent corresponding
internal revenue code of the United States, as amended from time to
time, shall be considered a single employer for purposes of this
subdivision.
Sec. 12. Subdivision (1) of section 38a-614 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October
1, 2024):
(1) Each domestic society transacting business in this state shall,
annually, on or before the first day of March, unless the commissioner
has extended such time for cause shown, file with the commissioner,
and electronically to the National Association of Insurance
Commissioners, a true and complete statement of its financial condition,
transactions and affairs for the preceding calendar year and pay the fee
specified in section 38a-11 for filing such annual statement. The
statement shall be in general form and context as approved by the
National Association of Insurance Commissioners for fraternal benefit
societies and as supplemented by additional information required by
the commissioner. An electronically filed true and complete report filed
in accordance with section 38a-53a that is timely submitted to the
National Association of Insurance Commissioners shall [not exempt a
domestic society from timely filing a true and complete paper copy with
the commissioner] be deemed to have been submitted to the
commissioner in accordance with the provisions of this section.
Sec. 13. Subsection (b) of section 38a-591l of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October Substitute House Bill No. 5503
Public Act No. 24-138 19 of 34
1, 2024):
(b) (1) Any independent review organization seeking to conduct
external reviews and expedited external reviews under section 38a-591g
shall submit the application form for approval or reapproval, as
applicable, to the commissioner and shall include all documentation
and information necessary for the commissioner to determine if the
independent review organization satisfies the minimum qualifications
established under this section.
(2) An approval or reapproval shall be effective for [two] three years,
unless the commissioner determines before the expiration of such
approval or reapproval that the independent review organization no
longer satisfies the minimum qualifications established under this
section.
(3) Whenever the commissioner determines that an independent
review organization has lost its accreditation or no longer satisfies the
minimum requirements established under this section, the
commissioner shall terminate the approval of the independent review
organization and remove the independent review organization from the
list of approved independent review organizations specified in
subdivision (2) of subsection (a) of this section.
Sec. 14. Section 38a-91aa of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2024):
As used in this section, sections 38a-91bb to 38a-91uu, inclusive, [and]
sections 38a-91ww, [and] 38a-91xx and section 15 of this act:
(1) "Affiliated company" means any company in the same corporate
system as a parent, an industrial insured or a member organization by
virtue of common ownership, control, operation or management.
(2) "Agency captive insurance company" means a captive insurance Substitute House Bill No. 5503
Public Act No. 24-138 20 of 34
company that:
(A) Is owned or directly or indirectly controlled by one or more
insurance agents or insurance producers licensed in accordance with
sections 38a-702a to 38a-702r, inclusive;
(B) Only insures against risks covered by insurance policies sold,
solicited or negotiated through the insurance agents or insurance
producers that own or control such captive insurance company; and
(C) Does not insure against risks covered by any health insurance
policy or plan.
(3) "Alien captive insurance company" means any insurance
company formed to write insurance business for its parent and affiliated
companies and licensed pursuant to the laws of an alien jurisdiction that
imposes statutory or regulatory standards on companies transacting the
business of insurance in such jurisdiction that the commissioner deems
to be acceptable.
(4) "Association" means any legal association of individuals,
corporations, limited liability companies, partnerships, associations or
other entities, where the association itself or some or all of the member
organizations:
(A) Directly or indirectly own, control or hold with power to vote all
of the outstanding voting securities or other voting interests of an
association captive insurance company incorporated as a stock insurer;
(B) Have complete voting control over an association captive
insurance company incorporated as a mutual corporation or formed as
a limited liability company; or
(C) Constitute all of the subscribers of an association captive
insurance company formed as a reciprocal insurer. Substitute House Bill No. 5503
Public Act No. 24-138 21 of 34
(5) "Association captive insurance company" means any company
that insures risks of the member organizations of an association, and
includes a company that also insures risks of such member
organizations' affiliated companies or of the association.
(6) "Branch business" means any insurance business transacted in this
state by a branch captive insurance company.
(7) "Branch captive insurance company" means any alien captive
insurance company or foreign captive insurance company licensed by
the commissioner to transact the business of insurance in this state
through a business unit with a principal place of business in this state.
(8) "Branch operations" means any business operations in this state of
a branch captive insurance company.
(9) "Captive insurance company" means any (A) pure captive
insurance company, agency captive insurance company, association
captive insurance company, industrial insured captive insurance
company, risk retention group, sponsored captive insurance company
or special purpose financial captive insurance company that is
domiciled in this state and formed or licensed under the provisions of
this section and sections 38a-91bb to 38a-91tt, inclusive, or (B) branch
captive insurance company.
(10) "Ceding insurer" means an insurance company, approved by the
commissioner and licensed or otherwise authorized to transact the
business of insurance or reinsurance in its state or country of domicile,
that cedes risk to a special purpose financial captive insurance company
pursuant to a reinsurance contract.
(11) "Commissioner" means the Insurance Commissioner.
(12) "Controlled unaffiliated business" means any person: Substitute House Bill No. 5503
Public Act No. 24-138 22 of 34
(A) Who, (i) in the case of a pure captive insurance company, is not
in the corporate system of a parent and the parent's affiliated companies,
(ii) in the case of an industrial insured captive insurance company, is not
in the corporate system of an industrial insured and the industrial
insured's affiliated companies, or (iii) in the case of a sponsored captive
insurance company, is not in the corporate system of a participant and
the participant's affiliated companies;
(B) Who, (i) in the case of a pure captive insurance company, has an
existing contractual relationship with a parent or one of the parent's
affiliated companies, (ii) in the case of an industrial insured captive
insurance company, has an existing contractual relationship with an
industrial insured or one of the industrial insured's affiliated companies,
or (iii) in the case of a sponsored captive insurance company, has an
existing contractual relationship with a participant or one of the
participant's affiliated companies; and
(C) Whose risks are managed by a pure captive insurance company,
an industrial insured captive insurance company or a sponsored captive
insurance company, as applicable, in accordance with section 38a-91qq.
(13) "Excess workers' compensation insurance" means, in the case of
an employer that has insured or self-insured its workers' compensation
risks in accordance with applicable state or federal law, insurance in
excess of a specified per-incident or aggregate limit established by the
commissioner.
(14) "Foreign captive insurance company" means any insurance
company formed to write insurance business for its parent and affiliated
companies and licensed pursuant to the laws of a foreign jurisdiction
that imposes statutory or regulatory standards on companies
transacting the business of insurance in such jurisdiction that the
commissioner deems to be acceptable. Substitute House Bill No. 5503
Public Act No. 24-138 23 of 34
(15) "Incorporated protected cell" means a protected cell that is
established as a corporation or a limited liability company, separate
from the sponsored captive insurance company with which it has
entered into a participant contract.
(16) "Industrial insured" means an insured:
(A) Who procures the insurance of any risk or risks by use of the
services of a full-time employee acting as an insurance manager or
buyer;
(B) Whose aggregate annual premiums for insurance on all risks total
at least twenty-five thousand dollars; and
(C) Who has at least twenty-five full-time employees.
(17) "Industrial insured captive insurance company" means any
company that insures risks of the industrial insureds that comprise an
industrial insured group, and includes a company that also insures risks
of such industrial insureds' affiliated companies.
(18) "Industrial insured group" means any group of industrial
insureds that collectively:
(A) Directly or indirectly own, control or hold with power to vote all
of the outstanding voting securities or other voting interests of an
industrial insured captive insurance company incorporated as a stock
insurer;
(B) Have complete voting control over an industrial insured captive
insurance company incorporated as a mutual corporation or formed as
a limited liability company; or
(C) Constitute all of the subscribers of an industrial insured captive
insurance company formed as a reciprocal insurer. Substitute House Bill No. 5503
Public Act No. 24-138 24 of 34
(19) "Insurance securitization" or "securitization" means a transaction
or a group of related transactions, which may include capital market
offerings, that are effected through related risk transfer instruments and
facilitating administrative agreements, in which all or part of the result
of such transaction is used to fund a special purpose financial captive
insurance company's obligations under a reinsurance contract with a
ceding insurer and by which:
(A) A special purpose financial captive insurance company directly
or indirectly obtains proceeds through the issuance of securities by such
company or any other person; or
(B) A person provides, for the benefit of a special purpose financial
captive insurance company, one or more letters of credit or other assets
that the commissioner has authorized such company to treat as
admitted assets for purposes of its annual report. "Insurance
securitization" or "securitization" does not include the issuance of a
letter of credit for the benefit of the commissioner to satisfy all or part of
a special purpose financial captive insurance company's capital and
surplus requirements under section 38a-91dd.
(20) "Member organization" means any individual, corporation,
limited liability company, partnership, association or other entity that
belongs to an association.
(21) "Mutual corporation" means a corporation organized without
stockholders and includes a nonprofit corporation with members.
(22) "Parent" means any individual, corporation, limited liability
company, partnership or other entity that directly or indirectly owns,
controls or holds with power to vote more than fifty per cent of the
outstanding voting:
(A) Securities of a pure captive insurance company organized as a
stock insurer; or Substitute House Bill No. 5503
Public Act No. 24-138 25 of 34
(B) Membership interests of a pure captive insurance company
organized as a nonprofit corporation or as a limited liability company.
(23) "Participant" means any association, corporation, limited liability
company, partnership, trust or other entity, and any affiliated company
or controlled unaffiliated business thereof, that is insured by a
sponsored captive insurance company pursuant to a participant
contract.
(24) "Participant contract" means a contract entered into by a
sponsored captive insurance company and a participant by which the
sponsored captive insurance company insures the risks of the
participant and limits the losses of each such participant to its pro rata
share of the assets of one or more protected cells identified in such
participant contract.
(25) "Protected cell" means a separate account established by a
sponsored captive insurance company, in which assets are maintained
for one or more participants in accordance with the terms of one or more
participant contracts to fund the liability of the sponsored captive
insurance company assumed on behalf of such participants as set forth
in such participant contracts.
(26) "Pure captive insurance company" means any company that
insures risks of its parent and affiliated companies or controlled
unaffiliated business.
(27) "Reinsurance contract" means a contract entered into by a special
purpose financial captive insurance company and a ceding insurer by
which the special purpose financial captive insurance company agrees
to provide reinsurance to the ceding insurer for risks associated with the
ceding insurer's insurance or reinsurance business.
(28) "Risk retention group" means a captive insurance company
organized under the laws of this state pursuant to the federal Liability Substitute House Bill No. 5503
Public Act No. 24-138 26 of 34
Risk Retention Act of 1986, 15 USC 3901 et seq., as amended from time
to time, as a stock insurer or mutual corporation, a reciprocal or other
limited liability entity.
(29) "Security" has the same meaning as provided in section 36b-3 and
includes any form of debt obligation, equity, surplus certificate, surplus
note, funding agreement, derivative or other financial instrument that
the commissioner designates as a security for purposes of this section
and sections 38a-91bb to 38a-91tt, inclusive.
(30) "Special purpose financial captive insurance company" means a
company that is licensed by the commissioner in accordance with
section 38a-91bb.
(31) "Special purpose financial captive insurance company security"
means a security issued by (A) a special purpose financial captive
insurance company, or (B) a third party, the proceeds of which are
obtained directly or indirectly by a special purpose financial captive
insurance company.
(32) "Sponsor" means any association, corporation, limited liability
company, partnership, trust or other entity that is approved by the
commissioner to organize and operate a sponsored captive insurance
company and to provide all or part of the required unimpaired paid-in
capital and surplus.
(33) "Sponsored captive insurance company" means a captive
insurance company:
(A) In which the minimum required unimpaired paid-in capital and
surplus are provided by one or more sponsors;
(B) That insures risks of its participants only through separate
participant contracts; and Substitute House Bill No. 5503
Public Act No. 24-138 27 of 34
(C) That funds its liability to each participant through one or more
protected cells and segregates the assets of each protected cell from the
assets of other protected cells and from the assets of the sponsored
captive insurance company's general account.
(34) "Surplus note" means an unsecured subordinated debt obligation
possessing characteristics consistent with the National Association of
Insurance Commissioners Statement of Statutory Accounting Principles
No. 41, as amended from time to time, and as modified or supplemented
by the commissioner.
Sec. 15. (NEW) (Effective October 1, 2024) (a) (1) Any sponsored captive
insurance company, including a sponsored captive insurance company
licensed as a special purpose financial captive insurance company, may,
upon application of such sponsored captive insurance company and
with the commissioner's prior written approval, convert one or more
protected cells or incorporated protected cells into a:
(A) Single protected cell or incorporated protected cell;
(B) New sponsored captive insurance company;
(C) New sponsored captive insurance company licensed as a special
purpose financial captive insurance company;
(D) New special purpose financial captive insurance company;
(E) New pure captive insurance company;
(F) New risk retention group;
(G) New agency captive insurance company;
(H) New industrial insured captive insurance company; or
(I) New association captive insurance company. Substitute House Bill No. 5503
Public Act No. 24-138 28 of 34
(2) Any such conversion of a protected cell or incorporated protected
cell, in accordance with subdivision (1) of this subsection, shall be
subject to the provisions of sections 38a-91aa to 38a-91xx, inclusive, of
the general statutes, as amended by this act, as applicable, and such
sponsored captive insurance company's plan of operation approved by
the commissioner, without affecting such converted protected cell's or
incorporated protected cell's assets, rights, benefits, obligations and
liabilities.
(b) Any conversion of a protected cell or incorporated protected cell
shall be deemed to be a continuation of such protected cell's or
incorporated protected cell's existence together with all of such
protected cell's or incorporated protected cell's assets, rights, benefits,
obligations and liabilities, as (1) a new protected cell or incorporated
protected cell, (2) a sponsored captive insurance company, (3) a
sponsored captive insurance company licensed as a special purpose
financial captive insurance company, (4) a pure captive insurance
company, (5) a risk retention group, (6) an industrial insured captive
insurance company, or (7) an association captive insurance company, as
applicable. Any such conversion of a protected cell or incorporated
protected cell shall be deemed to occur without any transfer or
assignment of such cell's assets, rights, benefits, obligations or liabilities,
and without the creation of any reversionary interest in, or impairment
of, any such assets, rights, benefits, obligations or liabilities.
(c) Any conversion of a protected cell or incorporated protected cell
shall not be construed to limit any rights or protections applicable to
such converted protected cell or incorporated protected cell or
applicable to such sponsored captive insurance company or sponsored
captive insurance company licensed as a special purpose financial
captive insurance company, as applicable, that existed immediately
prior to the date of such conversion.
(d) Any protected cell or incorporated protected cell that converts Substitute House Bill No. 5503
Public Act No. 24-138 29 of 34
into an incorporated protected cell, a new captive insurance company
or risk retention group, in accordance with the provisions of this section,
shall perform such conversion in accordance with chapter 601 or 613 of
the general statutes, as applicable, or in accordance with any such
provisions of the general statutes applicable to the formation of any
other type of legal entity permissible under the laws of this state, as
applicable.
Sec. 16. Section 19a-754c of the general statutes is amended by adding
subsection (f) as follows (Effective October 1, 2024):
(NEW) (f) Notwithstanding any provision of this section, the Covered
Connecticut program shall only include in-network health care
providers and in-network services, unless the health carrier's network is
deemed by the Insurance Commissioner to be inadequate. Benefits
described in subsection (b) of this section and cost-sharing available to
all eligible individuals pursuant to subdivision (1) of subsection (b) of
this section shall only apply if such eligible individuals use in-network
health care providers or in-network facilities.
Sec. 17. Section 38a-556 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective from passage):
(a) There is hereby created a nonprofit legal entity to be known as the
Health Reinsurance Association. All insurers, health care centers and
self-insurers doing business in the state, as a condition to their authority
to transact the applicable kinds of health insurance defined in section
38a-551, shall be members of the association. The association shall
perform its functions under a plan of operation established and
approved under subsection (b) of this section, and shall exercise its
powers through a board of directors established under this section.
(b) (1) The board of directors of the association shall be made up of
nine individuals selected by participating members, subject to approval Substitute House Bill No. 5503
Public Act No. 24-138 30 of 34
by the commissioner, two of whom shall be appointed by the
commissioner on or before July 1, 1993, to represent health care centers.
To select the initial board of directors, and to initially organize the
association, the commissioner shall give notice to all members of the
time and place of the organizational meeting. In determining voting
rights at the organizational meeting each member shall be entitled to
vote in person or proxy. The vote shall be a weighted vote based upon
the net health insurance premium derived from this state in the previous
calendar year. If the board of directors is not selected within sixty days
after notice of the organizational meeting, the commissioner may
appoint the initial board. In approving or selecting members of the
board, the commissioner may consider, among other things, whether all
members are fairly represented. Members of the board may be
reimbursed from the moneys of the association for expenses incurred by
them as members, but shall not otherwise be compensated by the
association for their services.
(2) The board shall submit to the commissioner a plan of operation
for the association necessary or suitable to assure the fair, reasonable
and equitable administration of the association. The plan of operation
shall become effective upon approval in writing by the commissioner.
Such plan shall continue in force until modified by the commissioner or
superseded by a plan submitted by the board and approved by the
commissioner. The plan of operation shall: (A) Establish procedures for
the handling and accounting of assets and moneys of the association; (B)
establish regular times and places for meetings of the board of directors;
(C) establish procedures for records to be kept of all financial
transactions, and for the annual fiscal reporting to the commissioner; (D)
establish procedures whereby selections for the board of directors shall
be made and submitted to the commissioner; (E) establish procedures to
amend, subject to the approval of the commissioner, the plan of
operations; (F) establish procedures for the selection of an administrator
and set forth the powers and duties of the administrator; (G) contain Substitute House Bill No. 5503
Public Act No. 24-138 31 of 34
additional provisions necessary or proper for the execution of the
powers and duties of the association; and (H) contain additional
provisions necessary for the association to establish health insurance
plans that qualify as acceptable coverage in accordance with the Pension
Benefit Guaranty Corporation and other state or federal programs that
may be established.
(c) The association shall have the general powers and authority
granted under the laws of this state to carriers to transact the kinds of
insurance defined under section 38a-551, and in addition thereto, the
specific authority to: (1) Enter into contracts necessary or proper to carry
out the provisions and purposes of this section and sections 38a-551 and
[38a-556a] 38a-557 to 38a-559, inclusive; (2) sue or be sued, including
taking any legal actions necessary or proper for recovery of any
assessments for, on behalf of, or against participating members; (3) take
such legal action as necessary to avoid the payment of improper claims
against the association or the coverage provided by or through the
association; (4) establish, with respect to health insurance provided by
or on behalf of the association, appropriate rates, scales of rates, rate
classifications and rating adjustments, such rates not to be unreasonable
in relation to the coverage provided and the operational expenses of the
association; (5) administer any type of reinsurance program, for or on
behalf of participating members; (6) pool risks among participating
members; (7) issue policies of insurance required or permitted by this
section and sections 38a-551 and [38a-556a] 38a-557 to 38a-559,
inclusive, in its own name or on behalf of participating members; (8)
administer separate pools, separate accounts or other plans as deemed
appropriate for separate members or groups of members; (9) operate
and administer any combination of plans, pools, reinsurance
arrangements or other mechanisms as deemed appropriate to best
accomplish the fair and equitable operation of the association; (10) set
limits on the amounts of reinsurance that may be ceded to the
association by its members; (11) appoint from among participating Substitute House Bill No. 5503
Public Act No. 24-138 32 of 34
members appropriate legal, actuarial and other committees as necessary
to provide technical assistance in the operation of the association, policy
and other contract design, and any other function within the authority
of the association; (12) apply for and accept grants, gifts and bequests of
funds from other states, federal and interstate agencies and independent
authorities, private firms, individuals and foundations for the purpose
of carrying out its responsibilities. Any such funds received shall be
deposited in the General Fund and shall be credited to a separate
nonlapsing account within the General Fund for the Health Reinsurance
Association and may be used by the Health Reinsurance Association in
the performance of its duties; and (13) perform such other duties and
responsibilities as may be required by state or federal law or permitted
by state or federal law and approved by the commissioner.
(d) Rates for coverage issued by or through the association shall not
be excessive, inadequate or unfairly discriminatory. All rates shall be
promulgated by the association through an actuarial committee
consisting of five persons who are members of the American Academy
of Actuaries, shall be filed with the commissioner and may be
disapproved within sixty days after the filing thereof if excessive,
inadequate or unfairly discriminatory.
(e) (1) Following the close of each fiscal year, the administrator shall
determine the net premiums, reinsurance premiums less administrative
expense allowance, the expense of administration pertaining to the
reinsurance operations of the association and the incurred losses for the
year. Any net loss shall be assessed to all participating members in
proportion to their respective shares of the total health insurance
premiums earned in this state during the calendar year, or with paid
losses in the year, coinciding with or ending during the fiscal year of the
association or on any other equitable basis as may be provided in the
plan of operations. For self-insured members of the association, health
insurance premiums earned shall be established by dividing the amount Substitute House Bill No. 5503
Public Act No. 24-138 33 of 34
of paid health losses for the applicable period by eighty-five per cent.
Net gains, if any, shall be held at interest to offset future losses or
allocated to reduce future premiums.
(2) Any net loss to the association represented by the excess of its
actual expenses of administering policies issued by the association over
the applicable expense allowance shall be separately assessed to those
participating members who do not elect to administer their plans. All
assessments shall be on an equitable formula established by the board.
(3) The association shall conduct periodic audits to assure the general
accuracy of the financial data submitted to the association and the
association shall have an annual audit of its operations by an
independent certified public accountant. The annual audit shall be filed
with the commissioner for his review and the association shall be subject
to the provisions of section 38a-14.
(f) All policy forms issued by or through the association shall conform
in substance to prototype forms developed by the association, shall in
all other respects conform to the requirements of this section and
sections 38a-551 and [38a-556a] 38a-557 to 38a-559, inclusive, and shall
be approved by the commissioner. The commissioner may disapprove
any such form if it contains a provision or provisions that are unfair or
deceptive or that encourage misrepresentation of the policy.
(g) Unless otherwise permitted by the plan of operation, the
association shall not issue, reissue or continue in force health care plan
coverage with respect to any person who is already covered under an
individual or group health care plan, or who is sixty-five years of age or
older and eligible for Medicare or who is not a resident of this state.
(h) Benefits payable under a health care plan insured by or reinsured
through the association shall be paid net of all other health insurance
benefits paid or payable through any other source, and net of all health Substitute House Bill No. 5503
Public Act No. 24-138 34 of 34
insurance coverages provided by or pursuant to any other state or
federal law including Title XVIII of the Social Security Act, Medicare,
but excluding Medicaid.
(i) There shall be no liability on the part of and no cause of action of
any nature shall arise against any carrier or its agents or its employees,
the Health Reinsurance Association or its agents or its employees or the
residual market mechanism established under the provisions of section
38a-557 or its agents or its employees, or the commissioner or the
commissioner's representatives for any action taken by them in the
performance of their duties under this section and sections 38a-551 and
[38a-556a] 38a-557 to 38a-559, inclusive. This provision shall not apply
to the obligations of a carrier, a self-insurer, the Health Reinsurance
Association or the residual market mechanism for payment of benefits
provided under a health care plan.
Sec. 18. Section 38a-556a of the general statutes is repealed. (Effective
from passage)