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General Assembly Raised Bill No. 1420
January Session, 2025
LCO No. 4397
Referred to Committee on HUMAN SERVICES
Introduced by:
(HS)
AN ACT CONCERNING THE CONNECTICUT PARTNERSHIP FOR
LONG-TERM CARE.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 17a-861 of the general statutes is repealed and the 1
following is substituted in lieu thereof (Effective July 1, 2025): 2
(a) The Office of Policy and Management shall establish an outreach 3
program to educate consumers as to: (1) The need for long-term care; (2) 4
mechanisms for financing such care; (3) the availability of long-term 5
care insurance; and (4) the asset protection provided under sections 17b-6
252 to 17b-254, inclusive, and 38a-475, as amended by this act. The Office 7
of Policy and Management shall provide public information to assist 8
individuals in choosing appropriate insurance coverage. 9
(b) The Secretary of the Office of Policy and Management, in 10
consultation with the Insurance Commissioner, shall, not later than 11
January 15, 2026, and annually thereafter, file a report, in accordance 12
with the provisions of section 11-4a, with the joint standing committees 13
of the General Assembly having cognizance of matters relating to aging, 14
human services and insurance and real estate on the incurred loss and 15
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actual paid loss for each long-term care policy precertified pursuant to 16
section 38a-475, as amended by this act, in the past three calendar years. 17
The secretary shall include a link to the report on the Internet web site 18
of the Office of Policy and Management and the Insurance Department 19
shall include a link to the report on the Insurance Department's Internet 20
web site. 21
(c) Not later than October 1, 2025, the Secretary of the Office of Policy 22
and Management shall file a report, in accordance with the provisions 23
of section 11-4a, with the joint standing committees of the General 24
Assembly having cognizance of matters relating to aging, human 25
services and insurance and real estate on the feasibility and effect on 26
access to long-term care insurance of a requirement that issuers of long-27
term care insurance policies provide policyholders an opportunity to 28
cancel such insurance and obtain full refunds of any premiums paid 29
since the start of the policies whenever such issuer files for rate increases 30
that exceed the rate of inflation. 31
Sec. 2. Section 38a-475 of the general statutes is repealed and the 32
following is substituted in lieu thereof (Effective July 1, 2025): 33
The Insurance Department shall only precertify long-term care 34
insurance policies that (1) alert the purchaser to the availability of 35
consumer information and public education provided by the 36
Department of Aging and Disability Services pursuant to section 17a-37
861, as amended by this act; (2) offer the option of home and 38
community-based services in addition to nursing home care; (3) in all 39
home care plans, include case management services delivered by an 40
access agency approved by the Office of Policy and Management and 41
the Department of Social Services as meeting the requirements for such 42
agency as defined in regulations adopted pursuant to subsection (m) of 43
section 17b-342, which services shall include, but need not be limited to, 44
the development of a comprehensive individualized assessment and 45
care plan and, as needed, the coordination of appropriate services and 46
the monitoring of the delivery of such services; (4) provide inflation 47
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protection; (5) provide for the keeping of records and an explanation of 48
benefit reports on insurance payments which count toward Medicaid 49
resource exclusion; [and] (6) do not tie executive compensation to 50
approval of higher rates for policyholders; and (7) provide the 51
management information and reports necessary to document the extent 52
of Medicaid resource protection offered and to evaluate the Connecticut 53
Partnership for Long-Term Care. No policy shall be precertified if it 54
requires prior hospitalization or a prior stay in a nursing home as a 55
condition of providing benefits. The commissioner may adopt 56
regulations, in accordance with chapter 54, to carry out the 57
precertification provisions of this section. 58
Sec. 3. Subsection (b) of section 38a-501 of the general statutes is 59
repealed and the following is substituted in lieu thereof (Effective July 1, 60
2025): 61
(b) (1) No insurance company, fraternal benefit society, hospital 62
service corporation, medical service corporation or health care center 63
may deliver or issue for delivery any long-term care policy that has a 64
loss ratio of less than sixty per cent for any individual long-term care 65
policy. An issuer shall file an annual report, not later than January 66
fifteenth, with the Insurance Commissioner on incurred losses and 67
actual paid losses for each long-term care policy issued in the state. An 68
issuer shall not use or change premium rates for a long-term care policy 69
unless the rates have been filed with and approved by the 70
commissioner. For a policy precertified in accordance with section 38a-71
475, as amended by this act, the Insurance Commissioner shall not 72
approve any rate increase greater than a rate increase that was allowable 73
at the time such policy was precertified. Any rate filings or rate revisions 74
shall demonstrate that anticipated claims in relation to premiums when 75
combined with actual experience to date can be expected to comply with 76
the loss ratio requirement of this section. An insurance company, 77
fraternal benefit society, hospital service corporation, medical service 78
corporation or health care center shall, as part of any long-term care 79
policy rate increase request, provide details of any and all reinsurance 80
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contracts associated with the policy at issue, including, but not limited 81
to, participation percentage of each reinsurer, by date of contract. A rate 82
filing shall include the factors and methodology used to estimate 83
irrevocable trust values if the policy includes an option for the 84
elimination period specified in subdivision (1) of subsection (a) of this 85
section. 86
(2) (A) Any insurance company, fraternal benefit society, hospital 87
service corporation, medical service corporation or health care center 88
that files a rate filing for an increase in premium rates for a long-term 89
care policy that is for twenty per cent or more shall spread the increase 90
over a period of not less than three years and not file a rate filing for an 91
increase in premium rates for the long-term care policy during the 92
period chosen. Such company, society, corporation or center shall use a 93
periodic rate increase that is actuarially equivalent to a single rate 94
increase and a current interest rate for the period chosen. 95
(B) Prior to implementing a premium rate increase, each such 96
company, society, corporation or center shall: 97
(i) Notify its policyholders of such premium rate increase and make 98
available to such policyholders the additional choice of reducing the 99
policy benefits to reduce the premium rate or electing coverage that 100
reflects the minimum set of affordable benefit options developed by the 101
commissioner pursuant to section 38a-475a. Such notice shall include a 102
description of such policy benefit reductions and minimum set of 103
affordable benefit options. The premium rates for any benefit reductions 104
shall be based on the new premium rate schedule; 105
(ii) Provide policyholders not less than thirty calendar days to elect a 106
reduction in policy benefits or coverage that reflects the minimum set of 107
affordable benefit options developed by the commissioner pursuant to 108
section 38a-475a; and 109
(iii) Include a statement in such notice that if a policyholder fails to 110
elect a reduction in policy benefits or coverage that reflects the 111
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minimum set of affordable benefit options developed by the 112
commissioner pursuant to section 38a-475a by the end of the notice 113
period and has not cancelled the policy, the policyholder will be deemed 114
to have elected to retain the existing policy benefits. 115
Sec. 4. Subsection (b) of section 38a-528 of the general statutes is 116
repealed and the following is substituted in lieu thereof (Effective July 1, 117
2025): 118
(b) (1) No insurance company, fraternal benefit society, hospital 119
service corporation, medical service corporation or health care center 120
may deliver or issue for delivery any long-term care policy or certificate 121
that has a loss ratio of less than sixty-five per cent for any group long-122
term care policy. An issuer shall file an annual report, not later than 123
January fifteenth, with the Insurance Commissioner on incurred losses 124
and actual paid losses for each long-term care policy issued in the state. 125
An issuer shall not use or change premium rates for a long-term care 126
policy or certificate unless the rates have been filed with the 127
commissioner. For a policy precertified in accordance with section 38a-128
475, as amended by this act, the Insurance Commissioner shall not 129
approve any rate increase greater than a rate increase that was allowable 130
at the time such policy was precertified. Deviations in rates to reflect 131
policyholder experience shall be permitted, provided each policy form 132
shall meet the loss ratio requirement of this section. Any rate filings or 133
rate revisions shall demonstrate that anticipated claims in relation to 134
premiums when combined with actual experience to date can be 135
expected to comply with the loss ratio requirement of this section. An 136
insurance company, fraternal benefit society, hospital service 137
corporation, medical service corporation or health care center shall, as 138
part of any long-term care policy rate increase request, provide details 139
of any and all reinsurance contracts associated with the policy at issue, 140
including, but not limited to, participation percentage of each reinsurer, 141
by date of contract. On an annual basis, an insurer shall submit to the 142
commissioner an actuarial certification of the insurer's continuing 143
compliance with the loss ratio requirement of this section. Any rate or 144
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rate revision may be disapproved if the commissioner determines that 145
the loss ratio requirement will not be met over the lifetime of the policy 146
form using reasonable assumptions. 147
(2) (A) Any insurance company, fraternal benefit society, hospital 148
service corporation, medical service corporation or health care center 149
that files a rate filing for an increase in premium rates for a long-term 150
care policy that is for twenty per cent or more shall spread the increase 151
over a period of not less than three years and not file a rate filing for an 152
increase in premium rates for the long-term care policy during the 153
period chosen. Such company, society, corporation or center shall use a 154
periodic rate increase that is actuarially equivalent to a single rate 155
increase and a current interest rate for the period chosen. 156
(B) Prior to implementing a premium rate increase, each such 157
company, society, corporation or center shall: 158
(i) Notify its certificate holders of such premium rate increase and 159
make available to such certificate holders the additional choice of 160
reducing the policy benefits to reduce the premium rate or electing 161
coverage that reflects the minimum set of affordable benefit options 162
developed by the commissioner pursuant to section 38a-475a. Such 163
notice shall include a description of such policy benefit reductions and 164
minimum set of affordable benefit options. The premium rates for any 165
benefit reductions shall be based on the new premium rate schedule; 166
(ii) Provide certificate holders not less than thirty calendar days to 167
elect a reduction in policy benefits or coverage that reflects the 168
minimum set of affordable benefit options developed by the 169
commissioner pursuant to section 38a-475a; and 170
(iii) Include a statement in such notice that if a certificate holder fails 171
to elect a reduction in policy benefits or coverage that reflects the 172
minimum set of affordable benefit options developed by the 173
commissioner pursuant to section 38a-475a by the end of the notice 174
period and has not cancelled the policy, the certificate holder will be 175
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deemed to have elected to retain the existing policy benefits. 176
This act shall take effect as follows and shall amend the following
sections:
Section 1 July 1, 2025 17a-861
Sec. 2 July 1, 2025 38a-475
Sec. 3 July 1, 2025 38a-501(b)
Sec. 4 July 1, 2025 38a-528(b)
Statement of Purpose:
To institute safeguards for participants in the Connecticut Partnership
for Long-Term Care.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
underlined.]