Connecticut 2025 Regular Session

Connecticut Senate Bill SB01420 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
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3		-	LCO 4397 1 of 7
	3	+	LCO No. 4397 1 of 7
4	4
5	5		General Assembly Raised Bill No. 1420
6	6		January Session, 2025
7	7		LCO No. 4397
8	8
9	9
10	10		Referred to Committee on HUMAN SERVICES
11	11
12	12
13	13		Introduced by:
14	14		(HS)
	15	+
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18	19		AN ACT CONCERNING THE CONNECTICUT PARTNERSHIP FOR
19	20		LONG-TERM CARE.
20	21		Be it enacted by the Senate and House of Representatives in General
21	22		Assembly convened:
22	23
23	24		Section 1. Section 17a-861 of the general statutes is repealed and the 1
24	25		following is substituted in lieu thereof (Effective July 1, 2025): 2
25	26		(a) The Office of Policy and Management shall establish an outreach 3
26	27		program to educate consumers as to: (1) The need for long-term care; (2) 4
27	28		mechanisms for financing such care; (3) the availability of long-term 5
28	29		care insurance; and (4) the asset protection provided under sections 17b-6
29	30		252 to 17b-254, inclusive, and 38a-475, as amended by this act. The Office 7
30	31		of Policy and Management shall provide public information to assist 8
31	32		individuals in choosing appropriate insurance coverage. 9
32	33		(b) The Secretary of the Office of Policy and Management, in 10
33	34		consultation with the Insurance Commissioner, shall, not later than 11
34	35		January 15, 2026, and annually thereafter, file a report, in accordance 12
35	36		with the provisions of section 11-4a, with the joint standing committees 13
36	37		of the General Assembly having cognizance of matters relating to aging, 14
37		-	human services and insurance and real estate on the incurred loss and 15 Raised Bill No. 1420
	38	+	human services and insurance and real estate on the incurred loss and 15
	39	+	Raised Bill No. 1420
38	40
39	41
40		-	LCO 4397 2 of 7
	42	+
	43	+	LCO No. 4397 2 of 7
41	44
42	45		actual paid loss for each long-term care policy precertified pursuant to 16
43	46		section 38a-475, as amended by this act, in the past three calendar years. 17
44	47		The secretary shall include a link to the report on the Internet web site 18
45	48		of the Office of Policy and Management and the Insurance Department 19
46	49		shall include a link to the report on the Insurance Department's Internet 20
47	50		web site. 21
48	51		(c) Not later than October 1, 2025, the Secretary of the Office of Policy 22
49	52		and Management shall file a report, in accordance with the provisions 23
50	53		of section 11-4a, with the joint standing committees of the General 24
51	54		Assembly having cognizance of matters relating to aging, human 25
52	55		services and insurance and real estate on the feasibility and effect on 26
53	56		access to long-term care insurance of a requirement that issuers of long-27
54	57		term care insurance policies provide policyholders an opportunity to 28
55	58		cancel such insurance and obtain full refunds of any premiums paid 29
56	59		since the start of the policies whenever such issuer files for rate increases 30
57	60		that exceed the rate of inflation. 31
58	61		Sec. 2. Section 38a-475 of the general statutes is repealed and the 32
59	62		following is substituted in lieu thereof (Effective July 1, 2025): 33
60	63		The Insurance Department shall only precertify long-term care 34
61	64		insurance policies that (1) alert the purchaser to the availability of 35
62	65		consumer information and public education provided by the 36
63	66		Department of Aging and Disability Services pursuant to section 17a-37
64	67		861, as amended by this act; (2) offer the option of home and 38
65	68		community-based services in addition to nursing home care; (3) in all 39
66	69		home care plans, include case management services delivered by an 40
67	70		access agency approved by the Office of Policy and Management and 41
68	71		the Department of Social Services as meeting the requirements for such 42
69	72		agency as defined in regulations adopted pursuant to subsection (m) of 43
70	73		section 17b-342, which services shall include, but need not be limited to, 44
71	74		the development of a comprehensive individualized assessment and 45
72	75		care plan and, as needed, the coordination of appropriate services and 46
73	76		the monitoring of the delivery of such services; (4) provide inflation 47
74		-	~~protection; (5) provide for the keeping of records and an explanation of 48~~ Raised Bill No. 1420
	77	+	Raised Bill No. 1420
75	78
76	79
77		-	LCO 4397 3 of 7
78	80
	81	+	LCO No. 4397 3 of 7
	82	+
	83	+	protection; (5) provide for the keeping of records and an explanation of 48
79	84		benefit reports on insurance payments which count toward Medicaid 49
80	85		resource exclusion; [and] (6) do not tie executive compensation to 50
81	86		approval of higher rates for policyholders; and (7) provide the 51
82	87		management information and reports necessary to document the extent 52
83	88		of Medicaid resource protection offered and to evaluate the Connecticut 53
84	89		Partnership for Long-Term Care. No policy shall be precertified if it 54
85	90		requires prior hospitalization or a prior stay in a nursing home as a 55
86	91		condition of providing benefits. The commissioner may adopt 56
87	92		regulations, in accordance with chapter 54, to carry out the 57
88	93		precertification provisions of this section. 58
89	94		Sec. 3. Subsection (b) of section 38a-501 of the general statutes is 59
90	95		repealed and the following is substituted in lieu thereof (Effective July 1, 60
91	96		2025): 61
92	97		(b) (1) No insurance company, fraternal benefit society, hospital 62
93	98		service corporation, medical service corporation or health care center 63
94	99		may deliver or issue for delivery any long-term care policy that has a 64
95	100		loss ratio of less than sixty per cent for any individual long-term care 65
96	101		policy. An issuer shall file an annual report, not later than January 66
97	102		fifteenth, with the Insurance Commissioner on incurred losses and 67
98	103		actual paid losses for each long-term care policy issued in the state. An 68
99	104		issuer shall not use or change premium rates for a long-term care policy 69
100	105		unless the rates have been filed with and approved by the 70
101	106		commissioner. For a policy precertified in accordance with section 38a-71
102	107		475, as amended by this act, the Insurance Commissioner shall not 72
103	108		approve any rate increase greater than a rate increase that was allowable 73
104	109		at the time such policy was precertified. Any rate filings or rate revisions 74
105	110		shall demonstrate that anticipated claims in relation to premiums when 75
106	111		combined with actual experience to date can be expected to comply with 76
107	112		the loss ratio requirement of this section. An insurance company, 77
108	113		fraternal benefit society, hospital service corporation, medical service 78
109	114		corporation or health care center shall, as part of any long-term care 79
110	115		policy rate increase request, provide details of any and all reinsurance 80
111		-	contracts associated with the policy at issue, including, but not limited 81
112		-	to, participation percentage of each reinsurer, by date of contract. A rate 82 Raised Bill No. 1420
	116	+	Raised Bill No. 1420
113	117
114	118
115		-	LCO 4397 4 of 7
116	119
	120	+	LCO No. 4397 4 of 7
	121	+
	122	+	contracts associated with the policy at issue, including, but not limited 81
	123	+	to, participation percentage of each reinsurer, by date of contract. A rate 82
117	124		filing shall include the factors and methodology used to estimate 83
118	125		irrevocable trust values if the policy includes an option for the 84
119	126		elimination period specified in subdivision (1) of subsection (a) of this 85
120	127		section. 86
121	128		(2) (A) Any insurance company, fraternal benefit society, hospital 87
122	129		service corporation, medical service corporation or health care center 88
123	130		that files a rate filing for an increase in premium rates for a long-term 89
124	131		care policy that is for twenty per cent or more shall spread the increase 90
125	132		over a period of not less than three years and not file a rate filing for an 91
126	133		increase in premium rates for the long-term care policy during the 92
127	134		period chosen. Such company, society, corporation or center shall use a 93
128	135		periodic rate increase that is actuarially equivalent to a single rate 94
129	136		increase and a current interest rate for the period chosen. 95
130	137		(B) Prior to implementing a premium rate increase, each such 96
131	138		company, society, corporation or center shall: 97
132	139		(i) Notify its policyholders of such premium rate increase and make 98
133	140		available to such policyholders the additional choice of reducing the 99
134	141		policy benefits to reduce the premium rate or electing coverage that 100
135	142		reflects the minimum set of affordable benefit options developed by the 101
136	143		commissioner pursuant to section 38a-475a. Such notice shall include a 102
137	144		description of such policy benefit reductions and minimum set of 103
138	145		affordable benefit options. The premium rates for any benefit reductions 104
139	146		shall be based on the new premium rate schedule; 105
140	147		(ii) Provide policyholders not less than thirty calendar days to elect a 106
141	148		reduction in policy benefits or coverage that reflects the minimum set of 107
142	149		affordable benefit options developed by the commissioner pursuant to 108
143	150		section 38a-475a; and 109
144	151		(iii) Include a statement in such notice that if a policyholder fails to 110
145	152		elect a reduction in policy benefits or coverage that reflects the 111
	153	+	Raised Bill No. 1420
	154	+
	155	+
	156	+
	157	+	LCO No. 4397 5 of 7
	158	+
146	159		minimum set of affordable benefit options developed by the 112
147	160		commissioner pursuant to section 38a-475a by the end of the notice 113
148		-	period and has not cancelled the policy, the policyholder will be deemed 114 Raised Bill No. 1420
149		-
150		-
151		-	LCO 4397 5 of 7
152		-
	161	+	period and has not cancelled the policy, the policyholder will be deemed 114
153	162		to have elected to retain the existing policy benefits. 115
154	163		Sec. 4. Subsection (b) of section 38a-528 of the general statutes is 116
155	164		repealed and the following is substituted in lieu thereof (Effective July 1, 117
156	165		2025): 118
157	166		(b) (1) No insurance company, fraternal benefit society, hospital 119
158	167		service corporation, medical service corporation or health care center 120
159	168		may deliver or issue for delivery any long-term care policy or certificate 121
160	169		that has a loss ratio of less than sixty-five per cent for any group long-122
161	170		term care policy. An issuer shall file an annual report, not later than 123
162	171		January fifteenth, with the Insurance Commissioner on incurred losses 124
163	172		and actual paid losses for each long-term care policy issued in the state. 125
164	173		An issuer shall not use or change premium rates for a long-term care 126
165	174		policy or certificate unless the rates have been filed with the 127
166	175		commissioner. For a policy precertified in accordance with section 38a-128
167	176		475, as amended by this act, the Insurance Commissioner shall not 129
168	177		approve any rate increase greater than a rate increase that was allowable 130
169	178		at the time such policy was precertified. Deviations in rates to reflect 131
170	179		policyholder experience shall be permitted, provided each policy form 132
171	180		shall meet the loss ratio requirement of this section. Any rate filings or 133
172	181		rate revisions shall demonstrate that anticipated claims in relation to 134
173	182		premiums when combined with actual experience to date can be 135
174	183		expected to comply with the loss ratio requirement of this section. An 136
175	184		insurance company, fraternal benefit society, hospital service 137
176	185		corporation, medical service corporation or health care center shall, as 138
177	186		part of any long-term care policy rate increase request, provide details 139
178	187		of any and all reinsurance contracts associated with the policy at issue, 140
179	188		including, but not limited to, participation percentage of each reinsurer, 141
180	189		by date of contract. On an annual basis, an insurer shall submit to the 142
181	190		commissioner an actuarial certification of the insurer's continuing 143
182	191		compliance with the loss ratio requirement of this section. Any rate or 144
	192	+	Raised Bill No. 1420
	193	+
	194	+
	195	+
	196	+	LCO No. 4397 6 of 7
	197	+
183	198		rate revision may be disapproved if the commissioner determines that 145
184	199		the loss ratio requirement will not be met over the lifetime of the policy 146
185		-	form using reasonable assumptions. 147 Raised Bill No. 1420
186		-
187		-
188		-	LCO 4397 6 of 7
189		-
	200	+	form using reasonable assumptions. 147
190	201		(2) (A) Any insurance company, fraternal benefit society, hospital 148
191	202		service corporation, medical service corporation or health care center 149
192	203		that files a rate filing for an increase in premium rates for a long-term 150
193	204		care policy that is for twenty per cent or more shall spread the increase 151
194	205		over a period of not less than three years and not file a rate filing for an 152
195	206		increase in premium rates for the long-term care policy during the 153
196	207		period chosen. Such company, society, corporation or center shall use a 154
197	208		periodic rate increase that is actuarially equivalent to a single rate 155
198	209		increase and a current interest rate for the period chosen. 156
199	210		(B) Prior to implementing a premium rate increase, each such 157
200	211		company, society, corporation or center shall: 158
201	212		(i) Notify its certificate holders of such premium rate increase and 159
202	213		make available to such certificate holders the additional choice of 160
203	214		reducing the policy benefits to reduce the premium rate or electing 161
204	215		coverage that reflects the minimum set of affordable benefit options 162
205	216		developed by the commissioner pursuant to section 38a-475a. Such 163
206	217		notice shall include a description of such policy benefit reductions and 164
207	218		minimum set of affordable benefit options. The premium rates for any 165
208	219		benefit reductions shall be based on the new premium rate schedule; 166
209	220		(ii) Provide certificate holders not less than thirty calendar days to 167
210	221		elect a reduction in policy benefits or coverage that reflects the 168
211	222		minimum set of affordable benefit options developed by the 169
212	223		commissioner pursuant to section 38a-475a; and 170
213	224		(iii) Include a statement in such notice that if a certificate holder fails 171
214	225		to elect a reduction in policy benefits or coverage that reflects the 172
215	226		minimum set of affordable benefit options developed by the 173
216	227		commissioner pursuant to section 38a-475a by the end of the notice 174
217	228		period and has not cancelled the policy, the certificate holder will be 175
	229	+	Raised Bill No. 1420
	230	+
	231	+
	232	+
	233	+	LCO No. 4397 7 of 7
	234	+
218	235		deemed to have elected to retain the existing policy benefits. 176
219	236		This act shall take effect as follows and shall amend the following
220	237		sections:
221		-	Raised Bill No. 1420
222		-
223		-
224		-	LCO 4397 7 of 7
225	238
226	239		Section 1 July 1, 2025 17a-861
227	240		Sec. 2 July 1, 2025 38a-475
228	241		Sec. 3 July 1, 2025 38a-501(b)
229	242		Sec. 4 July 1, 2025 38a-528(b)
230	243
231		-	HS Joint Favorable
	244	+	Statement of Purpose:
	245	+	To institute safeguards for participants in the Connecticut Partnership
	246	+	for Long-Term Care.
	247	+
	248	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
	249	+	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
	250	+	underlined.]
232	251