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Section
38a-469
Definitions.
Section
38a-470
(Formerly Sec. 38-174n) - Lien on workers' compensation awards for insurers. Notice of lien.
Section
38a-471
(Formerly Sec. 38-174o) - Third party prescription programs. Notice of cancellation. Applicability of section.
Section
38a-472
(Formerly Sec. 38-174a) - Assignment of insurance proceeds to doctor, hospital or state agency. Lien for state care. Notice of lien.
Section
38a-472a
Medical provider indemnification agreements prohibited.
Section
38a-472b
Medical provider indemnification contracts. Professional actions and related liability.
Section
38a-472c
Dental policies. Estimate of reimbursement. Material adjustments to fee schedules for in-network providers. Notice.
Section
38a-472d
Public education outreach program re health insurance availability and eligibility requirements.
Section
38a-472e
Health insurer. Requirements re offer to contract with a school-based health center.
Section
38a-472f
Network adequacy. Health carrier duties and responsibilities. Access plan filing.
Section
38a-472g
Restrictions applicable to prior authorization or precertification.
Section
38a-472h
Fees charged by dentists, optometrists and ophthalmologists for noncovered benefits. Notice and posting required.
Section
38a-472i
Payment amount of professional services component of covered colonoscopy or endoscopic services.
Section
38a-472j
Restrictions applicable to cost-sharing for covered benefits. Regulations.
Section
38a-472k
Disability income policies. Discretionary clauses prohibited. Regulations.
Section
38a-473
Medicare supplement expense factors. Age, gender, previous claim or medical history rating prohibited.
Section
38a-474
Medicare supplement policy rate increases: Procedure. Age, gender, previous claim or medical history rating prohibited.
Section
38a-475
Precertification of long-term care policies under the Connecticut Partnership for Long-Term Care. Regulations.
Section
38a-476
Preexisting condition coverage.
Section
38a-476a
Compliance with the Health Insurance Portability and Accountability Act. Guaranteed renewability. Discrimination based on health status, newborns' and mothers' health prohibited. Parity of mental health benefits. Disclosure of information for employers. Construction. Application. Regulations.
Section
38a-476b
Standards re psychotropic drug availability in health plans.
Section
38a-476c
Policies and contracts with variable network and enrollee cost-sharing. Approval. Limitations.
Section
38a-477
Standardized claim forms. Information necessary for filing a claim. Regulations.
Section
38a-477a
Notification by Insurance Commissioner of required benefits and policy forms.
Section
38a-477aa
Cost-sharing and health care provider reimbursements for emergency services and surprise bills.
Section
38a-477b
Postclaims underwriting prohibited unless approval granted. Application for approval of rescission, cancellation or limitation. Decision. Appeals. Regulations.
Section
38a-477bb
Cost-sharing re facility fees.
Section
38a-477c
Disclosure of state and federal medical loss ratio with each health insurance application.
Section
38a-477cc
Contracts for pharmacy services with health carriers or pharmacy benefits managers.
Section
38a-477d
Information to be made available to consumers.
Section
38a-477dd
Contracts with health carriers. Certain provisions concerning disclosures to covered persons prohibited.
Section
38a-477e
Health carriers to maintain Internet web site and toll-free telephone number. Available information. Exception.
Section
38a-477ee
Mental health and substance use disorder benefits. Nonquantitative treatment limitations. Reports. Public hearings. Regulations.
Section
38a-477f
Contract provision prohibiting certain disclosures prohibited.
Section
38a-477g
Contracts between health carriers and participating providers.
Section
38a-477h
Participating provider directories.
Sections
38a-477i to 38a-477z
Reserved for future use.
Section
38a-478
Definitions.
Section
38a-478a
Commissioner's report to the Governor and the General Assembly.
Section
38a-478b
Penalty for managed care organization's failure to file data and reports. Commissioner's report to the Governor and the General Assembly on organizations that fail to file data and reports.
Section
38a-478c
Managed care organization's report to the commissioner: Data, reports and information required.
Section
38a-478d
Provider directory. Notification to enrollee of termination or withdrawal of enrollee's primary care provider.
Section
38a-478e
Medical protocols. Procedure prior to change. Physician input. Notification of change.
Section
38a-478f
Provider profile development requirements.
Section
38a-478g
Managed care contract requirements. Plan description requirements.
Section
38a-478h
Contract requirements and notice for removal or departure of provider. Retaliatory action prohibited.
Section
38a-478i
Limitation on enrollee rights prohibited.
Section
38a-478j
Coinsurance and deductible payments based on negotiated discounts.
Section
38a-478k
Gag clauses prohibited.
Section
38a-478l
Consumer report card required. Content. Data analysis by commissioner.
Sections
38a-478m and 38a-478n
Internal grievance procedure; notice re procedure and final resolution; penalties; fines allocated to Office of the Healthcare Advocate. Exhaustion of internal appeal mechanisms; external appeal to commissioner; applicability to health insurers, managed care organizations and utilization review companies; fees; preliminary review; full review; public outreach program; expedited external appeal; requirements for and approval of independent review entities; filing of report.
Section
38a-478o
Confidentiality and antidiscrimination procedures required.
Section
38a-478p
Expedited utilization review. Standardized process required.
Section
38a-478q
Use of laboratories covered by plan required.
Section
38a-478r
Emergency rooms. Prudent layperson standard. Presenting symptoms or final diagnosis as basis for coverage. Mandatory coverage for medically necessary health care services for emergency medical conditions.
Section
38a-478s
Nonapplicability to self-insured employee welfare benefit plans and workers' compensation plans.
Section
38a-478t
Commissioner of Public Health to receive data.
Section
38a-478u
Regulations.
Section
38a-478v
Applicability of Unfair and Prohibited Insurance Practices Act. Examination by Insurance Commissioner. Regulations.
Section
38a-479
Definitions. Access to fee schedules. Fee information to be confidential.
Section
38a-479a
Physicians and managed care organizations to discuss issues relative to contracting between such parties.
Section
38a-479aa
Preferred provider networks. Definitions. Licensing. Fees. Requirements. Exception, regulations.
Section
38a-479aaa
Pharmacy benefits managers. Definitions.
Section
38a-479b
Material changes to fee schedules. Return of payment by provider. Appeals. Filing of claim by provider under other applicable insurance coverage. Certain clauses, covenants and agreements prohibited. Exception.
Section
38a-479bb
Requirements for managed care organizations that contract with preferred provider networks. Requirements for preferred provider networks.
Section
38a-479bbb
Registration of pharmacy benefits managers required. Application for registration. Fee. Surety bond. Exemption from registration.
Sections
38a-479c to 38a-479z
Reserved for future use.
Section
38a-479cc
Duties of a preferred provider network when providing services pursuant to a contract with a managed care organization.
Section
38a-479ccc
Certificate of registration; when issued or refused. Suspension, revocation or refusal to issue or renew registration; grounds.
Section
38a-479dd
Preferred provider network examination of outstanding amounts. Notice. Commissioner's duties.
Section
38a-479ddd
Hearing on denial of certificate. Subsequent application.
Section
38a-479ee
Violations. Penalties. Investigations and staffing. Grievances. Referrals from Healthcare Advocate.
Section
38a-479eee
Claims payment to be made by electronic funds transfer upon written request.
Section
38a-479ff
Adverse action or threat of adverse action against complainant prohibited. Exception. Civil actions by aggrieved persons.
Section
38a-479fff
Expiration of certificates of registration. Renewal. Fees.
Section
38a-479gg
Regulations.
Section
38a-479ggg
Regulations.
Sections
38a-479hh to 38a-479pp
Reserved for future use.
Section
38a-479hhh
Investigations and hearings. Powers of commissioner. Appeals.
Section
38a-479iii
Pharmacy audits.
Sections
38a-479jjj to 38a-479nnn
Reserved for future use.
Section
38a-479ooo
Definitions.
Section
38a-479ppp
Annual report by pharmacy benefits managers. Standardized form. Confidentiality of information. Penalty. Regulations. Commissioner's report to the General Assembly.
Section
38a-479qq
Medical discount plans: Definitions, prohibited sales practices, penalties.
Section
38a-479qqq
Annual report by health carriers. Regulations.
Section
38a-479rr
Medical discount plan organizations: Licensure. List of authorized marketers. Provider agreements. Minimum net worth. Suspension of authority and revocation or nonrenewal of license. Reinstatement of license. Maintenance of information. Regulations. Penalties. Advertising and marketing materials. Investigations.
Section
38a-479rrr
Annual certification by health carriers.
Sections
38a-479ss to 38a-479zz
Reserved for future use.
Section
38a-479sss
Annual report by commissioner to the General Assembly re outpatient prescription drug costs.
Section
38a-479ttt
Annual report by commissioner to the General Assembly re prescription drug rebates.
Section
38a-480
(Formerly Sec. 38-174) - Applicability of statutes to certain policies and contracts.
Section
38a-481
(Formerly Sec. 38-165) - Filing of policy form, application, classification of risks and rates. Approval of rates. Prescription drug rebates. Medicare supplement policies: Age, gender, previous claim or medical history rating prohibited. Reduction of payments on basis of Medicare eligibility. Optional life insurance rider. Treatment of health insurance issued to association or certain other insurance arrangements. Special enrollment periods. Grandfathered and nongrandfathered plans.
Section
38a-482
(Formerly Sec. 38-166) - Form of policy.
Section
38a-482a
Individual health insurance policy to contain definition of “medically necessary” or “medical necessity”.
Section
38a-482b
Individual health insurance policy providing limited coverage to include disclosure. Limited coverage defined.
Section
38a-482c
Annual and lifetime limits.
Section
38a-483
(Formerly Sec. 38-167) - Standard provisions of individual health policy.
Section
38a-483a
Exclusionary riders for individual health insurance policies. Regulations.
Section
38a-483b
Time limits for coverage determinations. Notice requirements.
Section
38a-483c
Coverage and notice re experimental treatments. Appeals.
Section
38a-484
(Formerly Sec. 38-168) - Policy provisions not to be less favorable than standard. Validity of policy issued in violation of law.
Section
38a-485
(Formerly Sec. 38-169) - Copy of application to be part of new policy or to be furnished with renewal. Alteration of application.
Section
38a-486
(Formerly Sec. 38-170) - Certain acts not to operate as waiver of rights.
Section
38a-487
(Formerly Sec. 38-171) - Coverage after termination date of policy.
Section
38a-488
(Formerly Sec. 38-172) - Discrimination.
Section
38a-488a
Mandatory coverage for the diagnosis and treatment of mental or nervous conditions. Exceptions. Benefits payable re type of provider or facility. State's claim against proceeds. Direct reimbursement for certain covered services rendered by certain out-of-network providers.
Section
38a-488b
Coverage for autism spectrum disorder therapies.
Section
38a-488c
Mental health and substance use disorder benefits. Nonquantitative treatment limitations.
Section
38a-488d
Coverage for substance abuse services provided pursuant to court order.
Section
38a-489
(Formerly Sec. 38-174e) - Continuation of coverage of mentally or physically handicapped children.
Section
38a-490
(Formerly Sec. 38-174g) - Coverage for newly born children. Notification to insurer.
Section
38a-490a
Coverage for birth-to-three program.
Section
38a-490b
Coverage for hearing aids.
Section
38a-490c
Coverage for craniofacial disorders.
Section
38a-490d
Mandatory coverage for blood lead screening and risk assessment.
Section
38a-491
(Formerly Sec. 38-174h) - Coverage for services performed by dentists in certain instances.
Section
38a-491a
Coverage for in-patient, outpatient or one-day dental services in certain instances.
Section
38a-491b
Assignment of benefits to a dentist or oral surgeon.
Section
38a-492
(Formerly Sec. 38-174i) - Coverage for accidental ingestion or consumption of controlled drugs. Benefits prescribed.
Section
38a-492a
Mandatory coverage for hypodermic needles and syringes.
Section
38a-492b
Coverage for certain off-label drug prescriptions.
Section
38a-492c
Coverage for low protein modified food products, amino acid modified preparations and specialized formulas.
Section
38a-492d
*(See end of section for amended version and effective date.) Mandatory coverage for diabetes testing and treatment.
Section
38a-492e
Mandatory coverage for diabetes outpatient self-management training.
Section
38a-492f
Mandatory coverage for certain prescription drugs removed from formulary.
Section
38a-492g
Mandatory coverage for prostate cancer screening and treatment.
Section
38a-492h
Mandatory coverage for certain Lyme disease treatments.
Section
38a-492i
Mandatory coverage for pain management.
Section
38a-492j
Mandatory coverage for ostomy-related supplies.
Section
38a-492k
Mandatory coverage for colorectal cancer screening.
Section
38a-492l
Mandatory coverage for neuropsychological testing for children diagnosed with cancer.
Section
38a-492m
Mandatory coverage for certain renewals of prescription eye drops.
Section
38a-492n
Mandatory coverage for certain wound-care supplies.
Section
38a-492o
Mandatory coverage for bone marrow testing.
Section
38a-492p
Mandatory coverage for medically monitored inpatient detoxification.
Section
38a-492q
Mandatory coverage for essential health benefits.
Section
38a-492r
Mandatory coverage for certain immunizations.
Section
38a-492s
Mandatory coverage for certain preventive care and screenings for individuals who are twenty-one years of age or younger.
Section
38a-492t
Mandatory coverage for prosthetic devices.
Section
38a-493
(Formerly Sec. 38-174k) - Mandatory coverage for home health care. Deductibles. Exception from deductible limits for medical savings accounts, Archer MSAs and health savings accounts.
Section
38a-494
(Formerly Sec. 38-174l) - Home health care by recognized nonmedical systems.
Section
38a-495
(Formerly Sec. 38-174m) - Medicare supplement policies. Coverage of home health aide services and mammography. Prescription drug riders.
Section
38a-495a
Medicare supplement policies and certificates. Minimum required policy benefits and standards. Regulations.
Section
38a-495b
Medicare supplement policies and certificates. Definitions.
Section
38a-495c
Medicare supplement premium rates charged on a community rate basis. Age, gender, previous claim or medical history rating prohibited. Preexisting conditions. Coverage for the disabled and qualified Medicare beneficiaries. Regulations.
Section
38a-495d
Refund of prepaid premium for Medicare supplement policies.
Section
38a-496
(Formerly Sec. 38-174q) - Coverage for occupational therapy.
Section
38a-497
(Formerly Sec. 38-174r) - Termination of coverage of children in individual policies. Coverage for stepchildren.
Section
38a-497a
Group coverage and benefits of a noncustodial parent. National Medical Support Notice. Notification of new employer by IV-D agency. Notification to parent. Enrollment of child.
Section
38a-498
(Formerly Sec. 38-174t) - Mandatory coverage for medically necessary ambulance services. Direct payment to ambulance provider.
Section
38a-498a
Prior authorization prohibited for certain 9-1-1 emergency calls.
Section
38a-498b
Mandatory coverage for mobile field hospital.
Section
38a-498c
Denial of coverage prohibited for health care services rendered to persons with an elevated blood alcohol content.
Section
38a-499
(Formerly Sec. 38-174v) - Coverage for services of physician assistants and certain nurses.
Section
38a-499a
Coverage for telehealth services.
Section
38a-500
(Formerly Sec. 38-174w) - Mandatory coverage for partners, sole proprietors and corporate officers for work-related injuries. Subrogation rights.
Section
38a-501
(Formerly Sec. 38-174x) - Individual long-term care policies. Disclosures. Spreading of premium rate increases of twenty per cent or more. Disclosure of premium rate increase.
Section
38a-501a
Individual short-term care policies. Approval of rates and forms. Disclosures. Regulations.
Section
38a-502
(Formerly Sec. 38-174ff) - Mandatory coverage for services provided by the Healthcare Center maintained by the Department of Veterans Affairs.
Section
38a-503
(Formerly Sec. 38-174gg) - Mandatory coverage for mammography, breast ultrasound and magnetic resonance imaging. Breast density information included in mammography report.
Section
38a-503a
Mandatory coverage for breast cancer survivors.
Section
38a-503b
Carriers to permit direct access to obstetrician-gynecologist.
Section
38a-503c
Mandatory coverage for maternity care. Interhospital transfer of newborn infant and mother.
Section
38a-503d
Mandatory coverage for mastectomy care. Termination of provider contract prohibited.
Section
38a-503e
Mandatory coverage for contraceptives and sterilization.
Section
38a-503f
Mandatory coverage for certain health benefits and services for women, infants, children and adolescents.
Section
38a-504
(Formerly Sec. 38-262i) - Mandatory coverage for treatment of tumors and leukemia. Mandatory coverage for reconstructive surgery, prosthesis, chemotherapy and wigs. Orally administered anticancer medications.
Section
38a-504a
Coverage for routine patient care costs associated with certain clinical trials.
Section
38a-504b
Clinical trial criteria.
Section
38a-504c
Evidence and information re eligibility for clinical trial. No coverage required for otherwise reimbursable costs.
Section
38a-504d
Clinical trials: Routine patient care costs.
Section
38a-504e
Clinical trials: Billing. Payments.
Section
38a-504f
Clinical trials: Standardized forms. Time frame for coverage determinations. Appeals. Regulations.
Section
38a-504g
Clinical trials: Submission and certification of policy forms.
Section
38a-505
(Formerly Sec. 38-378) - Insurance Commissioner's powers concerning comprehensive health care plans. Disclosures.
Section
38a-506
(Formerly Sec. 38-173) - Penalty.
Section
38a-507
Coverage for services performed by chiropractors.
Section
38a-508
Coverage for adopted children.
Section
38a-509
Mandatory coverage for infertility diagnosis and treatment. Limitations.
Section
38a-510
Prescription drug coverage. Mail order pharmacies. Step therapy use.
Section
38a-510a
Prescription drug coverage. Synchronized refills.
Section
38a-510b
Prescription drug coverage. Prior authorization for naloxone hydrochloride or similar drug not required.
Section
38a-510c
Coverage for investigational drug, biological product or device for insureds with terminal illnesses. Liability of health carrier.
Section
38a-511
Copayments re in-network imaging services.
Section
38a-511a
Copayments re in-network physical therapy services and in-network occupational therapy services.
Section
38a-512
Applicability of statutes to certain major medical expense policies.
Section
38a-512a
Continuation of coverage.
Section
38a-512b
Termination of coverage of children in group policies. Coverage for stepchildren.
Section
38a-512c
Annual and lifetime limits.
Section
38a-513
Approval of policy forms and small employer rates. Prescription drug rebates. Medicare supplement policies. Age, gender, previous claim or medical history rating prohibited. Optional life insurance rider. Group specified disease policies.
Section
38a-513a
Time limits for coverage determinations. Notice requirements.
Section
38a-513b
Coverage and notice re experimental treatments. Appeals.
Section
38a-513c
Group health insurance policy to contain definition of “medically necessary” or “medical necessity”.
Section
38a-513d
Insurers prohibited from issuing policy with limited coverage to employer as replacement for a comprehensive health insurance plan. Disclosure required in policy providing limited coverage. Limited coverage defined.
Section
38a-513e
Premium payment by employer following employee termination. Exceptions. Right to continuation of coverage following relocation or closing of covered establishment not affected.
Section
38a-513f
Claims information to be provided to certain employers. Restrictions. Subpoenas.
Section
38a-513g
Employer submission of plan cost information to Comptroller.
Section
38a-514
(Formerly Sec. 38-174d) - Mandatory coverage for the diagnosis and treatment of mental or nervous conditions. Exceptions. Benefits payable re type of provider or facility. State's claims against proceeds. Direct reimbursement for certain covered services rendered by certain out-of-network providers.
Section
38a-514a
Biologically-based mental illness. Coverage required.
Section
38a-514b
Coverage for autism spectrum disorder.
Section
38a-514c
Mental health and substance use disorder benefits. Nonquantitative treatment limitations.
Section
38a-514d
Coverage for substance abuse services provided pursuant to court order.
Section
38a-515
Continuation of coverage of mentally or physically handicapped children.
Section
38a-516
Coverage for newly born children. Notification to insurer.
Section
38a-516a
Coverage for birth-to-three program.
Section
38a-516b
Coverage for hearing aids.
Section
38a-516c
Coverage for craniofacial disorders.
Section
38a-516d
Coverage for neuropsychological testing for children diagnosed with cancer.
Section
38a-517
Coverage for services performed by dentist in certain instances.
Section
38a-517a
Coverage for in-patient, outpatient or one-day dental services in certain instances.
Section
38a-517b
Assignment of benefits to a dentist or oral surgeon.
Section
38a-518
Coverage for accidental ingestion or consumption of controlled drugs. Benefits prescribed.
Section
38a-518a
Mandatory coverage for hypodermic needles and syringes.
Section
38a-518b
Coverage for certain off-label drug prescriptions.
Section
38a-518c
Coverage for low protein modified food products, amino acid modified preparations and specialized formulas.
Section
38a-518d
*(See end of section for amended version and effective date.) Mandatory coverage for diabetes testing and treatment.
Section
38a-518e
Mandatory coverage for diabetes outpatient self-management training.
Section
38a-518f
Mandatory coverage for certain prescription drugs removed from formulary.
Section
38a-518g
Mandatory coverage for prostate cancer screening and treatment.
Section
38a-518h
Mandatory coverage for certain Lyme disease treatments.
Section
38a-518i
Mandatory coverage for pain management.
Section
38a-518j
Mandatory coverage for ostomy-related supplies.
Section
38a-518k
Mandatory coverage for colorectal cancer screening.
Section
38a-518l
Mandatory coverage for certain renewals of prescription eye drops.
Section
38a-518m
Mandatory coverage for certain wound-care supplies.
Section
38a-518n
Reserved for future use.
Section
38a-518o
Mandatory coverage for bone marrow testing.
Section
38a-518p
Mandating coverage for medically monitored inpatient detoxification.
Section
38a-518q
Mandatory coverage for essential health benefits.
Section
38a-518r
Mandatory coverage for certain immunizations.
Section
38a-518s
Mandatory coverage for certain preventive care and screenings for individuals who are twenty-one years of age or younger.
Section
38a-518t
Mandatory coverage for prosthetic devices.
Section
38a-519
(Formerly Sec. 38-174j) - Offset proviso prohibited in certain policies. Required disclosures for group long-term disability policies.
Section
38a-520
Mandatory coverage for home health care. Deductibles. Exception from deductible limits for medical savings accounts. Archer MSAs and health savings accounts.
Section
38a-521
Home health care by recognized nonmedical systems.
Section
38a-522
Medicare supplement policies. Coverage of home health aide service.
Section
38a-523
(Formerly Sec. 38-174p) - Group hospital or medical insurance coverage for comprehensive rehabilitation services.
Section
38a-524
Coverage for occupational therapy.
Section
38a-525
Mandatory coverage for medically necessary ambulance services. Direct payment to ambulance provider.
Section
38a-525a
Prior authorization prohibited for certain 9-1-1 emergency calls.
Section
38a-525b
Mandatory coverage for mobile field hospital.
Section
38a-525c
Denial of coverage prohibited for health care services rendered to persons with an elevated blood alcohol content.
Section
38a-526
Coverage for services of physician assistants and certain nurses.
Section
38a-526a
Coverage for telehealth services.
Section
38a-527
Mandatory coverage for partners, sole proprietors and corporate officers for work-related injuries.
Section
38a-528
Group long-term care policies. Disclosures. Spreading of premium rate increases of twenty per cent or more. Disclosure of premium rate increase.
Section
38a-528a
Group short-term care policies. Approval of rates and forms. Disclosures. Regulations.
Section
38a-529
Mandatory coverage for services provided by the Healthcare Center maintained by the Department of Veterans Affairs.
Section
38a-530
Mandatory coverage for mammography, breast ultrasound and magnetic resonance imaging. Breast density information included in mammography report.
Section
38a-530a
Mandatory coverage for breast cancer survivors.
Section
38a-530b
Carriers to permit direct access to obstetrician-gynecologist.
Section
38a-530c
Mandatory coverage for maternity care. Interhospital transfer of newborn infant and mother.
Section
38a-530d
Mandatory coverage for mastectomy care. Termination of provider contract prohibited.
Section
38a-530e
Mandatory coverage for contraceptives and sterilization.
Section
38a-530f
Mandatory coverage for certain health benefits and services for women, infants, children and adolescents.
Section
38a-531
(Formerly Sec. 38-174hh) - Mandatory coverage for employees of certain employers. Approval of policy forms.
Section
38a-532
(Formerly Sec. 38-262a) - Assignment of incidents of ownership under group life, health or accident policy.
Section
38a-533
(Formerly Sec. 38-262b) - Mandatory coverage for the treatment of medical complications of alcoholism.
Section
38a-534
Coverage for services performed by chiropractors.
Section
38a-535
Mandatory coverage for preventive pediatric care and blood lead screening and risk assessment.
Section
38a-535a
Notification of individual coverage and benefits of a noncustodial parent to a custodial parent, when. Regulations.
Section
38a-536
Mandatory coverage for infertility diagnosis and treatment. Limitations.
Section
38a-537
(Formerly Sec. 38-262c) - Notice of cancellation or discontinuation to covered employees. Fine. Notice of transfer of coverage. Failure to procure coverage.
Section
38a-538
(Formerly Sec. 38-262d) - Continuation of benefits under group employee health plans.
Section
38a-539
(Formerly Sec. 38-262f) - Group hospital or medical expense insurance policy coverage for treatment of alcoholism on an outpatient basis.
Section
38a-540
(Formerly Sec. 38-262g) - Duplication of coverage under group health insurance policies.
Section
38a-541
(Formerly Sec. 38-262h) - Group health policy to allow spouse coverage as both employee and dependent, when. Effect of collective bargaining agreements.
Section
38a-542
Mandatory coverage for treatment of tumors and leukemia. Mandatory coverage for reconstructive surgery, prosthesis, chemotherapy and wigs. Orally administered anticancer medications.
Section
38a-542a
Coverage for routine patient care costs associated with certain clinical trials.
Section
38a-542b
Clinical trial criteria.
Section
38a-542c
Evidence and information re eligibility for clinical trial. No coverage required for otherwise reimbursable costs.
Section
38a-542d
Clinical trials: Routine patient care costs.
Section
38a-542e
Clinical trials: Billing. Payments.
Section
38a-542f
Clinical trials: Standardized forms. Time frame for coverage determinations. Appeals. Regulations.
Section
38a-542g
Clinical trials: Submission and certification of policy forms.
Section
38a-543
(Formerly Sec. 38-262j) - Reduction of payments on basis of Medicare eligibility.
Section
38a-544
Prescription drug coverage. Mail order pharmacies. Step therapy use.
Section
38a-544a
Prescription drug coverage. Synchronized refills.
Section
38a-544b
Prescription drug coverage. Prior authorization for naloxone hydrochloride or similar drug not required.
Section
38a-545
(Formerly Sec. 38-262k) - Group dental health insurance plans. Alternative coverage option.
Section
38a-546
(Formerly Sec. 38-379) - Discontinuation and replacement of group health insurance policy. Regulations.
Section
38a-547
Termination of policy or contract due to insurer ceasing to offer health insurance in this state; maternity benefits to continue for six weeks following termination of the pregnancy, when.
Section
38a-548
Penalty.
Section
38a-549
Coverage for adopted children.
Section
38a-550
Copayments re in-network imaging services.
Section
38a-550a
Copayments re in-network physical therapy services and in-network occupational therapy services.
Section
38a-551
(Formerly Sec. 38-371) - Definitions.
Section
38a-552
(Formerly Sec. 38-372) - Provision of service to certain low-income individuals.
Sections
38a-553 to 38a-555
(Formerly Secs. 38-373 to 38-375) - Minimum standard benefits of comprehensive health care plans; optional and excludable benefits; preexisting conditions; use of managed care plans. Additional requirements and eligibility under group comprehensive health care plans; coverage for stepchildren; continuation of benefits under group plans; Insurance Commissioner's authority to coordinate benefits. Additional requirements for individual comprehensive health care plans; carrier obligations concerning termination of coverage.
Section
38a-556
(Formerly Sec. 38-376) - Health Reinsurance Association. Board of directors. Powers and authority. Rates. Net loss assessment. Immunity from liability.
Section
38a-556a
Connecticut Clearinghouse.
Section
38a-557
(Formerly Sec. 38-377) - Hospital service corporations and medical service corporations. Residual market mechanism. Insurance Commissioner's powers concerning such mechanisms.
Section
38a-558
(Formerly Sec. 38-380) - Office of Health Care Access.
Section
38a-559
(Formerly Sec. 38-381) - Commissioner of Social Services. Contract authority concerning Medicaid programs.
Section
38a-560
Small employer grouping for health insurance coverage.
Sections
38a-561 to 38a-563
Reserved for future use.
Section
38a-564
Definitions.
Section
38a-565
Special health care plans.
Section
38a-566
Health insurance plans or insurance arrangements covering employees of a small employer. Trusts. Trade associations.
Section
38a-567
Provisions of small employer plans and arrangements.
Section
38a-568
Coverage under small employer health care plans and arrangements. Approval by commissioner.
Section
38a-569
Connecticut Small Employer Health Reinsurance Pool.
Sections
38a-570 to 38a-572
Issuance of special health care plans by the Health Reinsurance Association to small employers. Issuance of individual special health care plans by the Health Reinsurance Association. Requirement to provide service to certain low-income persons.
Section
38a-573
Validity of separate provisions.
Section
38a-574
Standard family health statement.
Sections
38a-575 and 38a-576
Reserved for future use.
Section
38a-577
(Formerly Sec. 38-174ii) - Consumer dental health plans. Definitions.
Section
38a-578
(Formerly Sec. 38-174jj) - Certificate of authority. Application requirements.
Section
38a-579
(Formerly Sec. 38-174kk) - Certificate of authority. Standards for issuance and renewal.
Section
38a-580
(Formerly Sec. 38-174ll) - General surplus required.
Section
38a-581
(Formerly Sec. 38-174mm) - Evidence of coverage to be provided to enrollees. Approval by commissioner.
Section
38a-582
(Formerly Sec. 38-174nn) - Schedule of charges. Approval by commissioner. Appeal of disapproval.
Section
38a-583
(Formerly Sec. 38-174oo) - Records. Commissioner's power to examine; maintenance; preservation.
Section
38a-584
(Formerly Sec. 38-174pp) - Complaint system.
Section
38a-585
(Formerly Sec. 38-174qq) - Requirements re filing of annual reports with commissioner.
Section
38a-586
(Formerly Sec. 38-174rr) - False or misleading advertising or solicitation and deceptive evidence of coverage prohibited.
Section
38a-587
(Formerly Sec. 38-174ss) - Suspension or revocation of certificate of authority. Hearing. Appeal.
Section
38a-588
(Formerly Sec. 38-174tt) - Penalty. Insolvency.
Section
38a-589
(Formerly Sec. 38-174uu) - Confidentiality.
Section
38a-590
(Formerly Sec. 38-174vv) - Commissioner's power to adopt regulations.
Section
38a-591
Compliance with the Patient Protection and Affordable Care Act. Regulations.
Section
38a-591a
Definitions.
Section
38a-591b
Health carrier responsibilities re utilization review.
Section
38a-591c
Utilization review criteria and procedures.
Section
38a-591d
Utilization review and benefit determinations. Urgent care requests. Information provided in notice of adverse determination.
Section
38a-591e
Internal grievance process of adverse determinations based on medical necessity. Expedited review of adverse determinations of urgent care requests.
Section
38a-591f
Internal grievance process of adverse determinations not based on medical necessity.
Section
38a-591g
External reviews and expedited external reviews.
Section
38a-591h
Record-keeping requirements. Report to commissioner upon request.
Section
38a-591i
Regulations.
Section
38a-591j
Utilization review companies: Licensure. Fees. Investigation of grievances. Duties.
Section
38a-591k
Violations. Notice and hearing. Penalties. Appeal.
Section
38a-591l
Independent review organizations conducting external reviews and expedited external reviews.
Section
38a-591m
Independent review organizations: Conflicts of interest. Liability. Record-keeping requirements. Report to commissioner upon request.
Section
38a-591n
Documents, communications, information and evidence provided to covered person or covered person's authorized representative upon request.
Sections
38a-592 to 38a-594
Reserved for future use.