(Formerly Sec. 38-174nn) - Schedule of charges. Approval by commissioner. Appeal of disapproval.

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(a) No schedule of charges for enrollee coverage for dental services, or any amendment thereto, may be used by a dental plan organization until a copy of such schedule or amendment has been filed with the commissioner for the commissioner's approval. The commissioner may disapprove the schedule of charges at any time if the commissioner finds that the charges are excessive, inadequate or unfairly discriminatory. If the commissioner disapproves the schedule of charges, the commissioner shall notify the dental plan organization within sixty days of the date of disapproval and specify in the notice the reason for disapproval. A hearing shall be granted within twenty days after a request in writing by the dental plan organization is received by the commissioner. It shall be unlawful for any dental plan organization whose schedule of charges has been disapproved to effect any contract or issue any subscription certificate that uses the disapproved schedule of charges until a revised schedule of charges has been approved. Any dental plan organization aggrieved by the action of the commissioner pursuant to this section may appeal therefrom, in accordance with the provisions of section 4-183.

(b) Charges shall be established in accordance with actuarial principles, but charges applicable to an enrollee shall not be individually determined based on the status of the enrollee's health.

(P.A. 88-272, S. 6; P.A. 17-15, S. 74.)

History: Sec. 38-174nn transferred to Sec. 38a-582 in 1991; P.A. 17-15 added “is received by the commissioner” in Subsec. (a), and made technical changes.


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