Connecticut General Statutes|Chapter 700c - Health Insurance

Sec. 38a-469. Definitions.

Sec. 38a-470. (Formerly Sec. 38-174n). Lien on workers' compensation awards for insurers. Notice of lien.

Sec. 38a-471. (Formerly Sec. 38-174o). Third party prescription programs. Notice of cancellation. Applicability of section.

Sec. 38a-472. (Formerly Sec. 38-174a). Assignment of insurance proceeds to doctor, hospital or state agency. Lien for state care. Notice of lien.

Sec. 38a-472a. Medical provider indemnification agreements prohibited.

Sec. 38a-472b. Medical provider indemnification contracts. Professional actions and related liability.

Sec. 38a-472c. Dental policies. Estimate of reimbursement. Material adjustments to fee schedules for in-network providers. Notice.

Sec. 38a-472d. Public education outreach program re health insurance availability and eligibility requirements.

Sec. 38a-472e. Health insurer. Requirements re offer to contract with a school-based health center.

Sec. 38a-472f. Network adequacy. Health carrier duties and responsibilities. Access plan filing.

Sec. 38a-472g. Restrictions applicable to prior authorization or precertification.

Sec. 38a-472h. Fees charged by dentists, optometrists and ophthalmologists for noncovered benefits. Notice and posting required.

Sec. 38a-472i. Payment amount of professional services component of covered colonoscopy or endoscopic services.

Sec. 38a-472j. Restrictions applicable to cost-sharing for covered benefits. Regulations.

Sec. 38a-472k. Disability income policies. Discretionary clauses prohibited. Regulations.

Sec. 38a-473. Medicare supplement expense factors. Age, gender, previous claim or medical history rating prohibited.

Sec. 38a-474. Medicare supplement policy rate increases: Procedure. Age, gender, previous claim or medical history rating prohibited.

Sec. 38a-475. Precertification of long-term care policies under the Connecticut Partnership for Long-Term Care. Regulations.

Sec. 38a-476. Preexisting condition coverage.

Sec. 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.

Sec. 38a-476b. Standards re psychotropic drug availability in health plans.

Sec. 38a-476c. Policies and contracts with variable network and enrollee cost-sharing. Approval. Limitations.

Sec. 38a-477. Standardized claim forms. Information necessary for filing a claim. Regulations.

Sec. 38a-477a. Notification by Insurance Commissioner of required benefits and policy forms.

Sec. 38a-477b. Postclaims underwriting prohibited unless approval granted. Application for approval of rescission, cancellation or limitation. Decision. Appeals. Regulations.

Sec. 38a-477c. Disclosure of state and federal medical loss ratio with each health insurance application.

Sec. 38a-477d. Information to be made available to consumers.

Sec. 38a-477e. Health carriers to maintain Internet web site and toll-free telephone number. Available information. Exception.

Sec. 38a-477f. Contract provision prohibiting certain disclosures prohibited.

Sec. 38a-477g. Contracts between health carriers and participating providers.

Sec. 38a-477h. Participating provider directories.

Secs. 38a-477i to 38a-477z.

Sec. 38a-477aa. Cost-sharing and health care provider reimbursements for emergency services and surprise bills.

Sec. 38a-477bb. Cost-sharing re facility fees.

Sec. 38a-477cc. Contracts for pharmacy services with health carriers or pharmacy benefits managers.

Sec. 38a-477dd. Contracts with health carriers. Certain provisions concerning disclosures to covered persons prohibited.

Sec. 38a-477ee. Mental health and substance use disorder benefits. Nonquantitative treatment limitations. Reports. Public hearings. Regulations.

Sec. 38a-478. Definitions.

Sec. 38a-478a. Commissioner's report to the Governor and the General Assembly.

Sec. 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.

Sec. 38a-478c. Managed care organization's report to the commissioner: Data, reports and information required.

Sec. 38a-478d. Provider directory. Notification to enrollee of termination or withdrawal of enrollee's primary care provider.

Sec. 38a-478e. Medical protocols. Procedure prior to change. Physician input. Notification of change.

Sec. 38a-478f. Provider profile development requirements.

Sec. 38a-478g. Managed care contract requirements. Plan description requirements.

Sec. 38a-478h. Contract requirements and notice for removal or departure of provider. Retaliatory action prohibited.

Sec. 38a-478i. Limitation on enrollee rights prohibited.

Sec. 38a-478j. Coinsurance and deductible payments based on negotiated discounts.

Sec. 38a-478k. Gag clauses prohibited.

Sec. 38a-478l. Consumer report card required. Content. Data analysis by commissioner.

Secs. 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.

Sec. 38a-478o. Confidentiality and antidiscrimination procedures required.

Sec. 38a-478p. Expedited utilization review. Standardized process required.

Sec. 38a-478q. Use of laboratories covered by plan required.

Sec. 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.

Sec. 38a-478s. Nonapplicability to self-insured employee welfare benefit plans and workers' compensation plans.

Sec. 38a-478t. Commissioner of Public Health to receive data.

Sec. 38a-478u. Regulations.

Sec. 38a-478v. Applicability of Unfair and Prohibited Insurance Practices Act. Examination by Insurance Commissioner. Regulations.

Sec. 38a-479. Definitions. Access to fee schedules. Fee information to be confidential.

Sec. 38a-479a. Physicians and managed care organizations to discuss issues relative to contracting between such parties.

Sec. 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.

Secs. 38a-479c to 38a-479z.

Sec. 38a-479aa. Preferred provider networks. Definitions. Licensing. Fees. Requirements. Exception, regulations.

Sec. 38a-479bb. Requirements for managed care organizations that contract with preferred provider networks. Requirements for preferred provider networks.

Sec. 38a-479cc. Duties of a preferred provider network when providing services pursuant to a contract with a managed care organization.

Sec. 38a-479dd. Preferred provider network examination of outstanding amounts. Notice. Commissioner's duties.

Sec. 38a-479ee. Violations. Penalties. Investigations and staffing. Grievances. Referrals from Healthcare Advocate.

Sec. 38a-479ff. Adverse action or threat of adverse action against complainant prohibited. Exception. Civil actions by aggrieved persons.

Sec. 38a-479gg. Regulations.

Secs. 38a-479hh to 38a-479pp.

Sec. 38a-479qq. Medical discount plans: Definitions, prohibited sales practices, penalties.

Sec. 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.

Secs. 38a-479ss to 38a-479zz.

Sec. 38a-479aaa. Pharmacy benefits managers. Definitions.

Sec. 38a-479bbb. Registration of pharmacy benefits managers required. Application for registration. Fee. Surety bond. Exemption from registration.

Sec. 38a-479ccc. Certificate of registration; when issued or refused. Suspension, revocation or refusal to issue or renew registration; grounds.

Sec. 38a-479ddd. Hearing on denial of certificate. Subsequent application.

Sec. 38a-479eee. Claims payment to be made by electronic funds transfer upon written request.

Sec. 38a-479fff. Expiration of certificates of registration. Renewal. Fees.

Sec. 38a-479ggg. Regulations.

Sec. 38a-479hhh. Investigations and hearings. Powers of commissioner. Appeals.

Sec. 38a-479iii. Pharmacy audits.

Secs. 38a-479jjj to 38a-479nnn.

Sec. 38a-479ooo. Definitions.

Sec. 38a-479ppp. Annual report by pharmacy benefits managers. Standardized form. Confidentiality of information. Penalty. Regulations. Commissioner's report to the General Assembly.

Sec. 38a-479qqq. Annual report by health carriers. Regulations.

Sec. 38a-479rrr. Annual certification by health carriers.

Sec. 38a-479sss. Annual report by commissioner to the General Assembly re outpatient prescription drug costs.

Sec. 38a-479ttt. Annual report by commissioner to the General Assembly re prescription drug rebates.

Sec. 38a-480. (Formerly Sec. 38-174). Applicability of statutes to certain policies and contracts.

Sec. 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.

Sec. 38a-482. (Formerly Sec. 38-166). Form of policy.

Sec. 38a-482a. Individual health insurance policy to contain definition of “medically necessary” or “medical necessity”.

Sec. 38a-482b. Individual health insurance policy providing limited coverage to include disclosure. Limited coverage defined.

Sec. 38a-482c. Annual and lifetime limits.

Sec. 38a-483. (Formerly Sec. 38-167). Standard provisions of individual health policy.

Sec. 38a-483a. Exclusionary riders for individual health insurance policies. Regulations.

Sec. 38a-483b. Time limits for coverage determinations. Notice requirements.

Sec. 38a-483c. Coverage and notice re experimental treatments. Appeals.

Sec. 38a-484. (Formerly Sec. 38-168). Policy provisions not to be less favorable than standard. Validity of policy issued in violation of law.

Sec. 38a-485. (Formerly Sec. 38-169). Copy of application to be part of new policy or to be furnished with renewal. Alteration of application.

Sec. 38a-486. (Formerly Sec. 38-170). Certain acts not to operate as waiver of rights.

Sec. 38a-487. (Formerly Sec. 38-171). Coverage after termination date of policy.

Sec. 38a-488. (Formerly Sec. 38-172). Discrimination.

Sec. 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.

Sec. 38a-488b. Coverage for autism spectrum disorder therapies.

Sec. 38a-488c. Mental health and substance use disorder benefits. Nonquantitative treatment limitations.

Sec. 38a-488d. Coverage for substance abuse services provided pursuant to court order.

Sec. 38a-489. (Formerly Sec. 38-174e). Continuation of coverage of mentally or physically handicapped children.

Sec. 38a-490. (Formerly Sec. 38-174g). Coverage for newly born children. Notification to insurer.

Sec. 38a-490a. Coverage for birth-to-three program.

Sec. 38a-490b. Coverage for hearing aids.

Sec. 38a-490c. Coverage for craniofacial disorders.

Sec. 38a-490d. Mandatory coverage for blood lead screening and risk assessment.

Sec. 38a-491. (Formerly Sec. 38-174h). Coverage for services performed by dentists in certain instances.

Sec. 38a-491a. Coverage for in-patient, outpatient or one-day dental services in certain instances.

Sec. 38a-491b. Assignment of benefits to a dentist or oral surgeon.

Sec. 38a-492. (Formerly Sec. 38-174i). Coverage for accidental ingestion or consumption of controlled drugs. Benefits prescribed.

Sec. 38a-492a. Mandatory coverage for hypodermic needles and syringes.

Sec. 38a-492b. Coverage for certain off-label drug prescriptions.

Sec. 38a-492c. Coverage for low protein modified food products, amino acid modified preparations and specialized formulas.

Sec. 38a-492d. *(See end of section for amended version and effective date.) Mandatory coverage for diabetes testing and treatment.

Sec. 38a-492e. Mandatory coverage for diabetes outpatient self-management training.

Sec. 38a-492f. Mandatory coverage for certain prescription drugs removed from formulary.

Sec. 38a-492g. Mandatory coverage for prostate cancer screening and treatment.

Sec. 38a-492h. Mandatory coverage for certain Lyme disease treatments.

Sec. 38a-492i. Mandatory coverage for pain management.

Sec. 38a-492j. Mandatory coverage for ostomy-related supplies.

Sec. 38a-492k. Mandatory coverage for colorectal cancer screening.

Sec. 38a-492l. Mandatory coverage for neuropsychological testing for children diagnosed with cancer.

Sec. 38a-492m. Mandatory coverage for certain renewals of prescription eye drops.

Sec. 38a-492n. Mandatory coverage for certain wound-care supplies.

Sec. 38a-492o. Mandatory coverage for bone marrow testing.

Sec. 38a-492p. Mandatory coverage for medically monitored inpatient detoxification.

Sec. 38a-492q. Mandatory coverage for essential health benefits.

Sec. 38a-492r. Mandatory coverage for certain immunizations.

Sec. 38a-492s. Mandatory coverage for certain preventive care and screenings for individuals who are twenty-one years of age or younger.

Sec. 38a-492t. Mandatory coverage for prosthetic devices.

Sec. 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.

Sec. 38a-494. (Formerly Sec. 38-174l). Home health care by recognized nonmedical systems.

Sec. 38a-495. (Formerly Sec. 38-174m). Medicare supplement policies. Coverage of home health aide services and mammography. Prescription drug riders.

Sec. 38a-495a. Medicare supplement policies and certificates. Minimum required policy benefits and standards. Regulations.

Sec. 38a-495b. Medicare supplement policies and certificates. Definitions.

Sec. 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.

Sec. 38a-495d. Refund of prepaid premium for Medicare supplement policies.

Sec. 38a-496. (Formerly Sec. 38-174q). Coverage for occupational therapy.

Sec. 38a-497. (Formerly Sec. 38-174r). Termination of coverage of children in individual policies. Coverage for stepchildren.

Sec. 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.

Sec. 38a-498. (Formerly Sec. 38-174t). Mandatory coverage for medically necessary ambulance services. Direct payment to ambulance provider.

Sec. 38a-498a. Prior authorization prohibited for certain 9-1-1 emergency calls.

Sec. 38a-498b. Mandatory coverage for mobile field hospital.

Sec. 38a-498c. Denial of coverage prohibited for health care services rendered to persons with an elevated blood alcohol content.

Sec. 38a-499. (Formerly Sec. 38-174v). Coverage for services of physician assistants and certain nurses.

Sec. 38a-499a. Coverage for telehealth services.

Sec. 38a-500. (Formerly Sec. 38-174w). Mandatory coverage for partners, sole proprietors and corporate officers for work-related injuries. Subrogation rights.

Sec. 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.

Sec. 38a-501a. Individual short-term care policies. Approval of rates and forms. Disclosures. Regulations.

Sec. 38a-502. (Formerly Sec. 38-174ff). Mandatory coverage for services provided by the Healthcare Center maintained by the Department of Veterans Affairs.

Sec. 38a-503. (Formerly Sec. 38-174gg). Mandatory coverage for mammography, breast ultrasound and magnetic resonance imaging. Breast density information included in mammography report.

Sec. 38a-503a. Mandatory coverage for breast cancer survivors.

Sec. 38a-503b. Carriers to permit direct access to obstetrician-gynecologist.

Sec. 38a-503c. Mandatory coverage for maternity care. Interhospital transfer of newborn infant and mother.

Sec. 38a-503d. Mandatory coverage for mastectomy care. Termination of provider contract prohibited.

Sec. 38a-503e. Mandatory coverage for contraceptives and sterilization.

Sec. 38a-503f. Mandatory coverage for certain health benefits and services for women, infants, children and adolescents.

Sec. 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.

Sec. 38a-504a. Coverage for routine patient care costs associated with certain clinical trials.

Sec. 38a-504b. Clinical trial criteria.

Sec. 38a-504c. Evidence and information re eligibility for clinical trial. No coverage required for otherwise reimbursable costs.

Sec. 38a-504d. Clinical trials: Routine patient care costs.

Sec. 38a-504e. Clinical trials: Billing. Payments.

Sec. 38a-504f. Clinical trials: Standardized forms. Time frame for coverage determinations. Appeals. Regulations.

Sec. 38a-504g. Clinical trials: Submission and certification of policy forms.

Sec. 38a-505. (Formerly Sec. 38-378). Insurance Commissioner's powers concerning comprehensive health care plans. Disclosures.

Sec. 38a-506. (Formerly Sec. 38-173). Penalty.

Sec. 38a-507. Coverage for services performed by chiropractors.

Sec. 38a-508. Coverage for adopted children.

Sec. 38a-509. Mandatory coverage for infertility diagnosis and treatment. Limitations.

Sec. 38a-510. Prescription drug coverage. Mail order pharmacies. Step therapy use.

Sec. 38a-510a. Prescription drug coverage. Synchronized refills.

Sec. 38a-510b. Prescription drug coverage. Prior authorization for naloxone hydrochloride or similar drug not required.

Sec. 38a-510c. Coverage for investigational drug, biological product or device for insureds with terminal illnesses. Liability of health carrier.

Sec. 38a-511. Copayments re in-network imaging services.

Sec. 38a-511a. Copayments re in-network physical therapy services and in-network occupational therapy services.

Sec. 38a-512. Applicability of statutes to certain major medical expense policies.

Sec. 38a-512a. Continuation of coverage.

Sec. 38a-512b. Termination of coverage of children in group policies. Coverage for stepchildren.

Sec. 38a-512c. Annual and lifetime limits.

Sec. 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.

Sec. 38a-513a. Time limits for coverage determinations. Notice requirements.

Sec. 38a-513b. Coverage and notice re experimental treatments. Appeals.

Sec. 38a-513c. Group health insurance policy to contain definition of “medically necessary” or “medical necessity”.

Sec. 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.

Sec. 38a-513e. Premium payment by employer following employee termination. Exceptions. Right to continuation of coverage following relocation or closing of covered establishment not affected.

Sec. 38a-513f. Claims information to be provided to certain employers. Restrictions. Subpoenas.

Sec. 38a-513g. Employer submission of plan cost information to Comptroller.

Sec. 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.

Sec. 38a-514a. Biologically-based mental illness. Coverage required.

Sec. 38a-514b. Coverage for autism spectrum disorder.

Sec. 38a-514c. Mental health and substance use disorder benefits. Nonquantitative treatment limitations.

Sec. 38a-514d. Coverage for substance abuse services provided pursuant to court order.

Sec. 38a-515. Continuation of coverage of mentally or physically handicapped children.

Sec. 38a-516. Coverage for newly born children. Notification to insurer.

Sec. 38a-516a. Coverage for birth-to-three program.

Sec. 38a-516b. Coverage for hearing aids.

Sec. 38a-516c. Coverage for craniofacial disorders.

Sec. 38a-516d. Coverage for neuropsychological testing for children diagnosed with cancer.

Sec. 38a-517. Coverage for services performed by dentist in certain instances.

Sec. 38a-517a. Coverage for in-patient, outpatient or one-day dental services in certain instances.

Sec. 38a-517b. Assignment of benefits to a dentist or oral surgeon.

Sec. 38a-518. Coverage for accidental ingestion or consumption of controlled drugs. Benefits prescribed.

Sec. 38a-518a. Mandatory coverage for hypodermic needles and syringes.

Sec. 38a-518b. Coverage for certain off-label drug prescriptions.

Sec. 38a-518c. Coverage for low protein modified food products, amino acid modified preparations and specialized formulas.

Sec. 38a-518d. *(See end of section for amended version and effective date.) Mandatory coverage for diabetes testing and treatment.

Sec. 38a-518e. Mandatory coverage for diabetes outpatient self-management training.

Sec. 38a-518f. Mandatory coverage for certain prescription drugs removed from formulary.

Sec. 38a-518g. Mandatory coverage for prostate cancer screening and treatment.

Sec. 38a-518h. Mandatory coverage for certain Lyme disease treatments.

Sec. 38a-518i. Mandatory coverage for pain management.

Sec. 38a-518j. Mandatory coverage for ostomy-related supplies.

Sec. 38a-518k. Mandatory coverage for colorectal cancer screening.

Sec. 38a-518l. Mandatory coverage for certain renewals of prescription eye drops.

Sec. 38a-518m. Mandatory coverage for certain wound-care supplies.

Sec. 38a-518n.

Sec. 38a-518o. Mandatory coverage for bone marrow testing.

Sec. 38a-518p. Mandating coverage for medically monitored inpatient detoxification.

Sec. 38a-518q. Mandatory coverage for essential health benefits.

Sec. 38a-518r. Mandatory coverage for certain immunizations.

Sec. 38a-518s. Mandatory coverage for certain preventive care and screenings for individuals who are twenty-one years of age or younger.

Sec. 38a-518t. Mandatory coverage for prosthetic devices.

Sec. 38a-519. (Formerly Sec. 38-174j). Offset proviso prohibited in certain policies. Required disclosures for group long-term disability policies.

Sec. 38a-520. Mandatory coverage for home health care. Deductibles. Exception from deductible limits for medical savings accounts. Archer MSAs and health savings accounts.

Sec. 38a-521. Home health care by recognized nonmedical systems.

Sec. 38a-522. Medicare supplement policies. Coverage of home health aide service.

Sec. 38a-523. (Formerly Sec. 38-174p). Group hospital or medical insurance coverage for comprehensive rehabilitation services.

Sec. 38a-524. Coverage for occupational therapy.

Sec. 38a-525. Mandatory coverage for medically necessary ambulance services. Direct payment to ambulance provider.

Sec. 38a-525a. Prior authorization prohibited for certain 9-1-1 emergency calls.

Sec. 38a-525b. Mandatory coverage for mobile field hospital.

Sec. 38a-525c. Denial of coverage prohibited for health care services rendered to persons with an elevated blood alcohol content.

Sec. 38a-526. Coverage for services of physician assistants and certain nurses.

Sec. 38a-526a. Coverage for telehealth services.

Sec. 38a-527. Mandatory coverage for partners, sole proprietors and corporate officers for work-related injuries.

Sec. 38a-528. Group long-term care policies. Disclosures. Spreading of premium rate increases of twenty per cent or more. Disclosure of premium rate increase.

Sec. 38a-528a. Group short-term care policies. Approval of rates and forms. Disclosures. Regulations.

Sec. 38a-529. Mandatory coverage for services provided by the Healthcare Center maintained by the Department of Veterans Affairs.

Sec. 38a-530. Mandatory coverage for mammography, breast ultrasound and magnetic resonance imaging. Breast density information included in mammography report.

Sec. 38a-530a. Mandatory coverage for breast cancer survivors.

Sec. 38a-530b. Carriers to permit direct access to obstetrician-gynecologist.

Sec. 38a-530c. Mandatory coverage for maternity care. Interhospital transfer of newborn infant and mother.

Sec. 38a-530d. Mandatory coverage for mastectomy care. Termination of provider contract prohibited.

Sec. 38a-530e. Mandatory coverage for contraceptives and sterilization.

Sec. 38a-530f. Mandatory coverage for certain health benefits and services for women, infants, children and adolescents.

Sec. 38a-531. (Formerly Sec. 38-174hh). Mandatory coverage for employees of certain employers. Approval of policy forms.

Sec. 38a-532. (Formerly Sec. 38-262a). Assignment of incidents of ownership under group life, health or accident policy.

Sec. 38a-533. (Formerly Sec. 38-262b). Mandatory coverage for the treatment of medical complications of alcoholism.

Sec. 38a-534. Coverage for services performed by chiropractors.

Sec. 38a-535. Mandatory coverage for preventive pediatric care and blood lead screening and risk assessment.

Sec. 38a-535a. Notification of individual coverage and benefits of a noncustodial parent to a custodial parent, when. Regulations.

Sec. 38a-536. Mandatory coverage for infertility diagnosis and treatment. Limitations.

Sec. 38a-537. (Formerly Sec. 38-262c). Notice of cancellation or discontinuation to covered employees. Fine. Notice of transfer of coverage. Failure to procure coverage.

Sec. 38a-538. (Formerly Sec. 38-262d). Continuation of benefits under group employee health plans.

Sec. 38a-539. (Formerly Sec. 38-262f). Group hospital or medical expense insurance policy coverage for treatment of alcoholism on an outpatient basis.

Sec. 38a-540. (Formerly Sec. 38-262g). Duplication of coverage under group health insurance policies.

Sec. 38a-541. (Formerly Sec. 38-262h). Group health policy to allow spouse coverage as both employee and dependent, when. Effect of collective bargaining agreements.

Sec. 38a-542. Mandatory coverage for treatment of tumors and leukemia. Mandatory coverage for reconstructive surgery, prosthesis, chemotherapy and wigs. Orally administered anticancer medications.

Sec. 38a-542a. Coverage for routine patient care costs associated with certain clinical trials.

Sec. 38a-542b. Clinical trial criteria.

Sec. 38a-542c. Evidence and information re eligibility for clinical trial. No coverage required for otherwise reimbursable costs.

Sec. 38a-542d. Clinical trials: Routine patient care costs.

Sec. 38a-542e. Clinical trials: Billing. Payments.

Sec. 38a-542f. Clinical trials: Standardized forms. Time frame for coverage determinations. Appeals. Regulations.

Sec. 38a-542g. Clinical trials: Submission and certification of policy forms.

Sec. 38a-543. (Formerly Sec. 38-262j). Reduction of payments on basis of Medicare eligibility.

Sec. 38a-544. Prescription drug coverage. Mail order pharmacies. Step therapy use.

Sec. 38a-544a. Prescription drug coverage. Synchronized refills.

Sec. 38a-544b. Prescription drug coverage. Prior authorization for naloxone hydrochloride or similar drug not required.

Sec. 38a-545. (Formerly Sec. 38-262k). Group dental health insurance plans. Alternative coverage option.

Sec. 38a-546. (Formerly Sec. 38-379). Discontinuation and replacement of group health insurance policy. Regulations.

Sec. 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.

Sec. 38a-548. Penalty.

Sec. 38a-549. Coverage for adopted children.

Sec. 38a-550. Copayments re in-network imaging services.

Sec. 38a-550a. Copayments re in-network physical therapy services and in-network occupational therapy services.

Sec. 38a-551. (Formerly Sec. 38-371). Definitions.

Sec. 38a-552. (Formerly Sec. 38-372). Provision of service to certain low-income individuals.

Secs. 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.

Sec. 38a-556. (Formerly Sec. 38-376). Health Reinsurance Association. Board of directors. Powers and authority. Rates. Net loss assessment. Immunity from liability.

Sec. 38a-556a. Connecticut Clearinghouse.

Sec. 38a-557. (Formerly Sec. 38-377). Hospital service corporations and medical service corporations. Residual market mechanism. Insurance Commissioner's powers concerning such mechanisms.

Sec. 38a-558. (Formerly Sec. 38-380). Office of Health Care Access.

Sec. 38a-559. (Formerly Sec. 38-381). Commissioner of Social Services. Contract authority concerning Medicaid programs.

Sec. 38a-560. Small employer grouping for health insurance coverage.

Secs. 38a-561 to 38a-563.

Sec. 38a-564. Definitions.

Sec. 38a-565. Special health care plans.

Sec. 38a-566. Health insurance plans or insurance arrangements covering employees of a small employer. Trusts. Trade associations.

Sec. 38a-567. Provisions of small employer plans and arrangements.

Sec. 38a-568. Coverage under small employer health care plans and arrangements. Approval by commissioner.

Sec. 38a-569. Connecticut Small Employer Health Reinsurance Pool.

Secs. 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.

Sec. 38a-573. Validity of separate provisions.

Sec. 38a-574. Standard family health statement.

Secs. 38a-575 and 38a-576.

Sec. 38a-577. (Formerly Sec. 38-174ii). Consumer dental health plans. Definitions.

Sec. 38a-578. (Formerly Sec. 38-174jj). Certificate of authority. Application requirements.

Sec. 38a-579. (Formerly Sec. 38-174kk). Certificate of authority. Standards for issuance and renewal.

Sec. 38a-580. (Formerly Sec. 38-174ll). General surplus required.

Sec. 38a-581. (Formerly Sec. 38-174mm). Evidence of coverage to be provided to enrollees. Approval by commissioner.

Sec. 38a-582. (Formerly Sec. 38-174nn). Schedule of charges. Approval by commissioner. Appeal of disapproval.

Sec. 38a-583. (Formerly Sec. 38-174oo). Records. Commissioner's power to examine; maintenance; preservation.

Sec. 38a-584. (Formerly Sec. 38-174pp). Complaint system.

Sec. 38a-585. (Formerly Sec. 38-174qq). Requirements re filing of annual reports with commissioner.

Sec. 38a-586. (Formerly Sec. 38-174rr). False or misleading advertising or solicitation and deceptive evidence of coverage prohibited.

Sec. 38a-587. (Formerly Sec. 38-174ss). Suspension or revocation of certificate of authority. Hearing. Appeal.

Sec. 38a-588. (Formerly Sec. 38-174tt). Penalty. Insolvency.

Sec. 38a-589. (Formerly Sec. 38-174uu). Confidentiality.

Sec. 38a-590. (Formerly Sec. 38-174vv). Commissioner's power to adopt regulations.

Sec. 38a-591. Compliance with the Patient Protection and Affordable Care Act. Regulations.

Sec. 38a-591a. Definitions.

Sec. 38a-591b. Health carrier responsibilities re utilization review.

Sec. 38a-591c. Utilization review criteria and procedures.

Sec. 38a-591d. Utilization review and benefit determinations. Urgent care requests. Information provided in notice of adverse determination.

Sec. 38a-591e. Internal grievance process of adverse determinations based on medical necessity. Expedited review of adverse determinations of urgent care requests.

Sec. 38a-591f. Internal grievance process of adverse determinations not based on medical necessity.

Sec. 38a-591g. External reviews and expedited external reviews.

Sec. 38a-591h. Record-keeping requirements. Report to commissioner upon request.

Sec. 38a-591i. Regulations.

Sec. 38a-591j. Utilization review companies: Licensure. Fees. Investigation of grievances. Duties.

Sec. 38a-591k. Violations. Notice and hearing. Penalties. Appeal.

Sec. 38a-591l. Independent review organizations conducting external reviews and expedited external reviews.

Sec. 38a-591m. Independent review organizations: Conflicts of interest. Liability. Record-keeping requirements. Report to commissioner upon request.

Sec. 38a-591n. Documents, communications, information and evidence provided to covered person or covered person's authorized representative upon request.

Secs. 38a-592 to 38a-594.