Insurance and Real Estate Committee
AN ACT CONCERNING THE LEGISLATIVE COMMISSIONERS' RECOMMENDATIONS FOR TECHNICAL REVISIONS AND MINOR CHANGES TO THE INSURANCE AND RELATED STATUTES
SUMMARY: This act broadens the applicability of various health insurance benefit requirements. It also makes numerous technical changes in the insurance statutes.
EFFECTIVE DATE: January 1, 2012, except for some technical changes, which are effective July 1, 2011 or October 1, 2011.
HEALTH INSURANCE BENEFITS
The act broadens the applicability of various health insurance benefits required by law, as summarized in Table 1. By doing so, the act applies the listed benefit requirements to individual and group health insurance policies delivered, issued, renewed, amended, or continued in the state. Most of the provisions apply to (1) individual and group health insurance policies that cover (a) basic hospital expenses; (b) basic medical-surgical expenses; (c) major medical expenses; or (d) hospital or medical services, including coverage under an HMO plan and (2) individual health insurance policies that cover limited benefits. (Due to the federal Employee Retirement Income Security Act (ERISA), state insurance benefit mandates do not apply to self-insured benefit plans. )
Table 1: Applicability of Health Insurance Benefits Expanded
Act § |
Benefit Requirement |
Existing Law Applies to Policies |
Act Expands Law to Apply to Policies |
33-34 |
Continuation of coverage of handicapped children |
Delivered, Issued |
Renewed, Amended, Continued |
35 |
Coverage of newly born child – individual policies |
Delivered, Issued, Renewed, Amended |
Continued |
36 |
Coverage of newly born child – group policies |
Delivered, Issued, Amended |
Renewed, Continued |
37-38 |
Coverage for hypodermic needles and syringes |
Delivered, Issued, Renewed |
Amended, Continued |
39-40 |
Coverage for off-label prescription drugs |
Delivered, Issued, Renewed |
Amended, Continued |
41-44 |
Coverage for home health care services |
Delivered, Issued, Renewed |
Amended, Continued |
45-46 |
Coverage for occupational therapy |
Delivered, Issued, Renewed |
Amended, Continued |
47-48 |
Coverage for services of physician assistants and certain nurses |
Delivered, Issued, Renewed |
Amended, Continued |
49-50 |
Direct access to obstetrician-gynecologist |
Delivered, Issued, Renewed, Amended |
Continued |
51-52 |
Coverage for maternity care |
Delivered, Issued, Renewed, Amended |
Continued |
53-54 |
Coverage for prescription contraceptives |
Delivered, Issued, Renewed, Continued |
Amended |
55-56 |
Coverage for chiropractic services |
Delivered, Issued, Renewed |
Amended, Continued |
57 and 62 |
Coverage for cancer clinical trials |
Delivered, Issued, Renewed |
Amended, Continued |
BACKGROUND
Related Acts
PA 11-172 expands the existing requirement for health insurance policies to cover cancer clinical trials. It requires policies delivered, issued, renewed, amended, or continued in Connecticut to cover costs associated with clinical trials for the treatment of disabling or life-threatening chronic diseases.
PA 11-171 expands the existing requirement for health insurance policies to cover newborns. It requires policies delivered, issued, renewed, amended, or continued in Connecticut to cover newborns for 61 days, instead of 31 days, after birth.
OLR Tracking: JLKTA: CR: df