Chapter

Health Insurance

Conn. Gen. Stat. § 38a-469— Definitions
Conn. Gen. Stat. § 38a-470— (Formerly Sec. 38-174n). Lien on workers' compensation awards for insurers. Notice of lien
Conn. Gen. Stat. § 38a-471— (Formerly Sec. 38-174o). Third party prescription programs. Notice of cancellation. Applicability of section
Conn. Gen. Stat. § 38a-472— (Formerly Sec. 38-174a). Assignment of insurance proceeds to doctor, hospital or state agency. Lien for state care. Notice of lien
Conn. Gen. Stat. § 38a-472a— Medical provider indemnification agreements prohibited
Conn. Gen. Stat. § 38a-472b— Medical provider indemnification contracts. Professional actions and related liability
Conn. Gen. Stat. § 38a-472c— Dental policies. Estimate of reimbursement. Material adjustments to fee schedules for in-network providers. Notice
Conn. Gen. Stat. § 38a-472d— Public education outreach program re health insurance availability and eligibility requirements
Conn. Gen. Stat. § 38a-472e— Health insurer. Requirements re offer to contract with a school-based health center
Conn. Gen. Stat. § 38a-472f— Network adequacy. Health carrier duties and responsibilities. Access plan filing
Conn. Gen. Stat. § 38a-472g— Restrictions applicable to prior authorization or precertification
Conn. Gen. Stat. § 38a-472h— Fees charged by dentists, optometrists and ophthalmologists for noncovered benefits. Notice and posting required
Conn. Gen. Stat. § 38a-472i— Payment amount of professional services component of covered colonoscopy or endoscopic services
Conn. Gen. Stat. § 38a-472j— Restrictions applicable to cost-sharing for covered benefits. Regulations
Conn. Gen. Stat. § 38a-472k— Disability income policies. Discretionary clauses prohibited. Regulations
Conn. Gen. Stat. § 38a-472l— l . Participating dental provider contracts. Third-party access. Restrictions. Exceptions
Conn. Gen. Stat. § 38a-473— Medicare supplement expense factors. Age, gender, previous claim or medical history rating prohibited
Conn. Gen. Stat. § 38a-474— Medicare supplement policy rate increases: Procedure. Age, gender, previous claim or medical history rating prohibited
Conn. Gen. Stat. § 38a-475— Precertification of long-term care policies under the Connecticut Partnership for Long-Term Care. Regulations
Conn. Gen. Stat. § 38a-475a— Minimum set of affordable benefit options for long-term care policies. Regulations
Conn. Gen. Stat. § 38a-476— Preexisting condition coverage
Conn. Gen. Stat. § 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
Conn. Gen. Stat. § 38a-476b— Standards re psychotropic drug availability in health plans
Conn. Gen. Stat. § 38a-476c— Policies and contracts with variable network and enrollee cost-sharing. Approval. Limitations
Conn. Gen. Stat. § 38a-477— Standardized claim forms. Information necessary for filing a claim. Regulations
Conn. Gen. Stat. § 38a-477a— Notification by Insurance Commissioner of required benefits and policy forms
Conn. Gen. Stat. § 38a-477aa— Cost-sharing and health care provider reimbursements for emergency services, urgent crisis center services and surprise bills
Conn. Gen. Stat. § 38a-477b— Postclaims underwriting prohibited unless approval granted. Application for approval of rescission, cancellation or limitation. Decision. Appeals. Regulations
Conn. Gen. Stat. § 38a-477bb— Cost-sharing re facility fees
Conn. Gen. Stat. § 38a-477c— Disclosure of state and federal medical loss ratio with each health insurance application
Conn. Gen. Stat. § 38a-477cc— Contracts for pharmacy services with health carriers or pharmacy benefits managers
Conn. Gen. Stat. § 38a-477d— Information to be made available to consumers. Explanations of benefits. Disclosures by health carriers. Specifications by consumers. Restrictions
Conn. Gen. Stat. § 38a-477dd— Contracts with health carriers. Certain provisions concerning disclosures to covered persons prohibited
Conn. Gen. Stat. § 38a-477e— Health carriers to maintain Internet web site and toll-free telephone number. Available information. Exception
Conn. Gen. Stat. § 38a-477ee— Mental health and substance use disorder benefits. Nonquantitative treatment limitations. Reports. Public hearings. Regulations
Conn. Gen. Stat. § 38a-477f— Contract provision prohibiting certain disclosures prohibited
Conn. Gen. Stat. § 38a-477ff— Third-party discounts and payments for covered benefits. Credit required
Conn. Gen. Stat. § 38a-477g— Contracts between health carriers and participating providers
Conn. Gen. Stat. § 38a-477gg— Contracts between health carriers and pharmacy benefits managers. Credit required for third-party discounts and payments for covered prescription drug benefits
Conn. Gen. Stat. § 38a-477h— Participating provider directories
Conn. Gen. Stat. § 38a-477hh— Denial of coverage for otherwise covered benefits based on measurement of blood oxygen level by pulse oximeter prohibited
Conn. Gen. Stat. § 38a-477i— Contract provisions containing all-or-nothing clauses, anti-steering clauses, anti-tiering clauses or gag clauses prohibited
Conn. Gen. Stat. § 38a-477ii— Pulse oximeter accuracy. Educational materials. Distribution and posting required
Conn. Gen. Stat. § 38a-477j
Conn. Gen. Stat. § 38a-477jj— Prescription drug formularies and lists of covered drugs. Removal or movement to higher cost-sharing tier during plan year prohibited. Exceptions. Study and report
Conn. Gen. Stat. § 38a-477kk— Proof of coverage to disclose whether coverage is fully insured or self-insured. Regulations
Conn. Gen. Stat. § 38a-477ll— ll . Coverage for health enhancement programs
Conn. Gen. Stat. § 38a-477mm— Prohibition on reduction in amount of reimbursement paid to telehealth provider for covered health care or health services that telehealth provider appropriately provided to insured through telehealth
Conn. Gen. Stat. § 38a-477nn— Prohibition on denial of reimbursement or prevention from participating in provider network based solely on health care provider's decision not to maintain specialty certification
Conn. Gen. Stat. § 38a-478— Definitions
Conn. Gen. Stat. § 38a-478a— Commissioner's report to the Governor and the General Assembly
Conn. Gen. Stat. § 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
Conn. Gen. Stat. § 38a-478c— Managed care organization's report to the commissioner: Data, reports and information required
Conn. Gen. Stat. § 38a-478d— Provider directory. Notification to enrollee of termination or withdrawal of enrollee's primary care provider
Conn. Gen. Stat. § 38a-478e— Medical protocols. Procedure prior to change. Physician input. Notification of change
Conn. Gen. Stat. § 38a-478f— Provider profile development requirements
Conn. Gen. Stat. § 38a-478g— Managed care contract requirements. Plan description requirements
Conn. Gen. Stat. § 38a-478h— Contract requirements and notice for removal or departure of provider. Retaliatory action prohibited
Conn. Gen. Stat. § 38a-478i— Limitation on enrollee rights prohibited
Conn. Gen. Stat. § 38a-478j— Coinsurance and deductible payments based on negotiated discounts
Conn. Gen. Stat. § 38a-478k— Gag clauses prohibited
Conn. Gen. Stat. § 38a-478l— l . Consumer report card required. Content. Data analysis by commissioner
Conn. Gen. Stat. § 38a-478m— 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
Conn. Gen. Stat. § 38a-478o— Confidentiality and antidiscrimination procedures required
Conn. Gen. Stat. § 38a-478p— Expedited utilization review. Standardized process required
Conn. Gen. Stat. § 38a-478q— Use of laboratories covered by plan required
Conn. Gen. Stat. § 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
Conn. Gen. Stat. § 38a-478s— Nonapplicability to self-insured employee welfare benefit plans and workers' compensation plans
Conn. Gen. Stat. § 38a-478t— Commissioner of Public Health to receive data
Conn. Gen. Stat. § 38a-478u— Regulations
Conn. Gen. Stat. § 38a-478v— Applicability of Unfair and Prohibited Insurance Practices Act. Examination by Insurance Commissioner. Regulations
Conn. Gen. Stat. § 38a-478w— Managed care organization's calculation of enrollee liability for covered benefits. Credit required for third-party discounts and payments
Conn. Gen. Stat. § 38a-479— Definitions. Access to fee schedules. Fee information to be confidential
Conn. Gen. Stat. § 38a-479a— Physicians and managed care organizations to discuss issues relative to contracting between such parties
Conn. Gen. Stat. § 38a-479aa— Preferred provider networks. Definitions. Licensing. Fees. Requirements. Exception
Conn. Gen. Stat. § 38a-479aaa— Pharmacy benefits managers. Definitions
Conn. Gen. Stat. § 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
Conn. Gen. Stat. § 38a-479bb— Requirements for managed care organizations that contract with preferred provider networks. Requirements for preferred provider networks
Conn. Gen. Stat. § 38a-479bbb— Registration of pharmacy benefits managers required. Application for registration. Fee. Surety bond. Exemption from registration
Conn. Gen. Stat. § 38a-479c
Conn. Gen. Stat. § 38a-479cc— Duties of a preferred provider network when providing services pursuant to a contract with a managed care organization
Conn. Gen. Stat. § 38a-479ccc— Certificate of registration; when issued or refused. Suspension, revocation or refusal to issue or renew registration; grounds
Conn. Gen. Stat. § 38a-479dd— Preferred provider network examination of outstanding amounts. Notice. Commissioner's duties
Conn. Gen. Stat. § 38a-479ddd— Hearing on denial of certificate. Subsequent application
Conn. Gen. Stat. § 38a-479ee— Violations. Penalties. Investigations and staffing. Grievances. Referrals from Healthcare Advocate
Conn. Gen. Stat. § 38a-479eee— Claims payment to be made by electronic funds transfer upon written request
Conn. Gen. Stat. § 38a-479ff— Adverse action or threat of adverse action against complainant prohibited. Exception. Civil actions by aggrieved persons
Conn. Gen. Stat. § 38a-479fff— Expiration of certificates of registration. Renewal. Fees
Conn. Gen. Stat. § 38a-479gg— Regulations
Conn. Gen. Stat. § 38a-479ggg— Regulations
Conn. Gen. Stat. § 38a-479hh
Conn. Gen. Stat. § 38a-479hhh— Investigations and hearings. Powers of commissioner. Appeals
Conn. Gen. Stat. § 38a-479iii— Pharmacy audits
Conn. Gen. Stat. § 38a-479jjj— Contract with 340B covered entity. Prohibited provisions. Reimbursement rates. Regulations
Conn. Gen. Stat. § 38a-479kkk
Conn. Gen. Stat. § 38a-479ooo— Definitions
Conn. Gen. Stat. § 38a-479ppp— Annual report by pharmacy benefits managers. Standardized form. Confidentiality of information. Penalty. Regulations. Commissioner's report to the General Assembly
Conn. Gen. Stat. § 38a-479qq— Medical discount plans: Definitions, prohibited sales practices, penalties
Conn. Gen. Stat. § 38a-479qqq— Annual report by health carriers. Regulations
Conn. Gen. Stat. § 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
Conn. Gen. Stat. § 38a-479rrr— Annual certification by health carriers
Conn. Gen. Stat. § 38a-479ss
Conn. Gen. Stat. § 38a-479sss— Annual report by commissioner to the General Assembly re outpatient prescription drug costs
Conn. Gen. Stat. § 38a-479ttt— Annual report by commissioner to the General Assembly re prescription drug rebates
Conn. Gen. Stat. § 38a-480— (Formerly Sec. 38-174). Applicability of statutes to certain policies and contracts
Conn. Gen. Stat. § 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
Conn. Gen. Stat. § 38a-482— (Formerly Sec. 38-166). Form of policy
Conn. Gen. Stat. § 38a-482a— Individual health insurance policy to contain definition of “medically necessary” or “medical necessity”
Conn. Gen. Stat. § 38a-482b— Individual health insurance policy providing limited coverage to include disclosure. Limited coverage defined
Conn. Gen. Stat. § 38a-482c— Annual and lifetime limits
Conn. Gen. Stat. § 38a-483— (Formerly Sec. 38-167). Standard provisions of individual health policy
Conn. Gen. Stat. § 38a-483a— Exclusionary riders for individual health insurance policies. Regulations
Conn. Gen. Stat. § 38a-483b— Time limits for coverage determinations. Notice requirements
Conn. Gen. Stat. § 38a-483c— Coverage and notice re experimental treatments. Appeals
Conn. Gen. Stat. § 38a-484— (Formerly Sec. 38-168). Policy provisions not to be less favorable than standard. Validity of policy issued in violation of law
Conn. Gen. Stat. § 38a-485— (Formerly Sec. 38-169). Copy of application to be part of new policy or to be furnished with renewal. Alteration of application
Conn. Gen. Stat. § 38a-486— (Formerly Sec. 38-170). Certain acts not to operate as waiver of rights
Conn. Gen. Stat. § 38a-487— (Formerly Sec. 38-171). Coverage after termination date of policy
Conn. Gen. Stat. § 38a-488— (Formerly Sec. 38-172). Discrimination
Conn. Gen. Stat. § 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
Conn. Gen. Stat. § 38a-488b— Coverage for autism spectrum disorder therapies
Conn. Gen. Stat. § 38a-488c— Mental health and substance use disorder benefits. Nonquantitative treatment limitations
Conn. Gen. Stat. § 38a-488d— Coverage for substance abuse services provided pursuant to court order
Conn. Gen. Stat. § 38a-488e— Coverage for mental health wellness examinations
Conn. Gen. Stat. § 38a-488f— Coverage for services provided under the Collaborative Care Model
Conn. Gen. Stat. § 38a-488g— Acute inpatient psychiatric coverage. Prior authorization not required
Conn. Gen. Stat. § 38a-489— (Formerly Sec. 38-174e). Continuation of coverage of mentally or physically handicapped children
Conn. Gen. Stat. § 38a-490— (Formerly Sec. 38-174g). Coverage for newly born children. Notification to insurer
Conn. Gen. Stat. § 38a-490a— Coverage for birth-to-three program
Conn. Gen. Stat. § 38a-490b— Coverage for hearing aids
Conn. Gen. Stat. § 38a-490c— Coverage for craniofacial disorders
Conn. Gen. Stat. § 38a-490d— Mandatory coverage for blood lead screening and risk assessment
Conn. Gen. Stat. § 38a-491— (Formerly Sec. 38-174h). Coverage for services performed by dentists in certain instances
Conn. Gen. Stat. § 38a-491a— Coverage for in-patient, outpatient or one-day dental services in certain instances
Conn. Gen. Stat. § 38a-491b— Assignment of benefits to a dentist or oral surgeon
Conn. Gen. Stat. § 38a-492— (Formerly Sec. 38-174i). Coverage for accidental ingestion or consumption of controlled drugs. Benefits prescribed
Conn. Gen. Stat. § 38a-492a— Mandatory coverage for hypodermic needles and syringes
Conn. Gen. Stat. § 38a-492b— Coverage for certain off-label drug prescriptions
Conn. Gen. Stat. § 38a-492c— Coverage for low protein modified food products, amino acid modified preparations and specialized formulas
Conn. Gen. Stat. § 38a-492d— Mandatory coverage for diabetes screening, testing and treatment
Conn. Gen. Stat. § 38a-492e— Mandatory coverage for diabetes outpatient self-management training
Conn. Gen. Stat. § 38a-492f— Mandatory coverage for certain prescription drugs removed from formulary
Conn. Gen. Stat. § 38a-492g— Mandatory coverage for prostate cancer screening and treatment
Conn. Gen. Stat. § 38a-492h— Mandatory coverage for certain Lyme disease treatments
Conn. Gen. Stat. § 38a-492i— Mandatory coverage for pain management
Conn. Gen. Stat. § 38a-492j— Mandatory coverage for ostomy-related supplies
Conn. Gen. Stat. § 38a-492k— Mandatory coverage for colorectal cancer screening
Conn. Gen. Stat. § 38a-492l— l . Mandatory coverage for neuropsychological testing for children diagnosed with cancer
Conn. Gen. Stat. § 38a-492m— Mandatory coverage for certain renewals of prescription eye drops
Conn. Gen. Stat. § 38a-492n— Mandatory coverage for certain wound-care supplies
Conn. Gen. Stat. § 38a-492o— Mandatory coverage for bone marrow testing
Conn. Gen. Stat. § 38a-492p— Mandatory coverage for medically monitored inpatient detoxification
Conn. Gen. Stat. § 38a-492q— Mandatory coverage for essential health benefits
Conn. Gen. Stat. § 38a-492r— Mandatory coverage for certain immunizations and consultation with health care provider
Conn. Gen. Stat. § 38a-492s— Mandatory coverage for certain preventive care and screenings for individuals who are twenty-one years of age or younger
Conn. Gen. Stat. § 38a-492t— Mandatory coverage for prosthetic devices
Conn. Gen. Stat. § 38a-492u— Coverage for psychotropic drugs. Standards re availability
Conn. Gen. Stat. § 38a-492v— Mandatory coverage for hospice services provided in home through a hospice care program to the extent provided for inpatient hospice services
Conn. Gen. Stat. § 38a-492w— Medically necessary wheelchair repairs, replacements. Coverage requirements
Conn. Gen. Stat. § 38a-492x— Mandatory coverage for coronary calcium scans
Conn. Gen. Stat. § 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
Conn. Gen. Stat. § 38a-494— (Formerly Sec. 38-174 l ). Home health care by recognized nonmedical systems
Conn. Gen. Stat. § 38a-495— (Formerly Sec. 38-174m). Medicare supplement policies. Coverage of home health aide services and mammography. Prescription drug riders
Conn. Gen. Stat. § 38a-495a— Medicare supplement policies and certificates. Minimum required policy benefits and standards. Regulations
Conn. Gen. Stat. § 38a-495b— Medicare supplement policies and certificates. Definitions
Conn. Gen. Stat. § 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. Exception. Regulations
Conn. Gen. Stat. § 38a-495d— Refund of prepaid premium for Medicare supplement policies
Conn. Gen. Stat. § 38a-496— (Formerly Sec. 38-174q). Coverage for occupational therapy
Conn. Gen. Stat. § 38a-497— (Formerly Sec. 38-174r). Termination of coverage of child, stepchild, or other dependent child in individual policies. Dental or vision coverage
Conn. Gen. Stat. § 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
Conn. Gen. Stat. § 38a-498— (Formerly Sec. 38-174t). Mandatory coverage for medically necessary ambulance services. Direct payment to ambulance provider
Conn. Gen. Stat. § 38a-498a— Prior authorization prohibited for certain 9-1-1 emergency calls or transporting enrollee to a hospital by ambulance when medically necessary. Denial of payment to ambulance provider responding to 9-1-1 local prehospital emergency medical service system call prohibited on basis that enrollee did not obtain approval prior to calling such system or transporting such enrollee when medically necessary by ambulance to a hospital
Conn. Gen. Stat. § 38a-498b— Mandatory coverage for mobile field hospital
Conn. Gen. Stat. § 38a-498c— Denial of coverage prohibited for health care services rendered to persons with an elevated blood alcohol content
Conn. Gen. Stat. § 38a-499— (Formerly Sec. 38-174v). Coverage for services of physician assistants and certain nurses
Conn. Gen. Stat. § 38a-499a— Coverage for telehealth services
Conn. Gen. Stat. § 38a-500— (Formerly Sec. 38-174w). Mandatory coverage for partners, sole proprietors and corporate officers for work-related injuries. Subrogation rights
Conn. Gen. Stat. § 38a-501— (Formerly Sec. 38-174x). Individual long-term care policies. Insurers authorized. Disclosures. Premium rate increases of twenty per cent or more. Disclosure of premium rate increase and minimum set of affordable benefit options
Conn. Gen. Stat. § 38a-501a— Individual short-term care policies. Approval of rates and forms. Disclosures. Regulations
Conn. Gen. Stat. § 38a-502— (Formerly Sec. 38-174ff). Mandatory coverage for services provided by the Healthcare Center maintained by the Department of Veterans Affairs
Conn. Gen. Stat. § 38a-503— (Formerly Sec. 38-174gg). Mandatory coverage for diagnostic and screening mammography, diagnostic and screening breast ultrasound, diagnostic and screening magnetic resonance imaging, breast biopsies, prophylactic mastectomies and breast reconstructive surgery. Breast density information included in report
Conn. Gen. Stat. § 38a-503a— Mandatory coverage for breast cancer survivors
Conn. Gen. Stat. § 38a-503b— Carriers to permit direct access to obstetrician-gynecologist
Conn. Gen. Stat. § 38a-503c— Mandatory coverage for maternity care. Interhospital transfer of newborn infant and mother
Conn. Gen. Stat. § 38a-503d— Mandatory coverage for mastectomy care. Termination of provider contract prohibited
Conn. Gen. Stat. § 38a-503e— Mandatory coverage for contraceptives and sterilization
Conn. Gen. Stat. § 38a-503f— Mandatory coverage for certain health benefits and services for women, infants, children and adolescents and certain evidence-based items or services for individuals
Conn. Gen. Stat. § 38a-503g— Mandatory coverage for ovarian cancer screening and monitoring
Conn. Gen. Stat. § 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
Conn. Gen. Stat. § 38a-504a— Coverage for routine patient care costs associated with certain clinical trials
Conn. Gen. Stat. § 38a-504b— Clinical trial criteria
Conn. Gen. Stat. § 38a-504c— Evidence and information re eligibility for clinical trial. No coverage required for otherwise reimbursable costs
Conn. Gen. Stat. § 38a-504d— Clinical trials: Routine patient care costs
Conn. Gen. Stat. § 38a-504e— Clinical trials: Billing. Payments
Conn. Gen. Stat. § 38a-504f— Clinical trials: Standardized forms. Time frame for coverage determinations. Appeals. Regulations
Conn. Gen. Stat. § 38a-504g— Clinical trials: Submission and certification of policy forms
Conn. Gen. Stat. § 38a-505— (Formerly Sec. 38-378). Insurance Commissioner's powers concerning comprehensive health care plans. Disclosures
Conn. Gen. Stat. § 38a-506— (Formerly Sec. 38-173). Penalty
Conn. Gen. Stat. § 38a-507— Coverage for services performed by chiropractors
Conn. Gen. Stat. § 38a-508— Coverage for adopted children
Conn. Gen. Stat. § 38a-509— Mandatory coverage for infertility diagnosis and treatment. Limitations
Conn. Gen. Stat. § 38a-510— Prescription drug coverage. Mail order pharmacies. Step therapy use
Conn. Gen. Stat. § 38a-510a— Prescription drug coverage. Synchronized refills
Conn. Gen. Stat. § 38a-510b— Prescription drug coverage. Prior authorization for naloxone hydrochloride or similar drug not required
Conn. Gen. Stat. § 38a-510c— Coverage for investigational drug, biological product or device for insureds with terminal illnesses. Liability of health carrier
Conn. Gen. Stat. § 38a-511— Copayments re in-network imaging services
Conn. Gen. Stat. § 38a-511a— Copayments re in-network physical therapy services and in-network occupational therapy services
Conn. Gen. Stat. § 38a-512— Applicability of statutes to certain major medical expense policies
Conn. Gen. Stat. § 38a-512a— Continuation of coverage
Conn. Gen. Stat. § 38a-512b— Termination of coverage of child, stepchild or other dependent child in group policies. Dental or vision coverage
Conn. Gen. Stat. § 38a-512c— Annual and lifetime limits
Conn. Gen. Stat. § 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
Conn. Gen. Stat. § 38a-513a— Time limits for coverage determinations. Notice requirements
Conn. Gen. Stat. § 38a-513b— Coverage and notice re experimental treatments. Appeals
Conn. Gen. Stat. § 38a-513c— Group health insurance policy to contain definition of “medically necessary” or “medical necessity”
Conn. Gen. Stat. § 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
Conn. Gen. Stat. § 38a-513e— Premium payment by employer following employee termination. Exceptions. Right to continuation of coverage following relocation or closing of covered establishment not affected
Conn. Gen. Stat. § 38a-513f— Claims information to be provided to certain employers. Restrictions. Subpoenas
Conn. Gen. Stat. § 38a-513g— Employer submission of plan cost information to Comptroller
Conn. Gen. Stat. § 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
Conn. Gen. Stat. § 38a-514a— Biologically-based mental illness. Coverage required
Conn. Gen. Stat. § 38a-514b— Coverage for autism spectrum disorder
Conn. Gen. Stat. § 38a-514c— Mental health and substance use disorder benefits. Nonquantitative treatment limitations
Conn. Gen. Stat. § 38a-514d— Coverage for substance abuse services provided pursuant to court order
Conn. Gen. Stat. § 38a-514e— Coverage for mental health wellness exams
Conn. Gen. Stat. § 38a-514f— Coverage for services provided under the Collaborative Care Model
Conn. Gen. Stat. § 38a-514g— Acute inpatient psychiatric coverage. Prior authorization not required
Conn. Gen. Stat. § 38a-515— Continuation of coverage of mentally or physically handicapped children
Conn. Gen. Stat. § 38a-516— Coverage for newly born children. Notification to insurer
Conn. Gen. Stat. § 38a-516a— Coverage for birth-to-three program
Conn. Gen. Stat. § 38a-516b— Coverage for hearing aids
Conn. Gen. Stat. § 38a-516c— Coverage for craniofacial disorders
Conn. Gen. Stat. § 38a-516d— Coverage for neuropsychological testing for children diagnosed with cancer
Conn. Gen. Stat. § 38a-517— Coverage for services performed by dentist in certain instances
Conn. Gen. Stat. § 38a-517a— Coverage for in-patient, outpatient or one-day dental services in certain instances
Conn. Gen. Stat. § 38a-517b— Assignment of benefits to a dentist or oral surgeon
Conn. Gen. Stat. § 38a-518— Coverage for accidental ingestion or consumption of controlled drugs. Benefits prescribed
Conn. Gen. Stat. § 38a-518a— Mandatory coverage for hypodermic needles and syringes
Conn. Gen. Stat. § 38a-518b— Coverage for certain off-label drug prescriptions
Conn. Gen. Stat. § 38a-518c— Coverage for low protein modified food products, amino acid modified preparations and specialized formulas
Conn. Gen. Stat. § 38a-518d— Mandatory coverage for diabetes screening, testing and treatment
Conn. Gen. Stat. § 38a-518e— Mandatory coverage for diabetes outpatient self-management training
Conn. Gen. Stat. § 38a-518f— Mandatory coverage for certain prescription drugs removed from formulary
Conn. Gen. Stat. § 38a-518g— Mandatory coverage for prostate cancer screening and treatment
Conn. Gen. Stat. § 38a-518h— Mandatory coverage for certain Lyme disease treatments
Conn. Gen. Stat. § 38a-518i— Mandatory coverage for pain management
Conn. Gen. Stat. § 38a-518j— Mandatory coverage for ostomy-related supplies
Conn. Gen. Stat. § 38a-518k— Mandatory coverage for colorectal cancer screening
Conn. Gen. Stat. § 38a-518l— l . Mandatory coverage for certain renewals of prescription eye drops
Conn. Gen. Stat. § 38a-518m— Mandatory coverage for certain wound-care supplies
Conn. Gen. Stat. § 38a-518n
Conn. Gen. Stat. § 38a-518o— Mandatory coverage for bone marrow testing
Conn. Gen. Stat. § 38a-518p— Mandating coverage for medically monitored inpatient detoxification
Conn. Gen. Stat. § 38a-518q— Mandatory coverage for essential health benefits
Conn. Gen. Stat. § 38a-518r— Mandatory coverage for certain immunizations and consultation with health care provider
Conn. Gen. Stat. § 38a-518s— Mandatory coverage for certain preventive care and screenings for individuals who are twenty-one years of age or younger
Conn. Gen. Stat. § 38a-518t— Mandatory coverage for prosthetic devices
Conn. Gen. Stat. § 38a-518u— Coverage for psychotropic drugs. Standards re availability
Conn. Gen. Stat. § 38a-518v— Mandatory coverage for hospice services in the home through a hospice care program to the extent provided for inpatient hospice services
Conn. Gen. Stat. § 38a-518w— Medically necessary wheelchair repairs, replacements. Coverage requirements
Conn. Gen. Stat. § 38a-518x— Mandatory coverage of coronary calcium scans
Conn. Gen. Stat. § 38a-519— (Formerly Sec. 38-174j). Offset proviso prohibited in certain policies. Required disclosures for group long-term disability policies
Conn. Gen. Stat. § 38a-520— Mandatory coverage for home health care. Deductibles. Exception from deductible limits for medical savings accounts. Archer MSAs and health savings accounts
Conn. Gen. Stat. § 38a-521— Home health care by recognized nonmedical systems
Conn. Gen. Stat. § 38a-522— Medicare supplement policies. Coverage of home health aide service
Conn. Gen. Stat. § 38a-523— (Formerly Sec. 38-174p). Group hospital or medical insurance coverage for comprehensive rehabilitation services
Conn. Gen. Stat. § 38a-524— Coverage for occupational therapy
Conn. Gen. Stat. § 38a-525— Mandatory coverage for medically necessary ambulance services. Direct payment to ambulance provider
Conn. Gen. Stat. § 38a-525a— Prior authorization prohibited for certain 9-1-1 emergency calls or transporting enrollee to a hospital by ambulance when medically necessary. Denial of payment to ambulance provider responding to 9-1-1 local prehospital emergency medical service system call prohibited on basis that enrollee did not obtain approval prior to calling such system or transporting such enrollee when medically necessary by ambulance to a hospital
Conn. Gen. Stat. § 38a-525b— Mandatory coverage for mobile field hospital
Conn. Gen. Stat. § 38a-525c— Denial of coverage prohibited for health care services rendered to persons with an elevated blood alcohol content
Conn. Gen. Stat. § 38a-526— Coverage for services of physician assistants and certain nurses
Conn. Gen. Stat. § 38a-526a— Coverage for telehealth services
Conn. Gen. Stat. § 38a-527— Mandatory coverage for partners, sole proprietors and corporate officers for work-related injuries
Conn. Gen. Stat. § 38a-528— Group long-term care policies. Insurers authorized. Disclosures. Premium rate increases of twenty per cent or more. Disclosure of premium rate increase and minimum set of affordable benefit options
Conn. Gen. Stat. § 38a-528a— Group short-term care policies. Approval of rates and forms. Disclosures. Regulations
Conn. Gen. Stat. § 38a-529— Mandatory coverage for services provided by the Healthcare Center maintained by the Department of Veterans Affairs
Conn. Gen. Stat. § 38a-530— Mandatory coverage for diagnostic and screening mammography, diagnostic and screening breast ultrasound, diagnostic and screening magnetic resonance imaging, breast biopsies, prophylactic mastectomies and breast reconstructive surgery. Breast density information included in report
Conn. Gen. Stat. § 38a-530a— Mandatory coverage for breast cancer survivors
Conn. Gen. Stat. § 38a-530b— Carriers to permit direct access to obstetrician-gynecologist
Conn. Gen. Stat. § 38a-530c— Mandatory coverage for maternity care. Interhospital transfer of newborn infant and mother
Conn. Gen. Stat. § 38a-530d— Mandatory coverage for mastectomy care. Termination of provider contract prohibited
Conn. Gen. Stat. § 38a-530e— Mandatory coverage for contraceptives and sterilization
Conn. Gen. Stat. § 38a-530f— Mandatory coverage for certain health benefits and services for women, infants, children and adolescents and certain evidence-based items or services for individuals
Conn. Gen. Stat. § 38a-530g— Mandatory coverage for ovarian cancer screening and monitoring
Conn. Gen. Stat. § 38a-531— (Formerly Sec. 38-174hh). Mandatory coverage for employees of certain employers. Approval of policy forms
Conn. Gen. Stat. § 38a-532— (Formerly Sec. 38-262a). Assignment of incidents of ownership under group life, health or accident policy
Conn. Gen. Stat. § 38a-533— (Formerly Sec. 38-262b). Mandatory coverage for the treatment of medical complications of alcoholism
Conn. Gen. Stat. § 38a-534— Coverage for services performed by chiropractors
Conn. Gen. Stat. § 38a-535— Mandatory coverage for preventive pediatric care and blood lead screening and risk assessment
Conn. Gen. Stat. § 38a-535a— Notification of individual coverage and benefits of a noncustodial parent to a custodial parent, when. Regulations
Conn. Gen. Stat. § 38a-536— Mandatory coverage for infertility diagnosis and treatment. Limitations
Conn. Gen. Stat. § 38a-537— (Formerly Sec. 38-262c). Notice of cancellation or discontinuation to covered employees. Fine. Notice of transfer of coverage. Failure to procure coverage
Conn. Gen. Stat. § 38a-538— (Formerly Sec. 38-262d). Continuation of benefits under group employee health plans
Conn. Gen. Stat. § 38a-539— (Formerly Sec. 38-262f). Group hospital or medical expense insurance policy coverage for treatment of alcoholism on an outpatient basis
Conn. Gen. Stat. § 38a-540— (Formerly Sec. 38-262g). Duplication of coverage under group health insurance policies
Conn. Gen. Stat. § 38a-541— (Formerly Sec. 38-262h). Group health policy to allow spouse coverage as both employee and dependent, when. Effect of collective bargaining agreements
Conn. Gen. Stat. § 38a-542— Mandatory coverage for treatment of tumors and leukemia. Mandatory coverage for reconstructive surgery, prosthesis, chemotherapy and wigs. Orally administered anticancer medications
Conn. Gen. Stat. § 38a-542a— Coverage for routine patient care costs associated with certain clinical trials
Conn. Gen. Stat. § 38a-542b— Clinical trial criteria
Conn. Gen. Stat. § 38a-542c— Evidence and information re eligibility for clinical trial. No coverage required for otherwise reimbursable costs
Conn. Gen. Stat. § 38a-542d— Clinical trials: Routine patient care costs
Conn. Gen. Stat. § 38a-542e— Clinical trials: Billing. Payments
Conn. Gen. Stat. § 38a-542f— Clinical trials: Standardized forms. Time frame for coverage determinations. Appeals. Regulations
Conn. Gen. Stat. § 38a-542g— Clinical trials: Submission and certification of policy forms
Conn. Gen. Stat. § 38a-543— (Formerly Sec. 38-262j). Reduction of payments on basis of Medicare eligibility
Conn. Gen. Stat. § 38a-544— Prescription drug coverage. Mail order pharmacies. Step therapy use
Conn. Gen. Stat. § 38a-544a— Prescription drug coverage. Synchronized refills
Conn. Gen. Stat. § 38a-544b— Prescription drug coverage. Prior authorization for naloxone hydrochloride or similar drug not required
Conn. Gen. Stat. § 38a-545— (Formerly Sec. 38-262k). Group dental health insurance plans. Alternative coverage option
Conn. Gen. Stat. § 38a-546— (Formerly Sec. 38-379). Discontinuation and replacement of group health insurance policy. Regulations
Conn. Gen. Stat. § 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
Conn. Gen. Stat. § 38a-548— Penalty
Conn. Gen. Stat. § 38a-549— Coverage for adopted children
Conn. Gen. Stat. § 38a-550— Copayments re in-network imaging services
Conn. Gen. Stat. § 38a-550a— Copayments re in-network physical therapy services and in-network occupational therapy services
Conn. Gen. Stat. § 38a-551— (Formerly Sec. 38-371). Definitions
Conn. Gen. Stat. § 38a-552— (Formerly Sec. 38-372). Provision of service to certain low-income individuals
Conn. Gen. Stat. § 38a-553— (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
Conn. Gen. Stat. § 38a-556— (Formerly Sec. 38-376). Health Reinsurance Association. Board of directors. Powers and authority. Rates. Net loss assessment. Immunity from liability
Conn. Gen. Stat. § 38a-556a— Connecticut Clearinghouse
Conn. Gen. Stat. § 38a-557— (Formerly Sec. 38-377). Hospital service corporations and medical service corporations. Residual market mechanism. Insurance Commissioner's powers concerning such mechanisms
Conn. Gen. Stat. § 38a-558— (Formerly Sec. 38-380). Office of Health Care Access
Conn. Gen. Stat. § 38a-559— (Formerly Sec. 38-381). Commissioner of Social Services. Contract authority concerning Medicaid programs
Conn. Gen. Stat. § 38a-560— Small employer grouping for health insurance coverage
Conn. Gen. Stat. § 38a-561
Conn. Gen. Stat. § 38a-564— Definitions
Conn. Gen. Stat. § 38a-565— Special health care plans
Conn. Gen. Stat. § 38a-566— Health insurance plans or insurance arrangements covering employees of a small employer. Trusts. Trade associations
Conn. Gen. Stat. § 38a-567— Provisions of small employer plans and arrangements
Conn. Gen. Stat. § 38a-568— Coverage under small employer health care plans and arrangements. Approval by commissioner
Conn. Gen. Stat. § 38a-569— Connecticut Small Employer Health Reinsurance Pool
Conn. Gen. Stat. § 38a-570— 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
Conn. Gen. Stat. § 38a-573— Validity of separate provisions
Conn. Gen. Stat. § 38a-574— Standard family health statement
Conn. Gen. Stat. § 38a-575
Conn. Gen. Stat. § 38a-577— (Formerly Sec. 38-174ii). Consumer dental health plans. Definitions
Conn. Gen. Stat. § 38a-578— (Formerly Sec. 38-174jj). Certificate of authority. Application requirements
Conn. Gen. Stat. § 38a-579— (Formerly Sec. 38-174kk). Certificate of authority. Standards for issuance and renewal
Conn. Gen. Stat. § 38a-580— (Formerly Sec. 38-174 ll ). General surplus required
Conn. Gen. Stat. § 38a-581— (Formerly Sec. 38-174mm). Evidence of coverage to be provided to enrollees. Approval by commissioner
Conn. Gen. Stat. § 38a-582— (Formerly Sec. 38-174nn). Schedule of charges. Approval by commissioner. Appeal of disapproval
Conn. Gen. Stat. § 38a-583— (Formerly Sec. 38-174oo). Records. Commissioner's power to examine; maintenance; preservation
Conn. Gen. Stat. § 38a-584— (Formerly Sec. 38-174pp). Complaint system
Conn. Gen. Stat. § 38a-585— (Formerly Sec. 38-174qq). Requirements re filing of annual reports with commissioner
Conn. Gen. Stat. § 38a-586— (Formerly Sec. 38-174rr). False or misleading advertising or solicitation and deceptive evidence of coverage prohibited
Conn. Gen. Stat. § 38a-587— (Formerly Sec. 38-174ss). Suspension or revocation of certificate of authority. Hearing. Appeal
Conn. Gen. Stat. § 38a-588— (Formerly Sec. 38-174tt). Penalty. Insolvency
Conn. Gen. Stat. § 38a-589— (Formerly Sec. 38-174uu). Confidentiality
Conn. Gen. Stat. § 38a-590— (Formerly Sec. 38-174vv). Commissioner's power to adopt regulations
Conn. Gen. Stat. § 38a-591— Compliance with the Patient Protection and Affordable Care Act. Regulations
Conn. Gen. Stat. § 38a-591a— *(See end of section for amended version of subdivision (7) and effective date.) Definitions
Conn. Gen. Stat. § 38a-591b— Health carrier responsibilities re utilization review
Conn. Gen. Stat. § 38a-591c— Utilization review criteria and procedures
Conn. Gen. Stat. § 38a-591d— Utilization review and benefit determinations. Urgent care requests. Information provided in notice of adverse determination
Conn. Gen. Stat. § 38a-591e— Internal grievance process of adverse determinations based on medical necessity. Expedited review of adverse determinations of urgent care requests
Conn. Gen. Stat. § 38a-591f— Internal grievance process of adverse determinations not based on medical necessity
Conn. Gen. Stat. § 38a-591g— External reviews and expedited external reviews
Conn. Gen. Stat. § 38a-591h— Record-keeping requirements. Report to commissioner upon request
Conn. Gen. Stat. § 38a-591i— Regulations
Conn. Gen. Stat. § 38a-591j— Utilization review companies: Licensure. Fees. Investigation of grievances. Duties
Conn. Gen. Stat. § 38a-591k— Violations. Notice and hearing. Penalties. Appeal
Conn. Gen. Stat. § 38a-591l— l . Independent review organizations conducting external reviews and expedited external reviews
Conn. Gen. Stat. § 38a-591m— Independent review organizations: Conflicts of interest. Liability. Record-keeping requirements. Report to commissioner upon request
Conn. Gen. Stat. § 38a-591n— Documents, communications, information and evidence provided to covered person or covered person's authorized representative upon request
Conn. Gen. Stat. § 38a-591o— Restrictions applicable to prospective or concurrent review of certain recurring prescription drugs. Exceptions
Conn. Gen. Stat. § 38a-592