2019 Connecticut General Statutes
Title 38a - Insurance
Chapter 700c - Health Insurance
Section 38a-557 - (Formerly Sec. 38-377). Hospital service corporations and medical service corporations. Residual market mechanism. Insurance Commissioner's powers concerning such mechanisms.
(a) Hospital service corporations and medical service corporations may participate in the Health Reinsurance Association established in section 38a-556, as a full member thereof, or by making health care plans available directly through a subscriber contract or combination of contracts or by forming a separate residual market mechanism substantially similar to said association.
(b) In the event that hospital service corporations and medical service corporations choose to form a separate residual market mechanism, the commissioner shall have the same regulatory powers over that residual market mechanism as the commissioner has over the Health Reinsurance Association, and such residual market mechanism shall have the same powers and duties as the association. Rating classifications under a residual market mechanism established under this section need not be the same as classifications established under the association, but any rates established by the residual market mechanism shall be approved by the commissioner. The commissioner shall adopt regulations, in accordance with the provisions of chapter 54, to carry out the requirements of this section.
(c) If hospital service corporations and medical service corporations do not elect to participate in the Health Reinsurance Association, such service corporations shall be required to make an individual health care plan available to every resident of this state except residents who are both sixty-five years of age or older and eligible for Medicare and whose coverage under a group or individual contract issued by such service corporations has terminated. Such coverage may be made available through a separate residual market mechanism established under this section.
(P.A. 75-616, S. 7, 12; P.A. 76-435, S. 23, 82; P.A. 86-106, S. 5; P.A. 12-145, S. 23; P.A. 15-247, S. 16.)
History: P.A. 76-435 included reference to terminated individual contracts issued by hospital or medical service corporation in Subsec. (c); P.A. 86-106 limited in Subsec. (c) the exemption from the required availability of individual comprehensive health care plans to those residents of this state who are at least 65 years of age and eligible for Medicare; Sec. 38-377 transferred to Sec. 38a-557 in 1991; P.A. 12-145 made technical changes, effective June 15, 2012; P.A. 15-247 amended Subsec. (a) by replacing “elect to meet the obligations of section 38a-552 by participating” with “participate”, deleting “comprehensive” and making a technical change, amended Subsec. (b) by adding reference to Ch. 54 and making a technical change, and amended Subsec. (c) by deleting “comprehensive”, effective July 10, 2015.
