House Bill No. 5499
Public Act No. 03-119
AN ACT CONCERNING HEALTH INSURANCE UNDERWRITING AND BENEFITS AND DISCLOSURE OF HEALTH BENEFIT AND CLAIM EXPERIENCE DATA TO CERTAIN BARGAINING AGENTS.
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1. Section 38a-481 of the general statutes is amended by adding subsection (h) as follows (Effective October 1, 2003):
(NEW) (h) No insurance company, fraternal benefit society, hospital service corporation, medical service corporation, health care center or other entity which delivers, issues for delivery, amends, renews or continues an individual health insurance policy in this state on or after October 1, 2003, may (1) move an insured individual from a standard underwriting classification to a substandard underwriting classification after the policy is issued; or (2) increase premium rates due to the claim experience or health status of an individual who is insured under the policy, except that the entity may increase premium rates for all individuals in an underwriting classification due to the claim experience or health status of the underwriting classification as a whole.
Sec. 2. Section 38a-531 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2003):
(a) For purposes of this section: (1) "Employer" means any person, firm, corporation, limited liability company, partnership or association engaged in business who has employees in this state; (2) "employee" means any person engaged in service to an employer in a business of [his] an employer; and (3) "continued" or "continuance date" means the anniversary date of the issuance of a policy after which the policy remains in effect until cancelled.
(b) Notwithstanding any other provisions of the general statutes, [every] each group health insurance policy providing coverage of the type specified in subdivisions (1), (2) and (4) of section 38a-469 delivered, issued for delivery, renewed or continued in any other state [on or after October 1, 1988,] offered by an employer, shall provide to covered employees of such employer employed in this state [coverage which meets the requirements of sections 38a-514, 38a-516, 38a-518, 38a-520, 38a-525, 38a-526, 38a-533 and 38a-538; and every such policy delivered, issued for delivery, renewed or continued in any other state on or after October 1, 1989, offered by an employer shall provide to such employees coverage which meets the requirements of section 38a-503; and every such policy delivered, issued for delivery, renewed or continued in any other state on or after October 1, 1990, offered by an employer shall provide to such employees coverage which meets the requirements of section 38a-535,] whenever, on the initial effective date of such policy or any renewal or continuance date thereafter, fifty-one per cent or more of the covered employees [under such policy] of such employer are employed in this state, coverage that meets the requirements of this title. The forms of such policies shall be submitted to the Insurance Commissioner for approval.
Sec. 3. Subsection (b) of section 38a-981 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2003):
(b) (1) An insurance institution or a third-party administrator providing insurance or administrative services with respect to an employer's employee benefit plan which provides its employees with health benefits shall, upon written request of an exclusive bargaining agent for such employees, provide such bargaining agent with information regarding description of health benefits available to such employees, claim experience regarding such benefits and the cost to the employer for such coverage or administrative services, as the case may be, for employees in the bargaining unit represented by such bargaining agent. If such employees constitute a subgroup of a multibargaining unit group, the information provided by the insurer shall, upon written request of the exclusive bargaining agent for the subgroup, include a description of available health benefits, claim experience regarding such benefits and the cost to the employer for such coverage or administrative services, as the case may be, for the entire multibargaining unit group or for subgroups within the multibargaining unit group. A copy of such information shall be provided at the same time to the employer by the insurance institution or administrator. Such information shall be made available to the bargaining agent and the employer only if the bargaining agent agrees in writing to pay all reasonable costs, as determined by the insurance institution or administrator, that are incurred by the insurance institution or administrator in developing and distributing the information. The information provided to such agent shall relate to the group of employees as a whole and shall not include any information relating to specific individuals. No requests made pursuant to this subdivision may seek information which relates to a period of time more than twenty-four months prior to the date such request was made.
(2) Prior to providing any information pursuant to subdivision (1) of this subsection, an insurance institution or third-party administrator may require the bargaining agent requesting such information to provide evidence in writing that such bargaining agent is currently designated or certified by the proper state or federal authority as the exclusive bargaining representative or agent of the employees who are the subject of the request.
Approved June 18, 2003