Connecticut Seal

House Bill No. 5204

Public Act No. 04-174

AN ACT CONCERNING MINOR CHANGES TO THE INSURANCE STATUTES.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. Subsection (c) of section 38a-41 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(c) The commissioner may, at any time, for cause, suspend, revoke or [reissue] refuse to renew any such license or in lieu of or in addition to suspension or revocation of such license the commissioner, after reasonable notice to and hearing of any holder of such license, may impose a fine not to exceed ten thousand dollars. Such hearings may be held by the commissioner or any person designated by the commissioner. Whenever a person other than the commissioner acts as the hearing officer, [he] the person shall submit to the commissioner a memorandum of [his] the person's findings and recommendations upon which the commissioner may base [his] a decision. The commissioner may, if the commissioner deems it in the interest of the public, publish in one or more newspapers of the state a statement that, under the provisions of this section, the commissioner has suspended or revoked the license of any insurance company or health care center to do business in this state.

Sec. 2. Subsection (f) of section 38a-41 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(f) Any company aggrieved by the action of the commissioner in revoking, suspending or refusing to [reissue] renew a license or in imposing a fine may appeal therefrom, in accordance with the provisions of section 4-183, except venue for such appeal shall be in the judicial district of New Britain. Appeals under this section shall be privileged in respect to the order of trial assignment.

Sec. 3. Subdivision (3) of subsection (b) of section 38a-129 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(3) "Control", "controlled by" and "under common control with" have the meaning assigned to them by section 38a-1, as amended. Control shall be presumed to exist if any person, directly or indirectly, owns, controls, holds with the power to vote, or holds proxies representing, ten per cent or more of the voting securities of any other person. This presumption may be rebutted by a showing [pursuant to subsection (j) of section 38a-135] that control does not exist in fact. The commissioner may, after furnishing all persons in interest notice and opportunity to be heard, determine that control exists in fact, notwithstanding the absence of a presumption to that effect.

Sec. 4. Section 38a-458 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(a) On and after June 16, 1989, any life insurance company doing business in this state may issue life insurance policies or certificates, or riders or endorsements thereto, which provide, within the terms and conditions of the policy or certificate, long-term care benefits as described in section 38a-501, provided such company is licensed for both life and health insurance in this state. The Insurance Commissioner may adopt regulations, in accordance with chapter 54, to implement the provisions of this section. Prior to the effective date of such regulations, any such policy, certificate, rider or endorsement may be filed with the commissioner and may be approved at the commissioner's discretion.

(b) Long-term care benefits provided pursuant to subsection (a) of this section shall not be subject to the requirements of subsection (b) of section 38a-501 or subsection (b) of section 38a-528.

(c) No insurance producer shall sell any such policy, certificate, rider or endorsement unless the agent* is licensed to sell both life and health insurance in this state.

(d) A life insurance policy with long-term care benefits issued pursuant to this section may include a rider that provides long-term care benefits that become payable upon exhaustion of benefits under the life insurance policy. The elimination period limitations shall apply only to the life insurance policy to which the rider is attached. Such rider shall not contain an additional elimination period and may calculate the waiver of premium from the time benefits are payable under such rider.

Sec. 5. Subdivision (6) of section 38a-838 of the general statutes, as amended by section 1 of public act 03-49, is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(6) "Insolvent insurer" means an insurer (A) licensed to transact insurance in this state either at the time the policy was issued or when the insured event occurred, and (B) determined to be insolvent by a court of competent jurisdiction, provided the term "insolvent insurer" shall (i) not be construed to mean any insurer with respect to which an order, decree, judgment or finding of insolvency, whether permanent or temporary in nature, or order of rehabilitation or conservation has been issued by a court of competent jurisdiction prior to October 1, 1971, and (ii) include the legal successor of the insolvent insurer in the event of the merger of the insolvent insurer.

Sec. 6. Subsection (f) of section 38a-493 of the general statutes, as amended by section 1 of public act 03-78, is repealed and the following is substituted in lieu thereof (Effective from passage):

(f) Home health care benefits may be subject to an annual deductible of not more than fifty dollars for each person covered under a policy and may be subject to a coinsurance provision which provides for coverage of not less than seventy-five per cent of the reasonable charges for such services. Such policy may also contain reasonable limitations and exclusions applicable to home health care coverage. A "high deductible health plan", as defined in Section 220(c)(2) or Section 223(c)(2) of the Internal Revenue Code of 1986, or any subsequent corresponding internal revenue code of the United States, as from time to time amended, used to establish a "medical savings account" or "Archer MSA" pursuant to Section 220 of said Internal Revenue Code [,] or a "health savings account" pursuant to Section 223 of said Internal Revenue Code shall not be subject to the deductible limits set forth in this subsection.

Sec. 7. Subsection (f) of section 38a-520 of the general statutes, as amended by section 2 of public act 03-78, is repealed and the following is substituted in lieu thereof (Effective from passage):

(f) Home health care benefits may be subject to an annual deductible of not more than fifty dollars for each person covered under a policy and may be subject to a coinsurance provision which provides for coverage of not less than seventy-five per cent of the reasonable charges for such services. Such policy may also contain reasonable limitations and exclusions applicable to home health care coverage. A "high deductible health plan", as defined in Section 220(c)(2) or Section 223(c)(2) of the Internal Revenue Code of 1986, or any subsequent corresponding internal revenue code of the United States, as from time to time amended, used to establish a "medical savings account" or "Archer MSA" pursuant to Section 220 of said Internal Revenue Code [,] or a "health savings account" pursuant to Section 223 of said Internal Revenue Code shall not be subject to the deductible limits set forth in this subsection.

Approved June 1, 2004