House Bill No. 5616
House Bill No. 5616
PUBLIC ACT NO. 98-27
AN ACT MAKING TECHNICAL CORRECTIONS TO THE
INSURANCE AND REAL ESTATE LAWS AND AMENDING
CERTAIN FILING DEADLINES FOR MANAGED CARE
ORGANIZATIONS.
Be it enacted by the Senate and House of
Representatives in General Assembly convened:
Section 1. Section 20-325f of the general
statutes is repealed and the following is
substituted in lieu thereof:
No real estate broker shall make any
unilateral offer of subagency or agree to
compensate, appoint, employ, cooperate with or
otherwise affiliate with a subagent for the sale
or purchase of real property without the informed
written consent of the person [for] whom the real
estate broker represents. Such written consent
shall contain the name and real estate license
number of the real estate broker to be appointed
as the subagent and shall contain a statement
notifying the person [for] whom the real estate
broker represents that the law imposes vicarious
liability on the principal for the acts of the
subagent.
Sec. 2. Subsection (a) of section 20-325h of
the general statutes is repealed and the following
is substituted in lieu thereof:
(a) After the termination of an agency
relationship between a real estate licensee and a
person [for] whom the real estate licensee
represented, no real estate licensee shall: (1)
Reveal confidential information concerning that
person; (2) use confidential information
concerning that person to the person's
disadvantage; or (3) use confidential information
concerning that person for the real estate
broker's or real estate salesperson's advantage or
the advantage of a third party, except as required
by legal process, as necessary to defend the real
estate broker or real estate salesperson from
allegations of wrongful or negligent conduct, or
as necessary to prevent the commission of a crime.
Sec. 3. Section 20-325g of the general
statutes is repealed and the following is
substituted in lieu thereof:
There shall be a conclusive presumption that a
person has given [his] informed consent to a dual
agency relationship with a real estate broker if
that person executes a written consent in the
following form prior to executing any contract or
agreement for the purchase, sale or lease of real
estate:
DUAL AGENCY CONSENT AGREEMENT
(1) This Dual Agency Consent Agreement is an
addendum to and make part of (check all that
apply):
firm and seller or landlord.
( ) Buyer [on] OR tenant agency agreement dated
(2) Seller and buyer (or landlord and tenant,
as the case may be) hereby acknowledge and agree
both buyer and seller (or landlord and tenant, as
the case may be) in the purchase and sale (or
lease) of the above referenced property and that
brokerage firm has been and is now the agent of
both seller and buyer (or landlord and tenant, as
the case may be). Seller and buyer (or landlord
and tenant, as the case may be) have both
consented to and hereby confirm their consent to
this dual representation.
(3) Seller and buyer (or landlord and tenant,
as the case may be) agree: (A) The brokerage firm
shall not be required to and shall not disclose to
either buyer or seller (or landlord or tenant, as
the case may be) any personal, financial or other
confidential information to such other party
without the express written consent of the party
whose information is disclosed, other than
information related to material property defects
which are known to the brokerage firm and other
information the brokerage firm is required to
disclose by law. (B) The brokerage firm may not
disclose: (i) To the buyer that the seller
(landlord) will accept less than the asking or
listed price, unless otherwise instructed to do so
in writing by the seller (landlord); (ii) to the
seller (landlord) that the buyer (tenant) can or
will pay a price greater than the price submitted
in a written offer to the seller (landlord),
unless otherwise instructed to do so in writing by
the buyer (tenant); (iii) the motivation of the
seller or buyer (or landlord or tenant, as the
case may be) for selling, buying or leasing
property, unless otherwise instructed in writing
by the respective party; or (iv) that a seller or
buyer will agree to financing terms other than
those offered, unless instructed in writing by the
respective party.
(4) Property information available through
the multiple listing service or otherwise,
including listed and sold properties, which has
been requested by either the seller or the buyer
(or landlord or tenant, as the case may be) shall
be disclosed to both seller and buyer (or landlord
and tenant, as the case may be).
(5) Both parties are advised to seek
competent legal and tax advice with regard to this
transaction, and with regard to all documents
executed in connection with this transaction,
including this Dual Agency Consent Agreement.
I have read and understand the above agreement
Buyer Seller Brokerage Firm
(Landlord) (Tenant)
(Authorized Representative)
(Company Name)
Date Date Date
Sec. 4. Section 38a-887 of the general
statutes is repealed and the following is
substituted in lieu thereof:
When the commissioner has caused to be paid
from [such] THE BROKERED TRANSACTIONS guaranty
fund any sum to the aggrieved person, the
department shall be subrogated to all of the
rights of the aggrieved person up to the amount
paid, and the aggrieved person shall assign all of
his right, title and interest in the claim. By
accepting payment from the guaranty fund the
aggrieved person shall agree to cooperate with the
department in any action it takes against the
licensed insurance producer or unlicensed person
acting as a producer engaged in the business of
insurance. Any amount and interest recovered by
the department shall be deposited to [such] SAID
guaranty fund.
Sec. 5. Subsection (a) of section 38a-884 of
the general statutes is repealed and the following
is substituted in lieu thereof:
(a) Any person aggrieved under section
38a-880 may apply to the Insurance Department for
an order directing payment out of [such] THE
BROKERED TRANSACTIONS guaranty fund subject to the
limitations stated in said section and the
limitations specified in this section.
Sec. 6. Subsection (d) of section 38a-884 of
the general statutes is repealed and the following
is substituted in lieu thereof:
(d) The payment from [such] SAID fund of any
amount in settlement of a claim against a licensed
insurance producer or an unlicensed person acting
as a producer engaged in the business of insurance
pursuant to an order under subsection (c), shall
constitute cause for the suspension or revocation
of any license issued by the commissioner or for
the imposition of a fine pursuant to section
38a-774 and for an order of restitution to the
fund in the amount it has paid, and such producer
or unlicensed person shall not be eligible to
apply for a license until he has repaid in full,
plus interest at a rate to be determined by the
department and which shall reflect current market
rates, the amount paid from [such] SAID guaranty
fund on his account. A discharge in bankruptcy
shall not relieve a person from the penalties and
disabilities provided in this subsection.
Sec. 7. Subsection (e) of section 38a-884 of
the general statutes is repealed and the following
is substituted in lieu thereof:
(e) If, at any time, the money deposited in
such guaranty fund is insufficient to satisfy any
duly authorized claim or portion thereof, the
department shall, when sufficient money has been
deposited in [such] SAID guaranty fund, satisfy
such unpaid claims or portions thereof, in the
order that such claims or portions thereof were
originally filed, plus accumulated interest at the
rate of four per cent a year.
Sec. 8. Section 38a-883 of the general
statutes is repealed and the following is
substituted in lieu thereof:
No application to recover compensation under
sections 38a-880 to 38a-889, inclusive, which
might subsequently result in an order for
collection from [such] THE BROKERED TRANSACTIONS
guaranty fund shall be brought later than two
years from the action of an insurance producer
duly licensed in this state under section 38a-769,
or an unlicensed person acting as a producer
engaged in the business of insurance, by reason of
the embezzlement of money or property, or the
unlawful obtainment of money or property from any
person by false pretenses, artifice, trickery or
forgery, or by reason of any fraud,
misrepresentation or deceit by or on the part of
any such producer or unlicensed person acting as a
producer engaged in the business of insurance,
excluding the failure in performance of
contractual obligations due to the impairment of
an insurer.
Sec. 9. Subsection (b) of section 38a-882 of
the general statutes is repealed and the following
is substituted in lieu thereof:
(b) If, at any time, the amount deposited in
the Brokered Transactions Guaranty Fund is under
one hundred thousand dollars, the department, in
its discretion, may assess all persons licensed as
insurance producers a fee not to exceed ten
dollars which shall be credited to [such] SAID
guaranty fund.
Sec. 10. Subdivision (8) of section 38a-816
of the general statutes, as amended by public act
97-95, is repealed and the following is
substituted in lieu thereof:
(8) Misrepresentation in insurance
applications. Making false or fraudulent
statements or representations on or relative to an
application for an insurance policy [,] for the
purpose of obtaining a fee, commission, money or
other benefit from any [insurers] INSURER,
producer or individual.
Sec. 11. Subdivision (11) of section 38a-816
of the general statutes, as amended by public act
97-95, is repealed and the following is
substituted in lieu thereof:
(11) Favored agent or insurer: Coercion of
debtors. (a) No person may (i) require, as a
condition precedent to the lending of money or
extension of credit, or any renewal thereof, that
the person to whom such money or credit is
extended or whose obligation the creditor is to
acquire or finance, negotiate any policy or
contract of insurance through a particular insurer
or group of insurers or producer or group of
producers; (ii) unreasonably disapprove the
insurance policy provided by a borrower for the
protection of the property securing the credit or
lien; or (iii) require directly or indirectly that
any borrower, mortgagor, purchaser, insurer [,] OR
producer pay a separate charge, in connection with
the handling of any insurance policy required as
security for a loan on real estate or pay a
separate charge to substitute the insurance policy
of one insurer for that of another; (iv) use or
disclose information resulting from a requirement
that a borrower, mortgagor or purchaser furnish
insurance of any kind on real property being
conveyed or used as collateral security to a loan,
when such information is to the advantage of the
mortgagee, vendor or lender, or is to the
detriment of the borrower, mortgagor, purchaser,
insurer or the producer complying with such a
requirement. (b) (i) Subsection (a) (iii) does not
include the interest which may be charged on
premium loans or premium advancements in
accordance with the security instrument. (ii) For
purposes of subsection (a) (ii), such disapproval
shall be deemed unreasonable if it is not based
solely on reasonable standards uniformly applied,
relating to the extent of coverage required and
the financial soundness and the services of an
insurer. Such standards shall not discriminate
against any particular type of insurer, nor shall
such standards call for the disapproval of an
insurance policy because such policy contains
coverage in addition to that required. (iii) The
commissioner may investigate the affairs of any
person to whom this subsection applies to
determine whether such person has violated this
subsection. If a violation of this subsection is
found, the person in violation shall be subject to
the same procedures and penalties as are
applicable to other provisions of section 38a-815,
subsections (b) and (e) of section 38a-817 and
this section. (iv) For purposes of this section,
"person" includes any individual, corporation,
limited liability company, association,
partnership or other legal entity.
Sec. 12. Section 38a-226d of the general
statutes, as amended by section 19 of public act
97-99, is repealed and the following is
substituted in lieu thereof:
The commissioner may find that the standards
in section 38a-226c, AS AMENDED, have been met if
each utilization review company has received
approval or accreditation by a utilization review
accreditation organization, or otherwise
demonstrates to the commissioner that it adheres
to standards which are substantially similar to
the standards in said section 38a-226c, AS
AMENDED, provided such approval, accreditation or
standards [does] DO not provide less protection to
enrollees than is provided under said section
38a-226c, AS AMENDED.
Sec. 13. Section 8 of public act 97-202 is
repealed and the following is substituted in lieu
thereof:
Each viatical settlement provider and
viatical settlement broker shall disclose in
writing the following information to each viator
prior to the date all parties execute a viatical
settlement contract:
(1) The possible alternatives to, or options
that may be exercised in conjunction with, the
viatical settlement contract, including, but not
limited to, accelerated death benefits offered by
the insurer of such viator's life insurance policy
or group life insurance policy to which the
viator's certificate relates;
(2) [Some] THAT SOME or all of the proceeds
of the viatical settlement may be free from
federal income tax or from state tax, and shall
advise parties to seek assistance from a
professional tax advisor;
(3) [Receipt] THAT RECEIPT of the viatical
settlement proceeds may adversely affect the
viator's eligibility for Medicaid or other
government benefits, and advice should be obtained
from the appropriate governmental agencies or
advisors;
(4) [The] THAT THE viatical settlement
provider may assign or otherwise transfer its
interests in the viaticated policy to a third
party;
(5) [The] THAT THE viator may rescind the
viatical settlement contract within fifteen days
after the viator's receipt of the viatical
settlement proceeds; and
(6) [The fact that] THAT the viatical
settlement proceeds may be subject to the claims
of creditors.
Sec. 14. Subsection (d) of section 38a-476 of
the general statutes, as amended by section 65 of
public act 97-8 of the June 18 special session, is
repealed and the following is substituted in lieu
thereof:
(d) With respect to a newly insured individual
who was previously covered under qualifying
coverage, but who was not covered under such
qualifying coverage for a preexisting condition,
as defined under the new health insurance plan or
arrangement, such plan or arrangement shall credit
the time such [person] INDIVIDUAL was previously
covered by qualifying coverage to the exclusion
period of the preexisting condition provision,
provided the preceding coverage was continuous to
a date less than sixty-three days prior to the
effective date of the new coverage, exclusive of
any applicable waiting period under such plan,
except in the case of a newly insured group member
whose preceding coverage was terminated due to an
involuntary loss of employment, the preceding
coverage must have been continuous to a date not
more than ninety days prior to the effective date
of the new coverage, exclusive of any applicable
waiting period, provided such newly insured group
member or dependent applies for such succeeding
coverage within sixty-three days of [their] SUCH
INDIVIDUAL'S initial eligibility.
Sec. 15. Subsection (a) of section 21 of
public act 97-99 is repealed and the following is
substituted in lieu thereof:
(a) Each managed care organization shall
conform to all applicable state and federal
antidiscrimination and confidentiality statutes,
shall ensure that the confidentiality of specified
enrollee patient information and records in
[their] ITS custody is protected, and shall have
written confidentiality policies and procedures.
Sec. 16. Subsection (e) of section 38a-497a
of the general statutes, as amended by section 15
of public act 97-7 of the June 18 special session,
is repealed and the following is substituted in
lieu thereof:
(e) If a parent is required by a court or an
administrative order to provide health coverage
for a child and the parent is eligible for family
health coverage through an employer doing business
in the state, such employer shall permit such
parent to enroll such child under such coverage
without regard to any open enrolment restrictions.
If a parent is enrolled but fails to make
application to obtain coverage of a child, the
employer shall enroll such child under health care
coverage upon application by the child's other
parent or by the Commissioner of Social Services,
or his designee, when such child is eligible under
the Medicaid program or is receiving child support
enforcement services pursuant to Title IV-D of the
Social Security Act. If a noncustodial parent in a
IV-D case provides such coverage and changes
employment, and the new employer provides health
care coverage, the IV-D agency or an agency under
cooperative agreement therewith shall transfer
notice of the provision for health care coverage
to such new employer. The notice shall operate to
enroll the child in the noncustodial parent's
health care plan if that portion of the obligor's
income which is subject to withholding pursuant to
subsection (e) of section 52-362, AS AMENDED, is
sufficient to cover both the support order and
health care coverage. At the time notice is
transferred to the employer, the IV-D agency, or
an agency under cooperative agreement therewith,
shall also cause a copy of the notice of such
transfer of health care coverage to be delivered
to the obligor and to the custodial parent. The
noncustodial parent may contest such notice by
filing a motion for modification with the family
support magistrate. An employer, subject to the
provisions of this section, shall not disenroll or
eliminate coverage of any such child unless the
employer is provided satisfactory written evidence
that: (1) A court or an administrative order for
health care coverage is no longer in effect; (2)
the child is or shall be enrolled in comparable
health care coverage which shall take effect not
later than the effective date of such disenrolment
or elimination; or (3) the employer has eliminated
family health care coverage for all of its
employees.
Sec. 17. Subsection (a) of section 38a-504 of
the general statutes, as amended by section 3 of
public act 97-198, is repealed and the following
is substituted in lieu thereof:
(a) Any insurance company, hospital service
corporation, medical service corporation, health
care center or fraternal benefit society which
delivers or issues for delivery in this state
individual health insurance policies providing
coverage of the type specified in subdivisions
(1), (2), (4), [(6),] (10), (11) and (12) of
section 38a-469, shall provide coverage under such
policies for the surgical removal of tumors and
treatment of leukemia, including outpatient
chemotherapy, reconstructive surgery, cost of any
nondental prosthesis including any maxillo-facial
prosthesis used to replace anatomic structures
lost during treatment for head and neck tumors or
additional appliances essential for the support of
such prosthesis, and outpatient chemotherapy
following surgical procedure in connection with
the treatment of tumors. Such benefits shall be
subject to the same terms and conditions
applicable to all other benefits under such
policies.
Sec. 18. Subdivision (1) of section 38a-846
of the general statutes, as amended by section 6
of public act 97-125, is repealed and the
following is substituted in lieu thereof:
(1) The board of directors, upon majority
vote, shall notify the commissioner of any
information which [they] IT may have indicating
any member insurer may be insolvent or in a
financial condition hazardous to its policyholders
or the public.
Sec. 19. Subsection (a) of section 4 of public
act 97-99 is repealed and the following is
substituted in lieu thereof:
(a) On or before May 1, 1998, and annually
thereafter, each managed care organization shall
submit to the commissioner:
(1) A report on its quality assurance plan
that includes, but is not limited to, information
on complaints related to providers and quality of
care, on decisions related to patient requests for
coverage and on prior authorization statistics.
Statistical information shall be submitted in a
manner permitting comparison across plans and
shall include, but not be limited to: (A) The
ratio of the number of complaints received to the
number of enrollees; (B) a summary of the
complaints received related to providers and
delivery of care or services and the action taken
on the complaint; (C) the ratio of the number of
prior authorizations denied to the number of prior
authorizations requested; (D) the number of
managed care organization's utilization review
determinations not to certify an admission,
service, procedure or extension of stay, and the
denials upheld and reversed on appeal within the
managed care organization's utilization review
procedure; (E) the percentage of those employers
or groups that renew their contracts within the
previous twelve months; and (F) NOTWITHSTANDING
THE PROVISIONS OF THIS SUBSECTION, ON OR BEFORE
JULY 1, 1998, AND ANNUALLY THEREAFTER, all data
required by the National Committee for Quality
Assurance (NCQA) for its Health Plan Employer Data
and Information Set (HEDIS). If an organization
does not provide information for the National
Committee for Quality Assurance for its Health
Plan Employer Data and Information Set, then it
shall provide such other equivalent data as the
commissioner may require by regulations adopted in
accordance with the provisions of chapter 54 of
the general statutes. The commissioner shall find
that the requirements of this subdivision have
been met if the managed care plan has received a
one-year or higher level of accreditation by the
National Committee for Quality Assurance and has
submitted the Health Plan Employee Data
Information Set data required by subparagraph (F)
of this subdivision.
(2) A model contract that contains the
provisions currently in force in contracts between
the organization and participating providers in
this state and, upon the commissioner's request, a
copy of any individual contracts between such
parties, provided the contract may withhold or
redact proprietary fee schedule information.
(3) A written statement of the types of
financial arrangements or contractual provisions
that the managed care organization has with
hospitals, utilization review companies,
physicians and any other health care providers
including, but not limited to, compensation based
on a fee-for-service arrangement, a risk-sharing
arrangement or a capitated risk arrangement.
(4) Such information as the commissioner
deems necessary to complete the consumer report
card he is required to develop and distribute
pursuant to section 13 of [this act] PUBLIC ACT
97-99, AS AMENDED. Such information may include,
but need not be limited to: (A) The organization's
characteristics, including its model, its profit
or nonprofit status, its address and telephone
number, the length of time it has been licensed in
this and any other state, its number of enrollees
and whether it has received any national or
regional accreditation; (B) a summary of the
information required by subdivision (3) of this
section, including any change in a plan's rates
over the prior three years, its medical loss ratio
or percentage of the total premium revenues spent
on medical care compared to administrative costs
and plan marketing, how it compensates health care
providers and its premium level; (C) a description
of services, the number of primary care physicians
and specialists, and distribution and the number
of hospitals, by county; (D) utilization review
information, including the name or source of any
established medical protocols and the utilization
review standards; (E) medical management
information, including the provider-to-patient
ratio by primary care provider and speciality care
provider, the percentage of primary and speciality
care providers who are board certified, and how
the medical protocols incorporate input as
required in section 6 of [this act] PUBLIC ACT
97-99, AS AMENDED; (F) the quality assurance
information required to be submitted under the
provisions of subdivision (1) of subsection (a) of
this section; (G) the status of the organization's
compliance with the reporting requirements of this
section; (H) whether the organization markets to
individuals and Medicare recipients; (I) the
number of hospital days per thousand enrollees;
and (J) the average length of hospital stays for
specific procedures, as may be requested by the
commissioner.
(5) A summary of the procedures used by
managed care organizations to credential
providers.
Approved April 29, 1998