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statutes  is  repealed  and   the   following   is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the general statutes is repealed and the following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statutes  is  repealed  and   the   following   is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