Substitute House Bill No. 5621
Substitute House Bill No. 5621
PUBLIC ACT NO. 98-122
AN ACT CONCERNING HEALTH INSURANCE FOR INDIVIDUAL
BUSINESS OWNERS.
Be it enacted by the Senate and House of
Representatives in General Assembly convened:
Section 38a-566 of the general statutes is
repealed and the following is substituted in lieu
thereof:
(a) Any individual or group health insurance
plan or any insurance arrangement shall be subject
to the provisions of sections 12-201, AS AMENDED,
12-211, 12-212a and 38a-564 to 38a-572, inclusive,
if it provides health insurance or is an insurance
arrangement covering one or more employees of a
small employer and if any one of the following
conditions are met:
(1) Any portion of the premium or benefits is
paid by a small employer or any covered individual
is reimbursed, whether through wage adjustments or
otherwise, by a small employer for any portion of
the premium; or
(2) The health insurance plan or arrangement
is treated by the employer or any of the covered
individuals as part of a plan or program for the
purposes of Section 162 or Section 106 of the
United States Internal Revenue Code.
(b) Nothing in this section shall be
[interpreted] CONSTRUED to apply the provisions of
sections 12-202 and 12-212a to health care
centers.
(c) Notwithstanding the provisions of
subsection (a) of this section, health insurance
plans or insurance arrangements issued to or in
accordance with a trust established pursuant to
collective bargaining, subject to the federal
Labor Management Relations Act and which cover, in
the aggregate, more than twenty-five employees of
all participating employers, shall not be subject
to the provisions of section 38a-567 or
subparagraph (A) of subdivision (2) of subsection
(e) of section 38a-569 and insurers or insurance
arrangements issuing only such plans shall not be
considered small employer carriers for purposes of
sections 38a-565 and 38a-568.
(d) A small employer carrier which ceases
marketing to small employers as provided in
subdivision (6) of subsection (b) of section
38a-565 may not cease enrolling new employers in a
policy issued to provide coverage to the members
of a trade association or to a trust on behalf of
a trade association if the following conditions
exist:
(1) Such trade association is a
not-for-profit trade association qualified under
26 USC Section 501c(6), was not formed solely for
the purpose of providing insurance and has been
operating continuously for at least twenty-five
years.
(2) The policy issued to or on behalf of such
association was in existence prior to June 1,
1990, and has annual premiums of less than
twenty-five million dollars.
(3) Such policy is offered on a guaranteed
issue basis to all small employer members and only
to members of such trade association.
(e) SUBSECTION (a) OF THIS SECTION SHALL NOT
APPLY TO AN INDIVIDUAL HEALTH INSURANCE PLAN
ISSUED TO A SELF-EMPLOYED INDIVIDUAL IF THE
CARRIER DISCLOSES ON THE APPLICATION AND MARKETING
MATERIALS, IN NOT LESS THAN TEN-POINT TYPE, THE
FOLLOWING NOTICE: "THIS PLAN IS ISSUED ON AN
INDIVIDUAL BASIS AND IS REGULATED AS AN INDIVIDUAL
HEALTH INSURANCE PLAN."
Approved May 27, 1998