PA 11-19—sSB 849

Insurance and Real Estate Committee

AN ACT CONCERNING THE LEGISLATIVE COMMISSIONERS' RECOMMENDATIONS FOR TECHNICAL REVISIONS AND MINOR CHANGES TO THE INSURANCE AND RELATED STATUTES

SUMMARY: This act broadens the applicability of various health insurance benefit requirements. It also makes numerous technical changes in the insurance statutes.

EFFECTIVE DATE: January 1, 2012, except for some technical changes, which are effective July 1, 2011 or October 1, 2011.

HEALTH INSURANCE BENEFITS

The act broadens the applicability of various health insurance benefits required by law, as summarized in Table 1. By doing so, the act applies the listed benefit requirements to individual and group health insurance policies delivered, issued, renewed, amended, or continued in the state. Most of the provisions apply to (1) individual and group health insurance policies that cover (a) basic hospital expenses; (b) basic medical-surgical expenses; (c) major medical expenses; or (d) hospital or medical services, including coverage under an HMO plan and (2) individual health insurance policies that cover limited benefits. (Due to the federal Employee Retirement Income Security Act (ERISA), state insurance benefit mandates do not apply to self-insured benefit plans. )

Table 1: Applicability of Health Insurance Benefits Expanded

Act

Benefit Requirement

Existing Law Applies to Policies

Act Expands Law to Apply to Policies

33-34

Continuation of coverage of handicapped children

Delivered, Issued

Renewed, Amended, Continued

35

Coverage of newly born child – individual policies

Delivered, Issued, Renewed, Amended

Continued

36

Coverage of newly born child – group policies

Delivered, Issued, Amended

Renewed, Continued

37-38

Coverage for hypodermic needles and syringes

Delivered, Issued, Renewed

Amended, Continued

39-40

Coverage for off-label prescription drugs

Delivered, Issued, Renewed

Amended, Continued

41-44

Coverage for home health care services

Delivered, Issued, Renewed

Amended, Continued

45-46

Coverage for occupational therapy

Delivered, Issued, Renewed

Amended, Continued

47-48

Coverage for services of physician assistants and certain nurses

Delivered, Issued, Renewed

Amended, Continued

49-50

Direct access to obstetrician-gynecologist

Delivered, Issued, Renewed, Amended

Continued

51-52

Coverage for maternity care

Delivered, Issued, Renewed, Amended

Continued

53-54

Coverage for prescription contraceptives

Delivered, Issued, Renewed, Continued

Amended

55-56

Coverage for chiropractic services

Delivered, Issued, Renewed

Amended, Continued

57 and 62

Coverage for cancer clinical trials

Delivered, Issued, Renewed

Amended, Continued

BACKGROUND

Related Acts

PA 11-172 expands the existing requirement for health insurance policies to cover cancer clinical trials. It requires policies delivered, issued, renewed, amended, or continued in Connecticut to cover costs associated with clinical trials for the treatment of disabling or life-threatening chronic diseases.

PA 11-171 expands the existing requirement for health insurance policies to cover newborns. It requires policies delivered, issued, renewed, amended, or continued in Connecticut to cover newborns for 61 days, instead of 31 days, after birth.

OLR Tracking: JLKTA: CR: df