Health Insurance: in General | MidpageHealth Insurance: in General
38a-469Definitions.38a-470(Formerly Sec. 38-174n). Lien on workers' compensation awards for insurers. Notice of lien.38a-471(Formerly Sec. 38-174o). Third party prescription programs. Notice of cancellation. Applicability of section.38a-472(Formerly Sec. 38-174a). Assignment of insurance proceeds to doctor, hospital or state agency. Lien for state care. Notice of lien.38a-472aMedical provider indemnification agreements prohibited.38a-472bMedical provider indemnification contracts. Professional actions and related liability.38a-472cDental policies. Estimate of reimbursement. Material adjustments to fee schedules for in-network providers. Notice.38a-472dPublic education outreach program re health insurance availability and eligibility requirements.38a-472eHealth insurer. Requirements re offer to contract with a school-based health center.38a-472fNetwork adequacy. Health carrier duties and responsibilities. Access plan filing.38a-472gRestrictions applicable to prior authorization or precertification.38a-472hFees charged by dentists, optometrists and ophthalmologists for noncovered benefits. Notice and posting required.38a-472iPayment amount of professional services component of covered colonoscopy or endoscopic services.38a-472jRestrictions applicable to cost-sharing for covered benefits. Regulations.38a-472kDisability income policies. Discretionary clauses prohibited. Regulations.38a-472lParticipating dental provider contracts. Third-party access. Restrictions. Exceptions.38a-473Medicare supplement expense factors. Age, gender, previous claim or medical history rating prohibited.38a-474Medicare supplement policy rate increases: Procedure. Age, gender, previous claim or medical history rating prohibited.38a-475Precertification of long-term care policies under the Connecticut Partnership for Long-Term Care. Regulations.38a-475aMinimum set of affordable benefit options for long-term care policies. Regulations.38a-476Preexisting condition coverage.38a-476aCompliance with the Health Insurance Portability and Accountability Act. Guaranteed renewability. Discrimination based on health status, newborns' and mothers' health prohibited. Parity of mental health benefits. Disclosure of information for employers. Construction. Application. Regulations.38a-476bStandards re psychotropic drug availability in health plans.38a-476cPolicies and contracts with variable network and enrollee cost-sharing. Approval. Limitations.38a-477Standardized claim forms. Information necessary for filing a claim. Regulations.38a-477aNotification by Insurance Commissioner of required benefits and policy forms.38a-477bPostclaims underwriting prohibited unless approval granted. Application for approval of rescission, cancellation or limitation. Decision. Appeals. Regulations.38a-477cDisclosure of state and federal medical loss ratio with each health insurance application.38a-477dInformation to be made available to consumers. Explanations of benefits. Disclosures by health carriers. Specifications by consumers. Restrictions.38a-477eHealth carriers to maintain Internet web site and toll-free telephone number. Available information. Exception.38a-477fContract provision prohibiting certain disclosures prohibited.38a-477gContracts between health carriers and participating providers.38a-477hParticipating provider directories.38a-477iContract provisions containing all-or-nothing clauses, anti-steering clauses, anti-tiering clauses or gag clauses prohibited.38a-477j to 38a-477zConn. Gen. Stat. § 38a-477j to 38a-477z38a-477aaCost-sharing and health care provider reimbursements for emergency services, urgent crisis center services and surprise bills.38a-477bbCost-sharing re facility fees.38a-477ccContracts for pharmacy services with health carriers or pharmacy benefits managers.38a-477ddContracts with health carriers. Certain provisions concerning disclosures to covered persons prohibited.38a-477eeMental health and substance use disorder benefits. Nonquantitative treatment limitations. Reports. Public hearings. Regulations.38a-477ffThird-party discounts and payments for covered benefits. Credit required.38a-477ggContracts between health carriers and pharmacy benefits managers. Credit required for third-party discounts and payments for covered prescription drug benefits.38a-477hhDenial of coverage for otherwise covered benefits based on measurement of blood oxygen level by pulse oximeter prohibited.38a-477iiPulse oximeter accuracy. Educational materials. Distribution and posting required.38a-477jjPrescription drug formularies and lists of covered drugs. Removal or movement to higher cost-sharing tier during plan year prohibited. Exceptions. Study and report.38a-477kkProof of coverage to disclose whether coverage is fully insured or self-insured. Regulations.38a-477llCoverage for health enhancement programs.38a-477mmProhibition on reduction in amount of reimbursement paid to telehealth provider for covered health care or health services that telehealth provider appropriately provided to insured through telehealth.38a-477nnProhibition on denial of reimbursement or prevention from participating in provider network based solely on health care provider's decision not to maintain specialty certification.