Conn. Gen. Stat. § 38a-476

Current with legislation from the 2024 Regular and Special Sessions.
Section 38a-476 - Preexisting condition coverage
(a) For the purposes of this section:
(1) "Health insurance plan"

means any hospital and medical expense incurred policy, hospital or medical service plan contract and health care center subscriber contract. "Health insurance plan" does not include (A) accident only, credit, dental, vision, Medicare supplement, long-term care or disability insurance, hospital indemnity coverage, coverage issued as a supplement to liability insurance, insurance arising out of a workers' compensation or similar law, automobile medical payments insurance, or insurance under which beneficiaries are payable without regard to fault and which is statutorily required to be contained in any liability insurance policy or equivalent self-insurance, or (B) policies of specified disease or limited benefit health insurance, provided the carrier offering such policies files on or before March first of each year a certification with the Insurance Commissioner that contains the following:

(i) A statement from the carrier certifying that such policies are being offered and marketed as supplemental health insurance and not as a substitute for hospital or medical expense insurance;
(ii) a summary description of each such policy including the average annual premium rates, or range of premium rates in cases where premiums vary by age, gender or other factors, charged for such policies in the state; and
(iii) in the case of a policy that is described in this subparagraph and that is offered for the first time in this state on or after October 1, 1993, the carrier files with the commissioner the information and statement required in this subparagraph at least thirty days prior to the date such policy is issued or delivered in this state.
(2) "Insurance arrangement" means any "multiple employer welfare arrangement", as defined in Section 3 of the Employee Retirement Income Security Act of 1974, as amended from time to time, except for any such arrangement that is fully insured within the meaning of Section 514(b)(6) of said act, as amended from time to time.
(3) "Preexisting conditions provision" means a policy provision that limits or excludes benefits relating to a condition based on the fact that the condition was present before the effective date of coverage, whether or not any medical advice, diagnosis, care or treatment was recommended or received before such effective date. Genetic information shall not be treated as a condition in the absence of a diagnosis of the condition related to such information. Pregnancy shall not be considered a preexisting condition.
(4) "Applicable waiting period" means the period of time imposed by the group policyholder or contractholder before an individual is eligible for participating in the group policy or contract.
(b)
(1) No group health insurance plan or insurance arrangement shall impose a preexisting conditions provision on any individual.
(2) No individual health insurance plan or insurance arrangement shall impose a preexisting conditions provision on any individual.
(3) No insurance company, fraternal benefit society, hospital service corporation, medical service corporation or health care center shall refuse to issue an individual health insurance plan or insurance arrangement to any individual solely on the basis that such individual has a preexisting condition.

Conn. Gen. Stat. § 38a-476

( P.A. 93-345, S. 3; P.A. 96-87, S. 1 -3; 96-177, S. 5; June 18 Sp. Sess. P.A. 97-8, S. 65, 88; P.A. 98-27, S. 14; P.A. 00-121; P.A. 02-24, S. 5; P.A. 07-113, S. 3; P.A. 08-110, S. 2; P.A. 11-58, S. 41; P.A. 14-122, S. 49; P.A. 15-247, S. 8; P.A. 17-15, S. 41.)

Amended by P.A. 19-0134,S. 1 of the Connecticut Acts of the 2019 Regular Session, eff. 1/1/2020.
Amended by P.A. 17-0015, S. 41 of the Connecticut Acts of the 2017 Regular Session, eff. 10/1/2017.
Amended by P.A. 15-0247, S. 8 of the Connecticut Acts of the 2015 Regular Session, eff. 7/10/2015.
Amended by P.A. 14-0122, S. 49 of the Connecticut Acts of the 2014 Regular Session, eff. 10/1/2014.
Amended by P.A. 11-0058, S. 41 of the the 2011 Regular Session, eff. 7/1/2011.