OLR Bill Analysis

sHB 5011

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

SUMMARY:

This bill expands the circumstances under which certain health insurance mandates apply. It also corrects statutory references and makes other minor and technical changes to the insurance laws.

EFFECTIVE DATE: Upon passage, except the mandate changes take effect January 1, 2013.

HEALTH INSURANCE MANDATES

By law, insurance companies, fraternal benefit societies, hospital service corporations, medical service corporations, and Health Care Centers (i. e. , HMOs) that issue or continue a Medicare supplement policy must file a request for approval with the Insurance Department at least 60 days before changing their rates. The bill extends this requirement to amended policies. By law, the department must hold a hearing and has 45 days from receiving the request to approve or deny it.

Under current law, requirements that health insurers offer specified benefits apply to new and renewed policies and, in most cases, to policies amended or continued on or after the mandate's effective date. As described in Table 1, the bill requires coverage of amended or continued policies in those cases where this is not currently required. The mandates apply to individual and group policies.

Table 1: Expansion of Applicability of Health Benefit Mandates

Benefit

Expansion

Amino acid modified and low protein modified food products when prescribed for the treatment of inherited metabolic diseases

Amended or continued policies

Medically necessary specialized formula

Amended or continued policies

Prescription drugs removed from formulary

Amended policies

Medically necessary ambulance services

Continued policies

The bill also specifies that the mandate regarding amino acid modified and low protein modified food products does not apply to accident-only policies.

COMMITTEE ACTION

Insurance and Real Estate Committee

Joint Favorable Substitute

Yea

20

Nay

0

(02/21/2012)