PA 10-127—sHB 5113

Select Committee on Aging

Insurance and Real Estate Committee

AN ACT CONCERNING BILLING FOR SERVICES COVERED BY LONG-TERM CARE INSURANCE BY MANAGED RESIDENTIAL COMMUNITIES

SUMMARY: This act requires a managed residential community (MRC) to help a resident, at his or her request, prepare and submit claims on a long-term care insurance policy. The resident must direct the insurer in writing to provide to the MRC (1) information about the resident's eligibility for insurance benefits and payments and (2) a copy of the insurer's decision on a benefit claim when it informs the resident of its decision. The act exempts this kind of assistance from the prohibition against MRCs controlling or managing residents' financial affairs.

The act prohibits insurers and other entities that deliver, issue for delivery, renew, continue, or amend individual or group long-term care policies in Connecticut from refusing to accept or reimburse claims prepared or submitted by an MRC solely because of the MRC's assistance. And it requires them to give the MRC the information a resident directs them to provide and a copy of any claims decision.

EFFECTIVE DATE: July 1, 2010

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