Connecticut Seal

General Assembly



February Session, 2014

LCO No. 3426



Offered by:


SEN. KELLY, 21st Dist.


To: Subst. Senate Bill No. 11

File No. 8

Cal. No. 44


In line 186, after "exchange" insert the following:

", provided the exchange has, prior to beginning any such negotiations, adopted written procedures pursuant to section 38a-1082, as amended by this act, that establish standards for premium rates"

After the last section, add the following and renumber sections and internal references accordingly:

"Sec. 501. Section 38a-1082 of the 2014 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):

(a) The board of directors of the exchange shall adopt written procedures, in accordance with the provisions of section 1-121, for: (1) Adopting an annual budget and plan of operations, including a requirement of board approval before the budget or plan may take effect; (2) hiring, dismissing, promoting and compensating employees of the exchange, including an affirmative action policy and a requirement of board approval before a position may be created or a vacancy filled; (3) acquiring real and personal property and personal services, including a requirement of board approval for any nonbudgeted expenditure in excess of five thousand dollars; (4) contracting for financial, legal, bond underwriting and other professional services, including a requirement that the exchange solicit proposals at least once every three years for each such service that it uses; (5) issuing and retiring bonds, bond anticipation notes and other obligations of the authority; (6) establishing requirements for certification of qualified health plans that include, but are not limited to, minimum standards for marketing practices, network adequacy, essential community providers in underserved areas, accreditation, quality improvement, uniform enrollment forms and descriptions of coverage, and quality measures for health benefit plan performance; (7) prescribing standards to ensure that premium rates for qualified health plans shall not be excessive, inadequate or unfairly discriminatory; (8) implementing the provisions of sections 38a-1080 to 38a-1090, inclusive, or other provisions of the general statutes. Any such written procedures adopted pursuant to this subdivision shall not conflict with or prevent the application of regulations promulgated by the Secretary under the Affordable Care Act; [(8)] (9) implementing and administering the all-payer claims database program established pursuant to section 38a-1091. Any such written procedures adopted pursuant to this subdivision shall include reporting requirements for reporting entities, as defined in section 38a-1091; and [(9)] (10) providing notice to a reporting entity, as defined in section 38a-1091, of, and the rules of practice for a hearing process for, such reporting entity's alleged failure to comply with reporting requirements.

(b) The board of directors of the exchange shall submit to the joint standing committee of the General Assembly having cognizance of matters relating to insurance a copy of each audit of the exchange conducted by an independent auditing firm, not later than seven days after the audit is received by said board of directors. "

This act shall take effect as follows and shall amend the following sections:

Sec. 501

from passage