Sec. 17b-295. Cost-sharing requirements under HUSKY Plan, Part B.
Sec. 17b-295. Cost-sharing requirements under HUSKY Plan, Part B. (a) The
commissioner shall impose cost-sharing requirements, including the payment of a premium or copayment, in connection with services provided under the HUSKY Plan,
Part B, to the extent permitted by federal law, and in accordance with the following
limitations:
(1) The commissioner may increase the maximum annual aggregate cost-sharing
requirements, provided such cost-sharing requirements shall not exceed five per cent
of the family's gross annual income. The commissioner may impose a premium requirement on families whose income exceeds two hundred thirty-five per cent of the federal
poverty level as a component of the family's cost-sharing responsibility, provided: (A)
The family's annual combined premiums and copayments do not exceed the maximum
annual aggregate cost-sharing requirement, and (B) premium requirements shall not
exceed the sum of thirty dollars per month per child, with a maximum premium of fifty
dollars per month per family. The commissioner shall not impose a premium requirement
on families whose income exceeds one hundred eighty-five per cent of the federal poverty level but does not exceed two hundred thirty-five per cent of the federal poverty
level; and
(2) The commissioner shall require each managed care plan to monitor copayments
and premiums under the provisions of subdivision (1) of this subsection.
(b) (1) Except as provided in subdivision (2) of this subsection, the commissioner
may impose limitations on the amount, duration and scope of benefits under the HUSKY
Plan, Part B.
(2) The limitations adopted by the commissioner pursuant to subdivision (1) of this
subsection shall not preclude coverage of any item of durable medical equipment or
service that is medically necessary.
(October 29 Sp. Sess. P.A. 97-1, S. 7, 23; P.A. 98-8, S. 2, 5; June 30 Sp. Sess. P.A. 03-3, S. 55; P.A. 05-280, S. 7; Nov.
2 Sp. Sess. P.A. 05-1, S. 1; P.A. 06-196, S. 135; P.A. 07-185, S. 7; June Sp. Sess. P.A. 07-2, S. 44.)
History: Oct. 29 Sp. Sess. P.A. 97-1 effective October 30, 1997; P.A. 98-8 amended Subsec. (a)(3) to require each
managed care plan, rather than its health care providers, to monitor copayments and premiums, effective April 7, 1998;
June 30 Sp. Sess. P.A. 03-3 amended Subsec. (a) to require commissioner to impose cost-sharing requirements in connection
with services provided under the HUSKY Plan, Part B to the extent permitted by federal law, to delete "may require" re
payment of premiums and copayments, to delete former Subdivs. (1) and (2) re maximum annual cost-sharing for families
and add new Subdiv. (1) providing that on and after October 1, 2003, commissioner may increase maximum annual cost-sharing for families in an amount not to exceed 5% of the family's gross annual income, and authorizing commissioner
to impose a premium on families with income exceeding 185% of the federal poverty level as a component of the family's
cost-sharing responsibility provided family's combined premiums and copayments do not exceed the maximum annual
cost-sharing requirement, and to redesignate former Subdiv. (3) redesignated as Subdiv. (2); P.A. 05-280 amended Subsec.
(a)(1) by substituting July 1, 2005, for October 1, 2003, and changing "may" to "shall" re commissioner increasing maximum
annual cost-sharing requirements, by requiring the commissioner to impose a premium requirement that does not exceed
the maximum annual aggregate cost-sharing requirement on families whose income exceeds 185% of the federal poverty
level but does not exceed 235% of the federal poverty level and by increasing the premium requirement on families whose
income exceeds 235% of the federal poverty level but does not exceed 300% of the federal poverty level, effective July
1, 2005; Nov. 2 Sp. Sess. P.A. 05-1 amended Subsec. (a)(1) by changing "shall" to "may" re commissioner's authority to
increase maximum annual cost-sharing requirements, by providing that commissioner shall not impose premium requirements on families whose income exceeds 185% but does not exceed 235% of federal poverty level, by removing provision
that required commissioner to increase premium requirements on families whose income exceeds 235% but does not
exceed 300% of federal poverty level, and by providing that commissioner may impose premium requirements on families
whose income exceeds 235% of federal poverty level, not exceeding $30 per month per child, with a maximum of $50 per
month per family, effective November 3, 2005; P.A. 06-196 made technical changes in Subsec. (a), effective June 7, 2006;
P.A. 07-185 amended Subsec. (a)(1) by deleting "On and after July 1, 2005, the", by specifying that Subpara. (B) applies
to "a family with income that exceeds two hundred thirty-five per cent of the federal poverty level but does not exceed
three hundred per cent of the federal poverty level" and by adding new Subpara. (C) specifying that "premium requirements
for a family with income that exceeds three hundred per cent of the federal poverty level but does not exceed four hundred
per cent of the federal poverty level who does not have any access to employer-sponsored health insurance coverage shall
not exceed the sum of fifty dollars per child, with a maximum premium of seventy-five dollars per month", effective July
1, 2007; June Sp. Sess. P.A. 07-2 deleted new language in Subsec. (a)(1)(B) and new Subsec. (a)(1)(C) added by P.A. 07-185, effective July 1, 2007.