Sec. 38a-473. Medicare supplement expense factors. Age, gender, previous claim or medical history rating prohibited. Exceptions.
Sec. 38a-473. Medicare supplement expense factors. Age, gender, previous
claim or medical history rating prohibited. Exceptions. (a) No insurance company,
fraternal benefit society, hospital service corporation, medical service corporation,
health care center or other entity which delivers or issues for delivery Medicare supplement insurance policies or certificates, written, delivered, continued or renewed in this
state during the previous calendar year shall incorporate in its rates for Medicare supplement insurance calculated in accordance with sections 38a-495, 38a-495a and 38a-522,
and any regulations adopted pursuant to said sections, factors for expenses which exceed
one hundred fifty per cent of the average expense ratio for the entire written premium
for all lines of health insurance of such company, society, corporation, center or other
entity for the previous calendar year.
(b) No insurance company, fraternal benefit society, hospital service corporation,
medical service corporation, health care center or other entity which delivers or issues for
delivery in this state any Medicare supplement policies or certificates shall incorporate in
its rates or determinations to grant coverage for Medicare supplement insurance policies
or certificates any factors or values based on the age, gender, previous claims history
or the medical condition of any person covered by such policy or certificate, except for
plans "H" to "J", inclusive, as provided in section 38a-495b. In plans "H" to "J", inclusive, previous claims history and the medical condition of the applicant may be used in
determinations to grant coverage under Medicare supplement policies and certificates
issued prior to January 1, 2006.
(P.A. 90-243, S. 179, 181; P.A. 91-406, S. 9, 29; P.A. 92-60, S. 20; P.A. 93-239, S. 4; 93-390, S. 3, 8; May 25 Sp. Sess.
P.A. 94-1, S. 39, 130; P.A. 05-20, S. 1.)
History: P.A. 91-406 corrected an internal reference; P.A. 92-60 made provisions applicable to any Medicare supplement
policy continued or renewed during the previous calendar year, made provisions applicable to all lines of health insurance
and made technical corrections for statutory consistency; P.A. 93-239 made technical corrections for statutory consistency
and accuracy; P.A. 93-390 made technical changes for statutory consistency by adding references to "any other entity"
and "certificate" and added Subsec. (b) prohibiting the incorporation of factors for age, gender and previous claim or
medical condition history, into the insurer's rate schedule, effective January 1, 1994; May 25 Sp. Sess. P.A. 94-1 amended
Subsec. (a) by making technical change, effective July 1, 1994; P.A. 05-20 made technical changes and amended Subsec.
(b) to reference "determinations to grant coverage" and plans "H" to "J", inclusive, "issued prior to January 1, 2006" re
use of claims history and medical condition, effective July 1, 2005.