Sec. 38a-476c. Policies and contracts with variable network and enrollee cost-sharing. Approval. Limitations.
Sec. 38a-476c. Policies and contracts with variable network and enrollee cost-sharing. Approval. Limitations. (a) The Insurance Commissioner shall approve any
health insurance policy or contract, including, but not limited to, a policy or contract
filed by a health care center, that uses variable networks and enrollee cost-sharing as
set forth in subsection (b) of this section if (1) the policy or contract meets the requirements of this title, (2) the policy or contract form or amendment thereto filed with the
commissioner is accompanied by a rate filing for the policy or contract and (3) the
commissioner finds that the rate filing reflects a reasonable reduction in premiums or
fees as compared to policies or contracts that do not use such variable networks and
enrollee cost-sharing.
(b) Such policies and contracts shall be limited to policies and contracts that: (1)
Offer choices among provider networks of different size; (2) offer different deductibles
depending on the type of health care facility used; or (3) offer prescription drug benefits
that use any combination of deductibles, coinsurance not to exceed thirty per cent or
copayments, including combinations of such deductibles, coinsurance or copayments
at different benefit levels.
(P.A. 05-238, S. 7.)