Sec. 38a-557. (Formerly Sec. 38-377). Hospital and medical service corporations. Residual market mechanism. Insurance Commissioner's powers concerning such mechanisms.
Sec. 38a-557. (Formerly Sec. 38-377). Hospital and medical service corporations. Residual market mechanism. Insurance Commissioner's powers concerning
such mechanisms. (a) Hospital and medical service corporations may elect to meet the
obligations of section 38a-552 by participating in the Health Reinsurance Association
established in section 38a-556, as a full member thereof, or by making comprehensive
health care plans available directly through a subscriber contract or combination of
contracts or by forming a separate residual market mechanism substantially similar to
the association established in section 38a-556.
(b) In the event that hospital and medical service corporations choose to form a
separate residual market mechanism, the commissioner shall have the same regulatory
powers over that residual market mechanism as he has over the Health Reinsurance
Association, and such residual market mechanism shall have the same powers and duties
as the association. Rating classifications under a residual market mechanism established
under this section need not be the same as classifications established under the association, but any rates established by the residual market mechanism shall be approved
by the commissioner. The commissioner shall promulgate regulations to carry out the
requirements of this section.
(c) If the hospital and medical service corporations do not elect to participate in the
Health Reinsurance Association, such hospital and medical service corporations shall
be required to make an individual comprehensive health care plan available to every
resident of this state except residents who are both sixty-five years of age or older and
eligible for Medicare and whose coverage under a group or individual contract issued
by such hospital or medical service corporation has terminated. Such coverage may be
made available through a separate residual market mechanism established under this
section.
(P.A. 75-616, S. 7, 12; P.A. 76-435, S. 23, 82; P.A. 86-106, S. 5.)
History: P.A. 76-435 included reference to terminated individual contracts issued by hospital or medical service corporation in Subsec. (c); P.A. 86-106 limited in Subsec. (c) the exemption from the required availability of individual comprehensive health care plans to those residents of this state who are at least 65 years of age and eligible for Medicare; Sec. 38-377 transferred to Sec. 38a-557 in 1991.