Sec. 38a-566. Health insurance plans or insurance arrangements covering employees of a small employer. Trusts. Trade associations. Self-employed individuals.
Sec. 38a-566. Health insurance plans or insurance arrangements covering employees of a small employer. Trusts. Trade associations. Self-employed individuals.
(a) Any individual or group health insurance plan or any insurance arrangement shall
be subject to the provisions of sections 12-201, 12-211, 12-212a and 38a-564 to 38a-572, inclusive, if it provides health insurance or is an insurance arrangement covering
one or more employees of a small employer and if any one of the following conditions
are met:
(1) Any portion of the premium or benefits is paid by a small employer or any
covered individual is reimbursed, whether through wage adjustments or otherwise, by
a small employer for any portion of the premium; or
(2) The health insurance plan or arrangement is treated by the employer or any of
the covered individuals as part of a plan or program for the purposes of Section 162 or
Section 106 of the United States Internal Revenue Code.
(b) Nothing in this section shall be construed to apply the provisions of sections
12-202 and 12-212a to health care centers.
(c) Notwithstanding the provisions of subsection (a) of this section, health insurance
plans or insurance arrangements issued to or in accordance with a trust established
pursuant to collective bargaining, subject to the federal Labor Management Relations
Act and which cover, in the aggregate, more than twenty-five employees of all participating employers, shall not be subject to the provisions of section 38a-567 or subparagraph
(A) of subdivision (2) of subsection (e) of section 38a-569 and insurers or insurance
arrangements issuing only such plans shall not be considered small employer carriers
for purposes of sections 38a-565 and 38a-568.
(d) A small employer carrier that ceases marketing to small employers as provided
in subsection (d) of section 38a-568 shall not cease enrolling new employers in a policy
issued to provide coverage to the members of a trade association or to a trust on behalf
of a trade association if the following conditions exist:
(1) Such trade association is a not-for-profit trade association qualified under 26
USC Section 501c(6), was not formed solely for the purpose of providing insurance and
has been operating continuously for at least twenty-five years.
(2) The policy issued to or on behalf of such association was in existence prior to
June 1, 1990, and has annual premiums of less than twenty-five million dollars.
(3) Such policy is offered on a guaranteed issue basis to all small employer members
and only to members of such trade association.
(e) Subsection (a) of this section shall not apply to an individual health insurance
plan issued to a self-employed individual if the carrier discloses on the application and
marketing materials, in not less than ten-point type, the following notice: "THIS PLAN
IS ISSUED ON AN INDIVIDUAL BASIS AND IS REGULATED AS AN INDIVIDUAL HEALTH INSURANCE PLAN."
(P.A. 90-134, S. 17, 28; P.A. 91-201, S. 3, 8; P.A. 92-125, S. 2, 5; P.A. 98-122; P.A. 08-33, S. 4.)
History: P.A. 91-201 added Subsec. (c) to account for Taft-Hartley trust plans; P.A. 92-125 added Subsec. (d) concerning
coverage to members of trade associations and trusts on behalf of a trade association; P.A. 98-122 substituted "construed"
for "interpreted" in Subsec. (b) and added new Subsec. (e) re self-employed individuals; P.A. 08-33 made technical changes
and changed "may" to "shall" in Subsec. (d), effective May 7, 2008.