Sec. 38a-582. (Formerly Sec. 38-174nn). Schedule of charges. Approval by commissioner. Appeal of disapproval.
Sec. 38a-582. (Formerly Sec. 38-174nn). Schedule of charges. Approval by
commissioner. Appeal of disapproval. (a) No schedule of charges for enrollee coverage for dental services, or any amendment thereto, may be used by a dental plan organization until a copy of such schedule or amendment has been filed with the commissioner
for his approval. The commissioner may disapprove the schedule of charges at any time
if he finds that the charges are excessive, inadequate or unfairly discriminatory. If the
commissioner disapproves the schedule of charges, he shall notify the dental plan organization within sixty days of the date of disapproval and specify in the notice the reason
for his disapproval. A hearing shall be granted within twenty days after a request in
writing by the dental plan organization. It shall be unlawful for any dental plan organization whose schedule of charges has been disapproved to effect any contract or issue any
subscription certificate which uses the disapproved schedule of charges until a revised
schedule of charges has been approved. Any dental plan organization aggrieved by the
action of the commissioner pursuant to this section may appeal therefrom, in accordance
with the provisions of section 4-183.
(b) Charges shall be established in accordance with actuarial principles, but charges
applicable to an enrollee shall not be individually determined based on the status of his
health.
(P.A. 88-272, S. 6.)
History: Sec. 38-174nn transferred to Sec. 38a-582 in 1991.