HB 5205 — AN ACT CONCERNING THE CONNECTICUT LIFE AND HEALTH INSURANCE GUARANTY ASSOCIATION.

General Assembly   RaisedSubstitute Bill No.

5205 February Session, 2018   LCO*_____HB05205INS___031618____* No.AN ACT CONCERNING THE CONNECTICUT LIFE AND HEALTH INSURANCE GUARANTY ASSOCIATION.

1291   *01291_______INS* Referred to Committee on INSURANCE AND REAL ESTATE   Introduced by:

  (INS)   AN ACT CONCERNING THE CONNECTICUT LIFE AND HEALTH INSURANCE GUARANTY ASSOCIATION.

(1) To any person, except for a nonresident certificate holder under a group policy or contract, who is the beneficiary, assignee or payee, including a health care provider rendering services covered under a health insurance policy or certificate, of the person covered under subdivision (2) of this subsection, regardless of where the person resides, and (2) any person who is the owner of, or certificate holder or enrollee under, such policy or contract, other than an unallocated annuity contract or a structured settlement annuity, and in each case who (A) is a resident, or (B) is not a resident, provided (i) the member insurer that issued such policy or contract is domiciled in this state, (ii) the state in which the person resides has an association similar to the association created by this section and sections 38a-837, 38a-838, 38a-845, 38a-853, 38a-859, as amended by this act, 38a-862, as amended by this act, 38a-863, as amended by this act, 38a-865, as amended by this act, and 38a-866, as amended by this act, and (iii) the person is not eligible for coverage by an association in any other state because the insurer was not licensed in [the]the anystate otherin statewhich the person resides at the time specified in the state's guaranty association law.

[.[.] [(h) The] and (E) the limits set forth in [subsection (g) of this section] this subsection are limits on the benefits for which the association is obligated before taking into account either the association's subrogation and assignment rights or the extent to which those benefits could be provided out of the assets of the impaired or insolvent insurer that are attributable to covered policies.

(h) The] and (E) the limits set forth in [subsection (g) of this section] this subsection are limits on the benefits for which the association is obligated before taking into account either the association's subrogation and assignment rights or the extent to which those benefits could be provided out of the assets of the impaired or insolvent insurer that are attributable to covered policies.

[and the receivership court;] (I) The association's obligations with respect to coverage under any policy or contract of the impaired or insolvent insurer or under any reissued or alternative policy or contract shall cease on the date the coverage or policy or contract is replaced by another similar policy or contract by the owner, the insuredinsured, the enrollee or the association;

[and] (8) Unless otherwise prohibited by law, file for an actuarially justified rate or premium increase for any policy or contract for which the association provides coverage under sections 38a-858 to 38a-875, inclusive, provided such increase is in accordance with the terms and conditions set forth in such policy or contract;

(B) The amount of the Class B assessment for long-term care insurance written by the impaired or insolvent insurer shall be allocated according to a methodology included in suchthe insurer's plan of operation and approved by the commissioner.

(e) (1) (A) Subject to the provisions of subparagraph (B) of this subdivision, the total of all assessments authorized by the association with respect to a member insurer for each subaccount of the life insurance and annuity account and for the health insurance[insurance] account shall not in any one calendar year exceed two per cent of such insurer's average annual premiums received in this state on the policies and contracts covered by the subaccount or account during the three calendar years preceding the year in which the member insurer became an impaired or insolvent insurer.

Assets attributable to covered policies or contracts, as used in this subsection, is that proportion of the assets which the reserves that should have been established for such policies or contracts bear to the reserve that should have been established for all policies or contracts of insurance or health benefitcare planscenter subscriber contracts and certificates written by the impaired or insolvent insurer.

8 July 1, 2018, and applicable to impairments and insolvencies occurring on or after said date 38a-871 Statement of Purpose:Legislative Commissioners:

ToIn (1)Section incorporate6(b)(2)(I), revisionsafter made"policy" by"or thecontract" Nationalwas Associationinserted of Insurance Commissioners to its Life and Healthafter Insurance"the Guarantyinsured" Association"the Modelenrollee" Actwas intoinserted thefor Connecticutaccuracy. Life and Health Insurance Guaranty Association Act, and (2) make other changes to the Connecticut Life and Health Insurance Guaranty Association Act.

[ProposedINS deletionsJoint areFavorable enclosedSubst. in brackets.

Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]