SB 1005 — AN ACT CONCERNING REQUIRED HEALTH INSURANCE COVERAGE FOR NEWBORN CHILDREN.

Senate General Assembly RaisedFile Bill No.

1005324 January Session, 2021 LCOSubstitute Senate Bill No.

37121005 ReferredSenate, toApril 7, 2021 The Committee on INSURANCEInsurance ANDand REALReal ESTATEEstate Introducedreported by:through SEN.

(INS)LESSER ANof ACTthe REQUIRING9th CERTAINDist., HEALTHChairperson INSURERSof TOthe AUTOMATICALLYCommittee PROVIDEon HEALTHthe INSURANCEpart COVERAGEof FORthe CERTAINSenate, NEWBORNS.that the substitute bill ought to pass.

AN ACT CONCERNING REQUIRED HEALTH INSURANCE COVERAGE FOR NEWBORN CHILDREN.

Section 38a-138a-490 of the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2022):

Termsused(a) inthistitleEach andsection2ofthisact,unlessitindividual appearsfromhealth insurance policy delivered, issued for delivery, renewed, amended or continued in this state providing coverage of the contexttype specified in subdivisions (1), (2), (4), (6), (10), (11) and (12) of section 38a-469 for a family member of the insured or subscriber shall, as to such family member's coverage, also provide that the contrary,health insurance benefits applicable for children shall havebe payable with respect to a scopenewly andborn meaningchild asof setthe forthinsured inor thissubscriber section.from the moment of birth.

(1)(b) "Affiliate"Coverage orfor "affiliated"such meansnewly aborn personchild thatshall directly,consist orof indirectlycoverage throughfor oneinjury orand moresickness intermediaries,including controls,necessary iscare controlledand bytreatment orof ismedically underdiagnosed commoncongenital controldefects withand anotherbirth person.abnormalities within the limits sSB1005 / File No.

(2)324 "Alien1 insurer"sSB1005 meansFile anyNo. insurer that has been chartered by or organized or constituted within or under the laws of any jurisdiction or country without the United States.

(3)324 "Annuities"of meansthe allpolicy. agreements to make periodical payments LCO No.

3712(c) 1If payment of 5a Raisedspecific Billpremium No.1005or wheresubscription fee is required to provide coverage for a child, the makingpolicy or continuancecontract may require that notification of allbirth orof somesuch newly born child and payment of the seriesrequired ofpremium or fees shall be furnished to the payments,insurer, hospital service corporation, medical service corporation or health care center not later than [sixty-one] one hundred twenty-one days after the amountdate of birth or the payment,date isof dependentdischarge uponfrom the continuancehospital, ofwhichever humanis lifelater, in order to continue coverage beyond such [sixty-one-day] period, provided failure to furnish such notice or ispay forsuch apremium specifiedor termfees ofshall years.not prejudice any claim originating within such [sixty-one-day] period.

This definition does not apply to payments made under a policy of life insurance.

(4) "Commissioner" means the Insurance Commissioner.

(5) "Control", "controlled by" or "under common control with" means the possession, direct or indirect, of the power to direct or cause the direction of the management and policies of a person, whether through the ownership of voting securities, by contract other than a commercial contract for goods or nonmanagement services, or otherwise, unless the power is the result of an official position with the person.

(6) "Domestic insurer" means any insurer that has been chartered by, incorporated, organized or constituted within or under the laws of this state.

(7) "Domestic surplus lines insurer" means any domestic insurer that has been authorized by the commissioner to write surplus lines insurance.

(8) "Foreign country" means any jurisdiction not in any state, district or territory of the United States.

(9) "Foreign insurer" means any insurer that has been chartered by or organized or constituted within or under the laws of another state or a territory of the United States.

(10) "Insolvency" or "insolvent" means, for any insurer, that it is unable to pay its obligations when they are due, or when its admitted assets do not exceed its liabilities plus the greater of:

(A) Capital and surplus required by law for its organization and continued operation;

or (B) the total par or stated value of its authorized and issued capital stock.

For purposes of this subdivision "liabilities" shall include but not be limited to reserves required by statute or by regulations adopted by LCO No.

3712 2 of 5 Raised Bill No.1005 the commissioner in accordance with the provisions of chapter 54 or specific requirements imposed by the commissioner upon a subject company at the time of admission or subsequent thereto.

(11) "Insurance" means any agreement to pay a sum of money, provide services or any other thing of value on the happening of a particular event or contingency or to provide indemnity for loss in respect to a specified subject by specified perils in return for a consideration.

In any contract of insurance, an insured shall have an interest which is subject to a risk of loss through destruction or impairment of that interest, which risk is assumed by the insurer and such assumption shall be part of a general scheme to distribute losses among a large group of persons bearing similar risks in return for a ratable contribution or other consideration.

(12) "Insurer" or "insurance company" includes any person or combination of persons doing any kind or form of insurance business other than a fraternal benefit society, and shall include a receiver of any insurer when the context reasonably permits.

(13) "Insured" means a person to whom or for whose benefit an insurer makes a promise in an insurance policy.

The term includes policyholders, subscribers, members and beneficiaries.

This definition applies only to the provisions of this title and does not define the meaning of this word as used in insurance policies or certificates.

(14) "Life insurance" means insurance on human lives and insurances pertaining to or connected with human life.

The business of life insurance includes granting endowment benefits, granting additional benefits in the event of death by accident or accidental means, granting additional benefits in the event of the total and permanent disability of the insured, and providing optional methods of settlement of proceeds.

Life insurance includes burial contracts to the extent provided by section 38a-464.

(15) "Mutual insurer" means any insurer without capital stock, the managing directors or officers of which are elected by its members.

LCO No.

3712 3 of 5 Raised Bill No.1005 (16) "Person" means an individual, a corporation, a partnership, a limited liability company, an association, a joint stock company, a business trust, an unincorporated organization or other legal entity.

(17) "Policy" means any document, including attached endorsements and riders, purporting to be an enforceable contract, which memorializes in writing some or all of the terms of an insurance contract.

(18) "State" means any state, district, or territory of the United States.

(19) "Subsidiary" of a specified person means an affiliate controlled by thepersondirectly,or indirectly throughoneor more intermediaries.

(20) "Unauthorized insurer" or "nonadmitted insurer" means an insurer that has not been granted a certificate of authority by the commissioner to transact the business of insurance in this state or an insurer transacting business not authorized by a valid certificate.

(21) "United States" means the United States of America, its territories and possessions, the Commonwealth of Puerto Rico and the District of Columbia.