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Section 38a-566 - Health insurance plans or insurance arrangements covering employees of a small employer. Trusts. Trade associations.

CT Gen Stat § 38a-566 (2019) (N/A)
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(a) Any individual or group health insurance plan or any insurance arrangement shall be subject to the provisions of sections 38a-552, 38a-564, 38a-567 and 38a-569, 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 (c) of section 38a-569.

(d) A small employer carrier that ceases marketing to small employers 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.

(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; P.A. 15-247, S. 18.)

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; P.A. 15-247 amended Subsec. (a) by replacing “12-201, 12-211, 12-212a and 38a-564 to 38a-572, inclusive” with “38a-552, 38a-564, 38a-567 and 38a-569”, amended Subsec. (c) by deleting provision re exclusion of insurers and insurance arrangements issuing plans to or in accordance with trust from consideration as small employer carriers and making a technical change, made technical changes in Subsec. (d), and deleted former Subsec. (e) re application of section to health insurance plan issued to self-employed individual, effective July 10, 2015.

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Section 38a-566 - Health insurance plans or insurance arrangements covering employees of a small employer. Trusts. Trade associations.