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General Assembly


February Session, 2002

LCO No. 4576


Offered by:

SEN. FONFARA, 1st Dist.


File No.

Cal. No.

Strike everything after the enacting clause and substitute the following in lieu thereof:
"Section 1. Section 38a-815 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2002):
No person shall engage in this state in any trade practice which is defined in section 38a-816, as amended, as, or determined pursuant to sections 38a-817 and 38a-818 to be, an unfair method of competition or an unfair or deceptive act or practice in the business of insurance, nor shall any domestic insurance company engage outside of this state in any act or practice defined in [subsections] subdivisions (1) to (12), inclusive, of section 38a-816, as amended. The commissioner shall have power to examine the affairs of every person engaged in the business of insurance in this state in order to determine whether such person has been or is engaged in any unfair method of competition or in any unfair or deceptive act or practice prohibited by sections 38a-815 to 38a-819, inclusive, as amended. When used in said sections, (1) "person" means any individual, corporation, limited liability company, association, partnership, reciprocal exchange, interinsurer, Lloyd's insurer, fraternal benefit society and any other legal entity engaged in the business of insurance, including producers and adjusters; (2) "the business of insurance" includes, but is not limited to, the utilization review and benefit payment business of a utilization review company that (A) assumes financial risk for the payment of health insurance benefits on behalf of an insurer or health care center, and (B) is obligated to pay claims for health benefits to health care providers and claimants; (3) "utilization review" has the meaning set forth in section 38a-226; and (4) "utilization review company" has the meaning set forth in section 38a-226.
Sec. 2. (NEW) (Effective October 1, 2002) A managed care organization, as defined in section 38a-478 of the general statutes, shall remain liable for its obligations under an insurance contract or under any provision of law notwithstanding that the managed care organization contracted with a person, as defined in section 38a-1 of the general statutes, to perform or fulfill all or part of such obligations. "

This act shall take effect as follows:

Section 1

October 1, 2002

Sec. 2

October 1, 2002