§ 38a-512c — Annual and lifetime limits.

(a) No group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, amended, renewed or continued in this state shall include an annual or lifetime limit on the dollar value of benefits for a covered individual, for covered benefits that are essential health benefits, as defined in (1) the Patient Protection and Affordable Care Act, P.L. 111-148, as amended from time to time, or regulations adopted thereunder, or (2) section 38a-518q, or regulations adopted thereunder. (b) This section shall not prohibit the inclusion of a lifetime limit on specific covered benefits that are not essential health benefits, provided the lifetime limit for reasonable charges or, when applicable, the allowance agreed upon by a health care provider and an insurer, health care center, hospital service corporation, medical service corporation or fraternal benefit society for charges actually incurred for any specific covered benefit, shall be not less than one million dollars per covered individual. See Sec. 38a-482c for similar provisions re individual policies.

Legislative History

(P.A. 11-58, S. 43; P.A. 17-15, S. 59; P.A. 18-10, S. 10.) History: P.A. 11-58 effective July 2, 2011; P.A. 17-15 made a technical change in Subsec. (a); P.A. 18-10 amended Subsec. (a) by designating existing provisions re Affordable Care Act as Subdiv. (1), and adding Subdiv. (2) re Sec. 38a-518q and regulations adopted thereunder, effective January 1, 2019.