Raised Bill No. 5247 is an act concerning employee health benefit consortiums, which introduces new regulations for self-funded multiple employer welfare arrangement (MEWA) trusts in Connecticut. The bill amends Section 38a-1 of the general statutes to include definitions for terms such as "actuarial value," "employer member," and "self-funded multiple employer welfare arrangement trust," among others, to clarify the language used in the regulation of health benefit plans provided by these trusts. It also redefines "insurance" and "insurer" to include entities doing insurance business, with the exception of fraternal benefit societies, and expands the definition of "insured." The bill specifies that from October 1, 2024, only licensed self-funded MEWA trusts can operate in the state, and from April 1, 2025, these trusts may offer health benefit plans to participating employees of one or more participating employers, with requirements to cover essential health benefits, avoid preexisting condition exclusions, and use actuarially sound pricing.

Additionally, the bill outlines the governance of these trusts, including the establishment of a board of trustees, financial and solvency requirements, and the purchase of insurance policies. Participating employers are liable for their share of liabilities, and the trusts are exempt from certain state fees and taxes. The bill also amends Section 38a-567 to modify rules for small employer health insurance plans, mandating guaranteed issue and renewability, and setting premium rate standards. It prohibits discriminatory practices by carriers or producers and requires third parties to comply with these provisions. The bill expands the Division of Consumer Affairs' responsibilities to include health benefit plans, updates the definition of "company" for examinations, and allows the commissioner to accept examination reports from other states. It also specifies the confidentiality of examination materials, expands the scope of market conduct examinations to include MEWAs, and ensures the commissioner can share examination results with regulatory and law enforcement officials. The bill includes insertions of new legal language and definitions, as well as deletions of certain terms, with most sections effective October 1, 2024, and one section effective April 1, 2025.

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