Substitute House Bill No. 5378 seeks to amend existing laws governing self-funded multiple employer welfare arrangements (MEWAs) in Connecticut and mandates a feasibility study for the establishment of the Connecticut Option Program aimed at reducing health insurance premiums. The bill repeals Section 38a-1 of the general statutes and introduces new definitions, including "health benefit plan," "self-funded multiple employer welfare arrangement," and "participating employer," while clarifying that "health benefit plan" does not encompass insurance products. It also outlines the licensing requirements for self-funded MEWA trusts, which must maintain a minimum initial capital and surplus, comply with essential health benefits as defined by the Affordable Care Act, and adhere to operational guidelines, including actuarially sound rating methodologies.

Additionally, the bill establishes a Division of Consumer Affairs within the Insurance Department to handle complaints related to health benefit plans and mandates the Office of Policy and Management to conduct a feasibility study for the Connecticut Option Program, with reports due in 2027 and 2028. The bill includes provisions that prohibit discriminatory practices based on health status, ensures that health benefit plans are renewable for eligible employees, and clarifies the roles of various entities involved in the insurance process. The effective date for the majority of the bill's provisions is set for January 1, 2027, while some provisions will take effect immediately upon passage.

Statutes affected:
Raised Bill:
INS Joint Favorable Substitute:
File No. 246: