Insurance and Real Estate Committee
JOINT FAVORABLE REPORT
Bill No.: HB-5013
Title: AN ACT CONCERNING MANDATED HEALTH INSURANCE BENEFIT REVIEW.
Vote Date: 3/22/2021
Vote Action: Joint Favorable
PH Date: 2/9/2021
File No.:
Disclaimer: The following JOINT FAVORABLE Report is prepared for the benefit of the
members of the General Assembly, solely for purposes of information, summarization and
explanation and does not represent the intent of the General Assembly or either chamber
thereof for any purpose.
SPONSORS OF BILL:
Rep. Cara Pavalock-D'Amato, 77th Dist.
REASONS FOR BILL:
This bill will adjust the way the General Assembly legislates new mandate health insurance
benefits.
RESPONSE FROM ADMINISTRATION/AGENCY:
None Expressed
NATURE AND SOURCES OF SUPPORT:
CT Association of Health Plans stated every year the legislature faces immense pressure
to adopt new insurance mandates with little or no information as to the cost/benefit analysis
of each proposal absent anecdotal substantiation. Mandate review affords policy makers the
ability to look at each proposal in a dispassionate, research-oriented manner.
Connecticut already ranks as one of the most mandated rich states in the nation. As such,
fully insured health insurance policies in the state are among the most expensive. Subjecting
new mandates to further review prior to passage, makes good sense.
Wyatt Bosworth, Asst Counsel, CBIA feels this bill, if enacted, would ensure a number of
safeguards are in place before any further mandates can be passed into law, and allows for
more cost-effective ways of generating mandated health benefit reviews. The bill allows the
Commissioner of the Connecticut Department of Insurance to contract with private actuarial
accounting firms, in addition to the University of Connecticut Center for Public Health and
Health Policy, to conduct mandated health benefit reviews upon referral by the Insurance and
Real Estate Committee. Under current law, the commissioner is only able to contract with
UConn. The cost-prohibitiveness of the current process is exemplified by looking at the
under-utilization of the mandate review process in the past. In the 1 years since the mandate
review process was made available to this committee, it has only been utilized three times to
review a total of 13 proposed mandates. Furthermore, no review on proposed health benefit 1
mandates has been conducted since 2013.
CT Chiropractic Association stated the current structure for reviewing health insurance
mandates is reasonable and allows needed oversight.
The proposal would establish a process where new proposed mandate is held in abeyance
until such time as the Department of Insurance has conducted a formal review of the issue
and provided a report to the committee. A public hearing could follow. CCA suggests that if
the committee adopts this approach, that it is to be very clear that any such review should
involve the participation of medical experts in the particular field so that the health benefits of
any such mandate to patients is considered.
Linda Kowalski Executive Director, Radiology Society of CT commented that the
proposal would establish a process where a new proposed mandate is held in abeyance until
such time as the Department of Insurance has conducted a formal review of the issue and
provided a report to the committee. A public hearing could follow. The Radiological Society of
Connecticut suggests that any such review involve the participation of medical experts in the
particular field so that the health benefits to patients is considered. The society also suggests
a technical change to the bill in line 13 that deletes the words offer or as we believe the
word provide is sufficient.
NATURE AND SOURCES OF OPPOSITION:
Bryte Johnson, ACS CAN feel this bill seeks to create a legislative review and approval
process for future insurance health benefit proposals before they can be acted upon by the
General Assembly. The bill requires future proposed insurance health benefits to be analyzed
for their impact on overall healthcare costs, insurance premiums, and safety and
effectiveness.
In 2021 it is estimated that approximately 22,910 CT residents will be diagnosed with cancer
while 6,400 will die from the disease. insurance coverage of cancer related health benefits for
prevention, early detection, diagnosis, treatment and rehabilitative care have helped to
prevent, detect and treat cancer at its earliest stages, saving lives and long term health care
costs. establishing artificial barriers at time when CT is already facing challenging economic
conditions as well as an uncertain future for affordable access to care only further
complicates efforts to ensure the people of CT have the care they need when they need it
Reported by: Diane Kubeck Date: March 30, 2021
Page 2 of 2 HB-5013


Statutes affected:
Committee Bill:
INS Joint Favorable:
File No. 328: