Insights

Coinsurance in HMO Plan Designs


On April 4, 2017, the Connecticut Insurance Department published Bulletin No. HC-118. The bulletin relates to a bill currently pending passage in the Connecticut General Assembly (Bill No. 7023), which allows health care centers to offer HMO plan designs with coinsurance (a design that was previously disallowed). The bulletin requires health care centers to proceed with their 2018 individual and small group plan design filings under the assumption that the bill will pass. Should the bill not pass, the bulletin contains remedial instructions. Although no new employer obligations result from the bulletin, employers with small group plans should be aware of the new law, particularly if HMOs are offered as part of the benefit design.

Bulletin No. HC-118 »
Bill No. 7023 »