Connecticut General Statutes 38a-582 – Schedule of charges. Approval by commissioner. Appeal of disapproval
(a) No schedule of charges for enrollee coverage for dental services, or any amendment thereto, may be used by a dental plan organization until a copy of such schedule or amendment has been filed with the commissioner for the commissioner’s approval. The commissioner may disapprove the schedule of charges at any time if the commissioner finds that the charges are excessive, inadequate or unfairly discriminatory. If the commissioner disapproves the schedule of charges, the commissioner shall notify the dental plan organization within sixty days of the date of disapproval and specify in the notice the reason for disapproval. A hearing shall be granted within twenty days after a request in writing by the dental plan organization is received by the commissioner. It shall be unlawful for any dental plan organization whose schedule of charges has been disapproved to effect any contract or issue any subscription certificate that uses the disapproved schedule of charges until a revised schedule of charges has been approved. Any dental plan organization aggrieved by the action of the commissioner pursuant to this section may appeal therefrom, in accordance with the provisions of § 4-183.
Terms Used In Connecticut General Statutes 38a-582
- Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
- Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
- Commissioner: means the Insurance Commissioner. See Connecticut General Statutes 38a-1
- Contract: A legal written agreement that becomes binding when signed.
(b) Charges shall be established in accordance with actuarial principles, but charges applicable to an enrollee shall not be individually determined based on the status of the enrollee’s health.