HB 5247 Summary

• Requires health insurers and related entities to make available to consumers in easily readable format information about coverage exclusions, restrictions on benefits, prescription drug deductible details, copayment and coinsurance amounts, and processes for seeking coverage of noncovered drugs effective January 1, 2022.

• Requires insurers to disclose that covered individuals who are legally capable of consenting may specify whether they wish to receive no explanations of benefits, receive them only to themselves, or designate a specific delivery method (mail, email, or secure electronic access).

• Mandates insurers comply with written consumer specifications within three business days and provide written confirmation of receipt, with methods remaining valid until the consumer submits a different specification in writing.

• Prohibits insurers from requiring consumers or policyholders to waive their right to limit disclosure of explanations of benefits as a condition of policy delivery, renewal, amendment, or continuation.

• Requires plain language disclosure of these consumer rights in all evidence of coverage documents, privacy communications, explanations of benefits, and website materials accessible to Connecticut consumers.