Raised Bill No. 5248 Summary

• Establishes a health benefit review program within the Insurance Department to evaluate mandated health benefits that receive a public hearing by a joint standing committee of the General Assembly, effective October 1, 2024.

• Expands the definition of "mandated health benefit" to include proposed legislation requiring health carriers to offer coverage for particular health care treatments, services, equipment, supplies, or drugs, and applies the review requirement to qualified health plans offered through the exchange and state employee plans.

• Requires the Insurance Commissioner, in consultation with the Executive Director of the Office of Health Strategy, to submit an annual mandated health benefit review report by February 1, 2026, and annually thereafter, assessing quality and cost impacts of each benefit.

• Specifies the review report must evaluate at least 15 factors including utilization rates, current coverage availability, impact on insurance premiums, scientific evidence of safety and effectiveness, and impact on qualified health plans offered through the exchange.

• Authorizes the Commissioner to contract with the University of Connecticut Center for Public Health and Health Policy or an actuarial accounting firm to conduct benefit reviews, and permits the joint standing committee to conduct informational public hearings following receipt of the review report.