Network Adequacy Review (repealed and replaced Bulletin HC-116)

Connecticut state seal STATE OF CONNECTICUT INSURANCE DEPARTMENT Bulletin No. HC-117 October 25,2016 TO: All Health Insurance Companies and Health Care Centers Authorized to Conduct Business in Connecticut, Including Dental and Vision Carriers RE: Network Adequacy Review This bulletin repeals and replaces Bulletin HC-116 in order to clarify that Dental and Vision Carriers are included. Public Act 16-205, An Act Concerning Standards and Requirements for Health Carriers' Provider Networks and Contracts Between Health Carriers and Participating Providers, requires the Insurance Department to determine the sufficiency of a health carrier's network. Carriers are required to maintain adequate arrangements to assure that covered members have reasonable access to participating providers located near the member's home or workplace. Beginning January 1, 2017, the public act requires health carriers to file with the Insurance Department each new network and access plan within 30 days prior to the date any new network will be offered. The public act excludes Dental and Vision carriers, however, pursuant to Connecticut General Statutes section 38a-8, the Commissioner requires all Dental and Vision carriers to file the same information. To facilitate the Insurance Department's review, carriers should complete the Network Adequacy Survey as the filing submission. The survey can be found on the Insurance Department's website (www.ct.gov/cid) under the tab "Forms and Applications." The survey form may also be requested from the Life and Health Division at the e-mail address listed below. The survey must be completed separately for each network offered. Annual Filing Carriers will be required to complete an annual filing for existing networks. Carriers should complete the Network Adequacy Survey as the submission. The survey can be found on the Insurance Department's website as listed above. For existing networks to be offered with plans effective for plan years beginning in 2017, the carrier should submit the Network Adequacy Survey for each network offered to the Insurance Department no later than September 15, 2016. For plans effective on and after January 1, 2018, such annual survey should be filed as part of the annual form filing process. Questions Please contact the Insurance Department Life and Health Division at cid.lh@ct.gov with any questions. ~L . wk Katharine L. Wade Insurance Commissioner www.ct.gov/cid P.O. Box 816 • Hartford, CT 06142-0816 An Eoual Oooortunitv Emolover