Sec. 38a-8-3. Duties and method of operations

(a) Commissioner. The Insurance Commissioner is the department head in accordance with section 4-5 of the Connecticut General Statutes and administers the provisions of Title 38a in accordance with section 4-8 of the Connecticut General Statutes. In carrying out his or her official duties, the Commissioner may delegate his or her authority to a deputy commissioner, chief of staff, a division of the department, an individual division director, a hearing officer or an examiner when appropriate. Such person shall serve as his or her designee at the pleasure of the Commissioner.

(b) Administration Division. The Administration Division:

(1) maintains accounting records of department;

(2) prepares and maintains payroll records for department;

(3) prepares budget for department;

(4) is responsible for mail, supplies, and other related support activities;

(5) processes receipts from fees collected from insurers and producers;

(6) processes taxes collected from surplus lines brokers and unauthorized insurers;

(7) maintains staff recruitment, classification and compensation;

(8) administers collective bargaining contracts;

(9) administers personnel policy and procedures, investigates complaints of misconduct;

(10) administers grievances;

(11) processes time and attendance for department;

(12) provides information technology support; and

(13) performs other related duties as assigned by the Commissioner.

(1) examines, reviews and analyzes the affairs and records of all insurance companies, fraternal benefit societies, health care centers, nonprofit hospital and medical service corporations, interlocal risk management agencies, employers' mutual associations, and life insurance departments of savings banks for solvency and compliance with applicable statutes, and issues appropriate licenses to conduct business in this state;

(2) reviews all applications submitted by domestic and foreign insurance companies and fraternal benefit societies and health care centers that desire to become licensed in this state;

(3) verifies, annually, the life insurance reserves held by all Connecticut chartered life insurance companies;

(4) receives and reviews registration statements as well as receives, reviews and approves or disapproves material transactions of insurance companies that are part of a holding company system;

(5) receives and reviews applications from insurance companies involved in mergers and tender offers;

(6) maintains records of insurance companies licensed in Connecticut and furnishes information regarding status of companies;

(8) licenses preferred provider networks and viatical settlement companies; and

(9) performs other related duties as assigned by the Commissioner.

(d) Life and Health Division. The Life and Health Division:

(1) accepts for filing, and approves or disapproves, all life and accident and health policy forms that licensed insurance companies, fraternal benefit societies, hospital or medical service corporations, and health care centers intend to sell in this state, and all contracts and disclosure statements that viatical settlement companies intend to use in the state, and approves or disapproves health care center, individual accident and health, credit life and health, individual long-term care, and Medicare supplement premium rates. Accepts for filing and has authority to disapprove group long-term care premium rates;

(2) accepts for filing reporting requirements, publishes report card, oversees contracting of vendors for expedited review process and external grievance process for managed care organizations;

(3) licenses utilization review companies; and

(4) performs other related duties as assigned by the Commissioner.

(e) Division of Rate Review - Property and Casualty. The Division of Rate Review - Property and Casualty:

(1) reviews and accepts or disapproves all policy forms, endorsements, rules, rates, and rating plans used by property and casualty insurance companies involving all lines of property and casualty insurance;

(2) licenses rating and advisory organizations, and, in addition, periodically examines the affairs of such organizations;

(3) approves statistical plans of insurers or rating organizations for the recording and reporting of loss and expense experience;

(4) investigates complaints involving rates and rating plans as well as complaints about individual policies;

(5) supervises the Connecticut Fair Plan, Workers' Compensation Assigned Risk Plan, the Connecticut Automobile Insurance Assigned Risk Plan and approves rates, rules, forms, and rating plans to be used therein;

(6) approves the forms, rules, rates, and administration of the Connecticut Fair Plan to determine that fire insurance is available to all Connecticut residents at a reasonable cost; and

(7) performs other related duties as assigned by the Commissioner.

(f) Licensing Division.

The Licensing Division:

(1) issues the following licenses:

(A) insurance producers, under chapter 701a and chapter 702, part II, of the Connecticut General Statutes;

(B) public adjusters, under chapter 701b and chapter 702, part IV, of the Connecticut General Statutes;

(D) casualty claim adjusters, under chapter 702, part VI, of the Connecticut General Statutes;

(E) surplus lines brokers, under chapter 701d and chapter 702, part VII, of the Connecticut General Statutes;

(F) fraternal agents, under chapter 701f and chapter 702, part IX, of the Connecticut General Statutes;

(G) motor vehicle physical damage appraisers, under chapter 702, part VI, of the Connecticut General Statutes;

(H) certified insurance consultants under chapter 701c and chapter 702, part III, of the Connecticut General Statutes;

(I) insurance premium finance companies, under the provisions of chapter 698, part VII, of the Connecticut General Statutes; and

(J) viatical settlement brokers and investment agents under chapter 700b of the Connecticut General Statutes;

(2) issues to applicants and insurers instructions regarding eligibility requirements necessary for the type of license applied for, in accordance with the statutes cited; and

(3) determines the qualification of applicants with due regard to the public interest and coordinates and administers qualifying examinations as required by the cited statutes.

(g) Consumer Affairs Division. (1) The Consumer Services Unit receives, reviews and responds to complaints and inquiries from state residents concerning insurance related problems. The staff examines each complaint to determine whether statutory requirements and contractual obligations within the commissioner's jurisdiction have been fulfilled. The Consumer Services Unit coordinates the resources available within the department to fully address consumer complaints. (2) The Market Conduct Unit investigates complaints against all licensees; prepares cases for presentation at department hearings; enforces compliance with licensing laws and regulations and other laws with the provisions of Title 38a of the Connecticut General Statutes. (3) The Insurance Fraud Unit receives information, analyzes and reports data relating to insurance fraud in Connecticut; provides education to the public on how to recognize, avoid and report insurance fraud and licenses medical discount plans and pharmacy benefit managers.

(h) Legal Division. The Legal Division provides legal advice and related services to the Commissioner and the seven divisions of the Insurance Department on a broad spectrum of issues that arise in regulating the insurance industry and in providing services to the consumer. In doing so, the legal staff of this office drafts, monitors and analyzes legislation; drafts and promulgates regulations; and participates in department hearings involving rates, license enforcement, and acquisitions of domestic insurance companies. The legal division also manages insurance company receiverships on behalf of the Commissioner upon his or her appointment by the Superior Court as receiver and provides oversight of the insurance guaranty associations and in doing so, keeps the staff of the consumer affairs division, and other department staff, informed on developments so they may properly service the inquiries and complaints of consumers.

(Effective September 25, 1992; Amended February 1, 2001; Amended September 9, 2008)