Sec. 38a-1040. Definitions.
Sec. 38a-1040. Definitions. As used in sections 38a-1040 to 38a-1050, inclusive:
(1) "Consumer" means an individual who receives or is attempting to receive services from a managed care organization and is a resident of this state.
(2) "Managed care organization" means an insurer, health care center, hospital or
medical service corporation or other organization delivering, issuing for delivery, renewing or amending any individual or group health managed care plan in this state.
(3) "Managed care plan" means a product offered by a managed care organization
that provides for the financing or delivery of health care services to persons enrolled in
the plan through: (A) Arrangements with selected providers to furnish health care services; (B) explicit standards for the selection of participating providers; (C) financial
incentives for enrollees to use the participating providers and procedures provided for by
the plan; or (D) arrangements that share risks with providers, provided the organization
offering a plan described under subparagraph (A), (B), (C) or (D) of this subdivision is
licensed by the Insurance Department pursuant to chapter 698, 698a or 700 and that the
plan includes utilization review pursuant to sections 38a-226 to 38a-226d, inclusive.
(P.A. 99-284, S. 1.)