AGO 1990-032D.

• Court: Connecticut

Connecticut Attorney General Opinions 1990. AGO 1990-032D. 1990Opinion No. 1990-032DHonorable Lorraine M. AronsonCommissionerDepartment of Income Maintenance110 Bartholomew AvenueHartford, Connecticut 06106Dear Commissioner Aronson: You have requested the opinion of the Attorney General as to whether the Department of Income Maintenance is authorized to enter into contractual arrangements with insurance companies in connection with a demonstration program to be jointly administered by the Department of Income Maintenance and the Insurance Department. Specifically, under the proposed contract, Income Maintenance would advise insurance companies whether payments to insured persons under insurance policies qualify for "asset exclusions" under the program. Income Maintenance would receive a contractual payment from the insurance companies for providing the contracted service. It is the opinion of the Attorney General that the Department of Income Maintenance is authorized to enter into such contractual arrangements provided that the regulations governing the program recognize the availability of a mechanism for obtaining such determinations.BackgroundBy way of background, 1989 Conn. Pub. Acts 89-352 authorizes a pilot program entitled "Connecticut Partnership for Long Term Care" whereby individuals may purchase long-term care insurance policies from private insurers that have been "precertified" by the Insurance Department and obtain "exclusions" from the asset limits that are otherwise applicable to eligibility for assistance under the Medicaid program to the extent that payments under the insurance policies meet specified requirements for long-term care benefits. If an individual is granted exclusions under the program, assets belonging to the individual in an amount equal to the dollar amount of the exclusions will not be counted in determining his or her eligibility for Medicaid. The purpose of the program is to encourage individuals to purchase long-term care insurance by offering the incentive of allowing Medicaid eligibility to be established without requiring the applicant to "spend-down" his or her resources to poverty levels. The Insurance Department in accordance with section 3 of the Act, has proposed regulations governing the participation of insurance companies in the program, which proposed regulations were noticed in the Connecticut Law Journal on January 2, 1990. Under the proposed regulations, private insurers that participate in the program must maintain records, that are subject to audit, documenting the extent to which payments under precertified policies qualify for asset exclusions. Income Maintenance will rely on the reports of the insurance companies in determining Medicaid eligibility and will grant Medicaid eligibility to individuals, who would otherwise be ineligible for assistance, based upon reports submitted by participating private insurers that payments were made under precertified insurance policies that qualify for exclusions. Under the...