# Connecticut prompt-pay law for dental claims

> What is the Connecticut prompt-pay deadline for dental claims, and what interest applies to late payment? Read against the statute text (Conn. Gen. Stat. §38a-816(15)).

URL: https://dentovio.com/dental-prompt-pay-laws/connecticut

Last verified: 2026-08-30

Dentovio is an independent publisher, not a law firm, insurance department, or government agency. This page was drafted with AI assistance and read against the primary sources linked here, with a per-claim verification record — quote, statutory pinpoint, and the URL actually opened — behind every deadline, rate, and applicability verdict in all fifty-one jurisdictions. It has not been reviewed by a credentialed attorney or dental billing specialist. These pages summarize state prompt-pay statutes as read against the official sources on the date shown, focusing on how each statute treats dental claims. Statutes change and their application turns on plan type, contract status, and claim facts. Educational reference only — not legal advice; confirm current law with the state insurance department or a licensed attorney before acting on a specific claim.

## Direct answer

Under Conn. Gen. Stat. §38a-816(15), the Connecticut payment deadline is 20 days (electronic format) and 60 days (paper format). An insurer, or any other entity responsible for paying a health care provider under an insurance policy, that misses those deadlines owes the amount of the claim plus interest at 15 percent per annum (§38a-816(15)(A)). Dental applicability: Covered, and dentists are inside by name of chapter. A self-funded private-employer (ERISA) plan is generally beyond this statute's reach and runs on the federal claims-procedure clock instead — but that comes from the courts reading 29 U.S.C. § 1144, not from its text, and it is not categorical: a self-funded governmental or church plan is not an ERISA plan at all, § 1144(b)(6) leaves multiple employer welfare arrangements open to state insurance law, and nothing in § 1144 bars a state from reaching the third-party administrator or the network contract.

## Payment deadlines

- Electronic claims: 20 days (electronic format)
- Paper claims: 60 days (paper format)

Connecticut puts its prompt-pay rule inside the Unfair Insurance Practices Act: failure to pay accident and health claims, including claims for payment to health care providers, within 60 days of a paper submission or 20 days of an electronic one is an unfair practice. The 10-day and 30-day figures that circulate are the deficiency-cure clock, not the payment deadline — on paper the insurer must notice deficiencies within 30 days and pay within 30 days of receiving the requested information; electronically those windows are 10 days each. Two escape hatches sit in the same subparagraph: the deadlines do not apply where the Insurance Commissioner determines a legitimate dispute exists as to coverage, liability, or damages, or that the claimant fraudulently caused or contributed to the loss.

## Interest and penalties on late payment

An insurer, or any other entity responsible for paying a health care provider under an insurance policy, that misses those deadlines owes the amount of the claim plus interest at 15 percent per annum (§38a-816(15)(A)). The statute does not say when accrual begins, so a day-21 or day-61 start is an assumption rather than statutory text. The 15 percent is in addition to any other penalties under the adjacent unfair-practice provisions, and interest amounting to less than one dollar goes to the University of Connecticut Health Center rather than the provider.

## Does it apply to dental? Dental expressly covered

Covered, and dentists are inside by name of chapter. The subdivision reaches "accident and health claims, including, but not limited to, claims for payment or reimbursement to health care providers," and its own definition of health care provider lists the licensure chapters — the range 375 to 383c includes chapter 379 (Dentistry) and chapter 379a (Dental Hygienists). No dental exception appears anywhere in subdivision (15).

## Self-funded (ERISA) plans

A self-funded private-employer (ERISA) dental plan is generally beyond a state prompt-pay statute's reach: 29 U.S.C. § 1144(b)(2)(B) bars a state from deeming such a plan an insurer, and the courts have read that to keep state insurance regulation off it. The statute itself never uses the words self-funded or prompt pay, and the rule is not categorical — a self-funded governmental or church plan is not an ERISA plan at all, so state law can reach it; § 1144(b)(6) leaves multiple employer welfare arrangements open to state insurance law; and nothing in § 1144 addresses state enforcement against the third-party administrator or the network contract. Where the plan is a self-funded ERISA group health plan, the federal claims-procedure deadlines apply instead: a post-service benefit determination within 30 days (one 15-day extension), at least 180 days to appeal, and an appeal decision within 60 days (or two 30-day levels), under 29 CFR 2560.503-1.

## Also in the statute

- Claims must be filed in accordance with the insurer's practices or procedures; the statute says nothing about network status either way.
- Enforcement runs through the Insurance Commissioner's cease-and-desist and penalty process under §38a-817(a); reported case law requires wrongful acts "with such frequency as to indicate a general business practice" for a private action.
- Currency: the General Statutes are revised to January 1, 2025, and the 2026 Supplement does not touch §38a-816. The 20/60-day timing dates to P.A. 11-58, effective January 1, 2012.

## Sources (statute text)

- [Conn. Gen. Stat. ch. 704 §38a-816 — Connecticut General Assembly (current edition)](https://www.cga.ct.gov/current/pub/chap_704.htm)
- [Connecticut Insurance Department — file a complaint](https://portal.ct.gov/cid)

## Related

- [All state prompt-pay pages](https://dentovio.com/dental-prompt-pay-laws/index.html.md)
- [Dental claim denial codes](https://dentovio.com/dental-claim-denial-codes/index.html.md)
- [Payer documentation requirements](https://dentovio.com/dental-claim-documentation/index.html.md)