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The Connecticut Utilization Review Company (URC) license

Utilization Review Company (URC)

Decides whether a health service is medically necessary, on a health carrier's behalf. At $6,000 it is the dearest license Connecticut issues, and the statute spends the money twice over: on regulating utilization review, and on medical consultations bought from the University of Connecticut School of Medicine.

Course

None

This license has no pre-licensing course route.

Ways in

1

There is no state exam for this license.

Exam

n/a

Not required on any of the routes below.

Every way to qualify

  1. Route 1 Apply with the state-specific application and the policies behind it

    No state exam for this license

    • The policies, procedures, sample letters and clinical review criteria the Connecticut-specific application asks for, filed with it and refiled in redlined form against the previously approved versions at every renewal, under Conn. Gen. Stat. 38a-591j(c)

    Conn. Gen. Stat. 38a-591j(a) forbids a utilization review company to conduct utilization review here for a health benefit plan under the commissioner's jurisdiction unless licensed, and renews it every two years. There is no course and no examination. 38a-591j(b) is the sentence worth reading: the $6,000 fee "shall be dedicated to the regulation of utilization review", except that the commissioner may use as much of it as necessary to implement the captive insurance sections and to contract with the University of Connecticut School of Medicine for medical consultations on consumer and market conduct matters. Public Act 22-84 doubled the fee from $3,000 and made the renewal biennial with effect from 1 January 2023; the examination vendor's March 2026 candidate handbook still prints $3,000 and an annual renewal for this license, three years after both changed, which is why the figures here come from the Department and the statute rather than from the handbook. Renewal applications are due each 1 October for a term starting 1 January, and any material change to an approved policy, letter or set of clinical criteria has to be filed within thirty days.

    Read at the Department on 2026-08-20

Connecticut asks a utilization review company for written procedures and clinical review criteria rather than for anything taught, and gives no examination for it. No national seller offers a Connecticut product for it.