House File 70 - Introduced HOUSE FILE 70 BY MOHR and KNIFF MCCULLA A BILL FOR An Act relating to Medicare supplement policies and an annual 1 open enrollment period. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 1140YH (4) 91 nls/ko
H.F. 70 Section 1. NEW SECTION . 514M.1 Medicare supplement 1 insurance annual open enrollment. 2 1. For purposes of this section, unless the context 3 otherwise requires: 4 a. Applicant means an individual who is a covered person 5 under an individual or group Medicare supplement policy. 6 Applicant includes an individual under the age of sixty-five 7 who qualifies for Medicare due to disability, end-stage renal 8 disease, or exposure to an environmental hazard. 9 b. Certificate means any certificate of coverage delivered 10 or issued for delivery in this state to a covered individual 11 under a group Medicare supplement policy. 12 c. Issuer means an insurance company, a fraternal benefit 13 society, a health care service plan, a health maintenance 14 organization, or any other entity delivering or issuing 15 for delivery in this state a Medicare supplement policy or 16 certificate. 17 d. Medicare supplement policy means an individual or group 18 policy of accident and sickness insurance or a subscriber 19 contract of hospital and medical service associations or 20 health maintenance organizations, other than a policy issued 21 pursuant to a contract under section 1876 of the federal Social 22 Security Act, as codified in 42 U.S.C. 1395 et seq., or an 23 issued policy under an approved demonstration project described 24 in section 603(c) of the Social Security Amendments of 1983, 25 section 2355 of the federal Deficit Reduction Act of 1984, or 26 section 9412(b) of the federal Omnibus Budget Reconciliation 27 Act of 1986, that is advertised, marketed, or designed 28 primarily as a supplement to reimbursements under Medicare 29 for hospital, medical, or surgical expenses of individuals 30 covered by Medicare. Medicare supplement policy does not 31 include Medicare advantage plans, outpatient prescription drug 32 plans established under Medicare part D, or any health care 33 prepayment plan that provides benefits pursuant to an agreement 34 under section 1833(a)(1)(A) of the federal Social Security Act. 35 -1- LSB 1140YH (4) 91 nls/ko 1/ 3
H.F. 70 2. Beginning January 1, 2025, applicants shall have an 1 annual thirty-one-day open enrollment period that begins on 2 March 1. 3 3. During the open enrollment period under subsection 2, an 4 issuer shall be prohibited from doing any of the following for 5 at least one Medicare supplement policy or certificate that the 6 issuer offers and that is available for issuance in the state: 7 a. Denying or conditioning the issuance or effectiveness of 8 the Medicare supplement policy or certificate. 9 b. Subjecting an applicant to medical underwriting, or 10 discriminating in the pricing of the Medicare supplement policy 11 or certificate because of the applicants health status, claims 12 experience, receipt of health care, or medical condition. 13 c. Imposing an exclusion of benefits based on an applicants 14 preexisting condition. 15 4. An issuer shall provide notice, in a form prescribed by 16 the commissioner of insurance, of the annual open enrollment 17 period at the time an applicant applies for a Medicare 18 supplement policy or certificate. 19 EXPLANATION 20 The inclusion of this explanation does not constitute agreement with 21 the explanations substance by the members of the general assembly. 22 This bill relates to Medicare supplement policies and an 23 annual open enrollment period. 24 Beginning January 1, 2025, applicants shall have an 25 annual 31-day open enrollment period that begins on March 1. 26 Applicant is defined in the bill as an individual who is a 27 covered person under an individual or group Medicare supplement 28 policy. Applicant includes an individual under the age of 65 29 who qualifies for Medicare due to disability, end-stage renal 30 disease, or exposure to an environmental hazard. Medicare 31 supplement policy is also defined in the bill. 32 During the open enrollment period, for at least one Medicare 33 supplement policy or certificate that the issuer offers 34 and that is available for issuance in the state, an issuer 35 -2- LSB 1140YH (4) 91 nls/ko 2/ 3
H.F. 70 is prohibited from denying or conditioning the issuance or 1 effectiveness of the Medicare supplement policy or certificate; 2 from subjecting an applicant to medical underwriting or 3 discriminating in the pricing of the Medicare supplement 4 policy or certificate because of the health status, claims 5 experience, receipt of health care, or medical condition of an 6 applicant; and from imposing an exclusion of benefits based on 7 an applicants preexisting condition. An issuer shall provide 8 notice, in a form prescribed by the commissioner of insurance, 9 of the annual open enrollment period at the time an applicant 10 applies for a Medicare supplement policy or certificate. 11 Issuer is defined in the bill. 12 -3- LSB 1140YH (4) 91 nls/ko 3/ 3