| 1 | + | *ES0215.1* |
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| 2 | + | February 15, 2024 |
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| 3 | + | ENGROSSED |
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| 4 | + | SENATE BILL No. 215 |
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| 5 | + | _____ |
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| 6 | + | DIGEST OF SB 215 (Updated February 14, 2024 10:36 am - DI 141) |
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| 7 | + | Citations Affected: IC 27-8. |
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| 8 | + | Synopsis: Medicare supplement insurance. Provides that after |
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| 9 | + | December 31, 2024, an issuer that makes a Medicare supplement |
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| 10 | + | policy or certificate available to persons at least 65 years of age must |
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| 11 | + | make the equivalent policy or certificate available to an individual |
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| 12 | + | (Continued next page) |
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| 13 | + | Effective: July 1, 2024. |
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| 14 | + | Walker K, Messmer, Carrasco, |
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| 15 | + | Freeman, Qaddoura, |
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| 16 | + | Randolph Lonnie M, Becker |
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| 17 | + | (HOUSE SPONSORS — CARBAUGH, ABBOTT, MORRIS, JUDY) |
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| 18 | + | January 9, 2024, read first time and referred to Committee on Insurance and Financial |
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| 19 | + | Institutions. |
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| 20 | + | January 25, 2024, amended, reported favorably — Do Pass. |
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| 21 | + | January 29, 2024, read second time, amended, ordered engrossed. |
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| 22 | + | January 30, 2024, engrossed. |
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| 23 | + | February 1, 2024, read third time, passed. Yeas 47, nays 2. |
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| 24 | + | HOUSE ACTION |
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| 25 | + | February 12, 2024, read first time and referred to Committee on Insurance. |
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| 26 | + | February 15, 2024, amended, reported — Do Pass. |
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| 27 | + | ES 215—LS 6945/DI 55 Digest Continued |
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| 28 | + | under 65 years of age who is eligible for Medicare because of having |
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| 29 | + | a federally defined disability or end stage renal disease. (Under current |
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| 30 | + | law, an issuer that makes a Medicare supplement policy or certificate |
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| 31 | + | available to persons at least 65 years of age is required only to make a |
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| 32 | + | Plan A policy or certificate available to individuals under 65 years of |
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| 33 | + | age, and is required to make the Plan A policy or certificate available |
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| 34 | + | to an individual under 65 years of age who is eligible for Medicare |
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| 35 | + | because of having a federally defined disability but is not required to |
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| 36 | + | make the Plan A policy or certificate available to an individual under |
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| 37 | + | 65 years of age who is eligible for Medicare because of having end |
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| 38 | + | stage renal disease.) Provides that if an individual who is less than 65 |
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| 39 | + | years of age, who is eligible for Medicare because of having a federally |
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| 40 | + | defined disability or end stage renal disease, and who meets certain |
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| 41 | + | conditions as to application timeliness applies for a Medicare |
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| 42 | + | supplement policy or certificate, the issuer of the policy or certificate |
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| 43 | + | is prohibited from: (1) denying or conditioning the issuance or |
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| 44 | + | effectiveness of the individual's policy or certificate; (2) charging the |
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| 45 | + | individual a premium rate for a policy or certificate standardized as |
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| 46 | + | Plan A, B, or D that exceeds the premium rate the issuer charges an |
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| 47 | + | individual who is 65 years of age; (3) charging the individual a |
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| 48 | + | premium rate for any other standardized lettered policy or certificate |
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| 49 | + | that exceeds 200% of the premium rate the issuer charges an individual |
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| 50 | + | who is 65 years of age; or (4) issuing to the individual a policy or |
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| 51 | + | certificate that contains a waiting period or a preexisting condition |
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| 52 | + | limitation or exclusion. Provides for the expiration of Code provisions |
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| 53 | + | that would be superseded by the new requirements applying to issuers |
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| 54 | + | of Medicare supplement policies or certificates. |
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| 55 | + | ES 215—LS 6945/DI 55ES 215—LS 6945/DI 55 February 15, 2024 |
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14 | | - | SECTION 1. IC 27-8-13-9, AS AMENDED BY P.L.227-2019, |
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15 | | - | SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE |
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16 | | - | JULY 1, 2024]: Sec. 9. (a) A Medicare supplement policy, contract, or |
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17 | | - | certificate in force in Indiana may not contain benefits that duplicate |
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18 | | - | benefits provided by Medicare. However, a change in Medicare |
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19 | | - | coverage that becomes effective after a Medicare supplement policy, |
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20 | | - | contract, or certificate is in force in Indiana and that causes a |
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21 | | - | duplication of benefits does not void the policy, contract, or certificate. |
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22 | | - | (b) The commissioner shall adopt rules under IC 4-22-2 to establish |
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23 | | - | specific standards for policy provisions of Medicare supplement |
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24 | | - | policies and certificates. Such standards shall be in addition to and in |
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25 | | - | accordance with Indiana law. No requirement of IC 27 relating to |
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26 | | - | minimum required policy benefits other than the minimum standards |
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27 | | - | contained in this chapter apply to Medicare supplement policies and |
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28 | | - | certificates. The standards may cover, but are not limited to: |
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29 | | - | (1) terms of renewability; |
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30 | | - | (2) initial and subsequent conditions of eligibility; |
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31 | | - | (3) nonduplication of coverage; |
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32 | | - | (4) probationary periods; |
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33 | | - | (5) benefit limitations, exceptions, and reductions; |
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34 | | - | (6) elimination periods; |
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35 | | - | (7) requirements for replacement; |
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36 | | - | (8) recurrent conditions; and |
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37 | | - | SEA 215 — Concur 2 |
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38 | | - | (9) definitions of terms. |
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39 | | - | (c) The commissioner may adopt rules under IC 4-22-2 that specify |
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40 | | - | prohibited policy provisions not specifically authorized by statute that, |
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41 | | - | in the opinion of the commissioner, are unjust, unfair, or unfairly |
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42 | | - | discriminatory to a person insured or proposed to be insured under a |
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43 | | - | Medicare supplement policy or certificate. |
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44 | | - | (d) Notwithstanding any other law, a Medicare supplement policy |
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45 | | - | or certificate shall not exclude or limit benefits for a loss incurred more |
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46 | | - | than six (6) months after the effective date of the policy because the |
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47 | | - | loss involves a preexisting condition. The policy or certificate shall not |
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48 | | - | define a preexisting condition more restrictively than a condition for |
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49 | | - | which medical advice was given or treatment was recommended by or |
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50 | | - | received from a physician within six (6) months before the effective |
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51 | | - | date of coverage. |
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52 | | - | (e) After June 30, 2020, an issuer that makes a Medicare |
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53 | | - | supplement policy or certificate available to a person who is at least |
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54 | | - | sixty-five (65) years of age and eligible for Medicare benefits as |
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55 | | - | described in 42 U.S.C. 1395c(1) shall make at least one (1) Medicare |
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56 | | - | supplement policy or certificate that meets the requirements of section |
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57 | | - | 9.5 of this chapter available to an individual who is eligible for and |
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58 | | - | enrolled in Medicare by reason of disability as described in 42 U.S.C. |
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59 | | - | 1395c(2). 42 U.S.C. 426 and 42 U.S.C. 423. This subsection expires |
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60 | | - | January 1, 2025. |
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61 | | - | SECTION 2. IC 27-8-13-9.1 IS ADDED TO THE INDIANA CODE |
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62 | | - | AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY |
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63 | | - | 1, 2024]: Sec. 9.1. After December 31, 2024, an issuer that makes a |
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64 | | - | Medicare supplement policy or certificate available to a person |
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65 | | - | who is at least sixty-five (65) years of age and is eligible for |
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66 | | - | Medicare benefits as described in 42 U.S.C. 1395c(1) shall make the |
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67 | | - | equivalent Medicare supplement policy or certificate available to |
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68 | | - | an individual who: |
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69 | | - | (1) is less than sixty-five (65) years of age; and |
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70 | | - | (2) is eligible for and enrolled in Medicare: |
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71 | | - | (A) by reason of a disability as described in 42 U.S.C. |
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72 | | - | 426(b) and defined in 42 U.S.C. 423(d); or |
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73 | | - | (B) by reason of being medically determined to have end |
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74 | | - | stage renal disease as described in 42 U.S.C. 426-1. |
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75 | | - | SECTION 3. IC 27-8-13-9.2 IS ADDED TO THE INDIANA CODE |
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76 | | - | AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY |
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77 | | - | 1, 2024]: Sec. 9.2. (a) This section applies to an individual: |
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78 | | - | (1) who is less than sixty-five (65) years of age; |
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79 | | - | (2) who is eligible for and enrolled in Medicare: |
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80 | | - | SEA 215 — Concur 3 |
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81 | | - | (A) by reason of a disability as described in 42 U.S.C. |
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82 | | - | 426(b) and defined in 42 U.S.C. 423(d); or |
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83 | | - | (B) by reason of being medically determined to have end |
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84 | | - | stage renal disease as described in 42 U.S.C. 426-1; and |
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85 | | - | (3) who applies for a Medicare supplement policy or |
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86 | | - | certificate and either: |
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87 | | - | (A) submits the application before or during the six (6) |
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88 | | - | month period beginning with the first day of the first |
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89 | | - | month during which the applicant becomes enrolled for |
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90 | | - | benefits under Medicare Part B without regard to age; or |
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91 | | - | (B) was enrolled for benefits under Medicare Part B |
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92 | | - | without regard to age before January 1, 2025, and: |
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93 | | - | (i) submits the application for a Medicare supplement |
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94 | | - | policy or certificate during the six (6) month period |
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95 | | - | beginning January 1, 2025; or |
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96 | | - | (ii) is unable to submit an application for a Medicare |
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97 | | - | supplement policy or certificate because an application |
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98 | | - | is not yet available but makes a request for an |
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99 | | - | application for a Medicare supplement policy or |
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100 | | - | certificate during the six (6) month period beginning |
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101 | | - | January 1, 2025. |
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102 | | - | (b) After December 31, 2024, the issuer of a Medicare |
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103 | | - | supplement policy or certificate shall not: |
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104 | | - | (1) deny or condition the issuance or effectiveness of a |
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105 | | - | Medicare supplement policy or certificate to which subsection |
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106 | | - | (a)(3) applies because of the health status, claims experience, |
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107 | | - | receipt of health care, or medical condition of an individual |
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108 | | - | described in subsection (a); |
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109 | | - | (2) charge an individual described in subsection (a) a |
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110 | | - | premium rate for a standardized Plan A, Plan B, or Plan D |
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111 | | - | Medicare supplement policy or certificate to which subsection |
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112 | | - | (a)(3) applies that exceeds the premium rate the issuer |
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113 | | - | charges an individual who is sixty-five (65) years of age for |
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114 | | - | the same Medicare supplement policy or certificate; |
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115 | | - | (3) charge an individual described in subsection (a) a |
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116 | | - | premium rate for any standardized lettered Medicare |
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117 | | - | supplement policy or certificate other than those specified in |
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118 | | - | subdivision (2) to which subsection (a)(3) applies that exceeds |
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119 | | - | two hundred percent (200%) of the premium rate the issuer |
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120 | | - | charges an individual who is sixty-five (65) years of age for |
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121 | | - | the same Medicare supplement policy or certificate; or |
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122 | | - | (4) issue to an individual described in subsection (a) a |
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123 | | - | SEA 215 — Concur 4 |
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124 | | - | Medicare supplement policy or certificate to which subsection |
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125 | | - | (a)(3) applies that contains: |
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126 | | - | (A) a waiting period; or |
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127 | | - | (B) a preexisting condition limitation or exclusion. |
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128 | | - | SECTION 4. IC 27-8-13-9.5, AS AMENDED BY P.L.156-2020, |
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| 71 | + | 1 SECTION 1. IC 27-8-13-9, AS AMENDED BY P.L.227-2019, |
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| 72 | + | 2 SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE |
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| 73 | + | 3 JULY 1, 2024]: Sec. 9. (a) A Medicare supplement policy, contract, or |
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| 74 | + | 4 certificate in force in Indiana may not contain benefits that duplicate |
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| 75 | + | 5 benefits provided by Medicare. However, a change in Medicare |
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| 76 | + | 6 coverage that becomes effective after a Medicare supplement policy, |
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| 77 | + | 7 contract, or certificate is in force in Indiana and that causes a |
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| 78 | + | 8 duplication of benefits does not void the policy, contract, or certificate. |
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| 79 | + | 9 (b) The commissioner shall adopt rules under IC 4-22-2 to establish |
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| 80 | + | 10 specific standards for policy provisions of Medicare supplement |
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| 81 | + | 11 policies and certificates. Such standards shall be in addition to and in |
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| 82 | + | 12 accordance with Indiana law. No requirement of IC 27 relating to |
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| 83 | + | 13 minimum required policy benefits other than the minimum standards |
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| 84 | + | 14 contained in this chapter apply to Medicare supplement policies and |
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| 85 | + | 15 certificates. The standards may cover, but are not limited to: |
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| 86 | + | 16 (1) terms of renewability; |
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| 87 | + | 17 (2) initial and subsequent conditions of eligibility; |
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| 88 | + | ES 215—LS 6945/DI 55 2 |
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| 89 | + | 1 (3) nonduplication of coverage; |
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| 90 | + | 2 (4) probationary periods; |
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| 91 | + | 3 (5) benefit limitations, exceptions, and reductions; |
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| 92 | + | 4 (6) elimination periods; |
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| 93 | + | 5 (7) requirements for replacement; |
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| 94 | + | 6 (8) recurrent conditions; and |
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| 95 | + | 7 (9) definitions of terms. |
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| 96 | + | 8 (c) The commissioner may adopt rules under IC 4-22-2 that specify |
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| 97 | + | 9 prohibited policy provisions not specifically authorized by statute that, |
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| 98 | + | 10 in the opinion of the commissioner, are unjust, unfair, or unfairly |
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| 99 | + | 11 discriminatory to a person insured or proposed to be insured under a |
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| 100 | + | 12 Medicare supplement policy or certificate. |
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| 101 | + | 13 (d) Notwithstanding any other law, a Medicare supplement policy |
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| 102 | + | 14 or certificate shall not exclude or limit benefits for a loss incurred more |
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| 103 | + | 15 than six (6) months after the effective date of the policy because the |
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| 104 | + | 16 loss involves a preexisting condition. The policy or certificate shall not |
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| 105 | + | 17 define a preexisting condition more restrictively than a condition for |
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| 106 | + | 18 which medical advice was given or treatment was recommended by or |
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| 107 | + | 19 received from a physician within six (6) months before the effective |
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| 108 | + | 20 date of coverage. |
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| 109 | + | 21 (e) After June 30, 2020, an issuer that makes a Medicare |
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| 110 | + | 22 supplement policy or certificate available to a person who is at least |
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| 111 | + | 23 sixty-five (65) years of age and eligible for Medicare benefits as |
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| 112 | + | 24 described in 42 U.S.C. 1395c(1) shall make at least one (1) Medicare |
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| 113 | + | 25 supplement policy or certificate that meets the requirements of section |
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| 114 | + | 26 9.5 of this chapter available to an individual who is eligible for and |
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| 115 | + | 27 enrolled in Medicare by reason of disability as described in 42 U.S.C. |
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| 116 | + | 28 1395c(2). 42 U.S.C. 426 and 42 U.S.C. 423. This subsection expires |
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| 117 | + | 29 January 1, 2025. |
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| 118 | + | 30 SECTION 2. IC 27-8-13-9.1 IS ADDED TO THE INDIANA CODE |
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| 119 | + | 31 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY |
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| 120 | + | 32 1, 2024]: Sec. 9.1. After December 31, 2024, an issuer that makes a |
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| 121 | + | 33 Medicare supplement policy or certificate available to a person |
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| 122 | + | 34 who is at least sixty-five (65) years of age and is eligible for |
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| 123 | + | 35 Medicare benefits as described in 42 U.S.C. 1395c(1) shall make the |
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| 124 | + | 36 equivalent Medicare supplement policy or certificate available to |
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| 125 | + | 37 an individual who: |
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| 126 | + | 38 (1) is less than sixty-five (65) years of age; and |
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| 127 | + | 39 (2) is eligible for and enrolled in Medicare: |
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| 128 | + | 40 (A) by reason of a disability as described in 42 U.S.C. |
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| 129 | + | 41 426(b) and defined in 42 U.S.C. 423(d); or |
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| 130 | + | 42 (B) by reason of being medically determined to have end |
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| 131 | + | ES 215—LS 6945/DI 55 3 |
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| 132 | + | 1 stage renal disease as described in 42 U.S.C. 426-1. |
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| 133 | + | 2 SECTION 3. IC 27-8-13-9.2 IS ADDED TO THE INDIANA CODE |
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| 134 | + | 3 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY |
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| 135 | + | 4 1, 2024]: Sec. 9.2. (a) This section applies to an individual: |
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| 136 | + | 5 (1) who is less than sixty-five (65) years of age; |
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| 137 | + | 6 (2) who is eligible for and enrolled in Medicare: |
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| 138 | + | 7 (A) by reason of a disability as described in 42 U.S.C. |
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| 139 | + | 8 426(b) and defined in 42 U.S.C. 423(d); or |
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| 140 | + | 9 (B) by reason of being medically determined to have end |
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| 141 | + | 10 stage renal disease as described in 42 U.S.C. 426-1; and |
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| 142 | + | 11 (3) who applies for a Medicare supplement policy or |
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| 143 | + | 12 certificate and either: |
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| 144 | + | 13 (A) submits the application before or during the six (6) |
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| 145 | + | 14 month period beginning with the first day of the first |
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| 146 | + | 15 month during which the applicant becomes enrolled for |
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| 147 | + | 16 benefits under Medicare Part B without regard to age; or |
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| 148 | + | 17 (B) was enrolled for benefits under Medicare Part B |
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| 149 | + | 18 without regard to age before January 1, 2025, and: |
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| 150 | + | 19 (i) submits the application for a Medicare supplement |
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| 151 | + | 20 policy or certificate during the six (6) month period |
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| 152 | + | 21 beginning January 1, 2025; or |
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| 153 | + | 22 (ii) is unable to submit an application for a Medicare |
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| 154 | + | 23 supplement policy or certificate because an application |
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| 155 | + | 24 is not yet available but makes a request for an |
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| 156 | + | 25 application for a Medicare supplement policy or |
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| 157 | + | 26 certificate during the six (6) month period beginning |
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| 158 | + | 27 January 1, 2025. |
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| 159 | + | 28 (b) After December 31, 2024, the issuer of a Medicare |
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| 160 | + | 29 supplement policy or certificate shall not: |
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| 161 | + | 30 (1) deny or condition the issuance or effectiveness of a |
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| 162 | + | 31 Medicare supplement policy or certificate to which subsection |
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| 163 | + | 32 (a)(3) applies because of the health status, claims experience, |
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| 164 | + | 33 receipt of health care, or medical condition of an individual |
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| 165 | + | 34 described in subsection (a); |
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| 166 | + | 35 (2) charge an individual described in subsection (a) a |
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| 167 | + | 36 premium rate for a standardized Plan A, Plan B, or Plan D |
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| 168 | + | 37 Medicare supplement policy or certificate to which subsection |
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| 169 | + | 38 (a)(3) applies that exceeds the premium rate the issuer |
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| 170 | + | 39 charges an individual who is sixty-five (65) years of age for |
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| 171 | + | 40 the same Medicare supplement policy or certificate; |
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| 172 | + | 41 (3) charge an individual described in subsection (a) a |
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| 173 | + | 42 premium rate for any standardized lettered Medicare |
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| 174 | + | ES 215—LS 6945/DI 55 4 |
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| 175 | + | 1 supplement policy or certificate other than those specified in |
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| 176 | + | 2 subdivision (2) to which subsection (a)(3) applies that exceeds |
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| 177 | + | 3 two hundred percent (200%) of the premium rate the issuer |
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| 178 | + | 4 charges an individual who is sixty-five (65) years of age for |
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| 179 | + | 5 the same Medicare supplement policy or certificate; or |
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| 180 | + | 6 (4) issue to an individual described in subsection (a) a |
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| 181 | + | 7 Medicare supplement policy or certificate to which subsection |
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| 182 | + | 8 (a)(3) applies that contains: |
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| 183 | + | 9 (A) a waiting period; or |
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| 184 | + | 10 (B) a preexisting condition limitation or exclusion. |
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| 185 | + | 11 SECTION 4. IC 27-8-13-9.5, AS AMENDED BY P.L.156-2020, |
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| 186 | + | 12 SECTION 110, IS AMENDED TO READ AS FOLLOWS |
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| 187 | + | 13 [EFFECTIVE JULY 1, 2024]: Sec. 9.5. (a) This section applies: |
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| 188 | + | 14 (1) after June 30, 2020; and |
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| 189 | + | 15 (2) to a Medicare supplement policy or certificate made available |
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| 190 | + | 16 under section 9(e) of this chapter to an individual who is eligible |
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| 191 | + | 17 for and enrolled in Medicare by reason of disability as described |
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| 192 | + | 18 in 42 U.S.C. 1395c(2). |
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| 193 | + | 19 (b) A Medicare supplement policy or certificate described in |
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| 194 | + | 20 subsection (a) must meet the following requirements: |
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| 195 | + | 21 (1) Except as provided in this section, meet all requirements of |
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| 196 | + | 22 this chapter that apply to a Medicare supplement policy or |
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| 197 | + | 23 certificate made available to a person who is at least sixty-five |
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| 198 | + | 24 (65) years of age and eligible for Medicare as described in 42 |
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| 199 | + | 25 U.S.C. 1395c(1). |
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| 200 | + | 26 (2) Be standardized as Plan A by the federal Centers for Medicare |
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| 201 | + | 27 and Medicaid Services. |
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| 202 | + | 28 (c) An individual may enroll in a Medicare supplement policy or |
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| 203 | + | 29 certificate under this section as follows: |
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| 204 | + | 30 (1) At any time the individual is authorized or required to enroll |
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| 205 | + | 31 under federal law. |
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| 206 | + | 32 (2) Either: |
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| 207 | + | 33 (A) on July 1, 2020; or |
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| 208 | + | 34 (B) six (6) months after enrolling in Medicare Part B; |
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| 209 | + | 35 whichever is later. |
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| 210 | + | 36 (3) Within six (6) months after receiving notice that the individual |
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| 211 | + | 37 has been retroactively enrolled in Medicare Part B due to a |
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| 212 | + | 38 retroactive eligibility decision under 42 U.S.C. 1395. |
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| 213 | + | 39 (4) Within six (6) months after experiencing a qualifying event |
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| 214 | + | 40 under 42 U.S.C. 1395. |
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| 215 | + | 41 (d) Notwithstanding any other law, an issuer or another entity may |
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| 216 | + | 42 provide to an insurance producer or another agent of the issuer or other |
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| 217 | + | ES 215—LS 6945/DI 55 5 |
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| 218 | + | 1 entity a commission or other compensation of not more than two |
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| 219 | + | 2 percent (2%) of the premium for the sale of a Medicare supplement |
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| 220 | + | 3 policy or certificate described in subsection (a). |
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| 221 | + | 4 (e) This section expires January 1, 2025. |
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| 222 | + | ES 215—LS 6945/DI 55 6 |
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| 223 | + | COMMITTEE REPORT |
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| 224 | + | Madam President: The Senate Committee on Insurance and |
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| 225 | + | Financial Institutions, to which was referred Senate Bill No. 215, has |
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| 226 | + | had the same under consideration and begs leave to report the same |
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| 227 | + | back to the Senate with the recommendation that said bill be |
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| 228 | + | AMENDED as follows: |
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| 229 | + | Page 2, line 32, delete "(a)". |
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| 230 | + | Page 3, delete lines 2 through 22. |
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| 231 | + | Page 3, line 42, delete "2024;" and insert "2025;". |
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| 232 | + | Page 4, line 6, delete "2024." and insert "2025.". |
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| 233 | + | and when so amended that said bill do pass. |
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| 234 | + | (Reference is to SB 215 as introduced.) |
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| 235 | + | BALDWIN, Chairperson |
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| 236 | + | Committee Vote: Yeas 7, Nays 1. |
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| 237 | + | _____ |
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| 238 | + | SENATE MOTION |
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| 239 | + | Madam President: I move that Senate Bill 215 be amended to read |
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| 240 | + | as follows: |
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| 241 | + | Page 4, after line 3, begin a new paragraph and insert: |
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| 242 | + | "SECTION 4. IC 27-8-13-9.5, AS AMENDED BY P.L.156-2020, |
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