Indiana 2024 Regular Session

Indiana Senate Bill SB0215 Compare Versions

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1+*ES0215.1*
2+February 15, 2024
3+ENGROSSED
4+SENATE BILL No. 215
5+_____
6+DIGEST OF SB 215 (Updated February 14, 2024 10:36 am - DI 141)
7+Citations Affected: IC 27-8.
8+Synopsis: Medicare supplement insurance. Provides that after
9+December 31, 2024, an issuer that makes a Medicare supplement
10+policy or certificate available to persons at least 65 years of age must
11+make the equivalent policy or certificate available to an individual
12+(Continued next page)
13+Effective: July 1, 2024.
14+Walker K, Messmer, Carrasco,
15+Freeman, Qaddoura,
16+Randolph Lonnie M, Becker
17+(HOUSE SPONSORS — CARBAUGH, ABBOTT, MORRIS, JUDY)
18+January 9, 2024, read first time and referred to Committee on Insurance and Financial
19+Institutions.
20+January 25, 2024, amended, reported favorably — Do Pass.
21+January 29, 2024, read second time, amended, ordered engrossed.
22+January 30, 2024, engrossed.
23+February 1, 2024, read third time, passed. Yeas 47, nays 2.
24+HOUSE ACTION
25+February 12, 2024, read first time and referred to Committee on Insurance.
26+February 15, 2024, amended, reported — Do Pass.
27+ES 215—LS 6945/DI 55 Digest Continued
28+under 65 years of age who is eligible for Medicare because of having
29+a federally defined disability or end stage renal disease. (Under current
30+law, an issuer that makes a Medicare supplement policy or certificate
31+available to persons at least 65 years of age is required only to make a
32+Plan A policy or certificate available to individuals under 65 years of
33+age, and is required to make the Plan A policy or certificate available
34+to an individual under 65 years of age who is eligible for Medicare
35+because of having a federally defined disability but is not required to
36+make the Plan A policy or certificate available to an individual under
37+65 years of age who is eligible for Medicare because of having end
38+stage renal disease.) Provides that if an individual who is less than 65
39+years of age, who is eligible for Medicare because of having a federally
40+defined disability or end stage renal disease, and who meets certain
41+conditions as to application timeliness applies for a Medicare
42+supplement policy or certificate, the issuer of the policy or certificate
43+is prohibited from: (1) denying or conditioning the issuance or
44+effectiveness of the individual's policy or certificate; (2) charging the
45+individual a premium rate for a policy or certificate standardized as
46+Plan A, B, or D that exceeds the premium rate the issuer charges an
47+individual who is 65 years of age; (3) charging the individual a
48+premium rate for any other standardized lettered policy or certificate
49+that exceeds 200% of the premium rate the issuer charges an individual
50+who is 65 years of age; or (4) issuing to the individual a policy or
51+certificate that contains a waiting period or a preexisting condition
52+limitation or exclusion. Provides for the expiration of Code provisions
53+that would be superseded by the new requirements applying to issuers
54+of Medicare supplement policies or certificates.
55+ES 215—LS 6945/DI 55ES 215—LS 6945/DI 55 February 15, 2024
156 Second Regular Session of the 123rd General Assembly (2024)
257 PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
358 Constitution) is being amended, the text of the existing provision will appear in this style type,
459 additions will appear in this style type, and deletions will appear in this style type.
560 Additions: Whenever a new statutory provision is being enacted (or a new constitutional
661 provision adopted), the text of the new provision will appear in this style type. Also, the
762 word NEW will appear in that style type in the introductory clause of each SECTION that adds
863 a new provision to the Indiana Code or the Indiana Constitution.
964 Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
1065 between statutes enacted by the 2023 Regular Session of the General Assembly.
11-SENATE ENROLLED ACT No. 215
12-AN ACT to amend the Indiana Code concerning insurance.
66+ENGROSSED
67+SENATE BILL No. 215
68+A BILL FOR AN ACT to amend the Indiana Code concerning
69+insurance.
1370 Be it enacted by the General Assembly of the State of Indiana:
14-SECTION 1. IC 27-8-13-9, AS AMENDED BY P.L.227-2019,
15-SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
16-JULY 1, 2024]: Sec. 9. (a) A Medicare supplement policy, contract, or
17-certificate in force in Indiana may not contain benefits that duplicate
18-benefits provided by Medicare. However, a change in Medicare
19-coverage that becomes effective after a Medicare supplement policy,
20-contract, or certificate is in force in Indiana and that causes a
21-duplication of benefits does not void the policy, contract, or certificate.
22-(b) The commissioner shall adopt rules under IC 4-22-2 to establish
23-specific standards for policy provisions of Medicare supplement
24-policies and certificates. Such standards shall be in addition to and in
25-accordance with Indiana law. No requirement of IC 27 relating to
26-minimum required policy benefits other than the minimum standards
27-contained in this chapter apply to Medicare supplement policies and
28-certificates. The standards may cover, but are not limited to:
29-(1) terms of renewability;
30-(2) initial and subsequent conditions of eligibility;
31-(3) nonduplication of coverage;
32-(4) probationary periods;
33-(5) benefit limitations, exceptions, and reductions;
34-(6) elimination periods;
35-(7) requirements for replacement;
36-(8) recurrent conditions; and
37-SEA 215 — Concur 2
38-(9) definitions of terms.
39-(c) The commissioner may adopt rules under IC 4-22-2 that specify
40-prohibited policy provisions not specifically authorized by statute that,
41-in the opinion of the commissioner, are unjust, unfair, or unfairly
42-discriminatory to a person insured or proposed to be insured under a
43-Medicare supplement policy or certificate.
44-(d) Notwithstanding any other law, a Medicare supplement policy
45-or certificate shall not exclude or limit benefits for a loss incurred more
46-than six (6) months after the effective date of the policy because the
47-loss involves a preexisting condition. The policy or certificate shall not
48-define a preexisting condition more restrictively than a condition for
49-which medical advice was given or treatment was recommended by or
50-received from a physician within six (6) months before the effective
51-date of coverage.
52-(e) After June 30, 2020, an issuer that makes a Medicare
53-supplement policy or certificate available to a person who is at least
54-sixty-five (65) years of age and eligible for Medicare benefits as
55-described in 42 U.S.C. 1395c(1) shall make at least one (1) Medicare
56-supplement policy or certificate that meets the requirements of section
57-9.5 of this chapter available to an individual who is eligible for and
58-enrolled in Medicare by reason of disability as described in 42 U.S.C.
59-1395c(2). 42 U.S.C. 426 and 42 U.S.C. 423. This subsection expires
60-January 1, 2025.
61-SECTION 2. IC 27-8-13-9.1 IS ADDED TO THE INDIANA CODE
62-AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
63-1, 2024]: Sec. 9.1. After December 31, 2024, an issuer that makes a
64-Medicare supplement policy or certificate available to a person
65-who is at least sixty-five (65) years of age and is eligible for
66-Medicare benefits as described in 42 U.S.C. 1395c(1) shall make the
67-equivalent Medicare supplement policy or certificate available to
68-an individual who:
69-(1) is less than sixty-five (65) years of age; and
70-(2) is eligible for and enrolled in Medicare:
71-(A) by reason of a disability as described in 42 U.S.C.
72-426(b) and defined in 42 U.S.C. 423(d); or
73-(B) by reason of being medically determined to have end
74-stage renal disease as described in 42 U.S.C. 426-1.
75-SECTION 3. IC 27-8-13-9.2 IS ADDED TO THE INDIANA CODE
76-AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
77-1, 2024]: Sec. 9.2. (a) This section applies to an individual:
78-(1) who is less than sixty-five (65) years of age;
79-(2) who is eligible for and enrolled in Medicare:
80-SEA 215 — Concur 3
81-(A) by reason of a disability as described in 42 U.S.C.
82-426(b) and defined in 42 U.S.C. 423(d); or
83-(B) by reason of being medically determined to have end
84-stage renal disease as described in 42 U.S.C. 426-1; and
85-(3) who applies for a Medicare supplement policy or
86-certificate and either:
87-(A) submits the application before or during the six (6)
88-month period beginning with the first day of the first
89-month during which the applicant becomes enrolled for
90-benefits under Medicare Part B without regard to age; or
91-(B) was enrolled for benefits under Medicare Part B
92-without regard to age before January 1, 2025, and:
93-(i) submits the application for a Medicare supplement
94-policy or certificate during the six (6) month period
95-beginning January 1, 2025; or
96-(ii) is unable to submit an application for a Medicare
97-supplement policy or certificate because an application
98-is not yet available but makes a request for an
99-application for a Medicare supplement policy or
100-certificate during the six (6) month period beginning
101-January 1, 2025.
102-(b) After December 31, 2024, the issuer of a Medicare
103-supplement policy or certificate shall not:
104-(1) deny or condition the issuance or effectiveness of a
105-Medicare supplement policy or certificate to which subsection
106-(a)(3) applies because of the health status, claims experience,
107-receipt of health care, or medical condition of an individual
108-described in subsection (a);
109-(2) charge an individual described in subsection (a) a
110-premium rate for a standardized Plan A, Plan B, or Plan D
111-Medicare supplement policy or certificate to which subsection
112-(a)(3) applies that exceeds the premium rate the issuer
113-charges an individual who is sixty-five (65) years of age for
114-the same Medicare supplement policy or certificate;
115-(3) charge an individual described in subsection (a) a
116-premium rate for any standardized lettered Medicare
117-supplement policy or certificate other than those specified in
118-subdivision (2) to which subsection (a)(3) applies that exceeds
119-two hundred percent (200%) of the premium rate the issuer
120-charges an individual who is sixty-five (65) years of age for
121-the same Medicare supplement policy or certificate; or
122-(4) issue to an individual described in subsection (a) a
123-SEA 215 — Concur 4
124-Medicare supplement policy or certificate to which subsection
125-(a)(3) applies that contains:
126-(A) a waiting period; or
127-(B) a preexisting condition limitation or exclusion.
128-SECTION 4. IC 27-8-13-9.5, AS AMENDED BY P.L.156-2020,
71+1 SECTION 1. IC 27-8-13-9, AS AMENDED BY P.L.227-2019,
72+2 SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
73+3 JULY 1, 2024]: Sec. 9. (a) A Medicare supplement policy, contract, or
74+4 certificate in force in Indiana may not contain benefits that duplicate
75+5 benefits provided by Medicare. However, a change in Medicare
76+6 coverage that becomes effective after a Medicare supplement policy,
77+7 contract, or certificate is in force in Indiana and that causes a
78+8 duplication of benefits does not void the policy, contract, or certificate.
79+9 (b) The commissioner shall adopt rules under IC 4-22-2 to establish
80+10 specific standards for policy provisions of Medicare supplement
81+11 policies and certificates. Such standards shall be in addition to and in
82+12 accordance with Indiana law. No requirement of IC 27 relating to
83+13 minimum required policy benefits other than the minimum standards
84+14 contained in this chapter apply to Medicare supplement policies and
85+15 certificates. The standards may cover, but are not limited to:
86+16 (1) terms of renewability;
87+17 (2) initial and subsequent conditions of eligibility;
88+ES 215—LS 6945/DI 55 2
89+1 (3) nonduplication of coverage;
90+2 (4) probationary periods;
91+3 (5) benefit limitations, exceptions, and reductions;
92+4 (6) elimination periods;
93+5 (7) requirements for replacement;
94+6 (8) recurrent conditions; and
95+7 (9) definitions of terms.
96+8 (c) The commissioner may adopt rules under IC 4-22-2 that specify
97+9 prohibited policy provisions not specifically authorized by statute that,
98+10 in the opinion of the commissioner, are unjust, unfair, or unfairly
99+11 discriminatory to a person insured or proposed to be insured under a
100+12 Medicare supplement policy or certificate.
101+13 (d) Notwithstanding any other law, a Medicare supplement policy
102+14 or certificate shall not exclude or limit benefits for a loss incurred more
103+15 than six (6) months after the effective date of the policy because the
104+16 loss involves a preexisting condition. The policy or certificate shall not
105+17 define a preexisting condition more restrictively than a condition for
106+18 which medical advice was given or treatment was recommended by or
107+19 received from a physician within six (6) months before the effective
108+20 date of coverage.
109+21 (e) After June 30, 2020, an issuer that makes a Medicare
110+22 supplement policy or certificate available to a person who is at least
111+23 sixty-five (65) years of age and eligible for Medicare benefits as
112+24 described in 42 U.S.C. 1395c(1) shall make at least one (1) Medicare
113+25 supplement policy or certificate that meets the requirements of section
114+26 9.5 of this chapter available to an individual who is eligible for and
115+27 enrolled in Medicare by reason of disability as described in 42 U.S.C.
116+28 1395c(2). 42 U.S.C. 426 and 42 U.S.C. 423. This subsection expires
117+29 January 1, 2025.
118+30 SECTION 2. IC 27-8-13-9.1 IS ADDED TO THE INDIANA CODE
119+31 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
120+32 1, 2024]: Sec. 9.1. After December 31, 2024, an issuer that makes a
121+33 Medicare supplement policy or certificate available to a person
122+34 who is at least sixty-five (65) years of age and is eligible for
123+35 Medicare benefits as described in 42 U.S.C. 1395c(1) shall make the
124+36 equivalent Medicare supplement policy or certificate available to
125+37 an individual who:
126+38 (1) is less than sixty-five (65) years of age; and
127+39 (2) is eligible for and enrolled in Medicare:
128+40 (A) by reason of a disability as described in 42 U.S.C.
129+41 426(b) and defined in 42 U.S.C. 423(d); or
130+42 (B) by reason of being medically determined to have end
131+ES 215—LS 6945/DI 55 3
132+1 stage renal disease as described in 42 U.S.C. 426-1.
133+2 SECTION 3. IC 27-8-13-9.2 IS ADDED TO THE INDIANA CODE
134+3 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
135+4 1, 2024]: Sec. 9.2. (a) This section applies to an individual:
136+5 (1) who is less than sixty-five (65) years of age;
137+6 (2) who is eligible for and enrolled in Medicare:
138+7 (A) by reason of a disability as described in 42 U.S.C.
139+8 426(b) and defined in 42 U.S.C. 423(d); or
140+9 (B) by reason of being medically determined to have end
141+10 stage renal disease as described in 42 U.S.C. 426-1; and
142+11 (3) who applies for a Medicare supplement policy or
143+12 certificate and either:
144+13 (A) submits the application before or during the six (6)
145+14 month period beginning with the first day of the first
146+15 month during which the applicant becomes enrolled for
147+16 benefits under Medicare Part B without regard to age; or
148+17 (B) was enrolled for benefits under Medicare Part B
149+18 without regard to age before January 1, 2025, and:
150+19 (i) submits the application for a Medicare supplement
151+20 policy or certificate during the six (6) month period
152+21 beginning January 1, 2025; or
153+22 (ii) is unable to submit an application for a Medicare
154+23 supplement policy or certificate because an application
155+24 is not yet available but makes a request for an
156+25 application for a Medicare supplement policy or
157+26 certificate during the six (6) month period beginning
158+27 January 1, 2025.
159+28 (b) After December 31, 2024, the issuer of a Medicare
160+29 supplement policy or certificate shall not:
161+30 (1) deny or condition the issuance or effectiveness of a
162+31 Medicare supplement policy or certificate to which subsection
163+32 (a)(3) applies because of the health status, claims experience,
164+33 receipt of health care, or medical condition of an individual
165+34 described in subsection (a);
166+35 (2) charge an individual described in subsection (a) a
167+36 premium rate for a standardized Plan A, Plan B, or Plan D
168+37 Medicare supplement policy or certificate to which subsection
169+38 (a)(3) applies that exceeds the premium rate the issuer
170+39 charges an individual who is sixty-five (65) years of age for
171+40 the same Medicare supplement policy or certificate;
172+41 (3) charge an individual described in subsection (a) a
173+42 premium rate for any standardized lettered Medicare
174+ES 215—LS 6945/DI 55 4
175+1 supplement policy or certificate other than those specified in
176+2 subdivision (2) to which subsection (a)(3) applies that exceeds
177+3 two hundred percent (200%) of the premium rate the issuer
178+4 charges an individual who is sixty-five (65) years of age for
179+5 the same Medicare supplement policy or certificate; or
180+6 (4) issue to an individual described in subsection (a) a
181+7 Medicare supplement policy or certificate to which subsection
182+8 (a)(3) applies that contains:
183+9 (A) a waiting period; or
184+10 (B) a preexisting condition limitation or exclusion.
185+11 SECTION 4. IC 27-8-13-9.5, AS AMENDED BY P.L.156-2020,
186+12 SECTION 110, IS AMENDED TO READ AS FOLLOWS
187+13 [EFFECTIVE JULY 1, 2024]: Sec. 9.5. (a) This section applies:
188+14 (1) after June 30, 2020; and
189+15 (2) to a Medicare supplement policy or certificate made available
190+16 under section 9(e) of this chapter to an individual who is eligible
191+17 for and enrolled in Medicare by reason of disability as described
192+18 in 42 U.S.C. 1395c(2).
193+19 (b) A Medicare supplement policy or certificate described in
194+20 subsection (a) must meet the following requirements:
195+21 (1) Except as provided in this section, meet all requirements of
196+22 this chapter that apply to a Medicare supplement policy or
197+23 certificate made available to a person who is at least sixty-five
198+24 (65) years of age and eligible for Medicare as described in 42
199+25 U.S.C. 1395c(1).
200+26 (2) Be standardized as Plan A by the federal Centers for Medicare
201+27 and Medicaid Services.
202+28 (c) An individual may enroll in a Medicare supplement policy or
203+29 certificate under this section as follows:
204+30 (1) At any time the individual is authorized or required to enroll
205+31 under federal law.
206+32 (2) Either:
207+33 (A) on July 1, 2020; or
208+34 (B) six (6) months after enrolling in Medicare Part B;
209+35 whichever is later.
210+36 (3) Within six (6) months after receiving notice that the individual
211+37 has been retroactively enrolled in Medicare Part B due to a
212+38 retroactive eligibility decision under 42 U.S.C. 1395.
213+39 (4) Within six (6) months after experiencing a qualifying event
214+40 under 42 U.S.C. 1395.
215+41 (d) Notwithstanding any other law, an issuer or another entity may
216+42 provide to an insurance producer or another agent of the issuer or other
217+ES 215—LS 6945/DI 55 5
218+1 entity a commission or other compensation of not more than two
219+2 percent (2%) of the premium for the sale of a Medicare supplement
220+3 policy or certificate described in subsection (a).
221+4 (e) This section expires January 1, 2025.
222+ES 215—LS 6945/DI 55 6
223+COMMITTEE REPORT
224+Madam President: The Senate Committee on Insurance and
225+Financial Institutions, to which was referred Senate Bill No. 215, has
226+had the same under consideration and begs leave to report the same
227+back to the Senate with the recommendation that said bill be
228+AMENDED as follows:
229+Page 2, line 32, delete "(a)".
230+Page 3, delete lines 2 through 22.
231+Page 3, line 42, delete "2024;" and insert "2025;".
232+Page 4, line 6, delete "2024." and insert "2025.".
233+and when so amended that said bill do pass.
234+(Reference is to SB 215 as introduced.)
235+BALDWIN, Chairperson
236+Committee Vote: Yeas 7, Nays 1.
237+_____
238+SENATE MOTION
239+Madam President: I move that Senate Bill 215 be amended to read
240+as follows:
241+Page 4, after line 3, begin a new paragraph and insert:
242+"SECTION 4. IC 27-8-13-9.5, AS AMENDED BY P.L.156-2020,
129243 SECTION 110, IS AMENDED TO READ AS FOLLOWS
130244 [EFFECTIVE JULY 1, 2024]: Sec. 9.5. (a) This section applies:
131245 (1) after June 30, 2020; and
132246 (2) to a Medicare supplement policy or certificate made available
133247 under section 9(e) of this chapter to an individual who is eligible
134248 for and enrolled in Medicare by reason of disability as described
135249 in 42 U.S.C. 1395c(2).
136250 (b) A Medicare supplement policy or certificate described in
137251 subsection (a) must meet the following requirements:
138252 (1) Except as provided in this section, meet all requirements of
139253 this chapter that apply to a Medicare supplement policy or
140254 certificate made available to a person who is at least sixty-five
141255 (65) years of age and eligible for Medicare as described in 42
142256 U.S.C. 1395c(1).
143257 (2) Be standardized as Plan A by the federal Centers for Medicare
144258 and Medicaid Services.
259+ES 215—LS 6945/DI 55 7
145260 (c) An individual may enroll in a Medicare supplement policy or
146261 certificate under this section as follows:
147262 (1) At any time the individual is authorized or required to enroll
148263 under federal law.
149264 (2) Either:
150265 (A) on July 1, 2020; or
151266 (B) six (6) months after enrolling in Medicare Part B;
152267 whichever is later.
153268 (3) Within six (6) months after receiving notice that the individual
154269 has been retroactively enrolled in Medicare Part B due to a
155270 retroactive eligibility decision under 42 U.S.C. 1395.
156271 (4) Within six (6) months after experiencing a qualifying event
157272 under 42 U.S.C. 1395.
158273 (d) Notwithstanding any other law, an issuer or another entity may
159274 provide to an insurance producer or another agent of the issuer or other
160275 entity a commission or other compensation of not more than two
161276 percent (2%) of the premium for the sale of a Medicare supplement
162277 policy or certificate described in subsection (a).
163-(e) This section expires January 1, 2025.
164-SEA 215 — Concur President of the Senate
165-President Pro Tempore
166-Speaker of the House of Representatives
167-Governor of the State of Indiana
168-Date: Time:
169-SEA 215 — Concur
278+(e) This section expires January 1, 2025.".
279+(Reference is to SB 215 as printed January 26, 2024.)
280+WALKER K
281+_____
282+COMMITTEE REPORT
283+Mr. Speaker: Your Committee on Insurance, to which was referred
284+Senate Bill 215, has had the same under consideration and begs leave
285+to report the same back to the House with the recommendation that said
286+bill be amended as follows:
287+Page 3, line 36, after "a" insert "standardized Plan A, Plan B, or
288+Plan D".
289+Page 3, line 40, delete "or".
290+Page 3, between lines 40 and 41, begin a new line block indented
291+and insert:
292+"(3) charge an individual described in subsection (a) a
293+premium rate for any standardized lettered Medicare
294+supplement policy or certificate other than those specified in
295+subdivision (2) to which subsection (a)(3) applies that exceeds
296+two hundred percent (200%) of the premium rate the issuer
297+charges an individual who is sixty-five (65) years of age for
298+ES 215—LS 6945/DI 55 8
299+the same Medicare supplement policy or certificate; or".
300+Page 3, line 41, delete "(3)" and insert "(4)".
301+and when so amended that said bill do pass.
302+(Reference is to SB 215 as reprinted January 30, 2024.)
303+CARBAUGH
304+Committee Vote: yeas 10, nays 0.
305+ES 215—LS 6945/DI 55