Rhode Island 2023 Regular Session

Rhode Island House Bill H6179 Compare Versions

Version 1 (Old)

Version 2 (New)

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5		-	2023 -- H 6179 ~~AS AMENDED~~
	5	+	2023 -- H 6179
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7	7		LC002612
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9	9		S TATE OF RHODE IS LAND
10	10		IN GENERAL ASSEMBLY
11	11		JANUARY SESSION, A.D. 2023
12	12		____________
13	13
14	14		A N A C T
15	15		RELATING TO INSURANCE – MEDICARE SUPPLEMENT INSURANCE POLICIES
16	16		Introduced By: Representatives Donovan, Messier, McNamara, Kislak, Ajello,
17	17		Speakman, Carson, Fogarty, Shallcross Smith, and Potter
18	18		Date Introduced: March 22, 2023
19	19		Referred To: House Health & Human Services
20	20
21	21
22	22		It is enacted by the General Assembly as follows:
23	23		SECTION 1. Section 27-18.2-3 of the General Laws in Chapter 27-18.2 entitled "Medicare 1
24	24		Supplement Insurance Policies" is hereby amended to read as follows: 2
25	25		27-18.2-3. Standards for policy provisions. [Effective July 1, 2023.] 3
26	26		(a) No Medicare supplement insurance policy or certificate in force in the state shall contain 4
27	27		benefits that duplicate benefits provided by Medicare. 5
28	28		(b) Notwithstanding any other provision of law of this state, a Medicare supplement policy 6
29	29		or certificate shall not exclude or limit benefits for loss incurred more than six (6) months from the 7
30	30		effective date of coverage because it involved a preexisting condition. The policy or certificate shall 8
31	31		not define a preexisting condition more restrictively than a condition for which medical advice was 9
32	32		given or treatment was recommended by or received from a physician within six (6) months before 10
33	33		the effective date of coverage. 11
34	34		(c) The commissioner shall adopt reasonable regulations to establish specific standards for 12
35	35		policy provisions of Medicare supplement policies and certificates. Those standards shall be in 13
36	36		addition to and in accordance with the applicable laws of this state, including but not limited to §§ 14
37	37		27-18-3(a) and 42-62-12 and regulations promulgated pursuant to those sections. No requirement 15
38	38		of this title or chapter 62 of title 42 relating to minimum required policy benefits, other than the 16
39	39		minimum standards contained in this chapter, shall apply to Medicare supplement policies and 17
40	40		certificates. The standards may cover, but not be limited to: 18
41	41		(1) Terms of renewability; 19
42	42
43	43
44	44		LC002612 - Page 2 of 4
45	45		(2) Initial and subsequent conditions of eligibility; 1
46	46		(3) Nonduplication of coverage; 2
47	47		(4) Probationary periods; 3
48	48		(5) Benefit limitations, exceptions, and reductions; 4
49	49		(6) Elimination periods; 5
50	50		(7) Requirements for replacement; 6
51	51		(8) Recurrent conditions; and 7
52	52		(9) Definitions of terms. 8
53	53		(d) The commissioner may adopt reasonable regulations that specify prohibited policy 9
54	54		provisions not specifically authorized by statute, if, in the opinion of the commissioner, those 10
55	55		provisions are unjust, unfair, or unfairly discriminatory to any person insured or proposed to be 11
56	56		insured under a Medicare supplement policy or certificate. 12
57	57		(e) The commissioner shall adopt reasonable regulations to establish minimum standards 13
58	58		for premium rates, benefits, claims payment, marketing practices, and compensation arrangements 14
59	59		and reporting practices for Medicare supplement policies and certificates. 15
60	60		(f) The commissioner may adopt any reasonable regulations necessary to conform 16
61	61		Medicare supplement policies and certificates to the requirements of federal law and regulations 17
62	62		promulgated pursuant to federal law, including but not limited to: 18
63	63		(1) Requiring refunds or credits if the policies or certificates do not meet loss ratio 19
64	64		requirements; 20
65	65		(2) Establishing a uniform methodology for calculating and reporting loss ratios; 21
66	66		(3) Assuring public access to policies, premiums, and loss ratio information of issuers of 22
67	67		Medicare supplement insurance; 23
68	68		(4) Establishing a process for approving or disapproving policy forms and certificate forms 24
69	69		and proposed premium increases; 25
70	70		(5) Establishing a policy for holding public hearings prior to approval of premium increases 26
71	71		that may include the applicant’s provision of notice of the proposed premium increase to all 27
72	72		subscribers subject to the proposed increase, at least ten (10) days prior to the hearing; and 28
73	73		(6) Establishing standards for Medicare select policies and certificates. 29
74	74		(g) Each Medicare supplement Plan A policy or applicable certificate that an issuer 30
75	75		currently, or at any time hereafter, makes available in this state shall be made available to any 31
76	76		applicant under the age of sixty-five (65) who is eligible for Medicare due to a disability or end-32
77	77		stage renal disease, provided that the applicant submits their application during the first six (6) 33
78	78		months immediately following the applicant’s initial eligibility for Medicare Part B, or alternate 34
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82	82		enrollment period as determined by the commissioner. The issuance or coverage of any Medicare 1
83	83		supplement policy pursuant to this section shall not be conditioned on the medical or health status 2
84	84		or receipt of health care by the applicant; and no insurer shall perform individual medical 3
85	85		underwriting on any applicant in connection with the issuance of a policy pursuant to this 4
86	86		subsection. 5
87		-	(h) Individuals enrolled in Medicare Parts A and B applying for a Medicare supplement 6
88		-	plan, regardless of age, shall receive guaranteed issue rights for standardized Medicare Supplement 7
89		-	Plan A during an annual enrollment period of at least one month each calendar year, as established 8
90		-	by the issuer. The issuance or coverage of any Medicare supplement policy pursuant to this section 9
91		-	shall not be conditioned on the medical or health status or receipt of health care by the applicant; 10
92		-	and no insurer shall perform individual medical underwriting in connection with the issuance of a 11
93		-	policy pursuant to this subsection; provided: 12
94		-	(1) That the applicant, having been enrolled in Medicare Part A and Part B, enrolled in a 13
95		-	Medicare Advantage plan under Medicare Part C, and remains enrolled in such a plan when the 14
96		-	Medicare supplement application is submitted. 15
97		-	SECTION 2. This act shall take effect upon passage. 16
	87	+	(h) Medicare recipients over sixty-five (65) years of age applying for Medicare supplement 6
	88	+	plan shall receive guaranteed issue rights. The issuance or coverage of any Medicare supplement 7
	89	+	policy pursuant to this section shall not be conditioned on the medical or health status or receipt of 8
	90	+	health care by the applicant; and no insurer shall perform individual medical underwriting in 9
	91	+	connection with the issuance of a policy pursuant to this subsection. 10
	92	+	SECTION 2. This act shall take effect upon passage. 11
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104	99		EXPLANATION
105	100		BY THE LEGISLATIVE COUNCIL
106	101		OF
107	102		A N A C T
108	103		RELATING TO INSURANCE – MEDICARE SUPPLEMENT INSURANCE POLICIES
109	104		***
110	105		This act would provide all Medicare recipients over sixty-five (65) years of age applying 1
111	106		for Medicare supplement plan guaranteed issue rights. The issuance or coverage of any Medicare 2
112	107		supplement plan would not be conditioned on the medical or health status or receipt of health care 3
113	108		by the applicant and no insurer shall perform individual medical underwriting in regards to issuance 4
114	109		of a policy. 5
115	110		This act would take effect upon passage. 6
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