Insurance Regulatory Insights

AR

Bulletin 03-2025

New

Bulletin reminding licensed entities which appoint insurance producers in the state to annually file appointment renewals and terminations with the Insurance Commissioner via NIPR.

WV

SB5351

New

Dental insurers shall submit a supplemental data statement for the preceding year by April 1 annually, that includes member, revenue, payment, and loss ratio data.

VA

HB2100 / SB1199

Movement

Proposed bill to require insurers to offer Med Supp policyholders an annual OE period beginning on the individual's birthday and ending 60 days after, where the individual can purchase any policy made available by any insurer in Virginia that offers the same benefits as the current coverage (does not include innovative benefits).

NH

HB774

Movement

^(fail)

Every issuer of Med Supp shall allow any beneficiary eligible for Medicare, including those disenrolling from current coverage by supplement insurance or a Med Advantage plan, to be offered a Med Supp plan based on community rating for the age of the recipient during the Medicare OE Period. Pricing of premiums based on medical underwriting or denial due to medical underwriting to cover preexisting conditions is prohibited for Med Supp plans.

Every insurer that offers Medicare Advantage Plans in the state of NH must also offer Med Supp Plans. Provides that Medicare Advantage Plans must provide an outline of coverage at the time of application and Med Advantage policies must have a 30-day premium refund notice. 

MS

HB1177

Movement

^(fail)

Amends SECTION 77-3-707, MISSISSIPPI CODE OF 1972, authorizing a telephone solicitor to make a telephone solicitation to any person in the state regarding any MA plan or Med Supp plan with whom they have an established business relationship or who has requested a call from the company.

IL

HB2775

Movement

Provides that Med Supp issuers shall provide coverage to an applicant who is U65 and voluntarily switches from a MA plan to a Medicare plan under Parts A, B, or D, or any combination of, as long as the application for Med Supp is submitted within 30 days after the effective date of the new plan. The Med Supp issuer may not charge a higher cost than what is normally offered to applicants who have become newly eligible for Medicare, nor raise costs or deny coverage for a preexisting condition.

OR

SB1181

Movement

Prohibits denial of a Med Supp policy due to a preexisting condition and charging different rates based on health status, geographic location, claims experience, age, and medical condition:

1) prior to or during the 6-month period beginning with the first day of the month the individual enrolled in Medicare Part B; or

2) during an annual 90-day OE period that begins January 1 each year.

GA

HB323

Movement

An individual may enroll in a Med Supp policy when currently enrolled in Medicare by reason of disability or ESRD during a one-time OE period of six months beginning on January 1, 2026.   An insurer shall not charge premium rates for a standardized Plan A, B, or D Med Supp policy for an U65 individual that exceeds premium rates charged for a 65+ individual. 

For Med Supp plans other than A, B, or D, insurers shall not charge premium rates for individuals U65 that exceed 200% of the rate for an individual over 65 or issue a Med Supp policy with a waiting period or pre-existing condition limitation/exclusion.

UT

HB258

Movement

Proposed bill creating a Med Supp OE period annually beginning on an enrollee's birthday and ending 60 days later, where an enrollee can switch to a comparable or lower tier plan offered by the same issuer as their current plan, without medical underwriting. 

TX

SB1945 / HB2516

Movement

An entity that offers coverage under a Med Supp plan to individuals over 65 must offer the same coverage to individuals under 65 who are eligible for and enrolled in Medicare by reason of disability or ESRD at the same premium rate and without pre-existing condition limitations and medical underwriting if enrolled during:

1) a one-time OE period between August 31, 2025 and March 2, 2026;

2)  the six-month period beginning the first day of the first month the individual becomes enrolled for benefits under Medicare Part B;

3)  a 60-day OE period each year beginning on the date of the individual's birth; or

4) a special enrollment period designated by the commissioner.

RI

S0610 / H5494

Movement

Prohibits the use of gender, attained-age, or issue-age rating structures for Med Supp policies issued after January 1, 2026, enforcing community rating as the sole methodology. Individuals with existing policies that utilize the now-prohibited rating structures will be allowed to maintain their current coverage or switch to new policies starting January 1, 2026.
 
Removes previous provision of guaranteed issue rights during an annual enrollment period, replacing with:
1) a 6-month OE period for individuals U65 who qualify for Medicare due to disability or ESRD upon reaching 65;

2) U65 individuals enrolled in a MA plan or Med Supp Plan A due to disability or ESRD have GI rights for any Med Supp Plan A made available in the state;

3) Individuals who have been covered by a Med Supp policy or MA plan with no gaps in coverage greater than 90 days will have a 30-day open enrollment period annually beginning on their birthday for any available Med Supp policy.

WV

HB2267

Movement

Amends and reenacts, §64-7-1 of the Code of West Virginia, 1931, relating to authorizing the Insurance Commissioner to promulgate a legislative rule relating to Med Supp Insurance.

OK

HB2805

Movement

^(Revised)

Requires annual dental loss ratio filing and rate submissions. Provides a formula for calculating minimum dental loss ratios and that the Commissioner will develop an average dental loss ratio.

OK

SB1101

Movement

Proposed bill outlining dental loss ratio calculation requirements. Would require carriers to annually file a dental loss ratio form for the preceding calendar year beginning July 31, 2026.

MT

SB335

Movement

Dental insurers shall file an annual statement of dental loss ratio annually by March 1. Dental loss ratios shouldn't be less than 80%, and if less than 80%, the carrier shall refund the excess premium to its covered individuals/groups before August 1 of the calendar year following the year for which the ratio described.

AL

SB204 / HB400

Movement

Requires insurers that provide dental coverage to allow covered beneficiaries to carry over the amount of unspent annual benefit maximum dollars into the next year for payment or reimbursement of dental care services.

AL

SB203 / HB401

Movement

Proposed bill outlining dental loss ratio calculation and annual reporting requirements.  The minimum dental loss ratio will be 85%, and the commissioner may take remediation, including rebate requirements, if carriers report a dental loss ratio below this amount.

WV

HB2785

Movement

Dental insurers shall file an annual report of dental loss ratio annually, that also includes number of enrollees, cost-sharing and deductible amounts, annual maximum coverage limit, and the number of enrollees who meet or exceed the annual coverage limit. The commissioner will calculate an average dental loss ratio and outlier plans may receive remediation or enforcement actions, including refunding the excess premium to its covered individuals/groups before September 1 of the fiscal year following the year for which the ratio described.

NH

SB121

Movement

Any licensed insurance company offering Medicare Advantage Plans in the state should provide 120 days' written notice to the commissioner when modifying or terminating its contract with CMS by mutual consent pursuant to 42 CFR 422.508, ceasing to offer MA plans in a particular county, or significantly modifying the offerings of its MA plans. 

WV

SJM8002

Movement

Bill seeking to level the playing field between Original Medicare and Medicare Advantage by

1) eliminating the Original Medicare 20 percent copays and
setting an out-of-pocket cap on medical expenses;

2) adding benefits to Original Medicare such as dental, vision, and hearing coverage;

3) eliminating the allowed excessive administrative costs and profits in the Medicare Advantage programs; and

4) recouping funds for the Medicare trust fund from the Medicare Advantage overpayments, fraud, and abuse