Insurance Regulatory Insights

RI

H5494

New

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; and

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.

RI

HB5431

New

U65- Individuals enrolled in Medicare Parts A and B would have a GI right to enrollment in any standardized Med Supp Plan A, if enrolled during the designated month-long period.

Over 65- Individuals would have a GI right to enroll in any Med Supp plan during the designated month-long period.

For both situations, the issuance or coverage shall not be conditioned on medical underwriting provided that the applicant, having been enrolled in Medicare Part A and Part B, enrolled in a MA plan under Medicare Part C and remains enrolled when the Med Supp application is submitted.

RI

HB5499 / S0267

New

Amends the current Med Supp regulation to implement continuous OE rights for individuals eligible for Medicare due to age (65+) or under 65 due to disability or ESRD. Also requires community rating. The Office of the Health Commissioner will conduct an annual review of Med Supp premium rates.

WV

HB2267 / SB347

New

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.

RI

HB5434

New

Bill seeking to protect and expand traditional Medicare while urging the United States Government to pass legislation and for CMS to take administrative action to protect citizens against the Medicare Advantage issues described within the bill.

RI

HB5465

New

Establishes "The Rhode Island Comprehensive Health Insurance Program," a single-payer health care insurance system, consolidating public and private payments into a Medicare-for-all style program, funded by progressive taxes.

NH

Bulletin 25-03

New

Sets forth expectations for how insurers should govern the development, acquisition, and use of AI technology. Also advises of the type of information and documentation that the Department may request during an investigation or examination regarding an insurer's use of AI Systems

IN

HB1226

Movement

^(revised)

Proposed bill that requires beginning January 1, 2026, Med Supp policyholders, who are at least 65 years of age, are eligible for an annual OE period within 60 days of their birthday, where they can purchase the same lettered, including any variation of the letter, Med Supp plan made available by an issuer different than their current policy.

VA

HB2100

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 or lesser benefits than those provided by the current coverage (does not include innovative benefits).

IA

HF 308 

Movement

^{(Renumbered- previously HF70)}

Proposed bill that Med Supp policyholders, including individuals under the age of 65 who qualify for Medicare due to disability, are eligible for a 31-day annual OE period beginning March 1. During the OE period, for at least one Med Supp policy offered and available in the state, issuers are prohibited from using medical underwriting, pre-existing condition exclusions, and discriminating in pricing. 

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. 

MS

HB1177

Movement

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 Medicare Advantage Plan or Med Supp Plan with whom they have an established business relationship or who has requested a call from the company.

VA

SB1199

Movement

^(revised)

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 or lesser benefits than those provided by the current coverage (does not include innovative benefits).

TN

SB0552

Movement

Extends the period of time following delivery of a Med Supp policy or certificate during which an applicant may have the premium refunded from 30 to 60 days.

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.

NH

HB774

Movement

Every issuer of Med Supp shall allow any beneficiary eligible for Medicare, including those disenrolling from current coverage by supplement insurance or a MA 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 MA plans in the state of NH must also offer Med Supp plans. Provides that MA plans must provide an outline of coverage at the time of application and MA policies must have a 30-day premium refund notice. 

WA

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.