Insurance Regulatory Insights

MN

HF2335 / SF2498

New

1) Provides that upon reinstatement, after suspension based on entitlement to medical assistance, there is no additional waiting period with respect to treatment of pre-existing conditions.

2) Pre-existing limitations shall appear as a separate paragraph of the​ policy or certificate and be labeled as "preexisting condition limitations.”

3) Revises Replacement Notice language.

4) Repeals Minnesota Statutes 2024, sections 62A.3099, subdivision 18b; and 62A.31, subdivision​ 13.21 1w, related to an Open Enrollment Period.

MN

SF2477

New

1) Adds that community rating may take into account premium increases in recognition of late enrollment or reenrollment. Premium increase of 10% applied as a flat percentage of premium for an individual who enrolls outside of initial enrollment and is not eligible for GI;

2) Prohibits refusing to renew plan unless enrollee has failed to pay premiums, performed fraud or material misrepresentation, moves out of the area where the issuer operates, or the carrier discontinues the plan; and

3) To discontinue a plan, the carrier must provide written notice to the commissioner no later than May 1 of the year before the date of discontinuance, provide written notice to each enrollee at least 90 days before discontinuance, and offer the individual an option to purchase another currently offered plan on a GI basis.

KS

HCR5013

New

Resolution urging Congress to give state insurance regulators authority over Medicare Advantage plans, and marketing and consumer disclosure laws and regulations on Medicare plans.

MN

HF2334

New

Requires annual dental rate filing submission that will be effective the next calendar year. Provides dental loss ratio reporting requirements beginning March 1, 2027. Dental loss ratio should not be less than 85%, and requires an annual refund of excess premium if loss ratio is less than 85%.

TX

HB1840

Movement

Proposed bill requiring Med Supp issuers to offer the same plans available to individuals 65 and older at the same premium rate to individuals under 65 who are eligible and enrolled in Medicare due to disability or ESRD.

NM

SB80

Movement

Proposed bill requiring insurers to notify of and offer Med Supp policyholders an annual OE period beginning on the individual's birthday and ending 60 days after.

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.

MD

SB956

Movement

^(revised)

For policies issued in the open enrollment period during the 30 days following the birthday of an individual enrolled in a Medicare supplement policy (§ 15–909(B)(6)) or to an individual at least 65 years old, a carrier shall pay the same commission rate to an insurance producer for the sale of Med Supp policy without regard to whether the policy is sold during an OE period, as an underwritten policy, or under the Birthday Rule.

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.

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

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.

ND

HB1481

Movement

Requires annual dental rate filing submission that will be effective the following January. Provides dental loss ratio should not be less than 75% and requires an annual refund of excess premium if loss ratio is less than 75%.

RI

S0346

Movement

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.