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- Insurance Regulatory Insights
Telos Actuarial brings you this week’s legislative and regulatory insurance insights from around the nation.
The newsletter is grouped into two categories:
New: proposed law recently introduced for consideration by Legislature
Movement: bill has progressed in legislative process
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New: proposed law recently introduced for consideration by Legislature
Medicare Advantage & Part D
State | Bill/Notice Number | Status | Summary |
|---|---|---|---|
All | New | Withdraws HPMS Memo from December 3, 2024 entitled “Change to Beneficiary Use of the SEP for Individuals Affected by a Government Entity-Declared Disaster or Other Emergency," which announced beneficiaries were required to make an election using the Special Election Period for Individuals Affected by a Government Entity-Declared Disaster or Other Emergency (Disaster/Emergency SEP) by contacting 1-800- MEDICARE to access the disaster/emergency SEP effective April 1, 2025. |
All Products
State | Bill/Notice Number | Status | Summary |
|---|---|---|---|
AR | New | Healthcare insurers shall not use artificial intelligence in the delivery of healthcare services unless the artificial intelligence is approved by the United States Food and Drug Administration and verified by a quality assurance laboratory. | |
NH | New | The Insurance Department will not enforce compliance with the annual filing requirements for | |
WI | 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 OCI may request during an investigation or examination regarding an Insurer's use of AI Systems |
Movement: bill has progressed in legislative process
Medicare Supplement
State | Bill/Notice Number | Status | Summary |
|---|---|---|---|
MN | Movement | 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. | |
IN | Movement | 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. | |
IL | 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 pre-existing condition. | |
TN | 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. | |
TX | 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:
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. |
Medicare Advantage
State | Bill/Notice Number | Status | Summary |
|---|---|---|---|
KS | Movement | Resolution urging Congress to give state insurance regulators authority over Medicare Advantage plans, and marketing and consumer disclosure laws and regulations on Medicare plans. |
Telos Actuarial’s team of experienced regulatory compliance professionals are ready to help YOU stay informed of legislative and regulatory changes. Reach out to us for more information!