Insurance Regulatory Insights

VA

HB2100 / SB1199

Approved

Effective July 1, 2025

1) Insurers must 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).

2) During this OE period, the Insurer may not deny or condition the issuance or discriminate in pricing based on health status or claims history.

3) Insurers must notify individuals at least 15 days but no more than 30 days prior to the commencement of the annual open enrollment period, and include:

-dates on which the OE period begins and ends

-the rights of the individual during the OE period

-any modification of benefits or adjustment of premiums for current policy

UT

HB258

Approved

Effective May 7, 2025

Insurers must offer Med Supp policyholders an annual OE period beginning on the individual's birthday and ending 60 days after, where the individual can switch to a comparable or lower tier plan offered by the same issuer as their current plan, without medical underwriting. 

LA

Bulletin 2025-1

New

Provides guidance regarding Act 357, Senate Bill 463, which mandates new regulations for calculating and reporting dental loss ratios.

IN

HB1226

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.

MN

SF2498

Movement

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 “pre-existing 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

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 the 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.

State

Bill/Notice Number

Status

Summary

WA

SIM8002

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.

State

Bill/Notice Number

Status

Summary

WA

SB5351

Movement

Dental only plans will be required to submit information to the commissioner, including members, revenue, payments, and dental loss ratio, annually before April 1 for the preceding year, based only on Washington data.

ND

HB1481

Movement

Requires annual dental loss ratio report by April 13 annually for the last calendar year. 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%.

OK

HB2805

Movement

Requires annual dental loss ratio filing beginning May 1, 2026. Provides a formula for calculating minimum dental loss ratios and provides 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 June 30, 2027.

MO

SB680

Movement

Proposed bill outlining dental loss ratio calculation and annual reporting requirements. The loss ratio report should be filed by March 1 every year for the previous calendar year. Dental plans shall provide annual rebates to enrollees by August 1 of the year following the applicable plan year if the dental loss ratio is less than 85%.

KS

HCR5013

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.