Insurance Regulatory Insights

VT

H275

New

1) Provides for guaranteed acceptance of an individual's application for coverage during the 6-month period following the individual’s 65th birthday and during an annual OE period that coincides with the federal OE period for Medicare Part D.

2) Prohibits insurers from charging additional premiums, fees, or penalties based on an individual’s failure to enroll in a Med Supp policy during their initial OE period upon attaining age 65. 

3) Prohibits preexisting condition exclusions in Med Supp policies and would permit enrollees to change at any time to another policy with comparable or lesser benefits. 

MT

SB335

New

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.

WV

HB2785

New

Dental insurers shall file an annual report of dental loss ratio 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.

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).

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 60 days after.

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. 

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

SB5351

Movement

^(revised)

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.

ND

HB1481

Movement

^(revised)

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

HB5465 / 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.