Insurance Regulatory Insights

IA

HB70

New

Proposed bill providing that Med Supp policyholders, including individuals under the age of 65 who qualify for Medicare due to disability, are eligible for a 30-day annual open enrollment 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 pricing discrimination. 

TX

HB1840

New

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.

UT

HB258

New

Proposed bill creating a Med Supp Open Enrollment period annually from Oct 15 through Dec 7, where an enrollee can switch to a comparable or lower tier plan offered by the same issuer as their current plan, without medical underwriting. Also, would implement the offering of Med Supp plans to individuals under 65 due to disability or ESRD.

WA

SJM 8002

Movement

Proposed 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.

NE

LB64

Movement

Proposed bill requiring insurers to offer Med Supp policyholders an annual open enrollment period beginning on the individual's birthday and 30 days after, effective January 1, 2026.

VA

HB2100

Movement

Proposed bill requiring insurers to offer Med Supp policyholders an annual open enrollment 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).

All States

(US Congress)

HR379

New

Proposed bill providing that the rule relating to "Short-Term, Limited-Duration Insurance and Independent, Noncoordinated Excepted Benefits Coverage" (89 Fed. Reg. 23338 (April 3, 2024)) shall have no force or effect.

CMS

CMS Release

(01/17/2025)

Fact Sheet

New

HHS announced the selection of 15 additional drugs covered under Medicare Part D for price negotiations. In accordance with the Inflation Reduction Act, the negotiations with participating drug companies for these 15 drugs will occur in 2025 and any negotiated prices will become effective in 2027.

WA

SB5351

New

Proposed bill outlining dental loss ratio calculation and reporting requirements.

ND

HB1481

New

Requires annual dental rate filing submission that will be effective the following January. Provides that dental loss ratio should not be less than 83% and requires an annual refund of excess premium if loss ratio is less than 83%.

MD

Bulletin 25-3

New

All insurers, non-profit health service plans, and dental plan organizations authorized to issue insurance contracts that provide health insurance, life insurance, property insurance, or casualty insurance in Maryland shall provide certain emergency contact and disaster planning information to the Maryland Insurance Administration by close of business on April 15, 2025.