Insurance Regulatory Insights

MA

Bulletin 2025-01

New

Provides the "Massachusetts Consumer’s Guide to Medicare" which is required to be attached and provided with the federal publication to persons eligible for Medicare.

OR

SB1181

New

Prohibits denial of a Med Supp policy due to a preexisting condition and charging different rates based on health status, geographic location, claims experience, age, and medical condition:

1) prior to or during the 6-month period beginning with the first day of the month the individual enrolled in Medicare Part B; or

2) during an annual 90-day OE period that begins January 1 each year.

AL

SB204

New

Requires insurers that provide dental coverage to allow covered beneficiaries to carry over the amount of unspent annual benefit maximum dollars into the next year for payment or reimbursement of dental care services.

AL

SB203

New

Proposed bill outlining dental loss ratio calculation and annual reporting requirements. The minimum dental loss ratio will be 85%, and the commissioner may take remediation, including rebate requirements, if carriers report a dental loss ratio below this amount.

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. 

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.

OK

HB2805

Movement

Requires annual dental loss ratio filing and rate submissions. Expected rate increases should be filed with the commissioner at least 60 days prior to proposed implementation. Provides a formula for calculating minimum dental loss ratios, provides minimum requirements, and requires an annual rebate if loss ratio is less than 85% (large group) and 80% (individual and small group).

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.

MT

SB335

Movement

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.

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.