Insurance Regulatory Insights

IL

HB2775

New

Provides that Med Supp issuers shall provide coverage to an applicant who 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 preexisting condition.

WA

HB1603

New

Provides GI of Med Supp coverage to an individual who voluntarily disenrolls from a MA plan and enrolls in Medicare Parts A and B.

RI

S0167

New

U65-

Individuals enrolled in Medicare Parts A and B would have a GI right to enrollment in any standardized plan that provides supplement coverage to Plan A, if enrolled during the designated month-long period.

Over 65-

Individuals would have a GI right to enroll in any Med Supp plan during the designated month-long period.

For both situations, the issuance or coverage shall not be conditioned on medical underwriting provided that the applicant, having been enrolled in Medicare Part A and Part B, enrolled in a MA plan under Medicare Part C and remains enrolled when the Med Supp application is submitted.

GA

HB323

New

An individual may enroll in a Med Supp policy when such individual is 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.

TX

HB2516

New

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:

(1) a one-time OE period between August 31, 2025 and March 2, 2026;

(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.

MD

SB956

New

For policies issued in the OEperiod during the 30 days following the birthday of an individual enrolled in a Med Supp policy (§ 15–909(B)(6)), a carrier shall pay the same commission rate to a broker for the sale of policy sold during a GI period as one sold during an OE period.

OK

SB1101

New

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 21, 2026.

KS

SB182

New

Proposed bill outlining dental loss ratio calculation and annual reporting requirements. After July 1, 2026, the required 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.

MO

SB680

New

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%.

MN

SF1204

New

Proposed bill outlining dental loss ratio calculation and annual filing and reporting requirements. The loss ratio report should be filed by March 1, 2027, and annually thereafter. Dental plans shall provide annual rebates to enrollees if the dental loss ratio is less than 85%.

WA

HB1639

New

An entity offering MA coverage to Washington residents shall disclose the following prior to enrollment and upon request after enrollment:

(a) The entity's claims denial rate expressed as a percentage;

(b) The percentage of denied claims granted upon appeal; and

(c) The process through which an enrollee may appeal a denial of coverage.

CA

SB242

Movement

Proposed bill making Med Supp plans available to otherwise qualified applicants who are under 65 and have ESRD. Also, would require a 90-day OE period beginning January 1 each year for any Med Supp plan available from an issuer.

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 or lesser benefits than those provided by the current coverage (does not include innovative benefits).

WA

HB1754

Movement

Requires Med Supp insurance to be offered on a GI basis during any annual OE period for Medicare Part B or Medicare Advantage.

TN

HB0508 / SB0552

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.

IA

SF71

Movement

Proposed bill providing Med Supp policyholders an annual OE period beginning on the individual's birthday and ending 30 days after, where the individual can purchase any policy that offers the same or lesser benefits than those provided by the current coverage. Insurers are prohibited from using medical underwriting, pre-existing condition exclusions, and discriminating in pricing.

IA

HF70

Movement

Proposed bill 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 OE 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 discriminating in pricing. 

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

SB121

Movement

Any licensed insurance company offering MA Plans in the state should provide 120 days' written notice to the commissioner when modifying or terminating its contract with CMS by mutual consent pursuant to 42 CFR 422.508, ceasing to offer MA plans in a particular county, or significantly modifying the offerings of its MA plans. 

OK

HB2805 / SB1060

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 80-85% (large group) and 75-80% (individual and small group).

ND

HB1481

Movement

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