2015 -- H 5376

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LC000405

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2015

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A N   A C T

RELATING TO INSURANCE - MEDICARE SUPPLEMENT INSURANCE POLICIES

     Introduced By: Representatives Messier, Ackerman, Casey, McLaughlin, and Johnston

     Date Introduced: February 11, 2015

     Referred To: House Corporations

     It is enacted by the General Assembly as follows:

     SECTION 1. Section 27-18.2-1 of the General Laws in Chapter 27-18.2 entitled

“Medicare Supplement Insurance Policies” is hereby amended to read as follows:

      27-18.2-1. Definitions. -- (a)"Applicant" means:

     (1) In the case of an individual Medicare supplement policy, the person who seeks to

contract for insurance benefits; and

     (2) In the case of a group Medicare supplement policy, the proposed certificate holder.

     (b) "Certificate" means, for the purposes of this chapter, any certificate delivered or

issued for delivery in this state under a group Medicare supplement policy.

     (c) "Certificate form" means the form on which the certificate is delivered or issued for

delivery by the issuer.

     (d) "Director" means the director of the department of business regulation.

     (e) "Issuer" includes insurance companies, fraternal benefit societies, health care service

plans, health maintenance organizations, and any other entity delivering or issuing for delivery in

this state Medicare supplement policies or certificates.

     (f) "Medicare" means the "Health Insurance for the Aged Act, "42 U.S.C. § 1395 et seq.

     (g) "Medicare supplement policy or "Medigap" means a group or individual policy of

accident and sickness insurance, as defined in § 27-18-1, or a subscriber contract of a nonprofit

hospital service corporation or of a nonprofit medical service corporation or an evidence of

coverage of a health maintenance organization as defined in § 42-62-4(5) or as licensed under

chapter 41 of this title, other than a policy issued pursuant to a contract under Section 1876 of the

Federal Social Security Act, 42 U.S.C. § 1395mm, or an issued policy under a demonstration

project specified in 42 U.S.C. § 1395ss(g)(1), which is advertised, marketed or designed primarily

as a supplement to reimbursements under Medicare for the hospital, medical or surgical expenses

of persons eligible for Medicare.

     (h) "Policy form" means the form on which the policy is delivered or issued for delivery

by the issuer.

     SECTION 2. Chapter 27-18.2 of the General Laws entitled "Medicare Supplement

Insurance Policies" is hereby amended by adding thereto the following section:

     27-18.2-12. Open enrollment. -- Notwithstanding any federal law to the contrary, any

insurer writing Medigap or any Medicare supplement insurance policy must accept a Medicare

enrollee’s application for coverage at any time throughout the year. Moreover, all Medicare

supplement insurance policies subject to this chapter must be offered on an open enrollment basis

to persons enrolled in Medicare whether enrolled by reason of age or by reason of disability.

Insurers may not make any premium rate distinctions because of health status, claims experience,

medical condition, or whether the applicant is receiving health care services. However, eligibility

for policies offered on a group basis shall be limited to those individuals who are members of the

group to which the policy is issued.

     SECTION 3. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE - MEDICARE SUPPLEMENT INSURANCE POLICIES

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     This act would expand the open enrollment period of all Medicare supplement insurance

policies, or Medigap, so that applications may be accepted anytime throughout the year.

     This act would take effect upon passage.

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