CHAPTER 20:06:13
MEDICARE SUPPLEMENT INSURANCE
Section
20:06:13:01 Repealed.
20:06:13:02 Definitions.
20:06:13:02.01 Requirements
for definition of "accident" and similar words in policies.
20:06:13:02.02 Requirements
for definitions in policies.
20:06:13:03 Applicability.
20:06:13:04
to 20:06:13:13 Repealed.
20:06:13:14 Eligible
expenses under Medicare.
20:06:13:14.01
and 20:06:13:15 Repealed.
20:06:13:16 Waiver of
coverage not allowed.
20:06:13:17 Applicability
of benefit standards.
20:06:13:17.01 Repealed.
20:06:13:17.02 General
standards for 1990 standardized Medicare supplement benefit plans.
20:06:13:17.03 Standards for
basic core benefits for 1990 standardized Medicare supplement benefit plans.
20:06:13:17.04 Standards for
additional benefits for 1990 standardized Medicare supplement benefit plans.
20:06:13:17.05 Requirements
for standard Medicare supplement benefit plans.
20:06:13:17.06 Make-up of
standardized benefit plans.
20:06:13:17.07 Suspension of
coverage during period of eligibility for Medicaid.
20:06:13:17.08 Reinstitution
of coverage following loss of eligibility for Medicaid.
20:06:13:17.09 Suspension
requested by policyholder.
20:06:13:17.10 Prescription drug benefits under Medicare supplement
plans.
20:06:13:17.11 General
standards for standardized Medicare supplement benefit plan -- Issued for
delivery after May 31, 2010.
20:06:13:17.12 Standards for
basic core benefits common to Medicare supplement insurance benefit Plans A, B,
C, D, F, F with High Deductible, G, M, and N.
20:06:13:17.13 Standards for
additional benefits.
20:06:13:17.14 Requirements
for standard Medicare supplement benefit plans -- Plans issued after May 31,
2010.
20:06:13:17.15 Make-up of
standardized benefit plans -- Issued after May 31, 2010.
20:06:13:18 Premium
adjustments to match Medicare benefit adjustments.
20:06:13:19 Renewability.
20:06:13:20 Extended
benefits on termination of insurance.
20:06:13:21 Loss
ratio standards.
20:06:13:21.01 Refund or
credit calculation.
20:06:13:22 Annual
filing of premium rates.
20:06:13:22.01 Filing of
premium adjustments after Medicare benefit change.
20:06:13:22.02 Public
hearings.
20:06:13:22.03 Filing and
approval of policies and certificates and of premium rates required.
20:06:13:22.04 One policy or
certificate form allowed -- Exceptions.
20:06:13:22.05 Discontinuance
of availability.
20:06:13:22.06 Combination of
experience for calculation of refund or credit.
20:06:13:22.07 New or
innovative benefits -- Policy or certificate form allowed -- Exceptions --
Issued after May 31, 2010.
20:06:13:23 Repealed.
20:06:13:24 Disclosure
of preexisting conditions.
20:06:13:25 Increased
benefits after issue.
20:06:13:26 Separate
additional premium disclosure.
20:06:13:27 Buyer's
guide.
20:06:13:28 Delivery
of buyer's guide.
20:06:13:29 Use of
term "Medicare supplement."
20:06:13:30 Disclosure
requirements for policies or subscriber contracts that are not Medicare
supplement policies.
20:06:13:31 Notice
requirements for policies or certificates that are not Medicare supplement
policies.
20:06:13:31.01 Disclosure
requirements for Medicare supplement policies -- Riders and endorsements.
20:06:13:31.02 "Usual,"
"customary," and "reasonable" requirements prohibited.
20:06:13:31.03 Right of
return.
20:06:13:32 Requirements
concerning application forms and replacement coverage.
20:06:13:32.01 Transferred.
20:06:13:32.02 Disclosure by
agent.
20:06:13:33 Repealed.
20:06:13:34 Replacement
requirements for direct response insurers.
20:06:13:35 Notice of
replacement.
20:06:13:36 Outline
of coverage requirements.
20:06:13:37 Delivery
of outline of coverage.
20:06:13:38 Revisions
of outline of coverage.
20:06:13:39 Repealed.
20:06:13:40 Style and
arrangement for outline of coverage.
20:06:13:41
and 20:06:13:42 Repealed.
20:06:13:43 Overinsurance.
20:06:13:43.01 Misrepresentation
-- Unfair or deceptive trade practices.
20:06:13:43.02 Determination
of suitability.
20:06:13:43.03 Medicare
supplement and Medicare Part C (Medicare Advantage) or Medicare Cost duplication.
20:06:13:44 Failure
to provide required forms.
20:06:13:45 Refund in
replacement situations.
20:06:13:46 Coverage
replaced within the same company.
20:06:13:47 Insurance
replaced by the same agent.
20:06:13:48 Repealed.
20:06:13:49 Requirements
for claims payment.
20:06:13:50 Policy
classification -- Requirements and limitations.
20:06:13:51 Notice of
benefit change.
20:06:13:52 Repealed.
20:06:13:53 Duplication
of coverage prohibited.
20:06:13:54 Repealed.
20:06:13:55 Exception
to reinstitution of coverage.
20:06:13:56 Continuation
and conversion rights.
20:06:13:57 Standards
for marketing.
20:06:13:58 Marketing
practices prohibited.
20:06:13:58.01 Health
insurance advertisement rate disclosures
20:06:13:58.02 Health
insurance advertisement disclosure statements.
20:06:13:59 Reporting
of multiple policies.
20:06:13:60 Cancellation
or nonrenewal of policies.
20:06:13:60.01 Guaranteed
renewable with benefit changes.
20:06:13:61 Agent
compensation limited.
20:06:13:62 Repealed.
20:06:13:63 Medicare
select policies and certificates.
20:06:13:64 Medicare
select authorization.
20:06:13:65 Approval
required for issuance.
20:06:13:66 Filing
plan of operation.
20:06:13:67 Filing of
changes.
20:06:13:68 Network
restrictions.
20:06:13:69 Coverage
for unavailable services.
20:06:13:70 Disclosure
and outline of coverage requirements.
20:06:13:71 Applicant
signature required.
20:06:13:72 Complaints
and grievances.
20:06:13:73 Required
offer of other Medicare supplement coverage.
20:06:13:74 Required
offer of replacement coverage without a restricted network provision.
20:06:13:75 Continuation.
20:06:13:76 Compliance
with data requests.
20:06:13:77 Creditable
coverage.
20:06:13:78 Medicare
Advantage plan.
20:06:13:79 Guaranteed
issue.
20:06:13:80 Guaranteed
issue -- Eligible persons.
20:06:13:80.01 Guaranteed
issue time periods.
20:06:13:80.02 Extended
medigap access for interrupted trial periods.
20:06:13:81 Guaranteed
issue -- Products to which eligible persons are entitled.
20:06:13:82 Guaranteed
issue -- Notification provisions.
20:06:13:83 Open
enrollment.
20:06:13:84 Open
enrollment required for Medicare eligible individuals regardless of age.
20:06:13:85 Notice
requirements.
20:06:13:86 Exchanging
of standardized plan.
20:06:13:86.01 Exchanging of
standardized plan -- Age rate schedule.
20:06:13:86.02 Exchanging of
standardized plan -- Rating class.
20:06:13:86.03 Exchanging of
standardized plan -- Preexisting conditions and incontestability period.
20:06:13:86.04 Exchanging of
standardized plan -- Offering.
20:06:13:87 Applicability
of genetic information.
20:06:13:88 Definitions
applicable to genetic information.
20:06:13:89 Use of
genetic information.
20:06:13:90 Request
of genetic testing.
20:06:13:91 Requirement
of genetic testing.
20:06:13:92 Genetic
information -- Underwriting purposes and enrollment.
Appendix A Medicare Supplement Refund Calculation Forms.
Appendix B Form for Reporting Medicare Supplement Policies.
Appendix C Notice to Applicant Regarding Replacement of Medicare Supplement Insurance.
Appendix D Outline of Medicare Supplement Coverage Policies Plans A through N.
Appendix E Instructions for Use of the Disclosure Statements for Health Insurance Policies Sold to Medicare Beneficiaries that Duplicate Medicare.