The Medicare Access and CHIP Reauthorization Act of 2015
(MACRA) requires that the standards set forth in this section be applied to all
Medicare supplement policies or certificates delivered or issued for delivery
in this state to individuals newly eligible for Medicare on or after January 1,
2020. No policy or certificate that provides coverage of the Medicare Part B
deductible may be advertised, solicited, delivered or issued for delivery in
this state as a Medicare supplement policy or certificate to individuals newly
eligible for Medicare on or after January 1, 2020. Benefits plan standards
applicable to Medicare supplement policies and certificates issued to
individuals newly eligible for Medicare on or after January 1, 2020 must comply
with the benefit standards of subsections (a)(1) and (a)(5) of this section.
Benefit plan standards applicable to Medicare supplement policies and
certificates issued to individuals eligible for Medicare before January 1,
2020, remain subject to the requirements of sections
38a-495a-5
and
38a-495a-5
a of the Regulations of Connecticut State Agencies.
(a)
Benefit Requirements. The
standards and requirements of section
38a-495a-6
a of the Regulations of Connecticut State Agencies shall apply to all Medicare
supplement policies or certificates delivered or issued for delivery to
individuals newly eligible for Medicare on or after January 1, 2020, with the
following exceptions:
(1) Standardized
Medicare supplement benefit Plan C is redesignated as Plan D and shall provide
the benefits contained in subsection (e)(3) of section
38a-495a-6
a of the Regulations of Connecticut State Agencies, but shall not provide
coverage for one hundred percent or any portion of the Medicare Part B
deductible.
(2) Standardized
Medicare supplement benefit Plan F is redesignated as Plan G and shall provide
the benefits contained in subsection (e)(5) of section
38a-495a-6
a of the Regulations of Connecticut State Agencies, but shall not provide
coverage for one hundred percent of any portion of the Medicare Part B
deductible.
(3) Standardized
Medicare supplement benefit plans C, F, and F With High Deductible may not be
offered to individuals newly eligible for Medicare on or after January 1,
2020.
(4) Standardized Medicare
supplement benefit Plan F With High Deductible is redesignated as Plan G With
High Deductible and shall provide the benefits contained in subsection (e)(6)
of section
38a-495a-6
a of the Regulations of Connecticut State Agencies, but shall not provide
coverage for one hundred percent or any portion of the Medicare Part B
deductible; provided further that the Medicare Part B deductible paid by the
beneficiary shall be considered an out-of-pocket expense in meeting the annual
high deductible.
(5) The reference
to Plans C or F contained in subsection (a)(1)(B) of section
38a-495a-6
a of the Regulations of Connecticut State Agencies is deemed a reference to
Plans D or G for purposes of this section.
(b)
Applicability to certain
Individuals. This section applies only to individuals who are deemed to
be eligible for benefits under Section 226(a) of the Social Security Act on or
after January 1, 2020, or individuals who are newly eligible for Medicare on or
after January 1, 2020:
(1) By reason of
attaining age 65 on or after January 1, 2020; or
(2) By reason of entitlement to benefits
under part A pursuant to Section 226(b) or 226A of the Social Security
Act.
(c)
Guaranteed Issue for Eligible Persons. For purposes of subsection
(e) of section
38a-495a-8 a of
the Regulations of Connecticut State Agencies in the case of any individual
newly eligible for Medicare on or after January 1, 2020, any reference to a
Medicare supplement policy C or F (including F With High Deductible) shall be
deemed to be a reference to Medicare supplement policy D or G (including G With
a High Deductible), respectively, that meet requirements of subsection (a) of
this section.
(d)
Applicability to Waivered States. In the case of a state described
in Section 1882 (p)(6) of the Social Security Act ("waivered" alternative
simplification states), MACRA prohibits the coverage of the Medicare Part B
deductible for any Medicare supplement policy sold or issued to an individual
who is newly eligible for Medicare on or after January 1, 2020.
(e)
Offer of Redesignated Plans to
Individuals Other Than Newly Eligible Individuals. On or after January
1, 2020, the standardized benefit plans described in subsection (a)(4) of this
section may be offered to any individual who was eligible for Medicare prior to
January 1, 2020, in addition to the standardized plans described in subsection
(e) of section
38a-495a-6
a of the Regulations of Connecticut State Agencies.