Chapter 20:06:13 - Medicare supplement insurance
- § 20:06:13:01 - Disclosure form required.Repealed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 - Allowed restrictions on coverage of accidents.Repealed
- § 20:06:13:05 - Effects of other insurance and coverage of accidents.Repealed
- § 20:06:13:06 - Restrictions for accidents while employed.Repealed
- § 20:06:13:07 - Denial of benefits to persons in skilled nursing facilities prohibited.Repealed
- § 20:06:13:08 - Skilled nursing facility - Exclusions.Repealed
- § 20:06:13:09 - Hospital reimbursement by nonprofit plans.Repealed
- § 20:06:13:10 - Mental or emotional disorders - Limitations and exclusions.Repealed
- § 20:06:13:11 - Nurse - Description of classes.Repealed
- § 20:06:13:12 - Coverage of sickness - Allowed restrictions.Repealed
- § 20:06:13:13 - Coverage of sickness - Other insurance. Repealed
- § 20:06:13:14 - Eligible expenses under Medicare
- § 20:06:13:14.01 - Health care expenses defined - Exclusions.Repealed
- § 20:06:13:15 - Permitted policy limitations and exclusions. Repealed
- § 20:06:13:16 - Waiver of coverage not allowed
- § 20:06:13:17 - Applicability of benefit standards
- § 20:06:13:17.01 - Benefits restored. Repealed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
- § 20:06:13:17.16 - Standard Medicare supplement benefit plans for 2020 standardized Medicare supplement benefit plan policies or certificates issued for delivery to individuals newly eligible for Medicare after December 31, 2019
- § 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 - Rate increases.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 - Replacement requirements for agents. 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 - Outline of coverage requirements for "usual and customary" benefits. Repealed
- § 20:06:13:40 - Style and arrangement for outline of coverage
- § 20:06:13:41 - Supplemental disclosure form.Repealed
- § 20:06:13:42 - Variable information for supplemental disclosure form. 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 - Payment and recognition of physicians. 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 - Filing of policies to comply with Medicare changes. Repealed
- § 20:06:13:53 - Duplication of coverage prohibited
- § 20:06:13:54 - Reinstitution of coverage. 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 - Requirements of insurers. 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, version 4
- Appendix B - Form for Reporting Medicare Supplement Policies, version 3
- Appendix C - Notice to Applicant Regarding Replacement of Medicare Supplement Insurance, version 2
- Appendix D - Outline of Medicare Supplement Coverage Policies Plans A Through N, version 3
- Appendix E - Instructions for Use of the Disclosure Statements for Health Insurance Policies Sold to Medicare Beneficiaries that Duplicate Medicare, version 2
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
- § 20:06:13:01 - Disclosure form required.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 - Allowed restrictions on coverage of accidents.Repealed
- § 20:06:13:05 - Effects of other insurance and coverage of accidents.Repealed
- § 20:06:13:06 - Restrictions for accidents while employed.Repealed
- § 20:06:13:07 - Denial of benefits to persons in skilled nursing facilities prohibited.Repealed
- § 20:06:13:08 - Skilled nursing facility - Exclusions.Repealed
- § 20:06:13:09 - Hospital reimbursement by nonprofit plans.Repealed
- § 20:06:13:10 - Mental or emotional disorders - Limitations and exclusions.Repealed
- § 20:06:13:11 - Nurse - Description of classes.Repealed
- § 20:06:13:12 - Coverage of sickness - Allowed restrictions.Repealed
- § 20:06:13:13 - Coverage of sickness - Other insurance. Repealed
- § 20:06:13:14 - Eligible expenses under Medicare
- § 20:06:13:14.01 - Health care expenses defined - Exclusions.Repealed
- § 20:06:13:15 - Permitted policy limitations and exclusions. Repealed
- § 20:06:13:16 - Waiver of coverage not allowed
- § 20:06:13:17 - Applicability of benefit standards
- § 20:06:13:17.01 - Benefits restored. 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
- § 20:06:13:17.16 - Standard Medicare supplement benefit plans for 2020 standardized Medicare supplement benefit plan policies or certificates issued for delivery to individuals newly eligible for Medicare after December 31, 2019
- § 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 - Rate increases.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 - Replacement requirements for agents. 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 - Outline of coverage requirements for "usual and customary" benefits. Repealed
- § 20:06:13:40 - Style and arrangement for outline of coverage
- § 20:06:13:41 - Supplemental disclosure form.Repealed
- § 20:06:13:42 - Variable information for supplemental disclosure form. 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 - Payment and recognition of physicians. 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 - Filing of policies to comply with Medicare changes. Repealed
- § 20:06:13:53 - Duplication of coverage prohibited
- § 20:06:13:54 - Reinstitution of coverage. 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 - Requirements of insurers. 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, version 4
- Appendix B - Form for Reporting Medicare Supplement Policies, version 3
- Appendix C - Notice to Applicant Regarding Replacement of Medicare Supplement Insurance, version 2
- Appendix D - Outline of Medicare Supplement Coverage Policies Plans A Through N, version 3
- Appendix E - Instructions for Use of the Disclosure Statements for Health Insurance Policies Sold to Medicare Beneficiaries that Duplicate Medicare, version 2