(a) Notwithstanding any other provision to the contrary, this subtitle applies to: (1) Medicare supplement policies and subscriber contracts that are delivered or issued for delivery in the State after July 1, 1992; (2) certificates that are issued under group Medicare supplement policies or subscriber contracts, which certificates have been delivered or issued for delivery in the State; […]
(a) A carrier may not issue, deliver, or renew a Medicare supplement policy in the State unless the Medicare supplement policy complies with this subtitle. (b) (1) Notwithstanding any other provision of this subtitle, an insurer or a nonprofit health service plan that is authorized to issue Medicare supplement policies under this article may issue Medicare supplement policies […]
A carrier shall restore any benefit that was eliminated from a Medicare supplement policy because of the federal Medicare Catastrophic Coverage Act of 1988.
(a) A Medicare supplement policy shall provide the minimum benefits required by federal law. (b) (1) For benefits designed to cover deductibles or coinsurance amounts under Medicare, a Medicare supplement policy shall provide for an automatic change in those benefits to coincide with changes in applicable Medicare deductible and copayment provisions. (2) Subject to approval by the Commissioner, a […]
(a) In this section, “low-dose mammography” means an x-ray examination of the breast using dedicated equipment, including an x-ray tube, filter, compression device, screens, films, and cassettes, specifically for mammography that delivers an average radiation exposure of less than one rad mid-breast with two views for each breast. (b) If the federal standard under § 1882(p) of […]
The Commissioner shall approve Medicare supplement policies that include benefits in addition to the minimum benefits listed in § 15-906(a) of this subtitle if the Medicare supplement policies and benefits: (1) conform with the federal Omnibus Budget Reconciliation Act of 1990 and the Medicare Supplement Insurance Minimum Standards Model Act and any regulations under the Model […]
(a) This section does not extend the number of days of hospitalization offered under § 15–906(a) of this subtitle to the extent those days of hospitalization have been used under the original Medicare supplement policy. (b) (1) If an application for a Medicare supplement policy or certificate is submitted during the 6–month period beginning with the first month […]
(a) Each Medicare supplement policy or certificate shall have prominently printed on the first page of the policy or certificate or attached to it, a notice that states that the applicant may: (1) return the Medicare supplement policy or certificate within 30 days after its delivery; and (2) receive a refund of the premium if after examination of […]
(a) In this section, “loss ratio” means the ratio of losses incurred to premiums earned on policies that are issued, delivered, or renewed in the State. (b) Medicare supplement policies shall return aggregate benefits that are reasonable in relation to the premium charged. (c) (1) For purposes of administering this subtitle and §§ 12-203 through 12-205 of this article, […]
(a) The Commissioner shall adopt reasonable regulations to establish specific standards for policy provisions of Medicare supplement policies and certificates. (b) (1) The standards adopted by the Commissioner are in addition to and shall be in accordance with applicable laws of the State, including this title and Title 14, Subtitle 1 of this article. (2) No requirement of this […]
The Commissioner shall adopt reasonable regulations that specify prohibited policy provisions, not otherwise specifically authorized by statute, that in the opinion of the Commissioner are unjust, unfair, or unfairly discriminatory to any individual insured or proposed to be insured under a Medicare supplement policy or certificate.
The Commissioner shall adopt reasonable regulations to establish minimum standards for benefits, claim payments, marketing practices, and compensation arrangements and reporting practices for Medicare supplement policies and certificates.
(a) The Commissioner shall adopt reasonable regulations as necessary to conform Medicare supplement policies and certificates to the requirements of federal law and regulations. (b) The regulations may include, but are not limited to, provisions that: (1) require rate adjustments, credits, or refunds if the Medicare supplement policies or certificates do not meet loss ratio requirements; (2) establish a […]
(a) The Commissioner shall prepare in clear, plain English the text of a Medicare supplement buyer’s guide that carriers must provide to prospective buyers of Medicare supplement policies under this section. (b) The buyer’s guide shall: (1) contain an outline of Medicare coverage; and (2) include advice and other information about purchasing Medicare supplement policies, including a reference to […]
(a) In order to provide for full and fair disclosure in the sale of Medicare supplement policies, a Medicare supplement policy or certificate may not be delivered in the State unless an outline of coverage is provided to the applicant at the time the application is delivered. (b) (1) In this subsection, “format” means style, arrangements, and overall […]
(a) The Commissioner may prescribe by regulation a standard form and the contents of an informational brochure for individuals eligible for Medicare by reason of age, which is intended to improve the buyer’s ability to choose the most appropriate coverage and to improve the buyer’s understanding of Medicare. (b) Except for direct response insurance policies, the Commissioner […]
(a) (1) Under any circumstance stated in this section, a carrier or insurance producer of a carrier shall give to a prospective buyer eligible for Medicare by reason of age a written statement as required, for each circumstance, by this section. (2) The written statement shall be given before the carrier or insurance producer accepts an application. (b) If […]
The Commissioner may adopt regulations for captions or notice requirements, determined to be in the public interest and designed to inform prospective insureds that particular insurance coverages are not Medicare supplement coverages, for all health insurance policies sold to individuals eligible for Medicare, other than Medicare supplement policies or disability income policies.
The Commissioner may adopt reasonable regulations to govern the full and fair disclosure of the information in connection with the replacement of health insurance policies, subscriber contracts, or certificates by individuals eligible for Medicare.
(a) (1) In this section, “compensation” means any pecuniary or nonpecuniary remuneration related to the sale or renewal of a Medicare supplement policy or certificate. (2) “Compensation” includes bonuses, gifts, and finders’ fees. (3) “Compensation” does not include noncash prizes or awards. (b) A carrier or other entity may provide a commission or other compensation to an insurance producer or […]
