58-54-1. Definitions. Unless the context clearly indicates otherwise, the following words, as used in this Article, have the following meanings: (1) "Applicant" means (i) in the case of an individual Medicare supplement policy or subscriber contract, the person who seeks to contract for insurance benefits; and (ii) in the case of a group Medicare supplement […]
58-54-10. Standards for policy provisions. (a) No policy in force in this State shall contain benefits that duplicate benefits provided by Medicare. (b) The Commissioner shall adopt rules to establish specific standards for provisions of policies. Such standards shall be in addition to and in accordance with applicable State law. No requirement of State law […]
58-54-15. Minimum standards for benefits, marketing practices, compensation arrangements, reporting practices, and claims payments. The Commissioner shall adopt rules to establish minimum standards for benefits, marketing practices, compensation arrangements, reporting practices, and claims payments under policies. (1989, c. 729, s. 1; 1989 (Reg. Sess., 1990), c. 941, s. 8; 1993, c. 504, s. 38.)
58-54-20. Loss ratio standards and filing requirements. (a) Every insurer providing group Medicare supplement insurance benefits to a resident of this State pursuant to G.S. 58-54-5 shall file a copy of the master policy and any certificate used in this State in accordance with the filing requirements and procedures applicable to group policies issued in […]
58-54-25. Disclosure standards. (a) In order to provide for full and fair disclosure in the sale of policies, no policy or certificate shall be delivered in this State unless an outline of coverage is delivered to the applicant at the time application is made. (b) The Commissioner shall prescribe the format and content of the […]
58-54-30. Notice of free examination. Policies or certificates shall have a notice prominently printed on the first page of the policy or certificate or attached thereon stating in substance that the applicant has the right to return the policy or certificate within 30 days of its delivery and to have the premium refunded if, after […]
58-54-35. Filing requirements for advertising. Every insurer providing Medicare supplement insurance or benefits in this State shall provide a copy of any Medicare supplement advertisement intended for use in this State whether through written, radio, or television medium to the Commissioner for review or approval by the Commissioner. (1989, c. 729, s. 1.)
58-54-40. Penalties. In addition to any other applicable penalties for violations of Articles 1 through 64 or 65 and 66 or 67 of this Chapter, the Commissioner may require any person that has violated or is violating any provision of this Article or any rule adopted under this Article to either (i) cease marketing any […]
58-54-45. By reason of disability. (a) For Persons Whose Eligibility for Medicare Occurred Before January 1, 2020. – In addition to any rule adopted under this Article that is directly or indirectly related to open enrollment, an insurer shall at least make standardized Medicare Supplement Plan A available to persons eligible for Medicare by reason […]
58-54-5. Applicability and scope. (a) Except as otherwise specifically provided, this Article applies to: (1) All policies delivered or issued for delivery in this State on or after August 7, 1989; and (2) All certificates issued under group policies that have been delivered or issued for delivery in this State on or after August 7, […]
58-54-50. Rules for compliance with federal law and regulations. The Commissioner may adopt temporary rules necessary to conform Medicare supplement policies and certificates to the requirements of federal law and regulations, including: (1) Requiring refunds or credits if the policies or certificates do not meet loss ratio requirements. (2) Establishing a uniform methodology for calculating […]
