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House File 228 - IntroducedA Bill ForAn Act 1relating to Medicare supplement policies and an annual
2open enrollment period.
3BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. NEW SECTION. 514M.1 Medicare supplement
2insurance — annual open enrollment.
31. For purposes of this section, unless the context
4otherwise requires:
5a. “Applicant” means an individual who is at least
6sixty-five years old who seeks to contract for benefits
7under an individual Medicare supplement policy, or a proposed
8covered individual under a group Medicare supplement policy.
9“Applicant” includes an individual under the age of sixty-five
10who qualifies for Medicare due to disability, end-stage renal
11disease, or exposure to an environmental hazard.
12b. “Certificate” means any certificate of coverage delivered
13or issued for delivery in this state to a covered individual
14under a group Medicare supplement policy.
15c. “Issuer” means an insurance company, a fraternal benefit
16society, a health care service plan, a health maintenance
17organization, or any other entity delivering or issuing
18for delivery in this state a Medicare supplement policy or
19certificate.
20d. “Medicare supplement policy” means an individual or group
21policy of accident and sickness insurance or a subscriber
22contract of hospital and medical service associations or
23health maintenance organizations, other than a policy issued
24pursuant to a contract under section 1876 of the federal Social
25Security Act, as codified in 42 U.S.C. §1395 et seq., or an
26issued policy under an approved demonstration project described
27in section 603(c) of the Social Security Amendments of 1983,
28section 2355 of the federal Deficit Reduction Act of 1984, or
29section 9412(b) of the federal Omnibus Budget Reconciliation
30Act of 1986, that is advertised, marketed, or designed
31primarily as a supplement to reimbursements under Medicare
32for hospital, medical, or surgical expenses of individuals
33covered by Medicare. “Medicare supplement policy” does not
34include Medicare advantage plans, outpatient prescription drug
35plans established under Medicare part D, or any health care
-1-1prepayment plan that provides benefits pursuant to an agreement
2under section 1833(a)(1)(A) of the federal Social Security Act.
32. Beginning January 1, 2024, applicants shall have an
4annual thirty-day open enrollment period that begins on the
5date of the applicant’s birthday.
63. During the open enrollment period under subsection 2, an
7issuer shall be prohibited from doing any of the following:
8a. Denying or conditioning the issuance or effectiveness of
9any Medicare supplement policy or certificate that the issuer
10offers and that is available for issuance in the state.
11b. Subjecting an applicant to medical underwriting, or
12discriminating in the pricing of a Medicare supplement policy
13or certificate because of the applicant’s health status, claims
14experience, receipt of health care, or medical condition.
15c. Imposing an exclusion of benefits based on an applicant’s
16preexisting condition.
174. An issuer shall provide notice, in a form prescribed by
18the commissioner of insurance, of the annual open enrollment
19period at the time an applicant applies for a Medicare
20supplement policy or certificate.
21EXPLANATION
22The inclusion of this explanation does not constitute agreement with
23the explanation’s substance by the members of the general assembly.
24This bill relates to Medicare supplement policies and an
25annual open enrollment period.
26Beginning January 1, 2024, applicants shall have an annual
2730-day open enrollment period that begins on the date of an
28applicant’s birthday. “Applicant” is defined in the bill as an
29individual who is at least 65 years old who seeks to contract
30for benefits under an individual Medicare supplement policy, or
31a proposed covered individual under a group Medicare supplement
32policy. “Applicant” includes an individual under the age of 65
33who qualifies for Medicare due to disability, end-stage renal
34disease, or exposure to an environmental hazard. “Medicare
35supplement policy” is also defined in the bill.
-2- 1During the open enrollment period, an issuer is prohibited
2from denying or conditioning the issuance or effectiveness
3of any Medicare supplement policy that the issuer offers and
4that is available for issuance in the state; from subjecting
5an applicant to medical underwriting or discriminating in the
6pricing of a Medicare supplement policy because of the health
7status, claims experience, receipt of health care, or medical
8condition of an applicant; and from imposing an exclusion
9of benefits based on an applicant’s preexisting condition.
10An issuer shall provide notice, in a form prescribed by the
11commissioner of insurance, of the annual open enrollment period
12at the time an applicant applies for a Medicare supplement
13policy or certificate. “Issuer” is defined in the bill.
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2open enrollment period.
3BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. NEW SECTION. 514M.1 Medicare supplement
2insurance — annual open enrollment.
31. For purposes of this section, unless the context
4otherwise requires:
5a. “Applicant” means an individual who is at least
6sixty-five years old who seeks to contract for benefits
7under an individual Medicare supplement policy, or a proposed
8covered individual under a group Medicare supplement policy.
9“Applicant” includes an individual under the age of sixty-five
10who qualifies for Medicare due to disability, end-stage renal
11disease, or exposure to an environmental hazard.
12b. “Certificate” means any certificate of coverage delivered
13or issued for delivery in this state to a covered individual
14under a group Medicare supplement policy.
15c. “Issuer” means an insurance company, a fraternal benefit
16society, a health care service plan, a health maintenance
17organization, or any other entity delivering or issuing
18for delivery in this state a Medicare supplement policy or
19certificate.
20d. “Medicare supplement policy” means an individual or group
21policy of accident and sickness insurance or a subscriber
22contract of hospital and medical service associations or
23health maintenance organizations, other than a policy issued
24pursuant to a contract under section 1876 of the federal Social
25Security Act, as codified in 42 U.S.C. §1395 et seq., or an
26issued policy under an approved demonstration project described
27in section 603(c) of the Social Security Amendments of 1983,
28section 2355 of the federal Deficit Reduction Act of 1984, or
29section 9412(b) of the federal Omnibus Budget Reconciliation
30Act of 1986, that is advertised, marketed, or designed
31primarily as a supplement to reimbursements under Medicare
32for hospital, medical, or surgical expenses of individuals
33covered by Medicare. “Medicare supplement policy” does not
34include Medicare advantage plans, outpatient prescription drug
35plans established under Medicare part D, or any health care
-1-1prepayment plan that provides benefits pursuant to an agreement
2under section 1833(a)(1)(A) of the federal Social Security Act.
32. Beginning January 1, 2024, applicants shall have an
4annual thirty-day open enrollment period that begins on the
5date of the applicant’s birthday.
63. During the open enrollment period under subsection 2, an
7issuer shall be prohibited from doing any of the following:
8a. Denying or conditioning the issuance or effectiveness of
9any Medicare supplement policy or certificate that the issuer
10offers and that is available for issuance in the state.
11b. Subjecting an applicant to medical underwriting, or
12discriminating in the pricing of a Medicare supplement policy
13or certificate because of the applicant’s health status, claims
14experience, receipt of health care, or medical condition.
15c. Imposing an exclusion of benefits based on an applicant’s
16preexisting condition.
174. An issuer shall provide notice, in a form prescribed by
18the commissioner of insurance, of the annual open enrollment
19period at the time an applicant applies for a Medicare
20supplement policy or certificate.
21EXPLANATION
22The inclusion of this explanation does not constitute agreement with
23the explanation’s substance by the members of the general assembly.
24This bill relates to Medicare supplement policies and an
25annual open enrollment period.
26Beginning January 1, 2024, applicants shall have an annual
2730-day open enrollment period that begins on the date of an
28applicant’s birthday. “Applicant” is defined in the bill as an
29individual who is at least 65 years old who seeks to contract
30for benefits under an individual Medicare supplement policy, or
31a proposed covered individual under a group Medicare supplement
32policy. “Applicant” includes an individual under the age of 65
33who qualifies for Medicare due to disability, end-stage renal
34disease, or exposure to an environmental hazard. “Medicare
35supplement policy” is also defined in the bill.
-2- 1During the open enrollment period, an issuer is prohibited
2from denying or conditioning the issuance or effectiveness
3of any Medicare supplement policy that the issuer offers and
4that is available for issuance in the state; from subjecting
5an applicant to medical underwriting or discriminating in the
6pricing of a Medicare supplement policy because of the health
7status, claims experience, receipt of health care, or medical
8condition of an applicant; and from imposing an exclusion
9of benefits based on an applicant’s preexisting condition.
10An issuer shall provide notice, in a form prescribed by the
11commissioner of insurance, of the annual open enrollment period
12at the time an applicant applies for a Medicare supplement
13policy or certificate. “Issuer” is defined in the bill.
-3-ko/rn