H.F. 228 Section 1. NEW SECTION . 514M.1 Medicare supplement 1 insurance —— annual open enrollment. 2 1. For purposes of this section, unless the context 3 otherwise requires: 4 a. “Applicant” means an individual who is at least 5 sixty-five years old who seeks to contract for benefits 6 under an individual Medicare supplement policy, or a proposed 7 covered individual under a group Medicare supplement policy. 8 “Applicant” includes an individual under the age of sixty-five 9 who qualifies for Medicare due to disability, end-stage renal 10 disease, or exposure to an environmental hazard. 11 b. “Certificate” means any certificate of coverage delivered 12 or issued for delivery in this state to a covered individual 13 under a group Medicare supplement policy. 14 c. “Issuer” means an insurance company, a fraternal benefit 15 society, a health care service plan, a health maintenance 16 organization, or any other entity delivering or issuing 17 for delivery in this state a Medicare supplement policy or 18 certificate. 19 d. “Medicare supplement policy” means an individual or group 20 policy of accident and sickness insurance or a subscriber 21 contract of hospital and medical service associations or 22 health maintenance organizations, other than a policy issued 23 pursuant to a contract under section 1876 of the federal Social 24 Security Act, as codified in 42 U.S.C. §1395 et seq., or an 25 issued policy under an approved demonstration project described 26 in section 603(c) of the Social Security Amendments of 1983, 27 section 2355 of the federal Deficit Reduction Act of 1984, or 28 section 9412(b) of the federal Omnibus Budget Reconciliation 29 Act of 1986, that is advertised, marketed, or designed 30 primarily as a supplement to reimbursements under Medicare 31 for hospital, medical, or surgical expenses of individuals 32 covered by Medicare. “Medicare supplement policy” does not 33 include Medicare advantage plans, outpatient prescription drug 34 plans established under Medicare part D, or any health care 35 -1- LSB 1083YH (12) 90 ko/rn 1/ 3

H.F. 228 prepayment plan that provides benefits pursuant to an agreement 1 under section 1833(a)(1)(A) of the federal Social Security Act. 2 2. Beginning January 1, 2024, applicants shall have an 3 annual thirty-day open enrollment period that begins on the 4 date of the applicant’s birthday. 5 3. During the open enrollment period under subsection 2, an 6 issuer shall be prohibited from doing any of the following: 7 a. Denying or conditioning the issuance or effectiveness of 8 any Medicare supplement policy or certificate that the issuer 9 offers and that is available for issuance in the state. 10 b. Subjecting an applicant to medical underwriting, or 11 discriminating in the pricing of a Medicare supplement policy 12 or certificate because of the applicant’s health status, claims 13 experience, receipt of health care, or medical condition. 14 c. Imposing an exclusion of benefits based on an applicant’s 15 preexisting condition. 16 4. An issuer shall provide notice, in a form prescribed by 17 the commissioner of insurance, of the annual open enrollment 18 period at the time an applicant applies for a Medicare 19 supplement policy or certificate. 20 EXPLANATION 21 The inclusion of this explanation does not constitute agreement with 22 the explanation’s substance by the members of the general assembly. 23 This bill relates to Medicare supplement policies and an 24 annual open enrollment period. 25 Beginning January 1, 2024, applicants shall have an annual 26 30-day open enrollment period that begins on the date of an 27 applicant’s birthday. “Applicant” is defined in the bill as an 28 individual who is at least 65 years old who seeks to contract 29 for benefits under an individual Medicare supplement policy, or 30 a proposed covered individual under a group Medicare supplement 31 policy. “Applicant” includes an individual under the age of 65 32 who qualifies for Medicare due to disability, end-stage renal 33 disease, or exposure to an environmental hazard. “Medicare 34 supplement policy” is also defined in the bill. 35 -2- LSB 1083YH (12) 90 ko/rn 2/ 3

H.F. 228 During the open enrollment period, an issuer is prohibited 1 from denying or conditioning the issuance or effectiveness 2 of any Medicare supplement policy that the issuer offers and 3 that is available for issuance in the state; from subjecting 4 an applicant to medical underwriting or discriminating in the 5 pricing of a Medicare supplement policy because of the health 6 status, claims experience, receipt of health care, or medical 7 condition of an applicant; and from imposing an exclusion 8 of benefits based on an applicant’s preexisting condition. 9 An issuer shall provide notice, in a form prescribed by the 10 commissioner of insurance, of the annual open enrollment period 11 at the time an applicant applies for a Medicare supplement 12 policy or certificate. “Issuer” is defined in the bill. 13 -3- LSB 1083YH (12) 90 ko/rn 3/ 3