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Bill > SF71


IA SF71

A bill for an act relating to Medicare supplement policies and an annual open enrollment period.


summary

Introduced
01/21/2025
In Committee
01/21/2025
Crossed Over
Passed
Dead

Introduced Session

91st General Assembly

Bill Summary

This bill relates to Medicare supplement policies and an annual open enrollment period. Beginning January 1, 2026, applicants shall have an annual 30-day open enrollment period that begins on the date of an applicant’s birthday. “Applicant” is defined in the bill as an individual who is at least 65 years old who seeks to contract for benefits under an individual Medicare supplement policy, or a proposed covered individual under a group Medicare supplement policy. “Applicant” includes an individual under the age of 65 who qualifies for Medicare due to disability, end-stage renal disease, or exposure to an environmental hazard. “Medicare supplement policy” is also defined in the bill. During the open enrollment period, an issuer is prohibited from denying or conditioning the issuance or effectiveness of any Medicare supplement policy that the issuer offers and that is available for issuance in the state; from subjecting an applicant to medical underwriting or discriminating in the pricing of a Medicare supplement policy because of the health status, claims experience, receipt of health care, or medical condition of an applicant; and from imposing an exclusion of benefits based on an applicant’s preexisting condition. During the open enrollment period, an applicant may choose a Medicare supplement policy or certificate that has the same or lesser benefits than the policy or certificate that the applicant is covered under on the date that the applicant’s open enrollment begins. An issuer shall provide notice, in a form prescribed by the commissioner of insurance, of the annual open enrollment period at the time an applicant applies for a Medicare supplement policy or certificate. “Issuer” is defined in the bill.

AI Summary

This bill establishes an annual 30-day open enrollment period for Medicare supplement insurance policies beginning January 1, 2026, during which individuals who are 65 or older, or who qualify for Medicare due to disability, end-stage renal disease, or environmental hazard exposure, can obtain or change their Medicare supplement insurance without facing restrictions. During this birthday-triggered enrollment period, insurance companies (referred to as "issuers") are prohibited from denying coverage, applying medical underwriting, discriminating in pricing based on health status, or imposing exclusions for preexisting conditions. Applicants may select a Medicare supplement policy with the same or lesser benefits as their current policy, and issuers must provide notice of this annual open enrollment period when an individual applies for coverage. The bill comprehensively defines key terms like "applicant," "Medicare supplement policy," and "issuer," and aims to provide more flexible and accessible supplemental health insurance options for Medicare beneficiaries by creating a standardized annual opportunity to review and change coverage.

Committee Categories

Business and Industry

Sponsors (1)

Last Action

Subcommittee recommends passage. (on 02/03/2025)

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