§ 20-1133 — Medicare supplement insurance; early enrollment discounts; applicability

Arizona § 20-1133

• Jurisdiction: Arizona
• Title 20: Arizona Revised Statutes
• Ch. 5: THE INSURANCE CONTRACT
• Art. 1: In General

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A. The director shall adopt rules necessary to comply with the requirements of the social security disability amendments of 1980 (P.L. 96-265; 42 United States Code section 1395ss) and any federal laws or regulations pertaining to that section, so that this state may retain its full authority to regulate minimum standards for medicare supplement insurance.

B. For the purposes of this section, an insurer may file for medicare supplement rates that include an early enrollment discount that will not be considered an attained age rating structure. An early enrollment discount shall diminish over a period of time and is only available to enrollees who purchase the plan within the early enrollment period designated by the insurer. Insurers shall disclose to all applicants how the early enrollment discount will diminish over time.

C. Subject to the other limitations provided in this subsection, a benefit mandated in this title for health insurance policies does not apply to medicare supplement insurance policies unless the mandated policy benefit is set forth in rules adopted pursuant to this section or unless the statute mandating the policy benefit expressly states that it is made specifically applicable to medicare supplement insurance policies. A medicare supplement insurance policy may not contain any exclusion for services provided by any type of properly licensed health care provider if the provider's services are eligible for medicare reimbursement and if the specific services in question would be covered by medicare. The scope of benefits of a medicare supplement policy may not be less than the minimum level of benefits established by federal law.

D. Notwithstanding any other provision of this title, rules adopted pursuant to this section apply to insurance provided under disability insurance policies, under subscription contracts of hospital, medical, dental or optometric service corporations, under certificates of fraternal benefit societies, under evidences of coverage of health care services organizations and under coverages issued by any other insurer, which policies, contracts, certificates, membership coverages, evidences of coverage and coverages are delivered or issued for delivery in this state on or after the effective date of rules adopted pursuant to subsection A of this section. In adopting the rules required by subsection A of this section, the director shall prescribe an effective date of the rules that will allow insurers sufficient time to bring their forms and practices into compliance with the requirements of the rule.