§ 3218 — Medicare supplemental insurance policies

§ 3218. Medicare supplemental insurance policies. (a) In this section:\n (1) "Medicare" means the coverage of health care costs provided under\nsubchapter XVIII of the federal Social Security Act, 42 U.S.C. §§ 1395\net seq.\n (2) "Medicare supplemental insurance" means any individual or group\naccident and health policy issued for delivery in this state on or after\nJune tenth, nineteen hundred eighty, providing for the payment or\nreimbursement for health care services not provided by medicare, except\nthat such terms shall not include a contract issued pursuant to\nsubsections (c) and (d) of section four thousand two hundred thirty-five\nor section four thousand three hundred five of this chapter which covers\nemployees of firms doing business in more than one state or the benefit\nstructure of which was the subject of collective bargaining affecting\nemployees of firms doing business in more than one state.\n (b) The superintendent shall promulgate rules and regulations which:\n (1) Establish as a separate classification, medicare supplemental\ninsurance.\n (2) Provide for minimum standards for medicare supplemental insurance\npolicies.\n (3) Require the ratio of benefits to premiums to be not less than an\nappropriate percentage determined by the superintendent and requiring\nthe annual filing of data that will demonstrate the insurer's\ncompliance.\n (4) Provide a uniform system of designation for said policies which\nindicates the type and scope of coverage afforded.\n (5) Provide for full disclosure of coverage in a clear and coherent\nmanner using words with common everyday language.\n (6) Prohibit the advertisement, sale, or solicitation of any accident\nor health insurance policy as being supplemental to medicare coverage\nunless it conforms to minimum standards for medicare supplemental\ninsurance policies provided by this section.\n (7) Provide for the publication and dissemination of a consumer's\nshopping guide for medicare supplemental insurance.\n (c) No authorized insurer shall issue or deliver in this state any\nmedicare supplemental insurance policy other than a medicare\nsupplemental insurance policy which includes the minimum standards as\napproved by the superintendent.\n (d) (1) Every authorized insurer engaged in issuing for delivery in\nthis state, policies for medicare supplemental insurance as set forth in\nthis section shall file with the superintendent a report of all claims\nexperience for such coverage for each twelve month period preceding the\ndates fixed by the superintendent for the filing of such reports. Such\nreports shall be made in writing and on a form prescribed by the\nsuperintendent not less than annually on dates determined by the\nsuperintendent.\n (2) The provisions of this subsection shall remain in force until\nDecember thirty-first, nineteen hundred eighty-three.\n