Connecticut Administrative Code
Title 38a - Insurance Department
495a - Medicare Supplement Insurance
Section 38a-495a-6b - Standard Medicare Supplement Benefit Plans for 2020 Standardized Medicare Supplement Benefits Plan Policies or Certificates Issued for Delivery to Individuals Newly Eligible for Medicare on or After January 1, 2020
Current through March 14, 2024
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires that the standards set forth in this section be applied to all Medicare supplement policies or certificates delivered or issued for delivery in this state to individuals newly eligible for Medicare on or after January 1, 2020. No policy or certificate that provides coverage of the Medicare Part B deductible may be advertised, solicited, delivered or issued for delivery in this state as a Medicare supplement policy or certificate to individuals newly eligible for Medicare on or after January 1, 2020. Benefits plan standards applicable to Medicare supplement policies and certificates issued to individuals newly eligible for Medicare on or after January 1, 2020 must comply with the benefit standards of subsections (a)(1) and (a)(5) of this section. Benefit plan standards applicable to Medicare supplement policies and certificates issued to individuals eligible for Medicare before January 1, 2020, remain subject to the requirements of sections 38a-495a-5 and 38a-495a-5 a of the Regulations of Connecticut State Agencies.
(a) Benefit Requirements. The standards and requirements of section 38a-495a-6 a of the Regulations of Connecticut State Agencies shall apply to all Medicare supplement policies or certificates delivered or issued for delivery to individuals newly eligible for Medicare on or after January 1, 2020, with the following exceptions:
(b) Applicability to certain Individuals. This section applies only to individuals who are deemed to be eligible for benefits under Section 226(a) of the Social Security Act on or after January 1, 2020, or individuals who are newly eligible for Medicare on or after January 1, 2020:
(c) Guaranteed Issue for Eligible Persons. For purposes of subsection (e) of section 38a-495a-8 a of the Regulations of Connecticut State Agencies in the case of any individual newly eligible for Medicare on or after January 1, 2020, any reference to a Medicare supplement policy C or F (including F With High Deductible) shall be deemed to be a reference to Medicare supplement policy D or G (including G With a High Deductible), respectively, that meet requirements of subsection (a) of this section.
(d) Applicability to Waivered States. In the case of a state described in Section 1882 (p)(6) of the Social Security Act ("waivered" alternative simplification states), MACRA prohibits the coverage of the Medicare Part B deductible for any Medicare supplement policy sold or issued to an individual who is newly eligible for Medicare on or after January 1, 2020.
(e) Offer of Redesignated Plans to Individuals Other Than Newly Eligible Individuals. On or after January 1, 2020, the standardized benefit plans described in subsection (a)(4) of this section may be offered to any individual who was eligible for Medicare prior to January 1, 2020, in addition to the standardized plans described in subsection (e) of section 38a-495a-6 a of the Regulations of Connecticut State Agencies.
