Code of Massachusetts Regulations
211 CMR - DIVISION OF INSURANCE
Title 211 CMR 71.00 - Medicare Supplement Insurance To Facilitate The Implementation Of M.G.L. c. 176k And Section 1882 Of The Federal Social Security Act
Section 71.07 - Renewability

(a) The Issuer shall not cancel or nonrenew the Policy solely on the ground of the health status of the individual.

(b) The Issuer shall not cancel or nonrenew the Policy, including an Alternate Innovative Benefit Rider, for any reason other than nonpayment of premium or material misrepresentation; provided that no Nonprofit Hospital Service Corporation or Medical Service Corporation shall be required to continue the coverage of a Policyholder who becomes a resident of a state other than Massachusetts.

(c) If the Medicare Supplement Insurance Policy is held by a group, and the group policy is terminated and is not replaced, as provided under 211 CMR 71.07(3)(e), the Issuer shall offer certificateholders an individual Medicare Supplement Insurance Policy which, at the option of the certificateholder:

(d) If an individual is a certificateholder in a group Medicare Supplement Insurance Policy and the individual terminates membership in the group, the Issuer shall:

(e) If a group Medicare Supplement Insurance Policy is replaced by another group Medicare Supplement Insurance Policy purchased by the same Policyholder, the Issuer of the replacement Policy shall offer coverage to all persons covered under the old group Policy on its date of termination. Coverage under the new Policy shall not contain any waiting period or preexisting condition limitation or exclusion.

(f) Termination of a Medicare Supplement Insurance Policy shall be without prejudice to any continuous loss which commenced while the Policy was in force, but the extension of benefits beyond the period during which the Policy was in force may be conditioned upon the continuous total disability of the Insured, limited to the duration of the Policy benefit period, if any, or payment of the maximum benefits. Receipt of Medicare Part D benefits will not be considered in determining a continuous loss.

(g) General Standards. The following standards apply to Medicare Supplement Insurance Policies and are in addition to all other requirements of 211 CMR 71.00.

(a) Issuers shall continue to renew Medicare Supplement Insurance Policies originally made effective prior to January 1, 1995 under the terms and conditions of those Policies, except as otherwise permitted or required under 211 CMR 71.03 and 211 CMR 71.12.

(b) Required Notice of Opportunity to Transfer to Community Rated Policy. Every Issuer that has issued a Medicare Supplement Insurance Policy to be effective prior to January 1, 1995 and has an existing Policyholder of a Medicare Supplement Insurance Policy and renews an age-rated Medicare Supplement Insurance Policy on or after January 1, 1995 shall provide notice at the time of renewal to its Policyholders of their right to transfer to a community rated Policy during the annual open enrollment periods held in February and March of calendar years 1995, 1996 and 1997 with coverage to begin June 1st of such calendar year without paying a surcharge in accordance with the provisions in 211 CMR 71.10(5).

(a) A Medicare Supplement Insurance Policy with benefits for outpatient prescription drugs in effect on December 31, 2005 shall be renewed, at the option of the Policyholder, for Policyholders who do not enroll in Medicare Part D.

(b) After December 31, 2005, a Medicare Supplement Insurance Policy with benefits for outpatient prescription drugs cannot be renewed after the Policyholder enrolls in Medicare Part D.

(c) Policyholders who are enrolled in a Medicare Supplement Insurance Policy with outpatient prescription drug coverage offered in Massachusetts on or after July 31, 1992 and who enroll in Medicare Part D shall be transferred by the Issuer from the Medicare Supplement Insurance Policy under which they were covered on December 31, 2005 to that Issuer's most comparable Medicare Supplement Insurance Policy without outpatient prescription drug coverage, where the benefits under the Medicare Supplement Insurance Policy without outpatient prescription drug coverage are the same as the benefits under the Medicare Supplement Insurance Policy with outpatient prescription drug coverage except for outpatient prescription drug coverage, unless the Issuer offers and a Policyholder chooses coverage under another Medicare Supplement Insurance Policy without outpatient prescription drug coverage or the Policyholder elects to remain in the same Medicare Supplement Insurance Policy, but with the outpatient prescription drug coverage eliminated and the premiums adjusted to reflect such elimination of coverage. The rate for such comparable policy shall be the same rate as the Issuer charges all other Policyholders for that Policy on the date of the transfer to the comparable policy.

(d) In the case where benefits under the Medicare Supplement Insurance Policy without outpatient prescription drug coverage and the benefits under the Medicare Supplement Insurance Policy with outpatient prescription drug coverage differ by more than outpatient prescription drug benefits, and unless the Issuer offers and a Policyholder chooses coverage under another Medicare Supplement Insurance Policy without outpatient prescription drug coverage, the Issuer shall:

(e) The coverage provided by the comparable policy or the "stripped-down policy" shall become effective simultaneous with the effective date of Medicare Part D coverage.

(f) The Issuer shall notify all Policyholders affected by this change and shall describe to such Policyholders all the reasons for the respective coverage and rate changes within 15 days of notification of enrollment in Medicare Part D.