Missouri Code of State Regulations
Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE
Division 400 - Life, Annuities and Health
Chapter 3 - Medicare Supplement Insurance
Section 20 CSR 400-3.100 - Rule to Implement Transitional Requirements for the Conversion of Medicare Supplement Insurance Benefits and Premiums to Conform to Medicare Program Revisions
Current through Register Vol. 49, No. 6, March 15, 2024
PURPOSE: This rule attempts to assure the orderly implementation and conversion of Medicare supplement insurance benefits and premiums due to changes in the federal Medicare program; provides for the reasonable standardization of the coverage, terms and benefits of Medicare supplement policies or contracts; facilitates public understanding of these policies or contracts; eliminates provisions contained in these policies or contracts which may be misleading or confusing in connection with the purchase of these policies or contracts to eliminate policy or contract provisions which may duplicate Medicare benefits; provides full disclosure of policy or contract benefits and benefit changes; and provides for refunds of premiums associated with benefits duplicating Medicare program benefits. This rule is promulgated pursuant to sections 376.850-376.890, RSMo.
(1) Applicability and Scope. This regulation shall take precedence over other rules and requirements relating to Medicare supplement policies or contracts only to the extent necessary to assure that benefits are not duplicated, that applicants receive adequate notice and disclosure of changes in Medicare supplement policies and contracts, that appropriate premium adjustments are made in a timely manner and that premiums are reasonable in relation to benefits. Except as otherwise provided, this rule shall apply to-
(2) Definitions. For purposes of this rule-
(3) Benefit Conversion Requirements.
(4) Requirements for New Policies and Certificates.
(5) Filing Requirements for Advertising. Every insurer, health care service plan or other entity providing Medicare supplement insurance or benefits in this state shall provide a copy of any advertisement intended for use in this state whether through written, radio or television medium to the director of insurance of this state for review by the director. This advertisement shall be submitted to the director no later than the first day on which the advertisement is used. The department shall stamp each advertisement in a manner which indicates that it has been reviewed but that the review does not constitute approval by the department. All Medicare supplement advertisements will be retained for thirty (30) days before being returned to the company. The advertisement shall comply with all applicable laws and rules of this state.
(6) Buyer's Guide. No insurer, health care service plan or other entity shall make use of or otherwise disseminate any buyer's guide or informational brochure which does not accurately outline current Medicare benefits and which has not been adopted by the director.
(7) Separability. If any provision of this regulation or the application of it to any persons or circumstances is for any reason held to be invalid, the remainder of the regulation and the application of that provision to other persons or circumstances shall not be affected by it.
*Original authority 1967.