INSURANCE -- MEDICARE SUPPLEMENT INSURANCE POLICIES, the official text

S3282 2026 -- S 3282 ======== LC006468 ======== STATE OF RHODE ISLAND IN GENERAL ASSEMBLY JANUARY SESSION, A.D. 2026 ____________ A N A C T RELATING TO INSURANCE -- MEDICARE SUPPLEMENT INSURANCE POLICIES Introduced By: Senators Lawson, and Murray Date Introduced: May 12, 2026 Referred To: Senate Health & Human Services It is enacted by the General Assembly as follows: 1 SECTION 1. Section 27-18.2-3 of the General Laws in Chapter 27-18.2 entitled Medicare 2 Supplement Insurance Policies is hereby amended to read as follows: 3 27-18.2-3. Standards for policy provisions. 4 (a) No Medicare supplement insurance policy or certificate in force in the state shall contain 5 benefits that duplicate benefits provided by Medicare. 6 (b) Notwithstanding any other provision of law of this state, a Medicare supplement policy 7 or certificate shall not exclude or limit benefits for loss incurred more than six (6) months from the 8 effective date of coverage because it involved a preexisting condition. The policy or certificate shall 9 not define a preexisting condition more restrictively than a condition for which medical advice was 10 given or treatment was recommended by or received from a physician within six (6) months before 11 the effective date of coverage. 12 (c) The commissioner shall adopt reasonable regulations to establish specific standards for 13 policy provisions of Medicare supplement policies and certificates. Those standards shall be in 14 addition to and in accordance with the applicable laws of this state, including but not limited to §§ 15 27-18-3(a) and 42-62-12 and regulations promulgated pursuant to those sections. No requirement 16 of this title or chapter 62 of title 42 relating to minimum required policy benefits, other than the 17 minimum standards contained in this chapter, shall apply to Medicare supplement policies and 18 certificates. The standards may cover, but not be limited to: 19 (1) Terms of renewability; 1 (2) Initial and subsequent conditions of eligibility; 2 (3) Nonduplication of coverage; 3 (4) Probationary periods; 4 (5) Benefit limitations, exceptions, and reductions; 5 (6) Elimination periods; 6 (7) Requirements for replacement; 7 (8) Recurrent conditions; and 8 (9) Definitions of terms. 9 (d) The commissioner may adopt reasonable regulations that specify prohibited policy 10 provisions not specifically authorized by statute, if, in the opinion of the commissioner, those 11 provisions are unjust, unfair, or unfairly discriminatory to any person insured or proposed to be 12 insured under a Medicare supplement policy or certificate. 13 (e) The commissioner shall adopt reasonable regulations to establish minimum standards 14 for premium rates, benefits, claims payment, marketing practices, and compensation arrangements 15 and reporting practices for Medicare supplement policies and certificates. 16 (f) The commissioner may adopt any reasonable regulations necessary to conform 17 Medicare supplement policies and certificates to the requirements of federal law and regulations 18 promulgated pursuant to federal law, including but not limited to: 19 (1) Requiring refunds or credits if the policies or certificates do not meet loss ratio 20 requirements; 21 (2) Establishing a uniform methodology for calculating and reporting loss ratios; 22 (3) Assuring public access to policies, premiums, and loss ratio information of issuers of 23 Medicare supplement insurance; 24 (4) Establishing a process for approving or disapproving policy forms and certificate forms 25 and proposed premium increases; 26 (5) Establishing a policy for holding public hearings prior to approval of premium increases 27 that may include the applicant’s provision of notice of the proposed premium increase to all 28 subscribers subject to the proposed increase, at least ten (10) days prior to the hearing; and 29 (6) Establishing standards for Medicare select policies and certificates. 30 (g) Each Medicare supplement Plan A policy or applicable certificate that an issuer 31 currently, or at any time hereafter, makes available in this state shall be made available to any 32 applicant under the age of sixty-five (65) who is eligible for Medicare due to a disability or end- 33 stage renal disease, provided that the applicant submits their application during the first six (6) 34 months immediately following the applicant’s initial eligibility for Medicare Part B, or alternate LC006468 - Page 2 of 4 1 enrollment period as determined by the commissioner. The issuance or coverage of any Medicare 2 supplement policy pursuant to this section shall not be conditioned on the medical or health status 3 or receipt of health care by the applicant; and no insurer shall perform individual medical 4 underwriting on any applicant in connection with the issuance of a policy pursuant to this 5 subsection. 6 (1) Any individual under the age of sixty-five (65) enrolled in a Medicare supplement Plan 7 A by reason of disability or end-stage renal disease pursuant to subsection (g) of this section, shall 8 receive a six-month (6) open enrollment period for any policy or applicable certificate that an issuer 9 currently makes available in this state beginning on the first day of the month in which the 10 individual both attains the age of sixty-five (65) and remains enrolled in Medicare Parts A & B. 11 (h) Each year, for the duration of the Medicare Annual Enrollment Period (AEP) for 12 coverage with an effective date of January 1 of the following year, an individual enrolled in a 13 Medicare supplement policy or Medicare Advantage plan who has been covered by any Medicare 14 supplement policy(s) or Medicare Advantage plan(s) or another form of credible coverage with no 15 gap in coverage greater than ninety (90) days beginning from that individual’s Medicare Initial 16 Enrollment Period (IEP) Medigap Open Enrollment Period , shall be afforded guaranteed issue 17 rights for any available Medicare supplement policy or applicable certificate that an issuer currently 18 makes available in this state. 19 (1) The issuance or coverage of any Medicare supplement policy pursuant to subsection 20 (h) of this section shall not be conditioned on the medical or health status or receipt of health care 21 by the applicant and no issuer shall perform individual medical underwriting on any applicant in 22 connection with the issuance of a policy pursuant to this subsection. 23 (2) For those individuals under the age of sixty-five (65) enrolled in a Medicare Advantage 24 or Medicare supplement Plan A due to a disability, pursuant to subsection (g) of this section the 25 individual shall be afforded guaranteed issue rights for every Medicare supplement Plan A policy 26 or applicable certificate that an issuer makes available in this state. Coverage shall be afforded 27 pursuant to subsection (h)(1) of this section. 28 SECTION 2. This act shall take effect upon passage. ======== LC006468 ======== LC006468 - Page 3 of 4 EXPLANATION BY THE LEGISLATIVE COUNCIL OF A N A C T RELATING TO INSURANCE -- MEDICARE SUPPLEMENT INSURANCE POLICIES *** 1 This act would expand guaranteed issue rights for Medigap plan enrollees who enroll 2 outside of a plan’s initial enrollment period. 3 This act would take effect upon passage. ======== LC006468 ======== LC006468 - Page 4 of 4