Z-0788.1                   _______________________________________________

                                                     SENATE BILL 5710

                              _______________________________________________

State of Washington                              53rd Legislature                             1993 Regular Session

By Senators Prentice, Prince and Moore; by request of Insurance Commissioner

Read first time 02/10/93.  Referred to Committee on Labor & Commerce.

Requiring minimum standards for benefits in medicare supplement insurance.

          AN ACT Relating to minimum standards for benefits in medicare supplement insurance; and amending RCW 48.66.041.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

        Sec. 1.  RCW 48.66.041 and 1992 c 138 s 4 are each amended to read as follows:

          (1) The insurance commissioner shall adopt rules to establish minimum standards for benefits in medicare supplement insurance policies and certificates.

          (2) The commissioner shall adopt rules to establish specific standards for medicare supplement insurance policy or certificate provisions.  These rules may include but are not limited to:

          (a) Terms of renewability;

          (b) Nonduplication of coverage;

          (c) Benefit limitations, exceptions, and reductions;

          (d) Definitions of terms;

          (e) Requiring refunds or credits if the policies or certificates do not meet loss ratio requirements;

          (f) Establishing uniform methodology for calculating and reporting loss ratios;

          (g) Assuring public access to policies, premiums, and loss ratio information of an issuer of medicare supplement insurance;

          (h) Establishing a process for approving or disapproving proposed premium increases; and

          (i) Establishing standards for medicare SELECT policies and certificates.

          (3) The insurance commissioner may adopt rules that establish disclosure standards for replacement of policies or certificates by persons eligible for medicare ((by reason of age)).

          (4) The insurance commissioner may by rule prescribe that an informational brochure, designed to improve the buyer's understanding of medicare and ability to select the most appropriate coverage, be provided to persons eligible for medicare by reason of age.  The commissioner may require that the brochure be provided to applicants concurrently with delivery of the outline of coverage, except with respect to direct response insurance, when the brochure may be provided upon request but no later than the delivery of the policy.

          (5) In the case of a state or federally qualified health maintenance organization, the commissioner may waive compliance with one or all provisions of this section until January 1, 1983.

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