BILL REQ. #:  H-3495.1 

Read first time 01/13/12.   Referred to Committee on Health Care & Wellness.

     AN ACT Relating to clarifying when evidence of insurability may be required for medicare supplement insurance policies; and amending RCW 48.66.045.

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

Sec. 1   RCW 48.66.045 and 2010 c 27 s 3 are each amended to read as follows:
     (1) Every issuer of a medicare supplement insurance policy or certificate providing coverage to a resident of this state issued on or after January 1, 1996, and before June 1, 2010, must:
     (a) Unless otherwise provided for in RCW 48.66.055, issue coverage under its standardized benefit plans B, C, D, E, F, G, K, and L without evidence of insurability to any resident of this state who is eligible for both medicare hospital and physician services by reason of age or by reason of disability or end-stage renal disease, if the medicare supplement policy replaces another medicare supplement standardized benefit plan policy or certificate B, C, D, E, F, G, K, or L, or other more comprehensive coverage than the replacing policy; and
     (b) Unless otherwise provided for in RCW 48.66.055, issue coverage under its standardized plans A, H, I, and J without evidence of insurability to any resident of this state who is eligible for both medicare hospital and physician services by reason of age or by reason of disability or end-stage renal disease, if the medicare supplement policy replaces another medicare supplement policy or certificate which is the same standardized plan as the replaced policy. After December 31, 2005, plans H, I, and J may be replaced only by the same plan if that plan has been modified to remove outpatient prescription drug coverage.
     (2)(a)(i) Unless otherwise provided for in RCW 48.66.055, every issuer of a medicare supplement insurance policy or certificate providing coverage to a resident of this state issued on or after June 1, 2010, must issue coverage under its standardized plans B, C, D, F, F with high deductible, G, K, L, M, or N ((without evidence of insurability)) to any resident of this state who is eligible for both medicare hospital and physician services by reason of age or by reason of disability or end-stage renal disease, if the medicare supplement policy or certificate replaces another medicare supplement policy or certificate or other more comprehensive coverage; and
     (((b))) (ii) Unless otherwise provided for in RCW 48.66.055, issue coverage under its standardized plan A ((without evidence of insurability)) to any resident of this state who is eligible for both medicare hospital and physician services by reason of age or by reason of disability or end-stage renal disease, if the medicare supplement policy or certificate replaces another standardized plan A medicare supplement policy or certificate.
     (b) If the medicare supplement policy or certificate being replaced was issued on or after June 1, 2010, the issuer of the medicare supplement insurance policy or certificate may not require evidence of insurability prior to issuing the new policy or certificate under (a) of this subsection. If the medicare supplement policy or certificate being replaced was issued prior to June 1, 2010, the issuer of the medicare supplement insurance policy or certificate may require evidence of insurability prior to issuing the new policy or certificate under (a) of this subsection.
     (3) Every issuer of a medicare supplement insurance policy or certificate providing coverage to a resident of this state issued on or after January 1, 1996, must set rates only on a community-rated basis. Premiums must be equal for all policyholders and certificate holders under a standardized medicare supplement benefit plan form, except that an issuer may vary premiums based on spousal discounts, frequency of payment, and method of payment including automatic deposit of premiums and may develop no more than two rating pools that distinguish between an insured's eligibility for medicare by reason of:
     (a) Age; or
     (b) Disability or end-stage renal disease.