Section 71.07 - Renewability(1) Medicare Supplement Insurance Policies shall include a renewability provision. The language or specifications of the provision shall be consistent with the type of contract issued. Medicare Supplement Insurance Policies, including Alternate Innovative Benefit Riders, shall not contain renewal provisions less favorable to the Insured than "Guaranteed Renewable" as that term is defined in 211 CMR 71.03.(2) All Medicare Supplement Insurance Policies, including Alternate Innovative Benefit Riders, shall contain a renewability provision as required by 211 CMR 71.07(1). Such provision shall be appropriately captioned and shall appear on the first page of the Policy and shall include any reservation by the Issuer of the right to change premiums.(3) Medicare Supplement Insurance Policies shall comply with the following requirements: (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: 1. Provides for continuation of the benefits contained in the group Policy; or2. Provides for benefits that otherwise meet the requirements of 211 CMR 71.07(3).(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:1. Offer the certificateholder the conversion opportunity described in 211 CMR 71.07(3)(c); or2. At the option of the group Policyholder, offer the certificateholder continuation of coverage under the group Policy.(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. 1. A Medicare Supplement Insurance Policy shall provide that benefits and premiums under the Policy shall be suspended at the request of the Policyholder for the period (not to exceed 24 months, unless the Issuer permits a longer period of suspension) in which the Policyholder has applied for and is determined to be entitled to medical assistance under Title XIX of the Social Security Act, but only if the Policyholder notifies the Issuer of such Policy within 90 days after the date the individual becomes entitled to such assistance.2. If suspension occurs and if the Policyholder loses entitlement to medical assistance, the Policy shall be automatically reinstituted (effective as of the date of termination of such entitlement) if the Policyholder provides notice of loss of entitlement within 90 days after the date of loss and pays the premium attributable to the period, effective as of the date of termination of entitlement.3. Each Medicare Supplement Insurance Policy shall provide that benefits and premiums under the Policy shall be suspended (for any period that may be provided by federal regulation) at the request of the Policyholder if the Policyholder is entitled to benefits under the Social Security Act § 226(b) and is covered under a group health plan (as defined in the Social Security Act § 1862(b)(1)(A)(v)). If suspension occurs and if the Policyholder loses coverage under the group health plan, the Policy shall be automatically reinstituted (effective as of the date of loss of coverage) if the Policyholder provides notice of loss of coverage within 90 days after the date of the loss.4. Reinstitution of such coverages as described in 211 CMR 71.07(3)(g)3. and 4.:a. Shall not provide for any waiting period with respect to treatment of preexisting conditions;b. Shall provide for coverage which is substantially equivalent to coverage in effect before the date of such suspension. If the suspended Medicare Supplement Insurance Policy provided coverage for outpatient prescription drugs, reinstitution of the Policy for Medicare Part D enrollees shall be without coverage for outpatient prescription drugs and shall otherwise provide substantially equivalent coverage to the coverage in effect before the date of suspension; andc. Shall provide for classification of premiums on terms at least as favorable to the Policyholder as the premium classification terms that would have applied to the Policyholder had the coverage not been suspended.(4)(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).(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: 1. not transfer the Policyholder to any other Medicare Supplement Insurance Policy;2. amend the Policyholder's coverage to a "stripped-down policy" that eliminates the outpatient prescription drug coverage; and3. adjust the premiums to reflect such elimination of coverage.(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.Amended by Mass Register Issue 1397, eff. 8/9/2019.