Section 71.08 - Policy Benefit Standards(1) A Medicare Supplement Insurance Policy shall not be advertised, solicited, delivered, issued, issued for delivery or renewed, unless the Policy meets the following requirements:(a) A Medicare Supplement Insurance Policy shall not indemnify against losses resulting from sickness on a different basis than losses resulting from accidents.(b) Any Medicare Supplement Insurance Policy shall provide that benefits designed to cover cost sharing amounts under Medicare will be changed automatically to coincide with any changes in the applicable Medicare deductible amount and copayment percentage factors and any Medicare Supplement Insurance Policy issued to be effective on or after January 1, 2006 shall provide that benefits will be changed automatically to coincide with any changes required under Massachusetts law regarding mandated benefits; premiums may be modified to correspond with such changes, if approved by the Commissioner in accordance with statutory and regulatory requirements; provided however, that such Policy shall provide that the Insured agrees to the change of benefits and premiums based on changes required under Massachusetts law regarding mandated benefits; provided further that, except as otherwise required by law, all Medicare Supplement Insurance Policies originally issued to be effective prior to January 1, 2006 shall maintain any Guaranteed Renewable fixed drug deductible and the same benefits covered in the original Policy; and provided further that, except as otherwise required by law, all Medicare Supplement Insurance Policies originally issued to be effective prior to January 1, 2020 shall maintain any Guaranteed Renewable benefit to cover the Medicare Part B deductible and the same benefits covered in the original Policy.(c) No Medicare Supplement Insurance Policy shall contain benefits that duplicate benefits provided by Medicare.(d) No Medicare Supplement Insurance Policy shall contain any waiting period or preexisting condition limitation or exclusion.(e) No Medicare Supplement Insurance Policy shall provide for termination of coverage of a spouse solely because of the occurrence of an event specified for termination of coverage of the Insured, other than the nonpayment of premium.(f) Each Medicare Supplement Insurance Policy shall be Guaranteed Renewable in accordance with the provisions of 211 CMR 71.07.(g) No Medicare Supplement Insurance Policy issued to be effective on or before December 31, 2005, which provides coverage for prescription drugs, shall exclude coverage of any such drug for the treatment of cancer or HIV/AIDS on the ground that the off-label use of the drug has not been approved by the United States Food and Drug Administration for that indication; provided however, that such drug is recognized for treatment of such indication in one of the standard reference compendia; or in the medical literature, as those terms are defined in M.G.L. c. 175, § 47O, or by the Commissioner under the provisions of M.G.L. c. 175, § 47P.(h) An Issuer of a Medicare Supplement Insurance Policy shall refund the unearned portion of any premium paid on a quarterly, semi-annual or annual basis upon the death of a Policyholder. An Issuer of a Medicare Supplement Insurance Policy may refund the unearned portion of any premium paid on a quarterly, semi-annual or annual basis in the case of cancellation by the Policyholder for reasons other than death. When calculating all such refunds, an Issuer of a Medicare Supplement Insurance Policy shall convert the billing mode from annual, semi-annual, or quarterly to monthly as of the date of death or cancellation by the Policyholder for reasons other than death and refund the premium paid less the sum of the monthly premiums earned to that point or use a refund methodology submitted to and approved by the Commissioner. All Medicare Supplement Issuers shall notify applicants regarding premium refunds in the required outline of coverage as set forth in 211 CMR 71.13(2)(c)2. Nothing in 211 CMR 71.08(1)(h) shall affect the rights of a Policyholder to return the Policy within 30 days of its delivery and receive a premium refund pursuant to 211 CMR 71.13(1)(e).(2) For Medicare Supplement Insurance Policies issued to be effective on or after January 1, 2006, the following Medicare Supplement options are mandatory as to standards and benefits and shall not be modified in any manner, except as provided in 211 CMR 71.09 or 71.21. No other Medicare Supplement options may be issued to be effective on or after January 1, 2006.(a)Medicare Supplement Core. A Medicare Supplement Core Insurance Policy shall provide the coverage as specified by the Commissioner and shall not provide any additional benefits.(b)Medicare Supplement 1. A Medicare Supplement 1 Insurance Policy shall provide the coverage specified by the Commissioner and shall not provide any additional benefits. Notwithstanding the provisions of any other section, a Medicare Supplement 1 Policy shall not be offered or issued after December 31, 2019 to persons becoming Medicare Eligible Persons on or after January 1, 2020. Subject to the provisions of any other section of law or this regulation, if a company offers persons who became Medicare Eligible Persons prior to January 1, 2020 the option of enrolling in a Medicare Supplement 1A plan, they are required to also offer those persons the option of enrolling in a Medicare Supplement 1 plan. All Medicare Supplement 1 policies in effect on December 31, 2019 shall be renewed, except as identified in 211 CMR 71.07.(c)Medicare Supplement 1A. Beginning January 1, 2020, a Medicare Supplement 1A Insurance Policy shall provide the coverage specified by the Commissioner and shall not provide any additional benefits. Subject to the provisions of any other section of law or 211 CMR 71.00, if an Issuer offers persons who became Medicare Eligible Persons prior to January 1, 2020 the option of enrolling in a Medicare Supplement 1 plan, they are required to also offer those persons the option of enrolling in a Medicare Supplement 1A plan.(d)Medicare Supplement 2. A Medicare Supplement 2 Insurance Policy shall provide the coverage specified by the Commissioner and shall not provide any additional benefits. Notwithstanding the provisions of any other section, a Medicare Supplement Insurance Policy with benefits for outpatient prescription drugs, including such benefits provided through Alternate Innovative Benefits Riders shall not be issued after December 31, 2005, but coverage in effect on December 31, 2005 shall be renewed, except as identified in 211 CMR 71.07(5).(e)Medicare Select. A Medicare Select Insurance Policy shall provide coverage in accordance with the provisions specified in 211 CMR 71.21.(3) For Medicare Supplement Insurance Policies issued to be effective on or after January 1, 2006, an Issuer offering Medicare Supplement Insurance shall make available to each prospective Policyholder a Policy form containing only Medicare Supplement Core Insurance benefits, in accordance with 211 CMR 71.08(2)(a).(4) No groups, packages or combinations of Medicare Supplement Insurance benefits other than those listed in 211 CMR 71.08(2) shall be offered for sale to be effective on or after January 1, 2006 in Massachusetts, except as may be permitted in 211 CMR 71.09.(5) Benefit plans for Medicare Supplement Insurance Policies issued to be effective on or after January 1, 2006 shall be uniform in structure, language, designation and format to the standard benefit plans listed in 211 CMR 71.08(2) and conform to the definitions in 211 CMR 71.03 and 211 CMR 71.05. Each benefit shall be structured in accordance with the format specified by the Commissioner for a Medicare Supplement Core Policy, a Medicare Supplement 1 Policy and a Medicare Supplement 1A Policy, as applicable, and shall list the benefits in the specified order. For purposes of 211 CMR 71.08, "structure, language, and format" means style, arrangement and overall content of a benefit.(6) An Issuer of Medicare Supplement Insurance may use, in addition to the benefit plan designations required in 211 CMR 71.08(2), other designations or product names to the extent permitted by law.(7) Every Issuer shall make available a Medicare Supplement Core Insurance Policy, as described in 211 CMR 71.08(2)(a), to each prospective Policyholder. An Issuer may make available to prospective Insureds any of the other Medicare Supplement Insurance benefit plans for which the prospective Insured is eligible, in addition to the Medicare Supplement Core.(8) No Issuer participating in the market for Medicare Supplement Insurance shall at any time knowingly permit a newly enrolling Eligible Person to terminate a Medicare Supplement 1 plan and purchase a Medicare Supplement 1A plan offered by that Issuer until the person has been covered under the Medicare Supplement 1 plan for at least a period of 12 months.Amended by Mass Register Issue 1397, eff. 8/9/2019.