14 Va. Admin. Code § 5-150-60

Current through Register Vol. 40, No. 22, June 17, 2024

Section 14VAC5-150-60 - Requirements for new policies and certificates

A. Effective 60 days after enactment of federal law mandating Medicare benefit changes no medicare supplement insurance policy, contract, or certificate shall be issued or issued for delivery in this Commonwealth which provides benefits which duplicate benefits provided by Medicare. No such policy, contract or certificate shall provide less benefits than those required under Chapter 36 (§ 38.2-3600 et seq.) of Title 38.2, or existing, Rules Governing the Implementation of the Individual Accident and Sickness Insurance Minimum Standards Act (Chapter 140, 14VAC5-140-10 et seq. of this title) with respect to medicare supplement policies except where duplication of Medicare benefits would result.

B. General requirements.

1. Within 90 days of August 31, 1988, every insurer, health services plan, health maintenance organization or other entity required to file its policies or contracts with the Commission shall file new medicare supplement insurance policies or contracts which eliminate any duplication of medicare supplement benefits with benefits provided by Medicare and which provide a clear description of the policy or contract benefit.

2. The filing required under subdivision 1 above shall provide for loss ratios which are in compliance with all statutory or regulatory requirements.

3. Every applicant for a Medicare supplement insurance policy, contract, or certificate shall be provided with an outline of coverage which in simple accurate terms describes benefits provided by Medicare and the medicare supplement policy or contract along with benefit limitations.

14 Va. Admin. Code § 5-150-60

Derived from Regulation 32, Case No. INS870293, § 7, eff. August 31, 1988.

Statutory Authority

§§ 38.2-223, 38.2-3516 through 38.2-3520, 38.2-3600 through 38.2-3607 and 38.2-514 of the Code of Virginia.