(a) In order to providefor full and fair disclosure in the sale of policies, no policy or certificateshall be delivered in this State unless an outline of coverage is delivered tothe applicant at the time application is made.
(b) The Commissionershall prescribe the format and content of the outline of coverage required bysubsection (a) of this section. For purposes of this section,"format" means style, arrangement, and overall appearance, includingsuch items as the size, color, and prominence of type and arrangement of textand captions. Such outline of coverage shall include:
(1) A description of theprincipal benefits and coverage provided in the policy;
(2) A statement of theexceptions, reductions, and limitations contained in the policy;
(3) A statement of therenewal provisions, including any reservation by the insurer of a right tochange premiums; and
(4) A statement that theoutline of coverage is a summary of the policy issued or applied for and thatthe policy should be consulted to determine governing contractual provisions.
(c) The Commissionermay prescribe by rule a standard form and the contents of an informationalbrochure for persons eligible for Medicare, which is intended to improve thebuyer's ability to select the most appropriate coverage and improve the buyer'sunderstanding of Medicare. Except in the case of direct response insurancepolicies, the Commissioner may require by rule that the information brochure beprovided to any prospective insured eligible for Medicare concurrently withdelivery of the outline of coverage. With respect to direct response insurancepolicies, the Commissioner may require by rule that the prescribed brochure beprovided upon request to any prospective insured eligible for Medicare, but inno event later than the time of policy delivery.
(d) The Commissionermay adopt rules for captions or notice requirements, determined to be in thepublic interest and designed to inform prospective insureds that particularinsurance coverages are not Medicare supplement coverages, for all accident andhealth insurance policies sold to persons eligible for Medicare, other than:Medicare supplement policies; disability income policies; basic, catastrophic,or major medical expense policies; or single premium, nonrenewable policies.
(e) The Commissionermay further adopt rules to govern the full and fair disclosure of theinformation in connection with the replacement of accident and health insurancepolicies, subscriber contracts, or certificates by persons eligible forMedicare.
(f) No insurer shalluse attained age as a structure or methodology for its Medicare supplementinsurance rates unless the structure or methodology is fully disclosed to theapplicant at the time of application or to the insured at the time of deliveryif the purchase is by mail order. All types of solicitation materials shallclearly indicate that the premiums are based on attained age, which means thatthose premiums will increase each year. The Commissioner shall prescribe byrule the format and content of the attained age rating disclosure notice. Thenotice shall include:
(1) A statement thatattained age rating means that rates increase as the insured ages or by the agegroup in which the insured is.
(2) An illustrationbased on actual attained age that states the dollar amount of premium increasefor the insured over a period of not less than 10 policy years and thatdisplays the life expectancy of the insured at the beginning of the period.
(3) A statement thatpremiums for other Medicare supplement policies that are on issue age bases donot increase as the insured ages.
(4) A statement thatother Medicare supplement policies that are on issue age bases should becompared to policies on attained age bases. (1989, c. 729, s. 1; 1991(Reg. Sess., 1992), c. 815, s. 2; 1998‑211, s. 12.)
(a) In order to providefor full and fair disclosure in the sale of policies, no policy or certificateshall be delivered in this State unless an outline of coverage is delivered tothe applicant at the time application is made.
(b) The Commissionershall prescribe the format and content of the outline of coverage required bysubsection (a) of this section. For purposes of this section,"format" means style, arrangement, and overall appearance, includingsuch items as the size, color, and prominence of type and arrangement of textand captions. Such outline of coverage shall include:
(1) A description of theprincipal benefits and coverage provided in the policy;
(2) A statement of theexceptions, reductions, and limitations contained in the policy;
(3) A statement of therenewal provisions, including any reservation by the insurer of a right tochange premiums; and
(4) A statement that theoutline of coverage is a summary of the policy issued or applied for and thatthe policy should be consulted to determine governing contractual provisions.
(c) The Commissionermay prescribe by rule a standard form and the contents of an informationalbrochure for persons eligible for Medicare, which is intended to improve thebuyer's ability to select the most appropriate coverage and improve the buyer'sunderstanding of Medicare. Except in the case of direct response insurancepolicies, the Commissioner may require by rule that the information brochure beprovided to any prospective insured eligible for Medicare concurrently withdelivery of the outline of coverage. With respect to direct response insurancepolicies, the Commissioner may require by rule that the prescribed brochure beprovided upon request to any prospective insured eligible for Medicare, but inno event later than the time of policy delivery.
(d) The Commissionermay adopt rules for captions or notice requirements, determined to be in thepublic interest and designed to inform prospective insureds that particularinsurance coverages are not Medicare supplement coverages, for all accident andhealth insurance policies sold to persons eligible for Medicare, other than:Medicare supplement policies; disability income policies; basic, catastrophic,or major medical expense policies; or single premium, nonrenewable policies.
(e) The Commissionermay further adopt rules to govern the full and fair disclosure of theinformation in connection with the replacement of accident and health insurancepolicies, subscriber contracts, or certificates by persons eligible forMedicare.
(f) No insurer shalluse attained age as a structure or methodology for its Medicare supplementinsurance rates unless the structure or methodology is fully disclosed to theapplicant at the time of application or to the insured at the time of deliveryif the purchase is by mail order. All types of solicitation materials shallclearly indicate that the premiums are based on attained age, which means thatthose premiums will increase each year. The Commissioner shall prescribe byrule the format and content of the attained age rating disclosure notice. Thenotice shall include:
(1) A statement thatattained age rating means that rates increase as the insured ages or by the agegroup in which the insured is.
(2) An illustrationbased on actual attained age that states the dollar amount of premium increasefor the insured over a period of not less than 10 policy years and thatdisplays the life expectancy of the insured at the beginning of the period.
(3) A statement thatpremiums for other Medicare supplement policies that are on issue age bases donot increase as the insured ages.
(4) A statement thatother Medicare supplement policies that are on issue age bases should becompared to policies on attained age bases. (1989, c. 729, s. 1; 1991(Reg. Sess., 1992), c. 815, s. 2; 1998‑211, s. 12.)
(a) In order to providefor full and fair disclosure in the sale of policies, no policy or certificateshall be delivered in this State unless an outline of coverage is delivered tothe applicant at the time application is made.
(b) The Commissionershall prescribe the format and content of the outline of coverage required bysubsection (a) of this section. For purposes of this section,"format" means style, arrangement, and overall appearance, includingsuch items as the size, color, and prominence of type and arrangement of textand captions. Such outline of coverage shall include:
(1) A description of theprincipal benefits and coverage provided in the policy;
(2) A statement of theexceptions, reductions, and limitations contained in the policy;
(3) A statement of therenewal provisions, including any reservation by the insurer of a right tochange premiums; and
(4) A statement that theoutline of coverage is a summary of the policy issued or applied for and thatthe policy should be consulted to determine governing contractual provisions.
(c) The Commissionermay prescribe by rule a standard form and the contents of an informationalbrochure for persons eligible for Medicare, which is intended to improve thebuyer's ability to select the most appropriate coverage and improve the buyer'sunderstanding of Medicare. Except in the case of direct response insurancepolicies, the Commissioner may require by rule that the information brochure beprovided to any prospective insured eligible for Medicare concurrently withdelivery of the outline of coverage. With respect to direct response insurancepolicies, the Commissioner may require by rule that the prescribed brochure beprovided upon request to any prospective insured eligible for Medicare, but inno event later than the time of policy delivery.
(d) The Commissionermay adopt rules for captions or notice requirements, determined to be in thepublic interest and designed to inform prospective insureds that particularinsurance coverages are not Medicare supplement coverages, for all accident andhealth insurance policies sold to persons eligible for Medicare, other than:Medicare supplement policies; disability income policies; basic, catastrophic,or major medical expense policies; or single premium, nonrenewable policies.
(e) The Commissionermay further adopt rules to govern the full and fair disclosure of theinformation in connection with the replacement of accident and health insurancepolicies, subscriber contracts, or certificates by persons eligible forMedicare.
(f) No insurer shalluse attained age as a structure or methodology for its Medicare supplementinsurance rates unless the structure or methodology is fully disclosed to theapplicant at the time of application or to the insured at the time of deliveryif the purchase is by mail order. All types of solicitation materials shallclearly indicate that the premiums are based on attained age, which means thatthose premiums will increase each year. The Commissioner shall prescribe byrule the format and content of the attained age rating disclosure notice. Thenotice shall include:
(1) A statement thatattained age rating means that rates increase as the insured ages or by the agegroup in which the insured is.
(2) An illustrationbased on actual attained age that states the dollar amount of premium increasefor the insured over a period of not less than 10 policy years and thatdisplays the life expectancy of the insured at the beginning of the period.
(3) A statement thatpremiums for other Medicare supplement policies that are on issue age bases donot increase as the insured ages.
(4) A statement thatother Medicare supplement policies that are on issue age bases should becompared to policies on attained age bases. (1989, c. 729, s. 1; 1991(Reg. Sess., 1992), c. 815, s. 2; 1998‑211, s. 12.)
