20-1133. Medicare supplement insurance;
applicability
A. The director shall adopt those rules as are necessary to comply with the
requirements of the social security disability amendments of 1980 (P.L. 96-265; 42 United
States Code section 1395ss) and any federal laws or regulations pertaining to that
section, so that this state may retain its full authority to regulate minimum standards
for medicare supplement insurance.
B. Subject to the other limitations provided in this subsection, no benefit
mandated in this title for health insurance policies shall apply to medicare supplement
insurance policies unless such mandated policy benefits are set forth in rules adopted
pursuant to this section or unless the statute mandating policy benefits expressly states
that it is made specifically applicable to medicare supplement insurance policies. No
medicare supplement insurance policy shall contain any exclusion for services provided by
any type of properly licensed health care provider if the provider's services are
eligible for medicare reimbursement and if the specific services in question would be
covered by medicare. In no event shall the scope of benefits of a medicare supplement
policy be less than the minimum level of benefits established by federal law.
C. Notwithstanding any other provision of this title, rules adopted pursuant to
this section apply to insurance furnished under disability insurance policies, under
subscription contracts of hospital, medical, dental or optometric service corporations,
under certificates of fraternal benefit societies, under evidences of coverage of health
care services organizations and under coverages issued by any other insurer, which
policies, contracts, certificates, membership coverages, evidences of coverage and
coverages are delivered or issued for delivery in this state on or after the effective
date of rules adopted pursuant to subsection A. In adopting the rules required by
subsection A, the director shall prescribe an effective date of the rules that will allow
insurers sufficient time to bring their forms and practices into compliance with the
requirements of the rule.
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