Relating to insurance

ARTICLE 1 - FEDERALLY CONFORMING CHANGES IN MEDICARE RELATED COVERAGES

Modifying certain provisions regulating medicare supplement insurance;
conforming certain provisions to the minimum federal standards and requiring compliance; modifying certain guaranteed issue requirements and deeming supplement plans eliminating outpatient prescription drug benefits due to requirements of the federal changes as satisfying guaranteed renewal requirements; requiring reinstatement of suspended policies providing coverage for outpatient prescription drugs for medicare part D enrollees to be without coverage for the drugs and to provide coverage substantially equivalent to the coverage in effect before suspension; requiring renewal of outpatient prescription drug coverage to be at the option of the policy holder; prohibiting the consideration of the receipt of part D benefits in determining continuous loss for termination of coverage purposes; prohibiting the issuance of prescription drug coverage after a certain date and prohibiting renewal after enrollment in medicare part D without certain policy modifications and premium
adjustments; changing certain references to medicare choice to medicare
advantage; modifying the definition of medicare supplement policy, excluding medicare advantage plans established under medicare part C, outpatient prescription drug plans under part D and certain health care prepayment plans from the definition and defining outpatient prescription drug; permitting duplication of benefits under certain conditions; defining health care expenses for loss ratios calculation purposes; requiring issuers of supplemental policies to file riders or amendments to policy or certificate forms to delete outpatient prescription drug benefits as required by federal law with the commissioner in the state of issuance; specifying certain alphabetization and cross reference changes instructions to the revisor of statutes

ARTICLE 2 - REGULATION OF STAND ALONE MEDICARE PART D PRESCRIPTION PLANS

Providing financial solvency regulation for stand alone medicare part D
prescription drug plans; defining certain terms; requiring a certificate of
authority from the commissioner of commerce to operate prepaid limited health service organizations, specifying certain application requirements and providing for issuance and denial; specifying certain filing requirements of authorized insurance entities not otherwise authorized to offer limited health services on a per capita or fixed prepayment basis and requiring the filing of notices with the commissioner of material modifications by prepaid limited health service organizations; requiring issuance to subscribers of evidence of coverage consistent with the requirements of medicare part D; providing for the application of other insurance laws to the organizations; authorizing exclusion of duplicate coverages; requiring the organizations to establish and maintain
complaint systems; granting the commissioner certain organization records examination authority; regulating investments; requiring the licensing of agents; specifying certain minimum net equity and deposit requirements for insolvency protection purposes; requiring the maintenance of fidelity bonds on officers and employees; specifying certain annual reporting requirements; specifying grounds and procedures for suspension or revocation by the commissioner of certificate of authority; imposing penalties for certain violations

ARTICLE 3 - TECHNICAL AND CONFORMING CHANGES

Making certain technical and conforming modifications to certain statutory
provisions relating to prohibited practices under the small employer health
benefit act, the definition of medicare related coverage for health plan company requirements purposes and the health maintenance organization (HMO) or community integrated service network (CISN) provider surcharge
(Ch. 17, 2005)