Legislative Session number- 84

Bill Name: SF0880

1E 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
(ra, ja)