Haw. Code R. § 16-12-6.06 - Standard Medicare supplement benefit plans for 2020 standardized Medicare supplement benefit plan policies or certificates issued for delivery to individuals newly eligible for Medicare on or after January 1, 2020
(a) No policy or certificate that provides
coverage of the Medicare Part B deductible may be advertised, solicited,
delivered, or issued for delivery in this State as a Medicare supplement policy
or certificate to individuals newly eligible for Medicare on or after January
1, 2020. All policies must comply with the following benefit standards. Benefit
plan standards applicable to Medicare supplement policies and certificates
issued to individuals eligible for Medicare before January 1, 2020, remain
subject to the requirements of sections
16-12-5.5,
16-12-6,
and
16-12-6.05.
(b) Benefit requirements. The
standards and requirements of section
16-12-6.05 shall apply to all Medicare supplement policies or certificates delivered or
issued for delivery to individuals newly eligible for Medicare on or after
January 1, 2020, with the following exceptions:
(1) Standardized Medicare supplement benefit
Plan C is redesignated as Plan D and shall provide the benefits contained in
section
16-12-6.05(f)(3)
but shall not provide coverage for 100 per cent or any portion of the Medicare
Part B deductible.
(2) Standardized
Medicare supplement benefit Plan F is redesignated as Plan G and shall provide
the benefits contained in section
16-12-6.05(f)(5)
but shall not provide coverage for 100 per cent or any portion of the Medicare
Part B deductible.
(3) Standardized
Medicare supplement benefit Plans C, F, and F with high deductible may not be
offered to individuals newly eligible for Medicare on or after January 1,
2020.
(4) Standardized Medicare
supplement benefit Plan F with high deductible is redesignated as Plan G with
high deductible and shall provide the benefits contained in section
16-12-6.05(f)(6)
of this regulation but shall not provide coverage for 100 per cent or any
portion of the Medicare Part B deductible; provided further that, the Medicare
Part B deductible paid by the beneficiary shall be considered an out-of-pocket
expense in meeting the annual high deductible.
(5) The reference to Plans C or F contained
in section
16-12-6.05(b)(2)
is deemed a reference to Plans D or G for purposes of this
section.
(c)
Applicability to certain individuals. This section applies to only individuals
that are newly eligible for Medicare on or after January 1, 2020:
(1) By reason of attaining age 65 on or after
January 1, 2020; or
(2) By reason
of entitlement to benefits under Part A pursuant to Section 226(b) or 226A of
the Social Security Act, or who is deemed to be eligible for benefits under
Section 226(a) of the Social Security Act on or after January 1,
2020.
(d) Guaranteed
issue for eligible persons. For purposes of section
16-12-6.3(e),
in the case of any individual newly eligible for Medicare on or after January
1, 2020, any reference to a Medicare supplement policy C or F (including F with
high deductible) shall be deemed to be a reference to Medicare supplement
policy D or G (including G with high deductible), respectively, that meets the
requirements of subsection (b).
(e)
Applicability to waivered states. In the case of a state described in Section
1882(p)(6) of the Social Security Act ("waivered" alternative simplification
states) the Medicare Access and CHIP Reauthorization Act of 2015 prohibits the
coverage of the Medicare Part B deductible for any Medicare supplement policy
sold or issued to an individual that is newly eligible for Medicare on or after
January 1, 2020.
(f) Offer of
redesignated plans to individuals other than newly eligible. On or after
January 1, 2020, the standardized benefit plans described in subsection (b)(4)
may be offered to any individual who was eligible for Medicare prior to January
1, 2020, in addition to the standardized plans described in section
16-12-6.05(f).
Notes
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