Haw. Code R. § 16-12-8 - Required disclosure provisions
(a) General rules
are as follows. Medicare supplement policies and certificates shall include a
renewal or continuation provision. The language or specifications of the
provision must be consistent with the type of contract issued. The provision
shall be appropriately captioned, shall appear on the first page of the policy
or certificate, and shall include any reservation by the issuer of the right to
change premiums and any automatic renewal premium increases based on the
policyholder's age.
(b) Except for
riders or endorsements by which the issuer effectuates a request made in
writing by the insured, exercises a specifically reserved right under a
Medicare supplement policy, or is required to reduce or eliminate benefits to
avoid duplication of Medicare benefits, all riders or endorsements added to a
Medicare supplement policy after date of issue, or at reinstatement, or
renewal, which reduce or eliminate benefits or coverage in the policy shall
require signed acceptance by the insured. After the date of policy or
certificate issue, any rider or endorsement which increases benefits or
coverage with a concomitant increase in premium during the policy term shall be
agreed to in writing signed by the insured, unless the benefits are required by
the minimum standards for Medicare supplement policies, or if the increased
benefits or coverage is required by law. Where a separate additional premium is
charged for benefits provided in connection with riders or endorsements, the
premium charge shall be set forth in the policy.
(c) Medicare supplement policies or
certificates shall not provide for the payment of benefits based on standards
described as "usual and customary," "reasonable and customary," or words of
similar import.
(d) If a Medicare
supplement policy or certificate contains any limitations with respect to
preexisting conditions, the limitations shall appear as a separate paragraph of
the policy and be labeled as "Preexisting Condition Limitations."
(e) Medicare supplement policies and
certificates shall have a notice prominently printed on the first page of the
policy or certificate or attached thereto stating in substance that the
policyholder or certificate holder shall have the right to return the policy or
certificate within thirty days of its delivery and to have the premium refunded
if, after examination of the policy or certificate, the insured person is not
satisfied for any reason.
(f)
(1) Issuers of accident and sickness policies
or certificates which provide hospital or medical expense coverage on an
expense incurred or indemnity basis to a person(s) eligible for Medicare shall
provide to those applicants a Guide to Health Insurance for People with
Medicare in the form developed jointly by the National Association of
Insurance Commissioners and the Centers for Medicare & Medicaid Services
and in a type size no smaller than twelve point type. Delivery of the
Guide shall be made whether or not the policies or
certificates are advertised, solicited, or issued as Medicare supplement
policies or certificates as defined in this regulation. Except in the case of
direct response issuers, delivery of the Guide shall be made
to the applicant at the time of application and acknowledgement of receipt of the Guide shall be obtained by the issuer. Direct response issuers shall deliver the Guide to the applicant upon request but not later than at the time the policy is delivered.
(2) For the purposes of
this section, "form" means the language, format, type size, type proportional
spacing, bold character, and line spacing.
Notes
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