Date:January 28, 2003
To:All Medicare Supplement Insurers
From:Guenther Ruch, Administrator
Regulation & Enforcement Division
Subject:Amendments to s. Ins 3.39, Wis. Adm. Code, for Compliance with BIPA

This bulletin is to inform you that effective January 1, 2003, s. Ins 3.39, Wis. Adm. Code, regarding standards for insurance sold to the Medicare eligible, was amended in order to comply with the Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act (BIPA) and the NAIC Medicare supplement insurance minimum standards model act modifications.

A copy of s. Ins 3.39, Wis. Adm. Code, is available on our website under the Laws, Rules, Bulletins section at http://oci.wi.gov/rules/339em2002.pdf (opens in new window). You may also obtain a copy by contacting our Central Files section at P.O. Box 7873, Madison, WI 53707-7873, (608) 264-8110.

The amendments to s. Ins 3.39, Wis. Adm. Code, include expanding the definition of those individuals eligible for guarantee issue. Section Ins 3.39 (34) (c), Wis. Adm. Code, was created to broaden the application period for guaranteed issue coverage and clarifies the notification requirement. Section Ins 3.39 (34) (d), Wis. Adm. Code, was created to provide extended Medicare supplement guaranteed issue as a result of interrupted trial periods.

Other amendments to the rule include clarification of eligible expenses regarding outpatient services paid under the prospective payment system and correcting references to Medicare supplement insurance and federal laws.

Any questions concerning this bulletin may be directed to Jerry Zimmer at jerry.zimmer@oci.state.wi.us or Kevin Zwart at kevin.zwart@wisconsin.gov.