Date:April 20, 2010
To:Writers of Medicare Supplement, Medicare Select and Medicare Cost Coverage
From:Sean Dilweg, Commissioner of Insurance
Subject:Amendments to Wisconsin Medicare Supplement Rule

This bulletin applies to all health insurers that offer Medicare supplement, Medicare select or Medicare cost coverage or market health insurance to Medicare beneficiaries.

Background

The National Association of Insurance Commissioners (NAIC) adopted changes to the NAIC Medigap model regulation by incorporating changes required by the federal Genetic Information Nondiscrimination Act of 2008 (GINA, Public Law 110-233) and the federal Medicare Improvements for Patients and Providers Act of 2008 (MIPPA, Public Law 110-175). The GINA law requires that states adopt necessary changes by July 1, 2009, and have regulations in place for MIPPA by September 24, 2009. States are required to adopt the NAIC model revision in order to continue to regulate the Medigap marketplace.

The intent of this bulletin is to provide information regarding the amendments to s. Ins 3.39, Wis. Adm. Code, enacted in order to comply with MIPPA, GINA and the NAIC requirements. Section Ins 3.39, Wis. Adm. Code, also was amended to reintroduce the high-deductible Medicare supplement plan that previously sunset. It also expands the categories of eligible persons who are guaranteed issuance of Medicare supplement or Medicare replacement policies under certain circumstances.

Wisconsin received a waiver of the federal standardization requirements by the Omnibus Budget Reconciliation Act (OBRA) of 1990 that required all new Medicare policies sold to comply with standardized benefit packages. Wisconsin, as a waived state, continues to offer to Medicare beneficiaries Medicare supplement, Medicare select, and Medicare cost policies with core benefits and optional riders, except for the high-deductible plans promulgated subsequent to the OBRA '90 standards. Wisconsin prohibits the sale of the standardized Medicare supplement Plans A - N found in most other states.

The following is effective May 21, 2009, and is in accordance with GINA and MIPPA:

Section Ins 3.39 (36), Wis. Adm. Code, regarding genetic information

s. Ins 3.39 (36), Wis. Adm. Code, was created to provide that beginning May 21, 2009, an issuer of a Medicare supplement policy or certificate may not deny or condition the issuance or effectiveness of the policy or certificate, including the imposition of any exclusion of benefits under the policy based on a preexisting condition, on the basis of the genetic information with respect to such individual. The issuer may not discriminate in the pricing of the policy or certificate including the adjustment of rates of an individual on the basis of the genetic information with respect to such individual. Issuers must also comply with ss. 631.89 and 632.748, Wis. Stat.

s. Ins 3.39 (36) (a), Wis. Adm. Code, regarding definitions related to genetic information, includes definitions of "Family member," "Genetic information," "Genetic services," "Genetic test," "Issuer of a Medicare supplement policy or certificate" and "Underwriting purposes."

s. Ins 3.39 (36) (b), Wis. Adm. Code, provides that an issuer of a Medicare supplement policy or certificate:

  • May not request or require an individual or a family member of such individual to undergo a genetic test,
  • May not request, require or purchase genetic information for use in underwriting,
  • May not request, require or purchase genetic information with respect to any individual prior to such individual's enrollment under the policy in connection with such enrollment.

s. Ins 3.39 (36) (c), Wis. Adm. Code, provides that the limitations regarding the use of genetic information does not limit the ability of an issuer of a Medicare supplement policy or certificate, to the extent otherwise permitted by law, from:

  • Denying or conditioning the issuance or effectiveness of a policy or certificate or increasing the premium for a group based on the manifestation of a disease or disorder of an insured or applicant.
  • Increasing the premium for any policy issued to an individual based on the manifestation of a disease or disorder of an individual who is covered under the policy.

s. Ins 3.39 (36) (d), Wis. Adm. Code, provides that the manifestation of a disease or disorder in one individual cannot also be used as genetic information about other group members to further increase the premium for the group.

s. Ins 3.39 (36) (e), Wis. Adm. Code, provides that an issuer of a Medicare supplement policy or certificate may not request or require an individual or a family member of such individual to undergo a genetic test. An issuer of a Medicare supplement policy or certificate is not precluded from obtaining and using the results of a genetic test in making a payment determination and may not request, require or purchase genetic information for use in underwriting. If genetic information is obtained, the request may only include the minimum amount necessary to accomplish the intended purpose.

s. Ins 3.39 (36) (f), Wis. Adm. Code, provides that if an issuer of a Medicare supplement policy or certificate obtains genetic information incidental to the requesting, requiring or purchasing of other information concerning any individual, such request, requirement or purchase may not be considered a violation of this section.

The following becomes effective June 1, 2010, in accordance with MIPPA, and amends s. Ins 3.39, Wis. Adm. Code, to meet NAIC requirements to the extent necessary:

Section Ins 3.39 (1), Wis. Adm. Code, regarding purpose

s. Ins 3.39 (1) (a), Wis. Adm. Code, provides that s. Ins 3.39, Wis. Adm. Code, establishes requirements for health and other disability insurance policies or certificates primarily sold to Medicare-eligible persons. Disclosure provisions are required for other disability policies or certificates sold to Medicare-eligible persons because such policies or certificates frequently are represented to, and purchased by, the Medicare-eligible as supplements to Medicare products, including Medicare Advantage and Medicare Prescription Drug plans.

s. Ins 3.39 (1) (c), Wis. Adm. Code, provides that any disability insurance policy or certificate that is designed to reduce or eliminate gaps arising from the coverages in a Medicare Advantage or Medicare Part D Prescription Drug plan shall comply with the requirements of s. Ins 3.39, Wis. Adm. Code, and pursuant to s. 104 (c) of Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) (42 U.S.C. 1302, 1395w-101 et. seq.), policies and certificates that are advertised, marketed or designed primarily to cover out-of-pocket costs under Medicare Advantage plans shall comply with Medicare supplement requirements of s. 1882 (o) of the Social Security Act (42 U.S.C. Section 1395 et. seq.).

Section Ins 3.39 (3), Wis. Adm. Code, regarding definitions

s. Ins 3.39 (3) (ce) and (cs), Wis. Adm. Code, create definitions of "Balance bill" and "Bankruptcy."

s. Ins 3.39 (3) (q), Wis. Adm. Code, amends the definitions of "Medicare" to require that the term "Medicare" be defined in the certificate as well as the policy.

s. Ins 3.39 (3) (v), Wis. Adm. Code, amends the definition of "Medicare replacement coverage" to reference that it conforms to the newly created s. Ins 3.39 (4s), Wis. Adm. Code, regarding Medicare supplement policies and certificates with effective dates on or after June 1, 2010.

s. Ins 3.39 (3) (w), Wis. Adm. Code, amends the definition of "Medicare supplement coverage" to reference that it conforms to the newly created s. Ins 3.39 (4s), (5m) and (30m), Wis. Adm. Code, regarding Medicare supplement, Medicare replacement and Medicare select policies and certificates with effectives dates on or after June 1, 2010.

Section Ins 3.39 (4), Wis. Adm. Code, regarding Medicare supplement and Medicare replacement policy and certificate requirements

s. Ins 3.39 (4), Wis. Adm. Code, was amended to clarify that it applies to policies and certificates with effective dates prior to June 1, 2010, and to reference certificates as well as policies.

s. Ins 3.39 (4) (a) 8, Wis. Adm. Code, was amended to include coinsurance as well as copayment.

Section Ins 3.39 (4s), Wis. Adm. Code, regarding Medicare supplement and Medicare replacement policy and certificate requirements for policies or certificates with effective dates on or after June 1, 2010

s. Ins 3.39 (4s), Wis. Adm. Code, was created to mirror the provisions of s. Ins 3.39 (4), Wis. Adm. Code, but was renumbered and does not include the references to outpatient prescription drugs. The provisions apply to group certificates as well as individual policies that relate coverage to Medicare or are structured, advertised, marketed or issued for delivery in Wisconsin on or after June 1, 2010, as a Medicare supplement or as a Medicare replacement policy or certificate.

s. Ins 3.39 (4s) (b) 5 and 7, Wis. Adm. Code, were amended to reference Appendix 2 and Appendices 3 through 6.

Section Ins 3.39 (5), Wis. Adm. Code, regarding authorized Medicare supplement and certificate designations, captions, required coverages, and permissible additional benefits

s. Ins 3.39 (5), Wis. Adm. Code, was amended to clarify that it applies to policies or certificates effective prior to June 1, 2010, and to reference that it applies to certificates as well as policies.

Section Ins 3.39 (5m), Wis. Adm. Code, regarding authorized Medicare supplement and certificate designation, captions, required coverages, and permissible additional benefits for policies or certificates with effective dates on or after June 1, 2010

s. Ins 3.39 (5m), Wis. Adm. Code, was created to mirror the provisions of s. Ins 3.39 (5), Wis. Adm. Code, but was renumbered. The provisions apply to all Medicare supplement policies or certificates delivered or issued in Wisconsin with effective dates on or after June 1, 2010.

s. Ins 3.39 (5m) (d) 4, Wis. Adm. Code, was created to provide coverage of coinsurance or copayments for all Medicare Part A eligible expenses for hospice and respite care.

s. Ins 3.39 (5m) (e) (intro.), Wis. Adm. Code, was created to provide that permissible coverage options may only be added to the policy or certificate as separate riders. The issuer may not issue to the same insured for the same period of coverage both the Medicare Part A Deductible rider and the Medicare 50% Part A Deductible rider. The issuer may not issue to the same insured for the same period of coverage both the Medicare Part B Deductible rider and the Medicare Part B Copayment or Coinsurance rider.

s. Ins 3.39 (5m) (e) 2, Wis. Adm. Code, was created to provide a new permissible coverage rider designated as MEDICARE 50% PART A DEDUCTIBLE RIDER. This optional rider provides coverage of 50% of the Medicare Part A hospital deductible per benefit period with no out-of-pocket maximum.

s. Ins 3.39 (5m) (e) 5, Wis. Adm. Code, was created to provide a new permissible coverage rider designated as MEDICARE PART B COPAYMENT OR COINSURANCE RIDER. This optional rider provides that the insured is subject to copayment or coinsurance that is the lesser of $20 per office visit or the Medicare Part B coinsurance and the lesser of $50 per emergency room visit or the Medicare Part B coinsurance that is in addition to the Medicare Part B medical deductible. The emergency room copayment or coinsurance fee shall be waived if the insured is admitted to any hospital and the emergency visit is subsequently covered as a Medicare Part A expense.

s. Ins 3.39 (5m) (e) 7, Wis. Adm. Code, amends the permissible coverage rider designation from Foreign Travel Rider to FOREIGN TRAVEL EMERGENCY RIDER.

s. Ins 3.39 (5m) (g) 12 and (h) 12, Wis. Adm. Code, regarding Medicare Supplement 50% Cost-Sharing Plan and Medicare Supplement 25% Cost-Sharing Plan were created to allow bracketed dollar amounts to be changed annually regarding the out-of-pocket limitation on annual expenditures under Medicare Parts A and B and to indicate the amount is indexed each year by the appropriate inflation adjustment specified by the secretary of the U.S. department of health and human services.

Section Ins 3.39 (5m) (k), Wis. Adm. Code, regarding Medicare supplement high deductible plan

s. Ins 3.39 (5m) (k) 1, Wis. Adm. Code, was created to reintroduce a Medicare supplement plan designated as MEDICARE SUPPLEMENT HIGH DEDUCTIBLE PLAN.

s. Ins 3.39 (5m) (k) 2, Wis. Adm. Code, provides that the Medicare supplement high deductible plan shall provide 100% of the basic Medicare supplement coverage, coverage of the Medicare Part A deductible, the Medicare Part B deductible, and for Medicare Part B excess charges and for additional home health care and foreign travel emergency services, following payment of the annual high deductible.

s. Ins 3.39 (5m) (k) 3, Wis. Adm. Code, provides that the annual high deductible shall consist of out-of-pocket expenses, other than premiums, for covered services explained above and shall be in addition to any other specific benefit deductibles.

s. Ins 3.39 (5m) (k) 4, Wis. Adm. Code, provides that the annual high deductible shall be adjusted annually by the U.S. department of health and human services to reflect the change in the Consumer Price Index.

Section Ins 3.39 (6), Wis. Adm. Code, regarding usual, customary and reasonable charges

s. Ins 3.39 (6), Wis. Adm. Code, was amended to reference the newly created s. Ins 3.39 (5m) (d) 6, 9 and 14, Wis. Adm. Code, regarding usual and customary home care expenses, usual and customary expenses for chiropractic services and usual and customary expenses for treatment of diabetes, respectively.

Section Ins 3.39 (7), Wis. Adm. Code, regarding authorized Medicare replacement policy and certificate designation, captions and minimum coverages

s. Ins 3.39 (7) (cm), Wis. Adm. Code, was created to apply to a Medicare cost policy or certificate issued after June 1, 2010, and references that the issuer may offer an enhanced Medicare cost plan that contains specified mandated benefits.

s. Ins 3.39 (7) (dm), Wis. Adm. Code, was created to apply to a Medicare cost policy or certificate issued after June 1, 2010, and references compliance with specified marketing standards. The outline of coverage and replacement form shall be modified to accurately reflect the benefits, exclusions and other requirements that differ from Medicare supplement policies.

Section Ins 3.39 (8), regarding permissible Medicare supplement and Medicare replacement policy or certificate exclusions and limitations

s. Ins 3.39 (8) (c), Wis. Adm. Code, was amended to include reference to the newly created s. Ins 3.39 (5m) and (30m), Wis. Adm. Code.

Section Ins 3.39 (9), Wis. Adm. Code, regarding authorized Medicare replacement policy and certificate designation, captions and required minimum coverages

s. Ins 3.39 (9) (b), Wis. Adm. Code, was amended to reference the renumbered Appendix 10.

Section Ins 3.39 (14), Wis. Adm. Code, regarding other requirements for policies or certificates with effective dates prior to June 1, 2010

s. Ins 3.39 (14) (title) and (14) (a), Wis. Adm. Code, were amended to apply to certificates as well as policies with effective dates prior to June 1, 2010.

s. Ins 3.39 (14) (d) 3., Wis. Adm. Code, was amended to reference that the other requirements for policies or certificates with effective dates prior to June 1, 2010, do not apply to the permissible additional coverage riders in the renumbered s. Ins 3.39 (5) (i), Wis. Adm. Code.

Section Ins 3.39 (14m), Wis. Adm. Code, regarding other requirements for policies or certificates with effective dates on or after June 1, 2010

s. Ins 3.39 (14m), Wis. Adm. Code, was created to mirror the provisions of s. Ins 3.39 (14), Wis. Adm. Code, but applies to all Medicare supplement policies or certificates delivered or issued in Wisconsin with effective dates on or after June 1, 2010, and to reference certificates and the newly created s. Ins 3.39 (5m), Wis. Adm. Code, as described above.

s. Ins 3.39 (14m) (d), Wis. Adm. Code, provides that an issuer shall continue to make available for purchase any policy form or certificate form issued after May 31, 2010, that has been approved by the commissioner.

s. Ins 3.39 (14m) (L), Wis. Adm. Code, was created to provide that for policies or certificates issued with an effective date on or after June 1, 2010, issuers shall combine the Wisconsin experience of all policy or certificate forms of the same type (individual or group) for purposes of calculating the loss ratio and rates. The rates for all such policies or certificates of the same type shall be adjusted by the same percentage. If the Wisconsin experience is not credible, then national experience can be considered.

Section Ins 3.39 (15), Wis. Adm. Code, regarding filing requirements for advertising

s. Ins 3.39 (15), Wis. Adm. Code, was amended to reference certificates as well as policies and to reference the OCI's advertisement filing form, OCI 26-042.

Section Ins 3.39 (17), Wis. Adm. Code, regarding new or innovative benefits

s. Ins 3.39 (17), Wis. Adm. Code, was created to provide that an issuer may offer policies or certificates with new or innovative benefits, in addition to the standardized benefits provided in a policy or certificate that otherwise complies with the applicable standards and is filed and approved by the commissioner. The new or innovative benefits may include only benefits that are appropriate to Medicare supplement insurance, are new or innovative, are not otherwise available and are cost-effective. New or innovative benefits may not include an outpatient prescription drug benefit. New or innovative benefits may not be used to change or reduce benefits, including a change of any cost-sharing provision.

Section Ins 3.39 (18), Wis. Adm. Code, regarding electronic enrollment

s. Ins 3.39 (18) (a), Wis. Adm. Code, was created to provide that any requirement that a signature of an insured be obtained by an agent or issuer offering any Medicare supplement or replacement plans shall be satisfied if all of the following are met:

  • The consent of the insured is obtained by telephonic or electronic enrollment by the issuer or group policyholder or certificateholder. A verification of the enrollment information shall be provided in writing to the applicant with the delivery of the policy or certificate.
  • The telephonic or electronic enrollment provides necessary and reasonable safeguards to ensure the accuracy, retention and prompt retrieval of records as required pursuant to ch. 137, subch. II, Wis. Stat.
  • The telephonic or electronic enrollment provides necessary and reasonable safeguards to ensure that the confidentiality of personal financial and health information as defined in s. 610.70, Wis. Stat., and ch. Ins 25, Wis. Adm. Code, is maintained.

s. Ins 3.39 (18) (b), Wis. Adm. Code, was created to provide that the issuer shall make available, upon request of the commissioner, records that demonstrate the issuer's ability to confirm enrollment and coverage.

Section Ins 3.39 (23), Wis. Adm. Code, regarding requirements for application forms and replacement coverage

s. Ins 3.39 (23) (d), Wis. Adm. Code, was amended to reference the renumbered Appendix 7.

Section Ins 3.39 (24), Wis. Adm. Code, regarding standards for marketing

s. Ins 3.39 (24) (g), Wis. Adm. Code, was amended to include Medicare Advantage Supplement, and to reference that the terms "Medicare Supplement," "Medigap," "Medicare Wrap Around," and "Medicare Advantage Supplement" and words of similar import may not be used in any materials including advertisements, unless the policy or certificate is issued in compliance with s. Ins 3.39, Wis. Adm. Code, regarding standards for disability insurance sold to the Medicare eligible.

Section Ins 3.39 (26), Wis. Adm. Code, regarding reporting of multiple policies

s. Ins 3.39 (26) (b), Wis. Adm. Code, was amended to include certificateholder as well as policyholder.

s. Ins 3.39 (26) (b), Wis. Adm. Code, was amended to reference the renumbered Appendix 9.

Section Ins 3.39 (30), Wis. Adm. Code, regarding Medicare select policies and certificates

s. Ins 3.39 (30) (a) 1, Wis. Adm. Code, was amended to provide that the provision applies to policies and certificates issued prior to June 1, 2010.

Section Ins 3.39 (30m), Wis. Adm. Code, regarding Medicare select policies and certificates

s. Ins 3.39 (30m), Wis. Adm. Code, was created to mirror the provisions of s. Ins 3.39 (30), Wis. Adm. Code, but applies to all Medicare supplement policies or certificates delivered or issued in Wisconsin on or after June 1, 2010, and references copayments as well as coinsurance.

s. Ins 3.39 (30m) (i) 1, Wis. Adm. Code, was amended to reference Appendix 2 and Appendix 5.

s. Ins 3.39 (30m) (p), Wis. Adm. Code, provides that Medicare select plans shall provide the basic Medicare coverage, coverage of the Medicare Part A deductible, the Medicare Part B deductible and for additional home health care, foreign travel emergency and preventive health care services.

s. Ins 3.39 (30m) (q), Wis. Adm. Code, provides that permissible additional coverage may be added to Medicare select plans as separate riders including the Medicare 50% Part A Deductible rider and the Medicare Part B Copayment or Coinsurance rider.

Section Ins 3.39 (31), Wis. Adm. Code, regarding refund or credit calculation

s. Ins 3.39 (31) (a), Wis. Adm. Code, was amended to reference renumbered Appendix 8.

Section Ins 3.39 (34) (b), Wis. Adm. Code, regarding guaranteed issue for eligible persons

s. Ins 3.39 (34) (b) 1. c, Wis. Adm. Code, regarding Eligible persons was amended to include an individual enrolled in an employee welfare benefit plan whereby the amount the individual pays for coverage under the plan increases from one 12-month period to the subsequent 12-month period by more than 25% and the new payment for the employer-sponsored coverage is greater than the premium charged under the Medicare supplement plan for which the individual is applying. An issuer may require reasonable documentation to substantiate the increase of the cost of coverage to the individual. Reasonable documentation that issuers may request includes premium billing statements and notices of premiums from employers for the most recent 12-month period.

s. Ins 3.39 (34) (b) 1s, Wis. Adm. Code, was created to include as Eligible persons an individual that is enrolled in a Medicare select plan and is notified by the issuer that a hospital is leaving the Medicare select network and that there is no other participating hospital within a 30 minute or 30-mile radius of the policyholder.

Section Ins 3.39 (34) (c), Wis. Adm. Code, regarding guaranteed issue time periods

s. Ins 3.39 (34) (c) 1, Wis. Adm. Code, regarding Guaranteed issue time periods was amended to reference that it applies to Eligible persons identified in the newly created s. Ins 3.39 (34) (b) 1s, Wis. Adm. Code, as described above.

Section Ins 3.39 (34) (e), Wis. Adm. Code, regarding products to which eligible persons are entitled

s. Ins 3.39 (34) (e), Wis. Adm. Code, titled Products to which eligible persons are entitled was amended to read Products to which eligible persons are entitled prior to June 1, 2010.

Section Ins 3.39 (34) (ez), Wis. Adm. Code, regarding products to which eligible persons are entitled

s. Ins 3.39 (34) (ez), Wis. Adm. Code, was created to mirror the provisions of s. Ins 3.39 (34) (e), Wis. Adm. Code, titled Products to which eligible persons are entitled but includes reference that it applies to Products to which eligible persons are entitled on or after June 1, 2010.

Section Ins 3.39 (35), Wis. Adm. Code, regarding exchange of Medicare supplement policy

s. Ins 3.39 (35), Wis. Adm. Code, was created to provide that an issuer that submits and receives approval to offer a Medicare supplement insurance policy that is effective or issued on or after June 1, 2010, may offer an exchange subject to the following requirements:

  • By or before May 31, 2011, on a one-time basis in writing, an issuer may offer to all of its existing Medicare supplement policyholders or certificateholders covered by a policy with an effective prior to June 1, 2010, the option to exchange the existing policy to a different policy that complies with newly created Medicare supplement, Medicare replacement or Medicare select policy requirements as described in s. Ins 3.39 (4s), (5m) and (30m), as applicable.
  • The offer shall be made on a nondiscriminatory basis without regard to the age or health status of the insured unless such offer or issue would be in violation of state or federal law.
  • The offer shall remain open for a minimum of 120 days from the date of the mailing by the issuer.
  • In the event of an exchange, if the replaced policy is priced on an issue age rate schedule, the rate charged to the insured for the newly exchanged policy shall recognize the policy reserve buildup, due to the pre-funding inherent in the use of an issue age rate basis, for the benefit of the insured.
  • The rating class of the new policy or certificate shall be the class closest to the insured's class of the replaced coverage.
  • The issuer may not apply new preexisting condition limitations or a new incontestability period to the newly issued policy for those benefits that were contained in the exchanged policy or certificate of the insured but may apply a preexisting condition limitation of no more than 6 months to any added benefits contained in the newly issued policy or certificate that were not present in the exchanged policy or certificate.

Section Ins 3.39, Appendix 1 through 5

s. Ins 3.39 Appendix 1 was amended to clarify that it applies to policies with an effective date prior to June 1, 2010.

s. Ins 3.39 Appendix 2 was created to apply to policies with an effective date on or after June 1, 2010.

s. Ins 3.39 Appendix 3 was created to apply to Medicare supplement policies and certificates with effective dates on or after June 1, 2010.

s. Ins 3.39 Appendix 4 was created to apply to Medicare supplement 50% and 25% cost-sharing policies or certificates with effective dates on or after June 1, 2010.

s. Ins 3.39 Appendix 5 was created to apply to Medicare select and Medicare select 50% and 25% cost-sharing policies and certificates issued on or after June 1, 2010.

The following appendices were renumbered:

Section Ins 3.39 Appendix 6 titled NOTICE OF CHANGE FOR OUTLINE OF COVERAGE was formerly numbered as Appendix 4.

Section Ins 3.39 Appendix 7 titled NOTICE TO APPLICANT REGARDING REPLACEMENT OF MEDICARE SUPPLEMENT, MEDICARE COST, MEDICARE SELECT, MEDICARE ADVANTAGE OR EXISTING ACCIDENT AND SICKNESS INSURANCE was formerly numbered as Appendix 5.

Section Ins 3.39 Appendix 8 titled MEDICARE SUPPLEMENT REFUND CALCULATION FORM was formerly numbered as Appendix 6.

Section Ins 3.39 Appendix 9 titled FORM FOR REPORTING MEDICARE SUPPLEMENT POLICIES was formerly numbered as Appendix 7.

Section Ins 3.39 Appendix 10 titled DISCLOSURE STATEMENTS was formerly numbered as Appendix 8.

In addition, the following were amended:

Section Ins 3.13 (2) (j) 3, Wis. Adm. Code, regarding the right to return the policy was amended to include Medicare supplement policies that are subject to this bulletin.

Section Ins 3.29 (3) (a) and (7) (b), Wis. Adm. Code, regarding replacement of accident and sickness insurance was amended to reference that Medicare supplement policies are exempt. Medicare supplement policies must comply with s. Ins 3.39 (23) (c) and (d), Wis. Adm. Code, regarding requirements for application forms and replacement coverage, and utilize the replacement form format in s. Ins 3.39 Appendix 7.

Policy form filing requirements

Wisconsin reviews and approves Medicare supplement form filings and Medicare supplement advertisements. Insurers submitting filings to comply with this bulletin should identify these filings by the TOI "MS09 Medicare Supplement-Other 2010."

Contact Information:

Questions regarding this bulletin should be directed to Kevin Zwart at kevin.zwart@wisconsin.gov, Moua Yang at moua.yang@wisconsin.gov or Lynn Pink at lynn.pink@wisconsin.gov.