BILL ANALYSIS
SENATE HEALTH
COMMITTEE ANALYSIS
Senator Elaine K. Alquist, Chair
BILL NO: AB 1543
A
AUTHOR: Jones and Fletcher
B
AMENDED: June 11, 2009
HEARING DATE: June 17, 2009
1
CONSULTANT:
5
Park/
4
3
SUBJECT
Medicare supplement coverage
SUMMARY
Makes conforming changes to the requirements and standards
that apply to Medicare supplement contracts and policies
(collectively Medigap policies), for the purpose of
complying with recent federal law changes affecting the
benefits, the issuance, and the pricing of Medigap
policies.
CHANGES TO EXISTING LAW
Existing federal law:
Existing federal law establishes the Medicare program as a
government-administered health insurance program for people
age 65 or older and certain people younger than age 65,
such as those with disabilities and those who have
permanent kidney failure.
Existing federal law, under the Medicare Improvements for
Patients and Providers Act of 2008 (MIPPA), requires states
to adopt by September 24, 2009, specific modernization
changes to Medigap policies, as outlined in the model
regulations developed by the National Association of
Continued---
STAFF ANALYSIS OF ASSEMBLY BILL 1543 (Jones and Fletcher)
Page 2
Insurance Commissioners (NAIC), and consistent with
requirements in MIPPA. MIPPA reduces from 14 to 11 the
number of standardized Medigap policies, and makes other
changes to Medigap coverage including changes to benefit
and cost-sharing requirements, and changes to disclosure
and issuance requirements.
Existing federal law, under the Genetic Information
Nondiscrimination Act of 2008 (GINA), prohibits a health
insurer, including issuers of Medigap policies, from
denying or conditioning the issuance, effectiveness, or
pricing of the policy on the basis of genetic information,
and requires states to enact conforming changes to Medigap
policies by July 1, 2009.
Existing state law:
Existing state law provides for regulation of health plans
by the Department of Managed Health Care (DMHC) under
Knox-Keene and for regulation of health insurers by the
California Department of Insurance (CDI) under the
Insurance Code.
Existing state law establishes standards for Medigap
policies sold in California, which provide Medicare
beneficiaries with coverage for benefits and cost-sharing
not covered by Medicare. Medigap policies are subject to
the jurisdiction of either DMHC or CDI depending on the
type of policy, in a manner generally consistent with
federal laws applicable to Medigap policies, including
benefit and cost-sharing requirements for 14 standardized
benefit plans, open enrollment and guaranteed issue of
Medigap policies for specified individuals, and specified
notices and disclosures that must be provided to Medigap
policy applicants and enrollees.
This bill:
This bill would make conforming changes in state law
regarding standards applicable to Medigap policies to
comply with the federal MIPPA and GINA.
Changes related to MIPPA
The bill would establish requirements for 11 new
standardized Medigap policies with an effective date on or
STAFF ANALYSIS OF ASSEMBLY BILL 1543 (Jones and Fletcher)
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after June 1, 2010, consistent with MIPPA, as follows:
Reduce from 14 to 11 the number of standardized policies,
by eliminating Plans E, H, I, J and High-Deductible Plan
J as the existing standardized policies, and establishing
the 11 new standardized policies as Plans A-D, Plan F,
High-Deductible Plan F, Plan G, and Plans K-N;
Require health plan and health insurer issuers of Medigap
policies (issuers) to, at a minimum, offer the basic
plan, Plan A, and require issuers choosing to offer any
Medigap policy or policies other than Plan A to also
offer either Plan C or Plan F;
Delete from the new standardized Medigap policies
preventive and at-home care benefits, and delete
prescription drug coverage from all standardized plans
(prescription drug coverage is now provided through
Medicare Part D);
Include hospice and respite care services as basic (core)
benefits which must be included in all standardized
Medigap policies;
Make changes to cost-sharing elements of standardized
plans, as specified;
The bill would retain and revise the existing standards
applicable to Medigap policies with an effective date on or
before June 1, 2010, with the following new provisions:
Permitting issuers to allow an enrollee, subscriber,
policyholder, or certificate holder (enrollee) to
exchange an existing policy for one of the new
standardized policies, and requiring issuers that choose
to do so to comply with specified requirements,
including, among other things, limiting any new
preexisting condition exclusion to six months, as
specified, and only for benefits not covered in the prior
policy; and,
Requiring an issuer choosing to offer an enrollee the
opportunity to change to a newer policy to make the same
offer to all enrollees in a particular policy, unless to
STAFF ANALYSIS OF ASSEMBLY BILL 1543 (Jones and Fletcher)
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do so would be in violation of state or federal law.
The bill would establish, for the purposes of open
enrollment, a correlation between 1990 standardized
Medicare supplement benefit plan letters (A, B, C, D, E, F,
high deductible F, G, H, I, J, high deductible J, K, and L)
and 2010 standardized Medicare supplement benefit plan
letters (A, B, C, D, F, high deductible F, G, K, L, M, N),
in the determination of what constitutes "equal" benefits.
(Existing law allows individuals to be entitled to an
annual open enrollment period lasting 30 days or more,
commencing with the individual's birthday, during which
time that person may purchase any Medicare supplement
coverage that offers benefits equal to or lesser than those
provided by the previous coverage.)
The bill would clarify that an individual enrolled in
Medicare B is entitled to open enrollment, upon being
notified that he or she is no longer eligible for Medi-Cal
benefits, including benefits with a share of cost.
(Existing law establishes a right of open enrollment for
Medicare B enrollees who lose Medi-Cal coverage, but does
not specify whether losing benefits with a share of cost
qualifies the Medicare beneficiary to open enrollment.
Medi-Cal beneficiaries who have a change in their income
have a share of cost imposed.)
The bill would require, upon timely receipt of notice from
an enrollee of their eligibility for Medi-Cal, as
specified, an issuer to refund any portion of the premium,
adjusted for paid claims, for that period during which an
enrollee is eligible for Medi-Cal and, at the enrollee's
request, the Medigap policy was placed in suspension.
The bill would prohibit issuers from requiring, requesting
or obtaining health information, as part of the application
process, for an applicant who is eligible for guaranteed
issue or open enrollment for any Medicare supplement
coverage, except as specified.
The bill would clarify that beneficiaries are entitled to
guaranteed issue of a Medigap policy when the employer
ceases or terminates an employee welfare benefit plan that
provides Medicare supplemental benefits and no longer
provides insurance that covers all of the coinsurance
STAFF ANALYSIS OF ASSEMBLY BILL 1543 (Jones and Fletcher)
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charges under Part B of Medicare. (Existing law requires
guaranteed issue of a Medigap policy for beneficiaries when
the employer ceases to provide coverage for some or all of
the supplemental benefits, but does not specifically
include a drop in coverage for Part B costs even where the
employer continues other Medigap coverage.)
The bill would make conforming changes to marketing and
consumer notice provisions to reflect the changes in
standardized Medigap policies;
Changes related to Genetic Information Nondiscrimination
Act of 2008
For Medigap policies that become effective on or after May
21, 2009, the bill would require issuers, including a third
party administrator acting on behalf of an issuer, to
adhere to requirements of the federal Genetic Information
Nondiscrimination Act of 2008 (GINA), including, among
other things:
Prohibiting an issuer from denying or conditioning the
issuance or effectiveness of a Medigap policy, including
any preexisting condition exclusion, or discriminating in
the pricing of a Medigap policy, on the basis of genetic
information with respect to an individual or family
member;
Prohibiting an issuer from requesting or requiring an
individual or a family member of that individual to
undergo a genetic test, except for specified limited
exceptions, subject to specified rules and procedures;
Prohibiting an issuer from requesting, requiring,
seeking, or purchasing genetic information for
underwriting purposes; or with respect to any individual
or family member of the individual prior to the
individual's enrollment under the contract, in connection
with that enrollment;
Enacting in state Medicare supplement law relevant
definitions from the federal GINA, including the
definition of "genetic information," which means, with
respect to any individual, information about the
individual's genetic tests, the genetic tests of family
members of the individual, and the manifestation of a
STAFF ANALYSIS OF ASSEMBLY BILL 1543 (Jones and Fletcher)
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disease or disorder in a family member of the individual;
and,
Providing that Medicare supplement policies must also
comply with existing state law applicable to genetic
testing and genetic information.
The bill makes other technical and conforming changes. As
an urgency measure, the bill's provisions would go into
immediate effect upon enactment.
FISCAL IMPACT
According to the Assembly Appropriations Committee, the
bill would result in no direct fiscal impact to DMHC or CDI
to continue oversight of Medigap insurance policies and
enforce conformity with recent changes to federal law.
BACKGROUND AND DISCUSSION
Author's statement
The authors state that this bill conforms California law
related to Medigap policies to requirements in two new
federal laws: GINA and MIPPA. The authors state that MIPPA
requires states to conform state Medigap law to changes
made by the NAIC model Medigap regulation as a result of
the two new federal laws, and failure to enact the changes
in the NAIC model act by the specified deadlines will
result in California losing its ability to regulate Medigap
policies.
Medicare and Medigap policies
Medicare is the federal health insurance program that
provides payment for certain medical expenses for most
people age 65 and older; certain disabled people under age
65, and people of all ages with end-stage renal disease
(permanent kidney failure treated with dialysis or a
transplant). Medicare is the nation's largest health
insurance program and covers nearly 40 million Americans.
Medicare has three types of benefits:
STAFF ANALYSIS OF ASSEMBLY BILL 1543 (Jones and Fletcher)
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Part A: The "hospital insurance program" covers inpatient
care in hospitals, skilled nursing facilities after a
hospital stay, and Religious Nonmedical Health Care
Institutions. Part A also helps cover hospice services
and home health care services. Most people are
automatically enrolled in Part A with no premium. The
deductible for Part A (which is calculated for each
"benefit period," which is defined as the period
beginning on the first day of hospitalization and
extending until the beneficiary has not been an inpatient
of a hospital or skilled nursing facility for 60
consecutive days) is more than $1,000 for calendar years
2008 and 2009.
Part B: The "supplementary medical insurance program"
covers a wide range of medical services, including
physicians' services and outpatient hospital services, as
well as equipment and supplies, such as prosthetic
devices. Part B is optional and most people will pay the
standard monthly Part B premium ($96.40 for 2008), but
some people will pay a higher premium based on their
income. The deductible for Part B in calendar years 2008
and 2009 is $135. Coinsurance for Part B is generally 20
percent of the Medicare-approved amount for the service,
but the beneficiary may also be subject to "excess
charges," or charges above the Medicare rate from
physicians or suppliers who don't accept the Medicare
rate.
Part D: The "voluntary prescription drug benefit program"
covers outpatient prescription drugs not otherwise
covered by Part B.
Beneficiaries can get their Part A and B benefits in two
ways. Under ''Original Medicare,'' beneficiaries get their
Part A and Part B benefits directly from the federal
government. Beneficiaries can also choose to get their Part
A and B benefits through private health plans, such as
HMOs, that contract with Medicare, which come under Part C
of Medicare, called the Medicare Advantage Program.
While Medicare provides extensive benefits, it is not
designed to cover the total cost of medical care for
Medicare beneficiaries. Under Original Medicare, even if
the items or services are covered by Medicare,
STAFF ANALYSIS OF ASSEMBLY BILL 1543 (Jones and Fletcher)
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beneficiaries are responsible for various deductible,
coinsurance, and in some cases copayment amounts. The
percentage of out-of-pocket health care expenses for
Medicare beneficiaries can be sizable and typically
increases with age. In addition, there are medical
expenses that are not covered by Medicare at all, such as
custodial nursing home care, hearing aids; eyeglasses;
dental care; acupuncture; chiropractic care; and health
care outside the United States.
For these reasons, most people who do not have coverage
from a current or previous employer that covers these gaps
choose to get some type of additional coverage to pay some
of the costs not covered by Original Medicare. A Medicare
supplemental (Medigap) policy is a health insurance policy
sold by private insurance companies specifically to fill
"gaps" in Original Medicare coverage. A Medigap policy
typically provides coverage for some or all of the
deductible and coinsurance amounts applicable to
Medicare-covered services, and sometimes covers items and
services that are not covered by Medicare. Under federal
law, insurance companies can only sell standardized Medigap
policies, of which there are currently 11 (assigned letters
A thru N, with some letter plans eliminated such as the
current Plan E, H, I, and J, and two versions of plan F,
one of which is a high-deductible option). In addition to
the core benefits which must be offered in all Medigap
policies, some plans may also cover other health care costs
that Medicare doesn't cover, such as foreign travel
emergency medical care.
Medigap policies are guaranteed issue at certain times for
eligible beneficiaries as specified in state and federal
law. For example, at the point where an individual first
becomes eligible for Medicare there is an "open enrollment"
period where they can purchase any Medigap policy without
medical underwriting. Beneficiaries are also guaranteed
coverage, or "guaranteed issue," when certain events occur,
such as the loss of employer-sponsored Medigap coverage.
Unless eligible for open enrollment or guaranteed issue,
Medicare beneficiaries wishing to purchase Medigap coverage
or change plans are subject to medical underwriting and can
be denied coverage based on their health status or claims
experience. Medigap policies are guaranteed renewable as
long as the premium is paid and, generally speaking, cannot
STAFF ANALYSIS OF ASSEMBLY BILL 1543 (Jones and Fletcher)
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be cancelled because of a person's health condition or for
any reason other than non-payment of the premium. Insurers
can however, in their discretion, increase the premiums for
Medigap coverage.
NAIC and Medigap model regulation
NAIC is the organization of insurance regulators from the
50 states, the District of Columbia and the five U.S.
territories. NAIC meetings are a national forum for
resolving major insurance issues that allows regulators to
develop common national policies on the regulation of
insurance when a national policy is appropriate. NAIC
develops and publishes model laws and regulations across
the broad spectrum of insurance issues, including health
insurance. In order to be considered for development and
adoption, a NAIC model law or regulation must involve a
national standard and/or require uniformity among all the
states. NAIC model laws often form the basis of state and
federal legislation and, in some instances, federal law
requires states to enact or to incorporate elements of NAIC
model laws.
The conference report of the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003 (MMA) included
language encouraging the NAIC to adopt standards
modernizing the Medigap market. In March 2007, NAIC
adopted a modernization proposal, and MIPPA, enacted on
July 15, 2008, provided for the implementation of these
changes and required states to adopt the NAIC changes. On
September 24, 2008, the NAIC adopted the revised model
Medigap regulation, which includes major changes to Medigap
plans and benefits pursuant to MIPAA and also contains
changes required by GINA. Under federal law, states must
adopt the NAIC model revisions in order to continue to
regulate the Medigap market; otherwise regulation of
Medigap policies falls to the federal Centers for Medicare
and Medicaid Services. States must adopt the revisions
required by GINA by July 1, 2009 and the revisions required
by MIPPA by September 24, 2009.
California law incorporates, but is not identical to, the
federal law affecting Medigap policies. According the
Federal Register, in their notice of recognition of NAIC
Model Standards for Regulation of Medicare Supplemental
Insurance, while states generally cannot modify the
STAFF ANALYSIS OF ASSEMBLY BILL 1543 (Jones and Fletcher)
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standardized benefit packages set out in the NAIC Model,
with respect to other provisions, states retain the
authority to enact regulatory provisions that are more
stringent than those that are incorporated in the NAIC
Model Standards or in the statutory
requirements.
Medicare Improvements for Patients and Providers Act
(MIPPA)
MIPPA, Public Law 110-275, includes major changes to
Medigap plans and benefits. MIPPA reduces from 14 to 11
the number of standardized Medigap plans. MIPPA requires
all issuers selling Medigap policies to offer at least the
basic standardized plan, Plan A, and requires issuers who
offer any other plan besides Plan A, to also then offer one
of two other plans, Plan C or Plan F. MIPPA eliminates
certain Medigap benefits that were determined to be
underutilized or outdated, specifically the preventive care
benefit and the at-home recovery benefit, and removes
prescription drugs from some benefit plans as a result of
the establishment of Medicare Part D coverage for
prescription drugs under MMA. According to the NAIC, the
eliminated preventive care benefit is no longer needed
because of the enhanced preventive care benefits now
offered in Medicare Part B. NAIC reports the at-home
recovery benefit was an underutilized and outdated benefit
given the limited availability of the benefit in the old
plans, and no longer provided a significant benefit. MIPPA
also adds hospice as a basic core benefit in all Medigap
policies.
Beneficiaries are not required to change to the new benefit
plans, which will be effective starting June 1, 2010. In
addition, the NAIC model provides for transition to the new
standardized policies, but does not require issuers to
offer existing policyholders a chance to exchange their
current policy without medical underwriting, unless an open
enrollment or guaranteed issue situation is involved. Once
the states adopt the revised model and issuers comply with
applicable state laws on approval of policy forms, rates
and advertising, issuers can market the new policies, but
they cannot become effective until June 1, 2010.
Genetic Information Nondiscrimination Act (GINA)
GINA, Public Law 110-233, enacted May 21, 2008, prohibits
STAFF ANALYSIS OF ASSEMBLY BILL 1543 (Jones and Fletcher)
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discrimination in health care coverage and employment based
on genetic information. GINA prohibits health insurers in
the group, individual, and Medigap policy markets from
denying coverage to a healthy individual or charging that
person higher premiums based solely on a genetic
predisposition to developing a disease in the future. GINA
also bars employers from using individuals' genetic
information when making hiring, firing, job placement, or
promotion decisions. In addition, insurers and employers
are not allowed under the law to request or demand a
genetic test, except for research-related purposes, and
only where the issuer adheres to specified disclosures and
limitations on the collection and use of the information.
A 2001 study by the American Management Association showed
that nearly two-thirds of major U.S. companies required
medical examinations of new hires. In addition, 14 percent
conducted tests for susceptibility to workplace hazards; 3
percent for breast and colon cancer; 1 percent for sickle
cell anemia; and, 20 percent for family medical history.
Prior legislation
SB 375 (Speier), Chapter 206, Statutes of 2005, made
certain changes to California's Medicare Supplement
coverage provisions to conform with the federal Medicare
Prescription Drug, Improvement, and Modernization Act of
2003. Expanded, as of January 1, 2007, eligibility
requirements for Medicare Supplement coverage including the
expansion of open enrollment to certain individuals who
lose Medi-Cal eligibility, and to individuals in Medicare
Advantage plans whose benefits are reduced. Prohibits
policy issuers from requesting health information from an
applicant who is guaranteed issuance of coverage.
Arguments in support
CDI, sponsor of this bill, states that this bill is
urgently needed because if California fails to adopt the
revisions by the mandated deadlines, the state will be
deemed to be out of compliance with federal law, and
thereby, lose the authority to regulate the Medigap market.
America's Health Insurance Plans, the national association
representing health insurance plans, writes in support of
this bill that the timeliness with which these conforming
provisions must take effect and consistency with the NAIC
model regulation are essential to ensuring that Medicare
STAFF ANALYSIS OF ASSEMBLY BILL 1543 (Jones and Fletcher)
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supplement policies are available to millions of California
seniors.
PRIOR ACTIONS
Assembly Floor: 74-0
Assembly Appropriations:17-0
Assembly Health: 19-0
COMMENTS
1. Urgency clause and conformity deadline. This bill
contains an urgency clause, which requires a
two-thirds vote of the Legislature, to ensure that the
provisions of this bill go into immediate effect upon
enactment. The deadline for states to comply with GINA
is July 1, 2009, and MIPPA is September 24, 2009. In
order to retain regulatory authority over the Medigap
market in California, California law must be amended
to comply with the federal requirements by the
deadlines. If states fail to adopt the revisions by
the mandated deadlines, then the state will be deemed
to be out of compliance with the federal requirements
and, thereby, lose the authority to regulate the
Medigap market in the state, and regulation of this
market would be assumed by the federal Centers for
Medicare and Medicaid Services (CMS).
2. Recommended technical amendments. Staff recommends
that the authors consider incorporating the following
technical amendments into the final version of this
bill; however, due to the urgent nature of this
legislation, if consensus is not reached on all of the
following technical amendments in time to have the
measure go into effect on July 1, 2009, these
amendments should become part of a technical clean-up
bill at a later date.
a. Page 13, lines 17-25:
(C) An issuer may not apply new preexisting condition
STAFF ANALYSIS OF ASSEMBLY BILL 1543 (Jones and Fletcher)
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limitations or a new incontestability period to the
new plan contract for those benefits contained in the
exchanged 1990 standardized plan contract of the
enrollee or subscriber, but may apply preexisting
condition limitations of no more than six months to
any added benefits contained in the new 2010
standardized plan contract not contained in the
exchanged plan contract. This subdivision paragraph
shall not apply to an applicant who is guaranteed
issue under Section 1358.11 or 1358.12.
b. Page 74, lines 5-13:
(C) An issuer shall not apply new preexisting
condition limitations or a new incontestability period
to the new policy for those benefits contained in the
exchanged 1990 standardized policy or certificate of
the insured, but may apply preexisting condition
limitations of no more than six months to any added
benefits contained in the new 2010 standardized policy
or certificate not contained in the exchanged policy.
This subdivision paragraph shall not apply to an
applicant who is guaranteed issue under Section
10192.11 or 10192.12.
c. Page 22, lines 1-5:
(C) If the Medicare supplement contract is terminated
by the master policyholder group contractholder and is
not replaced as provided under subparagraph (E), the
issuer shall offer enrollees or subscribers an
individual Medicare supplement contract which, at the
option of the enrollee or subscriber, does one of the
following:
d. Page 39, lines 22-26:
(i) Commencing January 1, 2007, an individual enrolled
in Medicare Part B is entitled to open enrollment
described in this section upon being notified that he
or she is no longer eligible for benefits, including
or only eligible for benefits with a share of cost,
under the Medi-Cal program because of an increase in
the individual's income or assets.
e. Page 99, lines 38-40, Page 100, lines 1-2:
(i) Commencing January 1, 2007, an individual enrolled
in Medicare Part B is entitled to open enrollment
STAFF ANALYSIS OF ASSEMBLY BILL 1543 (Jones and Fletcher)
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described in this section upon being notified that he
or she is no longer eligible for benefits, including
or only eligible for benefits with a share of cost,
under the Medi-Cal program because of an increase in
the individual's income or assets.
f. Page 26, lines 38-40, Page 27, lines 1-6:
(c) Benefit plans shall be uniform in structure,
language, designation and format to the standard
benefit plans A to L J , inclusive, listed in
subdivision (e), and shall conform to the definitions
in Section 1358.4. Each benefit shall be structured in
accordance with the format provided in subdivisions
(b), (c), (d), and (e) of Section 1358.8 and list the
benefits in the order listed in subdivision (e). For
purposes of this section, "structure, language, and
format" means style, arrangement, and overall content
of a benefit.
g. Page 87, lines 7-15:
(c) Benefit plans shall be uniform in structure,
language, designation and format to the standard
benefit plans A to L J ,, inclusive, listed in
subdivision (e), and shall conform to the definitions
in Section 10192.4. Each benefit shall be structured
in accordance with the format provided in subdivisions
(b), (c), (d), and (e) of Section 10192.8 and list the
benefits in the order listed in subdivision (e). For
purposes of this section, "structure, language, and
format" means style, arrangement, and overall content
of a benefit.
h. Page 40, lines 11-16:
(1) The individual is enrolled under an employee
welfare benefit plan that provides health benefits
that supplement the benefits under Medicare, the plan
either terminates or ceases to provide all of those
supplemental health benefits to the individual, and or
the employer no longer provides the individual with
insurance that covers all of the payment for the
20-percent coinsurance.
i. Page 100, lines 25-30:
(1) The individual is enrolled under an employee
STAFF ANALYSIS OF ASSEMBLY BILL 1543 (Jones and Fletcher)
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welfare benefit plan that provides health benefits
that supplement the benefits under Medicare, the plan
either terminates or ceases to provide all of those
supplemental health benefits to the individual, and or
the employer no longer provides the individual with
insurance that covers all of the payment for the
20-percent coinsurance.
j. Page 50, lines 3-5:
(ii) The cover page shall contain the 14-plan 12-plan
(A-L) charts. The plans offered by the issuer shall be
clearly identified. Innovative benefits shall be
explained in a manner approved by the director.
k. Page 112, lines 10-13:
(II) The cover page shall contain the 14-plan 12-plan
(A-L) charts. The plans offered by the insurer shall
be clearly identified. Innovative benefits shall be
explained in a manner approved by the commissioner.
The text shall read:
l. Page 84, lines 29-40, Page 85, lines 1-2:
(b) With respect to the standards for basic (core)
benefits for benefit plans A, B, C, D, F, F with high
deductible high deductible F, G, M, and N, every
issuer of Medicare supplement insurance benefit plans
shall make available a policy or certificate including
only the following basic "core" package of benefits to
each prospective insured. An issuer may make available
to prospective insureds any of the other Medicare
Supplement Insurance Benefit Plans in addition to the
basic (core) package, but not in lieu of it. However,
the benefits described in paragraphs (6) and (7) and
8) shall not be offered so long as California is
required to disallow these benefits for Medicare
beneficiaries by the centers for Medicare and Medicaid
Services or other agent of the federal government
under Section 1395ss of Title 42 of the United States
Code.
m. Page 123, lines 36-39:
(B) For policies sold for effective dates on or after
June 1, 2010, a listing of all the policies, plans, A
to D, inclusive, F, F with high deductible F, G, and K
to N, inclusive, for Medicare beneficiaries under the
STAFF ANALYSIS OF ASSEMBLY BILL 1543 (Jones and Fletcher)
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age 65 that are available from the company.
POSITIONS
Support: California Department of Insurance (sponsor)
America's Health Insurance Plans
Oppose: None received
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