Read the full stored bill text
Senate
File
71
-
Introduced
SENATE
FILE
71
BY
ROZENBOOM
A
BILL
FOR
An
Act
relating
to
Medicare
supplement
policies
and
an
annual
1
open
enrollment
period.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
TLSB
1551XS
(4)
91
nls/ko
S.F.
71
Section
1.
NEW
SECTION
.
514M.1
Medicare
supplement
1
insurance
——
annual
open
enrollment.
2
1.
For
purposes
of
this
section,
unless
the
context
3
otherwise
requires:
4
a.
“Applicant”
means
an
individual
who
is
at
least
5
sixty-five
years
old
who
seeks
to
contract
for
benefits
6
under
an
individual
Medicare
supplement
policy,
or
a
proposed
7
covered
individual
under
a
group
Medicare
supplement
policy.
8
“Applicant”
includes
an
individual
under
the
age
of
sixty-five
9
who
qualifies
for
Medicare
due
to
disability,
end-stage
renal
10
disease,
or
exposure
to
an
environmental
hazard.
11
b.
“Certificate”
means
any
certificate
of
coverage
delivered
12
or
issued
for
delivery
in
this
state
to
a
covered
individual
13
under
a
group
Medicare
supplement
policy.
14
c.
“Issuer”
means
an
insurance
company,
a
fraternal
benefit
15
society,
a
health
care
service
plan,
a
health
maintenance
16
organization,
or
any
other
entity
delivering
or
issuing
17
for
delivery
in
this
state
a
Medicare
supplement
policy
or
18
certificate.
19
d.
“Medicare
supplement
policy”
means
an
individual
or
group
20
policy
of
accident
and
sickness
insurance
or
a
subscriber
21
contract
of
hospital
and
medical
service
associations
or
22
health
maintenance
organizations,
other
than
a
policy
issued
23
pursuant
to
a
contract
under
section
1876
of
the
federal
Social
24
Security
Act,
as
codified
in
42
U.S.C.
§1395
et
seq.,
or
an
25
issued
policy
under
an
approved
demonstration
project
described
26
in
section
603(c)
of
the
Social
Security
Amendments
of
1983,
27
section
2355
of
the
federal
Deficit
Reduction
Act
of
1984,
or
28
section
9412(b)
of
the
federal
Omnibus
Budget
Reconciliation
29
Act
of
1986,
that
is
advertised,
marketed,
or
designed
30
primarily
as
a
supplement
to
reimbursements
under
Medicare
31
for
hospital,
medical,
or
surgical
expenses
of
individuals
32
covered
by
Medicare.
“Medicare
supplement
policy”
does
not
33
include
Medicare
advantage
plans,
outpatient
prescription
drug
34
plans
established
under
Medicare
part
D,
or
any
health
care
35
-1-
LSB
1551XS
(4)
91
nls/ko
1/
3
S.F.
71
prepayment
plan
that
provides
benefits
pursuant
to
an
agreement
1
under
section
1833(a)(1)(A)
of
the
federal
Social
Security
Act.
2
2.
Beginning
January
1,
2026,
applicants
shall
have
an
3
annual
thirty-day
open
enrollment
period
that
begins
on
the
4
date
of
the
applicant’s
birthday.
5
3.
During
the
open
enrollment
period
under
subsection
2,
an
6
issuer
shall
be
prohibited
from
doing
any
of
the
following:
7
a.
Denying
or
conditioning
the
issuance
or
effectiveness
of
8
any
Medicare
supplement
policy
or
certificate
that
the
issuer
9
offers
and
that
is
available
for
issuance
in
the
state.
10
b.
Subjecting
an
applicant
to
medical
underwriting,
or
11
discriminating
in
the
pricing
of
a
Medicare
supplement
policy
12
or
certificate
because
of
the
applicant’s
health
status,
claims
13
experience,
receipt
of
health
care,
or
medical
condition.
14
c.
Imposing
an
exclusion
of
benefits
based
on
an
applicant’s
15
preexisting
condition.
16
4.
During
the
open
enrollment
period,
an
applicant
may
17
choose
a
Medicare
supplement
policy
or
certificate
that
has
the
18
same
or
lesser
benefits
than
the
policy
or
certificate
that
the
19
applicant
is
covered
under
on
the
date
on
which
the
applicant’s
20
annual
thirty-day
open
enrollment
period
begins.
21
5.
An
issuer
shall
provide
notice,
in
a
form
prescribed
by
22
the
commissioner
of
insurance,
of
the
annual
open
enrollment
23
period
at
the
time
an
applicant
applies
for
a
Medicare
24
supplement
policy
or
certificate.
25
EXPLANATION
26
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
27
the
explanation’s
substance
by
the
members
of
the
general
assembly.
28
This
bill
relates
to
Medicare
supplement
policies
and
an
29
annual
open
enrollment
period.
30
Beginning
January
1,
2026,
applicants
shall
have
an
annual
31
30-day
open
enrollment
period
that
begins
on
the
date
of
an
32
applicant’s
birthday.
“Applicant”
is
defined
in
the
bill
as
an
33
individual
who
is
at
least
65
years
old
who
seeks
to
contract
34
for
benefits
under
an
individual
Medicare
supplement
policy,
or
35
-2-
LSB
1551XS
(4)
91
nls/ko
2/
3
S.F.
71
a
proposed
covered
individual
under
a
group
Medicare
supplement
1
policy.
“Applicant”
includes
an
individual
under
the
age
of
65
2
who
qualifies
for
Medicare
due
to
disability,
end-stage
renal
3
disease,
or
exposure
to
an
environmental
hazard.
“Medicare
4
supplement
policy”
is
also
defined
in
the
bill.
5
During
the
open
enrollment
period,
an
issuer
is
prohibited
6
from
denying
or
conditioning
the
issuance
or
effectiveness
7
of
any
Medicare
supplement
policy
that
the
issuer
offers
and
8
that
is
available
for
issuance
in
the
state;
from
subjecting
9
an
applicant
to
medical
underwriting
or
discriminating
in
the
10
pricing
of
a
Medicare
supplement
policy
because
of
the
health
11
status,
claims
experience,
receipt
of
health
care,
or
medical
12
condition
of
an
applicant;
and
from
imposing
an
exclusion
13
of
benefits
based
on
an
applicant’s
preexisting
condition.
14
During
the
open
enrollment
period,
an
applicant
may
choose
a
15
Medicare
supplement
policy
or
certificate
that
has
the
same
16
or
lesser
benefits
than
the
policy
or
certificate
that
the
17
applicant
is
covered
under
on
the
date
that
the
applicant’s
18
open
enrollment
begins.
An
issuer
shall
provide
notice,
in
a
19
form
prescribed
by
the
commissioner
of
insurance,
of
the
annual
20
open
enrollment
period
at
the
time
an
applicant
applies
for
a
21
Medicare
supplement
policy
or
certificate.
“Issuer”
is
defined
22
in
the
bill.
23
-3-
LSB
1551XS
(4)
91
nls/ko
3/
3