MEDICARE SUPPLEMENT OPEN ENROLLMENT

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AN ACT
RELATING TO HEALTH INSURANCE; REQUIRING ISSUERS OF MEDICARE
SUPPLEMENT POLICIES TO PROVIDE OPEN ENROLLMENT PERIODS.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
SECTION 1. Section 59A-24A-3 NMSA 1978 (being Laws 1989,
Chapter 28, Section 3, as amended) is amended to read:
"59A-24A-3. DEFINITIONS.--As used in the Medicare
Supplement Act:
A. "applicant" means:
(1) in the case of an individual medicare
supplement policy, the person who seeks to contract for
insurance benefits; or
(2) in the case of a group medicare
supplement policy, the proposed certificate holder;
B. "certificate" means any certificate delivered or
issued for delivery in this state under a group medicare
supplement policy;
C. "certificate form" means the document on which a
certificate is delivered or issued for delivery;
D. "eligible policyholder" means a beneficiary of
medicare coverage provided pursuant to part A or part B of
Title 18 of the federal Social Security Act, as amended, who is
sixty-five years of age or older and insured under a medicare
supplement policy;
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E. "issuer" means insurance companies, fraternal
benefit societies, nonprofit health care plans, health
maintenance organizations and any other entities that deliver
or issue for delivery in this state medicare supplement
policies or certificates;
F. "medicare" means the federal Health Insurance
for the Aged Act, Title XVIII of the Social Security Amendments
of 1965, as then constituted or later amended;
G. "medicare supplement policy" means:
(1) a group policy as defined in Chapter 59A,
Article 23 NMSA 1978;
(2) an individual policy as defined in
Chapter 59A, Article 22 NMSA 1978; or
(3) a group or individual certificate issued
pursuant to the Nonprofit Health Care Plan Law or the Health
Maintenance Organization Law that is advertised, marketed or
designed as a supplement to reimbursements under medicare for
the hospital, medical or surgical expenses of persons eligible
for medicare;
H. "policy form" means the document on which a
policy is delivered or issued for delivery by the issuer; and
I. "superintendent" means the superintendent of
insurance."
SECTION 2. A new section of the Medicare Supplement Act
is enacted to read:
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"ANNUAL OPEN ENROLLMENT.--
A. Every issuer participating in the market for
medicare supplement policies shall offer an annual open
enrollment period to all eligible policyholders. Each eligible
policyholder's open enrollment period shall commence with the
first day of the eligible policyholder's birthday month and
remain open for at least sixty days thereafter. During the
open enrollment period:
(1) each eligible policyholder may purchase
any medicare supplement policy of an equal or lesser value to
the eligible policyholder's current medicare supplement policy
offered in this state; and
(2) an issuer shall:
(a) guarantee the issuance of any
medicare supplement policy offered in this state; and
(b) not deny, delay or condition the
issuance or effectiveness, or discriminate in the price of
coverage, of a medicare supplement policy based on the health
status, claims, experience, receipt of health care or medical
condition of an eligible policyholder.
B. A medicare supplement policy obtained by an
eligible policyholder pursuant to Subsection A of this section
shall not have any coverage exclusions related to preexisting
conditions that would have been covered under the eligible
policyholder's previous medicare supplement policy.
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C. At least thirty days before the beginning of an
eligible policyholder's open enrollment period, but not more
than sixty days before the beginning of the open enrollment
period, the issuer of an eligible policyholder's medicare
supplement policy shall notify the eligible policyholder of:
(1) the dates on which the open enrollment
period begins and ends;
(2) the rights provided to the eligible
policyholder by this section; and
(3) any modifications to the medicare
supplement policy currently held by the eligible policyholder
or any adjustments to the premiums charged for that policy.
D. The form and content of the notification
required pursuant to Subsection C of this section shall be
filed with and approved by the superintendent prior to
distribution to eligible policyholders."
SECTION 3. EFFECTIVE DATE.--The effective date of the
provisions of this act is January 1, 2027.