Providing for annual open enrollment period; and abrogating a regulation.
Summary
SB1185 would amend Pennsylvania’s Medicare Supplement Insurance Act to create a guaranteed annual open enrollment period for individuals already insured under a Medicare supplement policy or certificate. The open enrollment period would begin on the insured person’s birthday and remain open for at least 90 days, during which the person could buy any Medicare supplement policy or certificate sold in Pennsylvania that offers the same benefits as the person’s current coverage. The bill specifies that innovative benefits are not counted when comparing whether two policies have the same benefits.
During that open enrollment window, insurers would be prohibited from denying coverage, conditioning issuance or effectiveness, or charging different prices based on an applicant’s health status, claims history, receipt of health care, or medical condition. The bill also requires insurers to notify affected policyholders 15 to 30 days before the open enrollment period begins, including the dates, the individual’s rights, and any changes to benefits or premiums in the current policy.
Impact
The bill would add a new section to the Medicare Supplement Insurance Act and would directly affect insurers offering Medicare supplement coverage in Pennsylvania, as well as current policyholders seeking to change plans. It would create a statutory right to annual guaranteed access to comparable Medigap coverage and would limit underwriting and pricing practices during that period. The bill also abrogates 31 Pa. Code § 89.778 to the extent the regulation conflicts with the new statutory open enrollment requirement, thereby overriding inconsistent administrative rules.
Sentiment
No committee transcripts or recorded votes were provided, so there is no documented debate or vote history to gauge formal sentiment. Based on the bill text, the measure appears consumer-protective and aimed at expanding access and portability for Medicare supplement enrollees, suggesting likely support from advocates for seniors and insurance access. The absence of recorded opposition in the provided materials means any controversy is not documented here.
Contention
The main policy issue is whether insurers should be required to offer a recurring guaranteed open enrollment period for Medigap coverage and to forgo health-based underwriting and pricing during that window. Supporters would likely emphasize consumer choice, continuity of coverage, and protection for older adults with changing health needs. Potential opponents, likely insurers or industry groups, may object to limits on underwriting flexibility, the administrative burden of annual notices, and the possibility of adverse selection if healthier enrollees switch plans more easily.