Seeks to promote increased consumer access to Medicare supplement health insurance policies.
This bill amends Rhode Island’s Medicare supplement insurance laws to expand access to Medigap coverage and strengthen state oversight of those policies. It directs the insurance commissioner to maintain and adopt regulations governing policy provisions, prohibited terms, premium-rate standards, claims payment, marketing, compensation, reporting, and compliance with federal requirements. The bill also preserves existing protections against duplicate Medicare benefits and limits on preexisting-condition exclusions.
A major substantive change is the creation and expansion of guaranteed access rights for Medicare supplement Plan A. The bill requires insurers that offer Plan A in Rhode Island to make it available to applicants under age 65 who qualify for Medicare because of disability or end-stage renal disease, and it bars medical underwriting or health-status-based denial for those applicants. It also provides guaranteed issue rights during an annual enrollment period for individuals enrolled in Medicare Parts A and B, including those in Medicare Advantage plans, and requires community-rated premium pricing for Medicare supplement policies. The bill further authorizes the Office of the Health Insurance Commissioner to conduct annual premium reviews and impose administrative penalties for violations, including fines, suspension of offerings, and corrective action orders. The act would take effect January 1, 2026.
The bill would amend § 27-18.2-3 of the Rhode Island General Laws, expanding statutory protections and access rules for Medicare supplement insurance policies. It would affect insurers selling Medigap policies in the state, the Office of the Health Insurance Commissioner, and Medicare beneficiaries—especially people under 65 who qualify for Medicare due to disability or end-stage renal disease, as well as beneficiaries seeking guaranteed issue coverage during annual enrollment. It also reinforces state regulatory authority over premium rates, underwriting, and policy form approval.
The available bill materials indicate generally favorable intent, with the stated purpose of promoting increased consumer access to Medicare supplement health insurance policies. The text emphasizes consumer protections, guaranteed access, and oversight rather than restrictions, suggesting a pro-consumer and pro-accessive coverage approach. No committee transcript or vote record is available here to show recorded opposition or support beyond the bill’s stated purpose.
The main likely points of contention are the bill’s impact on insurer underwriting discretion, pricing, and market participation. Insurers may object to mandatory guaranteed issue, community rating, limits on medical underwriting, and annual premium review requirements, particularly if they believe these provisions could increase adverse selection or administrative burden. Consumer advocates and disability-rights stakeholders would likely support the bill’s expanded access for under-65 Medicare beneficiaries and stronger anti-discrimination protections, while any opposition would likely center on cost, rate-setting, and regulatory compliance concerns.