RELATING TO INSURANCE -- MEDICARE SUPPLEMENT INSURANCE POLICIES
This bill amends Rhode Island’s Medicare supplement insurance law to expand guaranteed issue rights for Medigap coverage. It requires insurers offering Medicare supplement Plan A in the state to make that coverage available to eligible applicants under age 65 who qualify for Medicare because of disability or end-stage renal disease, so long as they apply within the specified enrollment window. The bill also creates a six-month open enrollment period for those under-65 enrollees when they later turn 65 and remain enrolled in Medicare Parts A and B.
The bill further extends guaranteed issue rights during the annual Medicare enrollment period to individuals who have maintained continuous coverage through Medicare supplement policies, Medicare Advantage plans, or other credible coverage with no gap greater than 90 days since their initial Medicare enrollment period. For those applicants, insurers may not deny coverage based on health status, receipt of health care, or individual medical underwriting. The measure also applies these guaranteed issue protections to under-65 individuals with disability-based Medicare coverage seeking Plan A coverage.
In addition to the guaranteed issue changes, the bill reinforces the Insurance Commissioner’s authority to regulate Medicare supplement policies. It preserves and expands regulatory standards for policy provisions, premium rates, claims practices, marketing, compensation, reporting, loss ratios, public access to policy information, and approval of policy forms and premium increases. The bill takes effect immediately upon passage.
The bill’s impact on state law is to broaden consumer access to Medigap policies and limit insurer discretion in underwriting and eligibility decisions for certain Medicare beneficiaries. It would require insurers to offer coverage more broadly to qualifying applicants and would likely increase regulatory oversight of premium increases and policy standards for Medicare supplement products in Rhode Island.
The overall sentiment reflected in the bill text is consumer-protective and access-oriented, with the measure framed as expanding coverage options for people who may otherwise face barriers to Medigap enrollment. No committee transcript or vote record was provided, so there is no documented public debate or recorded opposition in the supplied materials. Based on the bill’s structure, likely points of contention would center on insurer concerns about adverse selection, premium impacts, and the administrative burden of expanded guaranteed issue requirements versus advocates’ interest in protecting Medicare beneficiaries with disabilities and continuous coverage.
The bill would amend Rhode Island General Laws chapter 27-18.2 governing Medicare supplement insurance policies by expanding guaranteed issue rights, prohibiting medical underwriting for specified applicants, and requiring insurers to offer Plan A coverage to certain under-65 Medicare beneficiaries and to eligible enrollees during annual enrollment periods. It also reinforces the Insurance Commissioner’s authority to regulate policy provisions, premium rates, claims handling, marketing, compensation, reporting, loss ratios, and approval of forms and premium increases, thereby increasing state oversight of Medigap products and insurer practices.
The bill appears generally favorable to consumers and Medicare beneficiaries, especially people under 65 who qualify for Medicare due to disability or end-stage renal disease and individuals seeking to switch or obtain Medigap coverage outside the initial enrollment period. Because no committee discussion or vote history was provided, there is no direct evidence of opposition or support in the record supplied. The measure’s framing suggests a policy goal of expanding access and reducing coverage barriers rather than restricting benefits.
The main likely point of contention is the balance between consumer access and insurer risk. Supporters would likely emphasize guaranteed issue rights, protection from medical underwriting, and broader access for disabled and chronically ill Medicare beneficiaries. Insurers or opponents could object that expanding guaranteed issue outside initial enrollment periods may increase adverse selection, raise premiums, and complicate underwriting and rate-setting. Another possible issue is the breadth of the commissioner’s regulatory authority over premium increases, loss ratios, and marketing practices.