An Act to amend and reenact § 38.2-3608 of the Code of Virginia, relating to Medicare supplement policies; regulations establishing minimum standards; work group; report.
HB358 amends Virginia’s Medicare supplement insurance statute to broaden the State Corporation Commission’s authority to issue and revise regulations establishing minimum standards for Medicare supplement policies. The bill keeps the existing framework for claims processing, payment standards, marketing practices, compensation arrangements, loss ratio refunds or credits, Medicare select policies, and insurer reporting, while clarifying that regulatory changes may be made only as needed to preserve federal approval of Virginia’s Medicare supplement program.
The bill also directs the Bureau of Insurance to convene a work group to study cost drivers affecting both Medicare Advantage and Medicare supplement policies and to develop recommendations for possible regulatory changes. The work group must examine claims standards, risk adjustment and market stabilization options, overpayment waste and abuse, insurer coverage-decision methodologies and disclosures, care quality and disparities, and consumer protections for people entering or switching Medicare supplement coverage. It must include insurers, hospitals, physicians, consumer counseling organizations, and at least two current or recent Medicare supplement policyholders, and it must report its findings by December 1, 2026.
HB358 affects § 38.2-3608 of the Code of Virginia by reaffirming and slightly expanding the State Corporation Commission’s regulatory authority over Medicare supplement insurance standards, while tying any expansion to maintaining federal approval of the state program. It also creates a formal stakeholder work group under the Bureau of Insurance to study Medicare supplement and Medicare Advantage cost and consumer-protection issues and to recommend statutory or regulatory changes. The bill primarily impacts insurers offering Medicare supplement policies, Medicare beneficiaries, consumer advocates, health care providers, and the SCC’s Bureau of Insurance.
The available record shows no committee transcript or recorded vote data, so there is no direct evidence of debate, opposition, or amendment activity in the materials provided. Based on the bill text, the measure appears policy-focused and technical, with an emphasis on consumer protections, market stability, and regulatory review rather than a partisan or highly controversial change. The inclusion of a broad stakeholder work group and a reporting requirement suggests an intent to build consensus and gather evidence before any major policy changes are made.
The main areas of potential contention are the balance between stronger consumer protections and preserving market stability, especially around open enrollment windows, guaranteed-issue rules, plan equivalency standards, and barriers to switching policies or carriers. Insurers may be concerned about regulatory changes that could increase costs, affect underwriting or compensation arrangements, or require new disclosures and reporting, while consumer advocates may push for greater flexibility and clearer protections for beneficiaries. The bill also raises questions about whether risk adjustment mechanisms or market stabilization pools should be used for Medicare supplement policies, which could be debated by insurers, providers, and consumer representatives.