SB 2575

Present law authorizes premium rates for medicare supplement policies to differ between (i) a person who qualifies for medicare who is 65 or older and (ii) a person who is younger than 65 but qualifies for medicare due to disability or end stage renal di sease ("non-age eligible person""). This bill requires insurers to utilize the weighted average aged premium rate, as described below, for medicare supplement policies and certificates issued to non-age eligible persons. This bill generally prohibits an insurer from denying, conditioning the effectiveness of, or discriminating in the pricing of a medicare supplement policy because of the health status, claims experience, receipt of health care, or medical condition of an applicant if the applicant meets any of the following criteria:  The applicant has submitted an application for the policy prior to or during the six-month period beginning on the first day of the month in which the applicant is both 65 or older and timely enrolled for benefits under medicare part B.  The applicant is a non-age eligible person and (i) has submitted an application for the policy prior to or during the six-month period beginning on the first day of the first month in which the non-age eligible person is enrolled for benefits under medicare part B, (ii) has enrolled for benefits under medicare part B prior to January 1, 2027, and (iii) has submitted an application or makes a request for an application for the policy during the six-month period beginning on January 1, 2027.  At the time the application is submitted, the applicant is insured under a medicare supplement policy and the applicant submits the application for the policy (i) to an insurer that is different than the supplier of the current supplement policy, (ii) within 60 days of the applicant's birthday, and (iii) the applicant seeks to maintain the same medicare supplement plan. This bill requires any medicare supplement policy available for sale in this state be made available to non-age eligible applicants who (i) ha ve submitted an application for the policy prior to or during the six-month period beginning on the first day of the first month in which the non-age eligible person is enrolled for benefits under medicare part B, (ii) ha ve enrolled for benefits under medicare part B prior to January 1, 2027, and (iii) ha ve submitted an application or makes a request for an applicati on for the policy during the six-month period beginning on January 1, 2027. A policy provided to a non-age eligible person is prohibited from containing any waiting period or preexisting condition limitation. WEIGHTED AVERAGE PREMIUM RATE In order to calculate the weighted average premium rate, this bill provides that one must first multiply the premium rate for each age band, 65 and over, by the number of individuals in this state insured in that age band to get the total premium for eac h age band. Then, calculate the sum of the premium for all age bands 65 and older to get the total premium for all age bands. Next, calculate the sum of the insureds for all age bands 65 and over to arrive at the total number of insureds for all age ban ds . Finally, divide the total premium for all age bands 65 and older by the total number of insureds for all age bands 65 and older. The resulting number is the weighted average premium rate. RULEMAKING This bill authorizes the commissioner of commerce and insurance to promulgate rules to determine the age-bands utilized to calculate the weighted average premium rate. APPLICABILITY This bill applies to policies, plans, and contracts entered into, renewed, amended, or modified on or after January 1, 2027."