| 1 | A bill to be entitled |
| 2 | An act relating to Medicare supplement policies; amending |
| 3 | s. 627.671, F.S.; revising a short title; amending s. |
| 4 | 627.6741, F.S.; requiring that insurers issuing Medicare |
| 5 | supplement policies in this state offer the opportunity to |
| 6 | enroll in a Medicare supplement policy to certain |
| 7 | individuals having a disability or end-stage renal |
| 8 | disease; permitting insurers offering Medicare supplement |
| 9 | policies to effect a one-time rate schedule change; |
| 10 | authorizing insurers to propose a rate adjustment that |
| 11 | considers the experience of policies or certificates for |
| 12 | persons younger than 65 years of age; establishing |
| 13 | credibility criteria for the rate adjustment; providing an |
| 14 | effective date. |
| 15 |
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| 16 | Be It Enacted by the Legislature of the State of Florida: |
| 17 |
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| 18 | Section 1. Section 627.671, Florida Statutes, is amended |
| 19 | to read: |
| 20 | 627.671 Medicare supplement reform; short title.--Sections |
| 21 | 627.671-627.675 may be cited as the "Alonzo Mourning Access to |
| 22 | Care Act Florida Medicare Supplement Reform Act." |
| 23 | Section 2. Subsection (1) of section 627.6741, Florida |
| 24 | Statutes, is amended to read: |
| 25 | 627.6741 Issuance, cancellation, nonrenewal, and |
| 26 | replacement.-- |
| 27 | (1)(a) An insurer issuing Medicare supplement policies in |
| 28 | this state shall offer the opportunity of enrolling in a |
| 29 | Medicare supplement policy, without conditioning the issuance or |
| 30 | effectiveness of the policy on, and without discriminating in |
| 31 | the price of the policy based on, the medical or health status |
| 32 | or receipt of health care by the individual: |
| 33 | 1.(a) To any individual who is 65 years of age or older, |
| 34 | or under 65 years of age and eligible for Medicare by reason of |
| 35 | disability or end-stage renal disease, and who resides in this |
| 36 | state, upon the request of the individual during the 6-month |
| 37 | period beginning with the first month in which the individual |
| 38 | has attained 65 years of age and is enrolled in Medicare Part B, |
| 39 | or is eligible for Medicare by reason of a disability or end- |
| 40 | stage renal disease, and is enrolled in Medicare Part B; or |
| 41 | 2.(b) To any individual who is 65 years of age or older, |
| 42 | or under 65 years of age and eligible for Medicare by reason of |
| 43 | a disability or end-stage renal disease, who and is enrolled in |
| 44 | Medicare Part B, and who resides in this state, upon the request |
| 45 | of the individual during the 2-month period following |
| 46 | termination of coverage under a group health insurance policy. |
| 47 | (b) The 6-month period to enroll in a Medicare supplement |
| 48 | policy for an individual who is under 65 years of age and is |
| 49 | eligible for Medicare by reason of disability or end-stage renal |
| 50 | disease and otherwise eligible under subparagraph (a)1. or |
| 51 | subparagraph (a)2. and first enrolled in Medicare Part B before |
| 52 | October 1, 2009, begins on October 1, 2009. |
| 53 | (c) A company that has offered Medicare supplement |
| 54 | policies to individuals under 65 years of age who are eligible |
| 55 | for Medicare by reason of disability or end-stage renal disease |
| 56 | before October 1, 2009, may, for one time only, effect a rate |
| 57 | schedule change that redefines the age bands of the premium |
| 58 | classes without activating the period of discontinuance required |
| 59 | by s. 627.410(6)(e)2. |
| 60 | (d) As a part of an insurer's rate filings, before and |
| 61 | including the insurer's first rate filing for a block of policy |
| 62 | forms in 2015, notwithstanding the provisions of s. |
| 63 | 627.410(6)(e)3., an insurer shall consider the experience of the |
| 64 | policies or certificates for the premium classes including |
| 65 | individuals under 65 years of age and eligible for Medicare by |
| 66 | reason of disability or end-stage renal disease separately from |
| 67 | the balance of the block so as not to affect the other premium |
| 68 | classes. For filings in such time period only, credibility of |
| 69 | that experience shall be as follows: if a block of policy forms |
| 70 | has 1,250 or more policies or certificates in force in the age |
| 71 | band including ages under 65 years of age, full or 100 percent |
| 72 | credibility shall be given to the experience; and if fewer than |
| 73 | 250 policies or certificates are in force, no or zero percent |
| 74 | credibility shall be given. Linear interpolation shall be used |
| 75 | for in-force amounts between the low and high values. Florida- |
| 76 | only experience shall be used if it is 100 percent credible. If |
| 77 | Florida-only experience is not 100 percent credible, a |
| 78 | combination of Florida-only and nationwide experience shall be |
| 79 | used. If Florida-only experience is zero percent credible, |
| 80 | nationwide experience shall be used. The insurer may file its |
| 81 | initial rates and any rate adjustment based upon the experience |
| 82 | of these policies or certificates or based upon expected claim |
| 83 | experience using experience data of the same company, other |
| 84 | companies in the same or other states, or using data publicly |
| 85 | available from the Centers for Medicaid and Medicare Services if |
| 86 | the insurer's combined Florida and nationwide experience is not |
| 87 | 100 percent credible, separate from the balance of all other |
| 88 | Medicare supplement policies. |
| 89 | |
| 90 | A Medicare supplement policy issued to an individual under |
| 91 | subparagraph (a)1. or subparagraph (a)2. paragraph (a) or |
| 92 | paragraph (b) may not exclude benefits based on a preexisting |
| 93 | condition if the individual has a continuous period of |
| 94 | creditable coverage, as defined in s. 627.6561(5), of at least 6 |
| 95 | months as of the date of application for coverage. |
| 96 | Section 3. This act shall take effect October 1, 2009. |