I

104TH CONGRESS

2D SESSION H. R. 3374

To amend title XVIII of the Social Security Act to provide annual and

other opportunities for individuals enrolled under a Medicare-select policy

to change to a medigap policy without prejudice.

IN THE HOUSE OF REPRESENTATIVES

MAY 1, 1996

Mr. BENTSEN introduced the following bill; which was referred to the

Committee on Commerce

A BILL

To amend title XVIII of the Social Security Act to provide

annual and other opportunities for individuals enrolled

under a Medicare-select policy to change to a medigap

policy without prejudice.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Medigap Protection

5 Act of 1996’’.
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1 SEC. 2. CONTINUED ACCESS TO MEDIGAP POLICIES BY

2 MEDICARE-SELECT ENROLLEES.

3 (a) IN GENERAL.—Section 1882(s) of the Social Se4 curity Act (42 U.S.C. 1395ss(s)) is amended—

5 (1) in paragraph (3), by striking ‘‘paragraphs

6 (1) and (2)’’ and inserting ‘‘paragraphs (1), (2), or

7 (3)’’,

8 (2) by redesignating paragraph (3) as para9 graph (4), and

10 (3) by inserting after paragraph (2) the follow11 ing new paragraph:

12 ‘‘(3)(A) The issuer of a medicare supplemental policy

13 shall provide enrollment periods described in subpara14 graph (B) during which an individual described in sub15 paragraph (C) may elect coverage under any such medi16 care supplemental policy of such issuer as a replacement

17 for the medicare select policy. The election of such a policy

18 shall become effective on a timely manner (as specified

19 by the Secretary). The provisions of paragraph (2)(C) (re20 lating to waiving application of certain preexisting limita21 tions) may apply to the enrollment of an individual under

22 a policy pursuant to this paragraph. In the case of such

23 an election, the issuer shall treat the individual as having

24 been covered under the policy during the period in which

25 the individual was covered under the medicare select policy
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1 for purposes of computing applicable premiums and apply2 ing any preexisting condition limitations.

3 ‘‘(B) The enrollment periods described in this sub4 paragraph are—

5 ‘‘(i) an open enrollment period (of at least 30

6 days’ duration) at least once every 12 months, and

7 ‘‘(ii) a reasonable open enrollment period for an

8 individual whose coverage under a medicare select

9 policy is terminated because the individual moves

10 out of the service area of the issuer of such medicare

11 select policy.

12 ‘‘(C) An individual described in this subparagraph is,

13 with respect to the issuer of a medicare supplemental pol14 icy, an individual who is enrolled in a medicare select pol15 icy and who would be eligible to enroll under the medicare

16 supplemental policy of the issuer under paragraph (2)(A)

17 at the time the individual became (or becomes) 65 years

18 of age.

19 ‘‘(D) In this paragraph, the term ‘medicare select pol20 icy’ means a policy issued and certified under subsection

21 (t)(1).

22 ‘‘(E) The Secretary is authorized to issue regulations

23 to carry out this paragraph.’’.

24 (b) EFFECTIVE DATE.—The amendments made by

25 subsection (a) shall apply to issuers of medicare supple-
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1 mental policies for periods beginning with the first day

2 of the first month that begins more than 90 days after

3 the date of the enactment of this Act.

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