I

104TH CONGRESS

1ST SESSION H. R. 1614

To amend the provisions of title XVIII of the Social Security Act relating

to Medigap policies to eliminate age rating in premiums, and for other

purposes.

IN THE HOUSE OF REPRESENTATIVES

MAY 11, 1995

Mr. DURBIN (for himself, Mr. KLECZKA, Mr. MEEK of Florida, Mr. PALLONE,

Mr. ACKERMAN, Mr. WAXMAN, Mr. MCDERMOTT, Ms. PELOSI, Mr.

FROST, Mr. KENNEDY of Rhode Island, Ms. KAPTUR, Mr. STARK, Mr.

OLVER, Mr. GENE GREEN of Texas, Mr. COLEMAN, Mr. GONZALEZ, Mr.

OBERSTAR, Mr. YATES, and Mr. HILLIARD) introduced the following bill;

which was referred to the Committee on Commerce

A BILL

To amend the provisions of title XVIII of the Social Security

Act relating to Medigap policies to eliminate age rating

in premiums, and for other purposes.

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 Consumer

5 Protection Act of 1995’’.
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1 SEC. 2. ELIMINATING ATTAINED AGE RATING FOR IN2 CREASES IN PREMIUMS FOR MEDIGAP POLI3 CIES.

4 Section 1882(r) of the Social Security Act (42 U.S.C.

5 1395ss(r)) is amended—

6 (1) in paragraph (1)—

7 (A) by striking ‘‘and’’ at the end of sub8 paragraph (A),

9 (B) by striking the period at the end of

10 subparagraph (B) and inserting ‘‘; and’’, and

11 (C) by inserting after subparagraph (B)

12 the following:

13 ‘‘(C) the premium for the policy does not in14 crease in any way on the basis of the age attained

15 after enrollment by the policyholder or

16 certificateholder.’’;

17 (2) by redesignating paragraph (6) as para18 graph (7);

19 (3) by inserting after paragraph (5) the follow20 ing new paragraph:

21 ‘‘(6) In the case of a medicare supplemental policy

22 in effect on the effective date of regulations to carry out

23 paragraph (1)(C), and which does not meet the require24 ments of such paragraph on such date, the policy shall

25 be considered to meet the requirement of such paragraph

26 only if the issuer of the policy makes available to the pol-
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1 icyholder the option of replacing such policy at the time

2 of the policyholder’s next renewal period with a medicare

3 supplemental policy which meets the requirements of para4 graph (1)(C) and all other applicable requirements of this

5 subsection.’’; and

6 (4) in paragraph (7)(A) (as redesignated by

7 paragraph (2)), by inserting ‘‘or the requirements of

8 paragraph (1)(C) or paragraph (6)’’ after ‘‘the loss

9 ratio requirements of this subsection’’.

10 SEC. 3. EFFECTIVE DATE.

11 (a) NAIC STANDARDS.—If, within 6 months after

12 the date of the enactment of this Act, the National Asso13 ciation of Insurance Commissioners (in this subsection re14 ferred to as the ‘‘NAIC’’) makes changes in the 1991

15 NAIC Model Regulation (as defined in section

16 1882(p)(1)(A) of the Social Security Act) to incorporate

17 the additional requirements imposed by the amendments

18 made by this Act, section 1882(g)(2)(A) of such Act shall

19 be applied in each State, effective for policies issued to

20 policyholders on and after the date specified in subsection

21 (c) (or, with respect to the requirements imposed by sec22 tion 1882(r)(6) of such Act, effective as of the date speci23 fied in subsection (c) for policies issued before such date),

24 as if the reference to the Model Regulation adopted on

25 June 6, 1979, were a reference to the 1991 NAIC Model
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1 Regulation (as so defined) as changed under this para2 graph (such changed Regulation referred to in this section

3 as the ‘‘1995 NAIC Model Regulation’’).

4 (b) SECRETARY STANDARDS.—If the NAIC does not

5 make changes in the 1991 NAIC Model Regulation (as

6 so defined) within the 6-month period specified in sub7 section (a), the Secretary of Health and Human Services

8 (in this section as the ‘‘Secretary’’) shall promulgate with9 in 90 days of the end of such period a regulation and sec10 tion 1882(g)(2)(A) of the Social Security Act shall be ap11 plied in each State, effective for policies issued to policy12 holders on and after the date specified in subsection (c)

13 (or, with respect to the requirements imposed by section

14 1882(r)(6) of such Act, effective as of the date specified

15 in subsection (c) for policies issued before such date), as

16 if the reference to the Model Regulation adopted in June

17 6, 1979, were a reference to the 1991 NAIC Model Regu18 lation (as so defined) as changed by the Secretary under

19 this subsection (such changed Regulation referred to in

20 this section as the ‘‘1995 Federal Regulation’’).

21 (c) DATE SPECIFIED.—

22 (1) IN GENERAL.—Subject to paragraph (2),

23 the date specified in this subsection for a State is

24 the earlier of—
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1 (A) the date the State adopts the 1995

2 NAIC Model Regulation or the 1995 Federal

3 Regulation; or

4 (B) 1 year after the date the NAIC or the

5 Secretary first adopts such regulations.

6 (2) ADDITIONAL LEGISLATIVE ACTION RE7 QUIRED.—In the case of a State which the Secretary

8 identifies, in consultation with the NAIC, as—

9 (A) requiring State legislation (other than

10 legislation appropriating funds) in order for

11 medicare supplemental policies to meet the

12 1995 NAIC Model Regulation or the 1995 Fed13 eral Regulation, but

14 (B) having a legislature which is not

15 scheduled to meet in 1996 in a legislative ses16 sion in which such legislation may be consid17 ered,

18 the date specified in this subsection is the first day

19 of the first calendar quarter beginning after the

20 close of the first legislative session of the State legis21 lature that begins on or after January 1, 1996. For

22 purposes of the previous sentence, in the case of a

23 State that has a 2-year legislative session, each year
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1 of such session shall be deemed to be a separate reg2 ular session of the State legislature.

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