Illinois Administrative Code › Title 50 - INSURANCE › Part 2008 - MINIMUM STANDARDS FOR INDIVIDUAL AND GROUP MEDICARE SUPPLEMENT INSURANCE › Subpart E - RATES, COMPENSATION AGREEMENT, DISCLOSURE, REPLACEMENT & MARKETING › Section 2008.90 - Required Disclosure Provisions

Current through Register Vol. 48, No. 28, July 12, 2024
a) General Rules
1) Medicare supplement policies and
				certificates shall include a renewal or continuation provision. The language or
				specifications of such provision must be consistent with the type of contract
				issued. Such provision shall be appropriately captioned and shall appear on the
				first page of the policy and shall include any reservation by the issuer of the
				right to change premiums and any automatic renewal premium increases based on
				the policyholder's age.
2) Except
				for riders or endorsements by which the issuer effectuates a request made in
				writing by the insured or exercises a specifically reserved right under a
				Medicare supplement policy, or is required to reduce or eliminate benefits to
				avoid duplication of Medicare benefits, all riders or endorsements added to a
				Medicare supplement policy after date of issue or at reinstatement or renewal
				which reduce or eliminate benefits or coverage in the policy shall require
				signed acceptance by the insured. After the date of policy or certificate
				issue, any rider or endorsement which increases benefits or coverage with an
				accompanying increase in premium during the policy term shall be agreed to in
				writing and signed by the insured, unless the benefits are required by the
				minimum standards for Medicare supplement policies, except if the increased
				benefits or coverage is required by law. Where a separate additional premium is
				charged for benefits provided in connection with riders or endorsements, such
				premium charge shall be set forth in the policy.
3) Medicare supplement policies or
				certificates shall not provide for the payment of benefits based on standards
				described as "usual and customary," "reasonable and customary," or words of
				similar import.
4) If a Medicare
				supplement policy or certificate contains any limitations with respect to
				preexisting conditions, such limitations shall appear as a separate paragraph
				of the policy and be labeled as "Preexisting Condition Limitations."
5) Medicare supplement policies and
				certificates shall have a notice prominently printed on the first page of the
				policy or certificate or attached thereto stating in substance that the
				policyholder or certificateholder shall have the right to return the policy or
				certificate within 30 days of its delivery and to have the premium refunded
				directly to him or her in a timely manner if, after examination of the policy
				or certificate, the insured person is not satisfied for any reason.
6) Issuers of accident and sickness policies
				or certificates that provide hospital or medical expense coverage on an expense
				incurred or indemnity basis to persons eligible for Medicare shall provide to
				those applicants a Guide to Health Insurance for People with Medicare approved
				by the Director and in type size no smaller than 12 point type. Delivery of the
				Guide shall be made whether or not such policies or certificates are
				advertised, solicited or issued as Medicare supplement policies or certificates
				as defined in this Part. Except in the case of direct response issuers,
				delivery of the Guide shall be made to the applicant at the time of application
				and acknowledgement of receipt of the Guide shall be obtained by the issuer.
				Direct response issuers shall deliver the Guide to the applicant upon request
				but not later than at the time the policy is delivered.