Illinois Administrative Code › Title 50 - INSURANCE › Part 2008 - MINIMUM STANDARDS FOR INDIVIDUAL AND GROUP MEDICARE SUPPLEMENT INSURANCE › Subpart B - COVERAGE, POLICY & BENEFIT PROVISIONS › Section 2008.72 - Standard Medicare Supplement Benefit Plans for 1990 Standardized Medicare Supplement Benefit Plan Policies or Certificates Issued for Delivery on or after February 11, 1992 and Prior to June 1, 2010

Current through Register Vol. 48, No. 28, July 12, 2024
a) An issuer shall make available to each
				prospective policyholder and certificateholder a policy form or certificate
				form containing only the basic "core" benefits, as defined in Section
				2008.71
				of this Part.
b) No groups,
				packages or combinations of Medicare supplement benefits other than those
				listed in this Section shall be offered for sale in this State, except as may
				be permitted in subsection (g) and Section
				2008.73
				of this Part.
c) Benefit plans
				shall be uniform in structure, language, designation and format to the standard
				benefit plans listed in subsection (e) of this Section and conform to the
				definitions in Section
				2008.40 of this Part.
				Each benefit shall be structured in accordance with the format provided in
				Section
				2008.71(b)
				and (c) and list the benefits in the order
				shown in Appendix B of this Part. For purposes of this Section, "structure,
				language, and format" means style, arrangement and overall content of a
				benefit.
d) An issuer may use, in
				addition to the benefit plan designations required in subsection (c) of this
				Section, other designations to the extent permitted by law.
e) Make-up of benefit plans:
1) Standardized Medicare supplement benefit
				Plan "A" shall be limited to the Basic (Core) Benefits Common to all Benefit
				Plans, as defined in Section
				2008.71(b)
				of this Part.
2) Standardized
				Medicare supplement benefit Plan "B" shall include only the following: The Core
				Benefit as defined in Section
				2008.71(b)
				of this Part, plus the Medicare Part A Deductible as defined in Section
				2008.71(c)(1)
				of this Part.
3) Standardized
				Medicare supplement benefit Plan "C" shall include only the following: The Core
				Benefit as defined in Section
				2008.71(b)
				of this Part, plus the Medicare Part A Deductible, Skilled Nursing Facility
				Care, Medicare Part B Deductible and Medically Necessary Emergency Care in a
				Foreign Country as defined in Section
				2008.71(c)(1),
				(2), (3) and (8) of this Part
				respectively.
4) Standardized
				Medicare supplement benefit Plan "D" shall include only the following: The Core
				Benefit as defined in Section
				2008.71(b)
				of this Part, plus the Medicare Part A Deductible, Skilled Nursing Facility
				Care, Medically Necessary Emergency Care in a Foreign Country and the At-Home
				Recovery Benefit as defined in Section
				2008.71(c)(1),
				(2), (8) and (10) of this Part
				respectively.
5) Standardized
				Medicare supplement benefit Plan "E" shall include only the following: The Core
				Benefit as defined in Section
				2008.71(b)
				of this Part, plus the Medicare Part A Deductible, Skilled Nursing Facility
				Care, Medically Necessary Emergency Care in a Foreign Country and Preventive
				Medical Care as defined in Section
				2008.71(c)(1),
				(2), (8) and (9) of this Part
				respectively.
6) Standardized
				Medicare supplement benefit Plan "F" shall include only the following: The Core
				Benefit as defined in Section
				2008.71(b)
				of this Part, plus the Medicare Part A Deductible, the Skilled Nursing Facility
				Care, the Part B Deductible, 100% of the Medicare Part B Excess Charges, and
				Medically Necessary Emergency Care in a Foreign Country as defined in Section
				2008.71(c)(1),
				(2), (3), (5) and (8) of this Part
				respectively.
7) Standardized
				Medicare supplement benefit high deductible Plan "F" shall include only the
				following: 100% of covered expenses following the payment of the annual high
				deductible Plan "F" deductible. The covered expenses include the Core Benefit
				as defined in Section
				2008.71(b)
				of this Part, plus the Medicare Part A deductible, Skilled Nursing Facility
				Care, the Medicare Part B deductible, 100% of the Medicare Part B Excess
				Charges, and Medically Necessary Emergency Care in a Foreign Country as defined
				in Section
				2008.71(c)(1),
				(2), (3), (5) and (8) respectively. The
				annual high deductible Plan "F" deductible shall consist of out-of-pocket
				expenses, other than premiums, for services covered by the Medicare supplement
				Plan "F" policy, and shall be in addition to any other specific benefit
				deductibles. The annual high deductible Plan "F" deductible shall be $1500 for
				1998 and 1999, and shall be based on the calendar year. It shall be adjusted
				annually thereafter by the Secretary to reflect the change in the Consumer
				Price Index for all urban consumers for the 12 month period ending with August
				of the preceding year, and rounded to the nearest multiple of $10.
8) Standardized Medicare supplement benefit
				Plan "G" shall include only the following: The Core Benefit as defined in
				Section
				2008.71(b)
				of this Part, plus the Medicare Part A Deductible, Skilled Nursing Facility
				Care, 80% of the Medicare Part B Excess Charges, Medically Necessary Emergency
				Care in a Foreign Country, and the At-Home Recovery Benefit as defined in
				Section
				2008.71(c)(1),
				(2), (4), (8) and (10) of this Part
				respectively.
9) Standardized
				Medicare supplement benefit Plan "H" shall consist of only the following: The
				Core Benefit as defined in Section
				2008.71(b)
				of this Part, plus the Medicare Part A Deductible, Skilled Nursing Facility
				Care, Basic Prescription Drug Benefit and Medically Necessary Emergency Care in
				a Foreign Country as defined in Section
				2008.71(c)(1),
				(2), (6) and (8) of this Part respectively.
				The outpatient prescription drug benefit shall not be included in a Medicare
				supplement policy sold after December 31, 2005.
10) Standardized Medicare supplement benefit
				Plan "I" shall consist of only the following: The Core Benefit as defined in
				Section
				2008.71(b)
				of this Part, plus the Medicare Part A Deductible, Skilled Nursing Facility
				Care, 100% of the Medicare Part B Excess Charges, Basic Prescription Drug
				Benefit, Medically Necessary Emergency Care in a Foreign Country and At-Home
				Recovery Benefit as defined in Section
				2008.71(c)(1),
				(2), (5), (6), (8) and (10) of this Part
				respectively. The outpatient prescription drug benefit shall not be included in
				a Medicare supplement policy sold after December 31, 2005.
11) Standardized Medicare supplement benefit
				Plan "J" shall consist of only the following: The Core Benefit as defined in
				Section
				2008.71(b)
				of this Part, plus the Medicare Part A Deductible, Skilled Nursing Facility
				Care, Medicare Part B Deductible, 100% of the Medicare Part B Excess Charges,
				Extended Prescription Drug Benefit, Medically Necessary Emergency Care in a
				Foreign Country, Preventive Medical Care and At-Home Recovery Benefit as
				defined in Section
				2008.71(c)(1),
				(2), (3), (5), (7), (8), (9) and (10) of this
				Part respectively. The outpatient prescription drug benefit shall not be
				included in a Medicare Supplement policy sold after December 31,
				2005.
12) Standardized Medicare
				supplement benefit high deductible Plan "J" shall consist of only the
				following: 100% of covered expenses following the payment of the annual high
				deductible Plan "J" deductible. The covered expenses include the Core Benefit
				as defined in Section
				2008.71(b)
				of this Part, plus the Medicare Part A deductible, Skilled Nursing Facility
				Care, Medicare Part B deductible, 100% of the Medicare Part B Excess Charges,
				Extended Outpatient Prescription Drug Benefit, Medically Necessary Emergency
				Care in a Foreign Country, Preventive Medical Care Benefit and At-Home Recovery
				Benefit as defined in Section
				2008.71(c)(1),
				(2), (8) and (10) respectively. The annual
				high deductible Plan "J" deductible shall consist of out-of-pocket expenses,
				other than premiums, for services covered by the Medicare supplement Plan "J"
				policy, and shall be in addition to any other specific benefit deductible. The
				annual deductible shall be $1500 for 1998 and 1999, and shall be based on a
				calendar year. It shall be adjusted annually thereafter by the Secretary to
				reflect the change in the Consumer Price Index for all urban consumers for the
				12 month period ending with August of the preceding year, and rounded to the
				nearest multiple of $10.