Illinois Administrative Code › Title 50 - INSURANCE › Part 2010 - ADVERTISEMENTS OF MEDICARE SUPPLEMENT INSURANCE › Appendix A - Interpretive Guidelines › ILLUSTRATION G - Guideline to Section 2010.60(a)(1)

Current through Register Vol. 48, No. 28, July 12, 2024
This Section prohibits the use of incomplete statements and
				  words or phrases which create deception by omission or commission. The
				  following examples are illustrations of the prohibitions created by this
				  Section:
a) An advertisement which
				describes any benefits that vary by age must disclose the fact.
b) An advertisement that uses a phrase such
				as "no age limit" must disclose that premiums may vary be age or that benefits
				may vary by age if such is the case.
c) Advertisements, applications, requests for
				additional information and similar materials are unacceptable if they state or
				imply that the recipient has been individually selected to be offered
				insurance, or has had his eligibility for such insurance individually
				determined in advance, when in fact the advertisement is directed to all
				persons in a group or to all persons whose names appear on a mailing
				list.
d) Advertisements for group
				or franchise group plans which provide a common benefit or a common combination
				of benefits shall not imply that the insurance coverage is tailored or designed
				specifically for that group, unless such is the fact.
e) It is unacceptable to use terms such as
				"enroll" or "join" with reference to group or blanket insurance coverage when
				such is not the case.
f) An
				advertisement, which states or implies immediate coverage is provided, is
				unacceptable unless suitable administrative procedures exist so that the policy
				is issued within fifteen working days after the application is received by the
				insurer.
g) Applications, request
				forms for additional information, and similar related materials are
				unacceptable if they resemble paper currency, bonds or stock certificates; or
				use any name, service mark, slogan, symbol or any device in such a manner that
				implies that the insurer or the policy advertised is connected with a
				government agency, such as the Social Security Administration or the Department
				of Health and Human Services.
h) An
				advertisement which uses the word "plan" without identifying it as a Medicare
				supplement insurance policy is not permissible.
i) An advertisement which implies in any
				manner that the prospective insured may realize a profit from obtaining
				Medicare supplement insurance is not permissible.
j) An advertisement which fails to disclose
				any waiting or elimination periods is unacceptable.
k) Examples of benefits payable under a
				policy shall not disclose only maximum benefits unless such maximum benefits
				are paid for loss from common or probable illnesses or accidents, rather than
				exceptional or rare illnesses or accidents or periods of confinement for such
				exceptional or rare accidents or illnesses.
l) When a range of benefit levels is set
				forth in an advertisement, it must be made clear that the insured will receive
				only the benefit level written or printed in the policy selected and
				issued.
m) Advertisements for
				policies whose premiums are modest because of their limited amount of benefits
				shall not describe premiums as "low," "low-cost," "budget" or use qualifying
				words of similar import. This Section also prohibits the use of words such as
				"only" and "just" in conjunction with statements of premium amounts when used
				to imply a bargain.
n) An
				advertisement which exaggerates the effects of statutorily mandated benefits or
				required policy provisions or which implies that such provisions are unique to
				the advertised policy is unacceptable. For example, the phrase, "Money Back
				Guarantee," is an exaggerated description of the thirty-day right to examine
				the policy and is not acceptable.
o) An advertisement which implies that a
				common type of policy or a combination of common benefits is "new," "unique,"
				"a bonus," "a breakthrough," or is otherwise unusual is unacceptable. Also, the
				addition of a novel method of premium payment to an otherwise common plan of
				insurance does not render it "new."
p) An advertisement may not omit the word
				"covered" when referring to benefits payable under its policy. Continued
				reference to "covered" is not necessary where this fact has been prominently
				disclosed in the advertisement.
q)
				An advertisement must state that benefits payable under the policy are based
				upon Medicare eligible expenses, if such is the case.
r) An advertisement which fails to disclose
				that the definition of "hospital" does not include a nursing home, convalescent
				home or extended care facility, as the case may be, is unacceptable.
s) A television, radio, mail or newspaper
				advertisement, or lead generating device which is designed to produce leads
				either by use of a coupon, a request to write or to call the company, or a
				subsequent advertisement prior to contact must include information disclosing
				that an insurance agent may contact the applicant if such is the
				fact.
t) Advertisements for
				policies designed to supplement Medicare shall not employ devices which are
				designed to create undue anxiety in the minds of the elderly. Such phrases as
				"here is where most people over 65 learn about the gaps in Medicare," or
				"Medicare is great, but ..." or which otherwise exaggerate the gaps in Medicare
				coverage are unacceptable. Phrases or devices which unduly excite fear of
				dependence upon relatives or charity are unacceptable. Phrases or devices which
				imply that long sicknesses or hospital stays are common among the elderly are
				unacceptable.
u) An advertisement
				which is an invitation to contract implying that the coverage is supplemental
				to Medicare, if it does not explain the manner in which it is supplemental to
				Medicare coverage, is not acceptable.
v) An advertisement which is an invitation to
				contract for Medicare supplement insurance is unacceptable if the
				advertisement:
1) Fails to disclose in clear
				language which of the Medicare benefits the policy is not designed to
				supplement or if it otherwise implies that Medicare provides only those
				benefits which the policy is designed to supplement;
2) Describes the in-patient hospital coverage
				of Medicare as "Medicare hospital," or "Medicare Part A" when the policy does
				not supplement the non-hospital or the psychiatric hospital benefits of
				Medicare Part A;
3) Fails to
				describe clearly the operation of the Part or Parts of Medicare which the
				policy is designed to supplement; or
4) Describes those Medicare benefits not
				supplemented by the policy in such a way as to minimize their importance
				relative to the Medicare benefits which are supplemented.