Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-8 - MEDICARE SUPPLEMENT INSURANCE › Rule 120-2-8-.17 - Required Disclosure Provisions

Current through Rules and Regulations filed through June 27, 2024
(1) General Rules.
(a) Medicare supplement policies and
				certificates shall include a renewal or continuation provision. The language or
				specifications of the provision shall 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.
(b)
				Except for riders or endorsements by which the issuer effectuates a request
				made in writing by the insured, 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
				that reduce or eliminate benefits or coverage in the policy shall require a
				signed acceptance by the insured. After the date of policy or certificate
				issue, any rider or endorsement that increases benefits or coverage with a
				concomitant increase in premium during the policy term shall be agreed to in
				writing signed by the insured, unless the benefits are required by the minimum
				standards for Medicare supplement policies, or 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, the premium charge
				shall be set forth in the policy.
(c) 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.
(d) 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."
(e) 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 thirty (30) days of its delivery and to have the premium
				refunded if, after examination of the policy or certificate, the insured person
				is not satisfied for any reason.
(f)
1.
				Issuers of accident and sickness policies or certificates which 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 in the form developed jointly by the
				National Association of Insurance Commissioners and CMS and in a type size no
				smaller than 12 point type. Delivery of the Guide shall be made whether or not
				the policies or certificates are advertised, solicited or issued as Medicare
				supplement policies or certificates as defined in this regulation. Except in
				the case of direct response issuers, delivery of the Guide shall be made to the
				applicant at the time of application and acknowledgment 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.
2. For the purposes of
				this section," form" means the language, format, type size, type proportional
				spacing, bold character, and line spacing.