Oklahoma Administrative Code › Title 365 - Insurance Department › Chapter 10 - Life, Accident and Health › Subchapter 5 - Minimum Standards; Contract Guidelines › Part 13 - MEDICARE SUPPLEMENT INSURANCE MINIMUM STANDARDS › Section 365:10-5-128.4 - Standard Medicare supplement benefit plans for 2020 standardized Medicare supplement benefit plan policies or certificates issued for delivery to individuals newly eligible for Medicare on or after January 1, 2020

Current through Vol. 41, No. 20, July 1, 2024
(a)
MACRA Requirements.
The
				  Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires the
				  following standards are applicable to all Medicare supplement policies or
				  certificates delivered or issued for delivery in this state to individuals
				  newly eligible for Medicare on or after January 1, 2020. No policy or
				  certificate that provides coverage of the Medicare Part B deductible may be
				  advertised, solicited, delivered or issued for delivery in this state as a
				  Medicare supplement policy or certificate to individuals newly eligible for
				  Medicare on or after January 1, 2020. All policies must comply with the
				  following benefit standards. Benefit plan standards applicable to Medicare
				  supplement policies and certificates issued to individuals eligible for
				  Medicare before January 1, 2020, remain subject to the requirements of O.A.C.
				  365:10-5-126,
				  365:10-5-127,
				  365:10-5-127.1,
				  365:10-5-128 and
				  365:10-5-128.2.
(b)
Benefit Requirements.
The
				  standards and requirements of O.A.C.
				  365:10-5-128.2 shall apply to all
				  Medicare supplement policies or certificates delivered or issued for delivery
				  to individuals newly eligible for Medicare on or after January 1, 2020, with
				  the following exceptions:
(1) Standardized
				  Medicare supplement benefit Plan C is redesignated as Plan D and shall provide
				  the benefits contained in O.A.C.
				  365:10-5-128.2(f)(3)
				  but shall not provide coverage for one hundred percent (100%) or any portion of
				  the Medicare Part B deductible.
(2)
				  Standardized Medicare supplement benefit Plan F is redesignated as Plan G and
				  shall provide the benefits contained in O.A.C.
				  365:10-5-128.2(f)(5)
				  but shall not provide coverage for one hundred percent (100%) or any portion of
				  the Medicare Part B deductible.
(3)
				  Standardized Medicare supplement benefit plans C, F, and F with High Deductible
				  may not be offered to individuals newly eligible for Medicare on or after
				  January 1, 2020.
(4) Standardized
				  Medicare supplement benefit Plan F With High Deductible is redesignated as Plan
				  G With High Deductible and shall provide the benefits contained in O.A.C.
				  365:10-5-128.2(f)(6)
				  but shall not provide coverage for one hundred percent (100%) or any portion of
				  the Medicare Part B deductible; provided further that, the Medicare Part B
				  deductible paid by the beneficiary shall be considered an out-of-pocket expense
				  in meeting the annual high deductible.
(5) The reference to Plans C or F contained
				  in O.A.C 365:10-5-128.2(b)
				  is deemed a reference to Plans D or G for purposes of this
				  section.