Rhode Island Code of Regulations › Title 230 - Department of Business Regulation › Chapter 20 - Insurance › Subchapter 30 - Health Insurance › Part 7 - Medicare Supplement Insurance Minimum Standards › Section 230-RICR-20-30-7.20 - Required Disclosure Provisions

Current through June 14, 2024
A. General Rules.
1. 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. The 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, 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 a
				  signed acceptance by the insured. After the date of policy or certificate
				  issue, any rider or endorsement which 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.
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 certificate holder 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.
6.
				  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 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.
7. For the
				  purposes of this section, "form" means the language, format, type size, type
				  proportional spacing, bold character, and line spacing.