South Carolina Code of Regulations › Chapter 69 - DEPARTMENT OF INSURANCE › Section 69-46 - Medicare Supplement Insurance

Current through Register Vol. 48, No. 6, June 28, 2024
Table of Contents
Table of Contents
Section 1.
Purpose
Section 2.
Authority
Section 3.
Applicability and Scope
Section 4.
Definitions
Section 5.
Policy Definitions and Terms
Section 6.
Policy Provisions
Section 7.
Minimum Benefit Standards for Pre-Standardized Medicare
						  Supplement Benefit Plan Policies or Certificates Issued for Delivery Prior to
						  May
						  1, 1992
Section 8.
Benefit Standards for 1991 Standardized Medicare Supplement
						  Benefit Plan Policies or Certificates Issued for Delivery on or After May 1,
						  1992 and With an Effective Date for Coverage Prior to June 1, 2010
Section 8.1
Benefit Standards for 2010 Standardized Medicare Supplement
						  Benefit Plan Policies or Certificates Issued for Delivery With an Effective
						  Date for Coverage on or After June 1, 2010
Section 9.
Standard Medicare Supplement Benefit Plans for 1990
						  Standardized Medicare Supplement Benefit Plan Policies or Certificates Issued
						  for Delivery on or After May 1, 1992 and With an Effective Date for Coverage
						  Prior to June 1, 2010.
Section 9.1
Standard Medicare Supplement Benefit Plans for
						  2010 Standardized Medicare Supplement
						  Benefit Plan Policies or Certificates issued for Delivery With an Effective
						  Date for Coverage on or After June 1, 2010.
Section 9.2
Standard Medicare Supplement Benefit Plans for 2020
						  Standardized Medicare Supplement Benefit Plan Policies or Certificates Issued
						  for Delivery on or After January 1, 2020.
Section 10.
Medicare Select Policies and Certificates
Section 11.
Open Enrollment
Section 12.
Guaranteed Issue for Eligible Persons
Section 13.
Standards for Claims Payment
Section 15.
Loss Ratio Standards and Refund or Credit of
						  Premium
Section 16.
Permitted Compensation Arrangements
Section 17.
Required Disclosure Provisions
Section 18.
Requirements for Application Forms and Replacement
						  Coverage
Section 19.
Filing Requirements for Advertising
Section 20.
Standards for Marketing
Section 21.
Appropriateness of Recommended Purchase and Excessive
						  Insurance
Section 22.
Reporting of Multiple Policies
Section 23.
Prohibition Against Preexisting Conditions, Waiting
						  Periods, Elimination Periods and Probationary Periods in Replacement Policies
						  or Certificates
Section 24.
Prohibition Against Use of Genetic Information and
						  Requests for Genetic Testing
Section 25.
Severability
Section 26.
Effective Date
Appendix A.
Reporting Form for Calculation of Loss Ratios
Appendix B.
Form for Reporting Duplicate Policies
Appendix C.
Disclosure Statements
Section 1. Purpose
The purpose of this regulation is to provide for the reasonable
			 standardization of coverage and simplification of terms and benefits of
			 Medicare Supplement policies; to facilitate public understanding and comparison
			 of such policies; to eliminate provisions contained in such policies which may
			 be misleading or confusing in connection with the purchase of such policies or
			 with the settlement of claims; and to provide for full disclosures in the sale
			 of accident and sickness insurance coverages to persons eligible for
			 Medicare.
Section 2.
		  Authority
This regulation is issued pursuant to the authority vested in the
			 director under S.C. Code Sections
			 38-3-110(2),
			 38-71-530(b)
			 and
			 1-23-10 et
			 seq.
Section 3.
		  Applicability and Scope
A. Except as
		  otherwise specifically provided in Sections
		  7, 13, 14, 17 and
		  22, this regulation shall apply to:
(1) All Medicare Supplement policies
		  delivered or issued for delivery in this state on or after the effective date
		  of this regulation; and
(2) All
		  certificates issued under group Medicare Supplement policies, which
		  certificates have been delivered or issued for delivery in this
		  state.