Date: May 6, 2009
For more information contact: Jim Guidry, (608) 264-6239 or jim.guidry@wisconsin.gov
Insurance Commissioner Issues New Rules for Medicare Supplement Policies
Madison, WI—Insurance Commissioner Sean Dilweg has announced the recent adoption of an administrative rule to implement changes in the operation of Medicare supplement plans in Wisconsin. The rule changes result from federal legislation that adds options for Medicare supplement policies and incorporates federal restrictions on the use of genetic information.
"These rule changes will bring Wisconsin Medicare supplement requirements in line with federal standards," said Dilweg. "They also provide Wisconsin seniors with protection from genetic discrimination by insurers."
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) directed the National Association of Insurance Commissioners (NAIC) to make changes to the NAIC Medigap Model regulation and requires states to adopt the NAIC model revision by September 24, 2009, in order to continue to regulate the Medigap marketplace. In addition to MIPPA, the rule reflects changes required by the Genetic Information Nondiscrimination Act of 2008 (GINA). States are required to adopt necessary GINA changes by July 1, 2009.
In Wisconsin, Medicare supplement policies are standardized across insurers and the changes required under MIPPA create two additional riders for Medicare supplement plans: a Medicare Part A 50% deductible with no out-of-pocket maximum limitation and a Medicare Part B 100% deductible with co-payment requirements for office and emergency room visits.
GINA bans the use of genetic information in the Medicare supplement underwriting process. GINA also prohibits Medicare supplement insurers from requiring that an individual or a family member undergo a genetic test. An issuer may not request, require or purchase genetic information for use in underwriting.
"I am especially pleased that Medicare supplement policyholders will receive protection from the use or misuse of their genetic information," said Dilweg.
The rule was developed through the participation of OCI's Health Advisory Council, whose membership is made up of insurers, health care providers, and representatives of the business community and the public.
OCI publishes several informational brochures to help seniors understand the options for Medicare supplement policies that are available to them. Informational publications can be viewed on the OCI Web site at oci.wi.gov, or ordered free from the agency by writing to OCI Publications, P.O. Box 7873, Madison, WI 53707-7873, or by calling 800-236-8517.
Created by the Legislature in 1871, Wisconsin's Office of the Commissioner of Insurance (OCI) was vested with broad powers to ensure that the insurance industry responsibly and adequately met the insurance needs of Wisconsin citizens. Today, OCI's mission is to lead the way in informing and protecting the public and responding to its insurance needs.