58-17A-2 Regulations to establish specific standards for policy provisions.
Regulations to establish specific standards for policy provisions.
The director shall
promulgate rules pursuant to chapter 1-26 to establish specific standards and requirements for
medicare supplement policies and certificates. The standards and requirements shall be in addition
to and in accordance with applicable laws of this state and may cover, but are not limited to:
Terms of renewability;
Initial and subsequent conditions of eligibility;
Nonduplication of coverage;
Benefit limitations, exceptions, and reductions;
Requirements for replacement;
Definitions of terms;
Filing requirements for forms and rates and rate schedules;
Compensation arrangements between insurers or other entities and their agents,
representatives, or producers;
Suitability and appropriateness of policy sold;
Data on application forms;
Continuation and conversion rights;
Loss ratio requirements and refund and credit calculations;
Suspension and reinstitution of coverage; and
Refund of premium for duplication and suspension and reinstitution of coverage.
The director may promulgate rules pursuant to chapter 1-26 that specify prohibited policy or
certificate provisions not otherwise specifically authorized by statute which, in the opinion of the
director, are unjust, unfair, or unfairly discriminatory to any person insured or proposed for coverage
under a medicare supplement policy or certificate. The director may also promulgate rules assuring
public access to rate and form information, establishing procedures for rate and form approvals or
disapprovals, and establishing a uniform methodology for calculating and reporting loss ratios.
The director shall promulgate rules pursuant to chapter 1-26 to establish minimum standards for
benefits and claims payment under medicare supplement policies and certificates and to establish
procedures for rate hearings.
Source: SL 1982, ch 360, § 2; SL 1989, ch 431, § 2; SL 1990, ch 396, § 2; SL 1992, ch 347, § 2.