Sec. 2014. Prohibition on first-dollar coverage under Medigap policies and development of new standards for Medigap policies
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Section 1882 of the Social Security Act (42 U.S.C. 1395ss) is amended by adding at the end the following new subsections: The Secretary shall request the National Association of Insurance Commissioners to review and revise the standards for benefit packages under subsection (p)(1), taking into account the changes in benefits resulting from the enactment of the Fiscal Sustainability Act of 2013 and to otherwise update standards to include the requirements for cost-sharing described in paragraph (2).
Such revisions shall be made consistent with the rules applicable under subsection (p)(1)(E) with the reference to the 1991 NAIC Model Regulation’ deemed a reference to the NAIC Model Regulation as published in the Federal Register on December 4, 1998, and as subsequently updated by the National Association of Insurance Commissioners to reflect previous changes in law and the reference to ‘date of enactment of this subsection deemed a reference to the date of enactment of the Fiscal Sustainability Act of 2013 .
To the extent practicable, such revision shall provide for the implementation of revised standards for benefit packages as of January 1, 2015. The cost-sharing requirements described in this paragraph are that, notwithstanding any other provision of law, no medicare supplemental policy may provide for coverage of— any portion of the unified deductible under section 1899C(b) for the year; and more than 50 percent of the cost-sharing (excluding premiums) otherwise applicable under parts A and B after the individual has met the unified deductible under section 1899C(b) for the year and before the individual has reached the first threshold annual out-of-pocket limit under section 1899B(b)(1) for the year.
The renewability requirement under subsection (q)(1) shall be satisfied with the renewal of the revised package under paragraph
(1)that most closely matches the policy in which the individual was enrolled prior to such revision. Notwithstanding any other provision of law, a medicare supplemental policies may not be issued to an individual after December 31, 2016, unless the individual was covered under a medicare supplemental policy as of such date. Nothing in this subsection shall be construed as prohibiting— the renewal after December 31, 2016, of a medicare supplemental policy that was issued on or before such date; or the issuance of a new medicare supplemental policy after such date as long as the individual was covered under any medicare supplemental policy as of such date. .
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Sec. 2014
Prohibition on first-dollar coverage under Medigap policies and development of new standards for Medigap policies
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