WASHINGTON STATUTES AND CODES

48.66.041 - Minimum standards required by rule -- Waiver.

Minimum standards required by rule — Waiver.

(1) The insurance commissioner shall adopt rules to establish minimum standards for benefits in medicare supplement insurance policies and certificates.

     (2) The commissioner shall adopt rules to establish specific standards for medicare supplement insurance policy or certificate provisions. These rules may include but are not limited to:

     (a) Terms of renewability;

     (b) Nonduplication of coverage;

     (c) Benefit limitations, exceptions, and reductions;

     (d) Definitions of terms;

     (e) Requiring refunds or credits if the policies or certificates do not meet loss ratio requirements;

     (f) Establishing uniform methodology for calculating and reporting loss ratios;

     (g) Assuring public access to policies, premiums, and loss ratio information of an issuer of medicare supplement insurance;

     (h) Establishing a process for approving or disapproving proposed premium increases; and

     (i) Establishing standards for medicare SELECT policies and certificates.

     (3) The insurance commissioner may adopt rules that establish disclosure standards for replacement of policies or certificates by persons eligible for medicare.

     (4) The insurance commissioner may by rule prescribe that an informational brochure, designed to improve the buyer's understanding of medicare and ability to select the most appropriate coverage, be provided to persons eligible for medicare by reason of age. The commissioner may require that the brochure be provided to applicants concurrently with delivery of the outline of coverage, except with respect to direct response insurance, when the brochure may be provided upon request but no later than the delivery of the policy.

     (5) In the case of a state or federally qualified health maintenance organization, the commissioner may waive compliance with one or all provisions of this section until January 1, 1983.