R.C.S.A. § 38a-495a-6b
Standard Medicare Supplement Benefit Plans for 2020 Standardized Medicare Supplement Benefits Plan Policies or Certificates Issued for Delivery to Individuals Newly Eligible for Medicare on or After January 1, 2020
Cite as Conn. Agencies Regs. § 38a-495a-6b
Benefits Plan Policies or Certificates Issued for Delivery to Individuals Newly Eligible
for Medicare on or After January 1, 2020
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires that the
standards set forth in this section be applied to all Medicare supplement policies
or certificates delivered or issued for delivery in this state to individuals newly
eligible for Medicare on or after January 1, 2020. No policy or certificate that provides
coverage of the Medicare Part B deductible may be advertised, solicited, delivered
or issued for delivery in this state as a Medicare supplement policy or certificate
to individuals newly eligible for Medicare on or after January 1, 2020. Benefits plan
standards applicable to Medicare supplement policies and certificates issued to individuals
newly eligible for Medicare on or after January 1, 2020 must comply with the benefit
standards of subsections (a)(1) and (a)(5) of this section. Benefit plan standards
applicable to Medicare supplement policies and certificates issued to individuals
eligible for Medicare before January 1, 2020, remain subject to the requirements of
sections 38a-495a-5 and 38a-495a-5a of the Regulations of Connecticut State Agencies.
(a) Benefit Requirements. The standards and requirements of section 38a-495a-6a of the Regulations of Connecticut
State Agencies shall apply to all Medicare supplement policies or certificates delivered
or issued for delivery to individuals newly eligible for Medicare on or after January
1, 2020, with the following exceptions:
(1) Standardized Medicare supplement benefit Plan C is redesignated as Plan D and shall
provide the benefits contained in subsection (e)(3) of section 38a-495a-6a of the
Regulations of Connecticut State Agencies, but shall not provide coverage for one
hundred percent or any portion of the Medicare Part B deductible.
(2) Standardized Medicare supplement benefit Plan F is redesignated as Plan G and shall
provide the benefits contained in subsection (e)(5) of section 38a-495a-6a of the
Regulations of Connecticut State Agencies, but shall not provide coverage for one
hundred percent of any portion of the Medicare Part B deductible.
(3) Standardized Medicare supplement benefit plans C, F, and F With High Deductible may
not be offered to individuals newly eligible for Medicare on or after January 1, 2020.
(4) Standardized Medicare supplement benefit Plan F With High Deductible is redesignated
as Plan G With High Deductible and shall provide the benefits contained in subsection
(e)(6) of section 38a-495a-6a of the Regulations of Connecticut State Agencies, but
shall not provide coverage for one hundred percent or any portion of the Medicare
Part B deductible; provided further that the Medicare Part B deductible paid by the
beneficiary shall be considered an out-of-pocket expense in meeting the annual high
deductible.
(5) The reference to Plans C or F contained in subsection (a)(1)(B) of section 38a-495a-6a
of the Regulations of Connecticut State Agencies is deemed a reference to Plans D
or G for purposes of this section.
(b) Applicability to certain Individuals. This section applies only to individuals who are deemed to be eligible for benefits
under Section 226(a) of the Social Security Act on or after January 1, 2020, or individuals
who are newly eligible for Medicare on or after January 1, 2020:
(1) By reason of attaining age 65 on or after January 1, 2020; or
(2) By reason of entitlement to benefits under part A pursuant to Section 226(b) or 226A
of the Social Security Act.
(c) Guaranteed Issue for Eligible Persons. For purposes of subsection (e) of section 38a-495a-8a of the Regulations of Connecticut
State Agencies in the case of any individual newly eligible for Medicare on or after
January 1, 2020, any reference to a Medicare supplement policy C or F (including F
With High Deductible) shall be deemed to be a reference to Medicare supplement policy
D or G (including G With a High Deductible), respectively, that meet requirements
of subsection (a) of this section.
(d) Applicability to Waivered States. In the case of a state described in Section 1882 (p)(6) of the Social Security Act
("waivered" alternative simplification states), MACRA prohibits the coverage of the
Medicare Part B deductible for any Medicare supplement policy sold or issued to an
individual who is newly eligible for Medicare on or after January 1, 2020.
(e) Offer of Redesignated Plans to Individuals Other Than Newly Eligible Individuals. On or after January 1, 2020, the standardized benefit plans described in subsection
(a)(4) of this section may be offered to any individual who was eligible for Medicare
prior to January 1, 2020, in addition to the standardized plans described in subsection
(e) of section 38a-495a-6a of the Regulations of Connecticut State Agencies.