50 Ill. Adm. Code 2008.91
Instructions for Use of the Disclosure Statements for Health Insurance Policies Sold to Medicare Beneficiaries that Duplicate Medicare
Section 2008
Section 2008.91 Instructions
for Use of the Disclosure Statements for Health Insurance Policies Sold to
Medicare Beneficiaries that Duplicate Medicare
a) Section 1882(d) of the federal Social Security Act prohibits
the sale of health insurance policies (the term policy or policies includes
certificates) that duplicate Medicare benefits unless the policy will pay
benefits without regard to other health coverage and the policy includes the
prescribed disclosure statement on, or together with, the application.
b) All types of health insurance policies that duplicate Medicare
shall include one of the disclosure statements found in Appendix Q of this
Part, according to the particular policy type involved, on the application or
together with the application. The disclosure statement may not vary from
those found in Appendix Q of this Part in terms of language or format (type
size, type proportional spacing, bold character, line spacing, and usage of
boxes around text).
c) State and Federal law prohibits insurers from selling a
Medicare supplement policy to a person that already has a Medicare supplement
policy except as a replacement.
d) Property/Casualty and Life insurance policies are not
considered health insurance.
e) Disability income policies are not considered to provide
benefits that duplicate Medicare.
f) Traditional Long-Term Care or Long-Term Care Partnership
insurance policies that coordinate with Medicare and other health insurance are
not considered to provide benefits that duplicate Medicare.
g) The Federal law does not preempt Illinois law.
h) The Federal law does not preempt existing Illinois form filing
requirements.
i) Section 1882 of the federal Social Security Act was amended
in subsection (d)(3)(A) to allow for alternative disclosure statements. The
disclosure statements already in Appendix Q remain. Issuers may use either
disclosure statements with the requisite insurance product. However, issuers
should use either the original disclosure statements found in Appendix Q of
this Part or the alternative disclosure statements, not use both
simultaneously.