Ala. Admin. Code r. 482-1-071-.06
Current through Register Vol. 43, No. 1, October 31, 2024
Section 482-1-071-.06 - Policy ProvisionsA. Except for permitted preexisting condition clauses as described in Section 7A(1) and Section 8A(1) of this chapter, no policy or certificate may be advertised, solicited or issued for delivery in this State as a Medicare supplement policy if the policy or certificate contains limitations or exclusions on coverage that are more restrictive than those of Medicare.B. No Medicare supplement policy or certificate may use waivers to exclude, limit or reduce coverage or benefits for specifically named or described preexisting diseases or physical conditions.C. No Medicare supplement policy or certificate in force in the State shall contain benefits which duplicate benefits provided by Medicare.D.(1) Subject to Rules 482-1-071-.07 A(4), (5) and (7), and Rules 482-1-071-.08 A(4) and (5), a Medicare supplement policy with benefits for outpatient prescription drugs in existence prior to January 1, 2006 shall be renewed for current policyholders who do not enroll in Part D at the option of the policyholder.(2) A Medicare supplement policy with benefits for outpatient prescription drugs shall not be issued after December 31, 2005.(3) After December 31, 2005, a Medicare supplement policy with benefits for outpatient prescription drugs may not be renewed after the policyholder enrolls in Medicare Part D unless: (a) The policy is modified to eliminate outpatient prescription coverage for expenses of outpatient prescription drugs incurred after the effective date of the individual's coverage under a Part D plan and;(b) Premiums are adjusted to reflect the elimination of outpatient prescription drug coverage at the time of Medicare Part D enrollment, accounting for any claims paid, if applicable. Author: Commissioner of Insurance
Ala. Admin. Code r. 482-1-071-.06
New Rule: September 18, 1981; effective January 1, 1982. Revised: November 14, 1986; effective February 14, 1987. Revised: March 5, 1992; effective March 15, 1992. Revised: March 12, 1996; effective March 25, 1996. Revised: October 22, 1998; effective January 1, 1999. Revised: April 28, 1999; effective July 1, 1999. Revised: June 30, 2003; effective July 21, 2003. Filed with LRS July 11, 2003. Rule is not subject to the Alabama Administrative Procedure Act. Revised: July 14, 2005; effective August 1, 2005. Rule is not subject to the Alabama Administrative Procedure Act.Statutory Authority:Code of Ala. 1975, §§ 27-2-17, 27-19-50etseq.