Section 2220.59 - Notice of New or Innovative Benefits(a) For the purposes of this section, "issuer" has the same meaning as in Insurance Code section 10192.4(i).(b) An issuer that offers one or more Medicare supplement plans with a new or innovative benefit as described in Insurance Code section 10192.91(f)(1) (each such benefit a "new or innovative benefit" hereinafter) shall provide the Notice of New or Innovative Benefits described in subdivision (g) of this Section 2220.59 together with the annual notice required by Insurance Code section 10192.11(h)(1), whenever the issuer provides such annual notice to a current policyholder or certificate holder of any Medicare supplement plan offered by the issuer. The issuer shall provide a separate Notice of New or Innovative Benefits for each plan offered by the issuer that has a new or innovative benefit.(c) An issuer described in subdivision (b) of this section shall provide the Notice of New or Innovative Benefits described in subdivision (g) of this section together with the information required by Insurance Code section 10192.17(j), whenever the issuer provides such information to a prospective policyholder or certificate holder of any Medicare supplement plan offered by the issuer. The issuer shall provide a separate Notice of New or Innovative Benefits for each plan offered by the issuer that has a new or innovative benefit.(d) In the Notice of New or Innovative Benefits, the issuer shall disclose, using the format specified in the form of notice shown in subdivision (g) of this section, the issuer's name, the name of the plan described in the Notice of New or Innovative Benefits, and the issuer's contact information. At a minimum, the issuer's contact information shall include the issuer's mailing address and telephone number so that a current or prospective policyholder or certificate holder can request additional information about the issuer's Medicare supplement plans with new or innovative benefits.(e) In the Notice of New or Innovative Benefits, the issuer shall disclose, in the format specified in the form of notice shown in subdivision (g) of this section, the total annual premium for the new or innovative benefits. If the premium for the new or innovative benefits is subject to rating factors, the issuer shall attach to the Notice of New or Innovative Benefits a rate sheet listing the amount of premium for the new or innovative benefits.(f) In the table within the Notice of New or Innovative Benefits, the issuer shall list each new or innovative benefit, a detailed description of each new or innovative benefit to the extent it is necessary to accurately describe the benefit, any limitations that apply to each new or innovative benefit, and the policyholder's or certificate holder's out-of-pocket cost, other than the annual premium, for each new or innovative benefit. The issuer may remove rows from, or add rows to, the table shown in subdivision (g) of this section, ensuring that the information described in this subdivision (f) is included for all covered new or innovative benefits.(g) The Notice of New or Innovative Benefits shall be in the following form; if the plan in question does not use a network of providers, the issuer shall omit the "YOUR OUT-OF-POCKET COSTS (In-Network Provider)" column, and shall omit "(Out-of-Network Provider)" from the heading of the remaining column, designated for out-of-pocket costs: Notice of New or Innovative Benefits
The purpose of this form is to notify consumers of the availability of a Medicare supplement plan offered for sale by [INSERT ISSUER NAME] that includes new or innovative benefits, in addition to the standardized coverage offered by the plan.
For additional information, please contact [INSERT ISSUER CONTACT INFORMATION].
New or innovative benefits added to Medicare supplement plan [INSERT PLAN NAME].
Total annual premium for new or innovative benefits only: $[XX.XX] [see attached rate sheet].
| NEW OR INNOVATIVE BENEFITS | YOUR OUT-OF-POCKET COSTS (In-Network Provider) | YOUR OUT-OF-POCKET COSTS (Out-of-Network Provider) |
| [New or innovative benefit, detailed description, and any limitations] | [Out-of-pocket cost] | [Out-of-pocket cost] |
| [New or innovative benefit, detailed description, and any limitations] | [Out-of-pocket cost] | [Out-of-pocket cost] |
| [New or innovative benefit, detailed description, and any limitations] | [Out-of-pocket cost] | [Out-of-pocket cost] |
Cal. Code Regs. Tit. 10, § 2220.59
Note: Authority cited: Section 10192.91, Insurance Code. Reference: Section 10192.91, Insurance Code.
1. New section filed 2-20-2024; operative 4/1/2024 (Register 2024, No. 8).