Sec. 1652.051. MINIMUM STANDARDS. (a) The commissioner shall adopt reasonable rules to establish specific standards for provisions in Medicare supplement benefit plans and standards for facilitating comparisons of different Medicare supplement benefit plans. The standards are in addition to and must be in accordance with:
(1) applicable laws of this state, including Chapters 842 and 1201;
(2) applicable federal law, rules, regulations, and standards; and
(3) any model rules and regulations required by federal law, including Section 1882, Social Security Act (42 U.S.C. Section 1395ss).
(b) The standards may include provisions relating to:
(1) terms of renewability;
(2) initial and subsequent conditions of eligibility;
(3) nonduplication of coverage;
(4) probationary periods;
(5) benefit limitations, exceptions, and reductions;
(6) elimination periods;
(7) requirements for replacement;
(8) recurrent conditions;
(9) definitions of terms; and
(10) exclusions required by state or federal law.
(c) The commissioner may adopt reasonable rules that specifically prohibit benefit plan provisions that:
(1) are not otherwise specifically authorized by statute; and
(2) the commissioner determines are unjust, unfair, or unfairly discriminatory to a person who is covered or proposed for coverage.
(d) Rules adopted under this section must include requirements that are at least equal to those required by federal law, rules, regulations, and standards, including Section 1882, Social Security Act (42 U.S.C. Section 1395ss).
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 4, eff. April 1, 2005.
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