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054.00.27-6. POLICY PROVISIONS.

AR ADC 054.00.27-6Arkansas Administrative CodeEffective: February 1, 2018

West's Arkansas Administrative Code
Title 054. Insurance Department
Division 00.
Rule 27. Minimum Standards for Medicare Supplement Policies
Effective: February 1, 2018
Ark. Admin. Code 054.00.27-6
054.00.27-6. POLICY PROVISIONS.
Currentness
A. Except for permitted preexisting condition clauses as described in Section 7(A)(1), Section 8A(1), and Section 8.1A(1) of this rule, no policy or certificate may be advertised, solicited or issued for delivery in the State of Arkansas 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 may include a policy fee or any other similar charge. Applicants cannot be required to pay any fee other than the approved premium.
D. No Medicare supplement policy or certificate in force in the State shall contain benefits which duplicate benefits provided by Medicare.
E. (1) Subject to Sections 7 (A)(4), (5), and (7) and 8(A)(4) and (5) of this rule, 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.

Credits

Amended July 1, 2009; Feb. 1, 2018.
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 054.00.27-6, AR ADC 054.00.27-6
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