Senior Issues (B) Task Force
Senior Issues (B) Task Force Page
Joint Executive (EX) / Plenary Committee Summary Report
Summer 2009 Meeting Summaries Index

The Senior Issues (B) Task Force met June 14, 2009.

During this meeting, the Task Force:

• Adopted revisions to the Long Term Care Insurance Model Act and Regulation that provide for independent review of benefit trigger decisions and prompt payment of claims.   
• Appointed a small subgroup to be chaired by Randy Moses (SD) to revise Appendix E of the Long Term Care Insurance Model Regulation to standardize claims reporting definitions. 
• Received an update on the implementation of the long-term care partnership program. Twenty-nine states have had state plan amendments approved by the Centers for Medicare and Medicaid Services (CMS) since the enactment of the Deficit Reduction Act of 2005. Twenty-three states are certifying partnership policies. One state, Wyoming, has a state plan amendment pending at CMS. Of the new states participating in the partnership, only one state—Wisconsin—has opted-out of reciprocity due to language in their enabling legislation, which they plan to correct. Of the four original partnership states, Connecticut and Indiana have opted-in to reciprocity. The Department of Health and Human Services (HHS) is collecting data from companies selling partnership policies and is committed to analyzing and posting data in very short order. A representative from HHS, Hunter McKay, is planning to attend the Fall National Meeting and hopes to have data to share.  

• Received an update on state adoption of revisions to the NAIC model regulation on Medicare supplement insurance, as required by the Genetic Information Nondiscrimination Act (GINA) and the Medicare Improvements for Patients and Providers Act (MIPPA). Forty-seven states responded to a joint survey by the NAIC and CMS. As of May 8, 13 of the 47 responding states have completed final adoption of the new rules. Of the responding states that have not yet completed adoption, all have taken substantial steps toward adoption, including holding public hearings, undergoing legislative review, publishing draft regulations, or submitting legislation to the governor for signature. Several more states are expected to complete their adoption this month as GINA’s July 1 deadline approaches. The majority of responding states (40 out of 47) do not require approval by their state legislatures. Of the seven states that do require legislature approval, three have already received such approval. Of the 40 states able to adopt the changes through their regulatory process, 10 have already completed that process. NAIC staff will continue to track state legislative and regulatory activity concerning implementation of these changes. 

• Received a report from the Accident and Health Working Group on their work on Medicare supplement and long-term care issues.

• Received revisions to the Medicare Supplement Compliance Manual from the Accident and Health Working Group. These revisions include a new section on new or improved benefits, which was originally drafted by the Task Force, and changes to include new 2010 standardized plans. The Task Force voted to accept and forward these revisions to the Health and Managed Care Committee with a recommendation that they be adopted. 

• Discussed issues regarding implementation of revisions to the Medicare supplement model regulation: rating and pooling issues, the five-year prohibition on discontinuance, and transition standards. The revisions to the Compliance Manual made by the Accident and Health Working Group include pooling of 1990 and 2010 standardized plans for the purposes of refund calculation and as otherwise necessary and appropriate. Otherwise, rating and pooling decisions are generally left up to state laws and regulations. 

• Distributed a memorandum from the Task Force’s subgroup on Medicare supplement implementation concerning the five-year prohibition from filing the same letter plan upon discontinuance of the plan as contained in Section 15E(b) of the NAIC model regulation on Medicare supplement insurance. The Subgroup suggests that states consider utilizing the commissioner discretion included in the model regulation to provide a one-year grace period to issuers of 1990 Medicare supplement plans who fail to file to offer the same letter plan by June 1, 2010, before making the five-year prohibition effective. Issuers should confirm with state departments of insurance that it is allowing the one-year grace period. This grace period would not apply to Medicare supplement plans K, L, M and N. 

• Discussed a concern that SERFF is not currently prepared to accept filings for new 2010 Medicare supplement plans. It was reported that new codes have been created for the 2010 plans, but that SERFF was not on track to accept filings until mid-2010. This is a concern, as states will need to accept numerous filings for 2010 Medicare supplement plans as early as possible. 

• Received a report from CMS staff on a number of Medicare supplement and Medicare private plan issues. CMS provided an update on developments concerning Medicare private plan agent compensation reporting requirements. CMS reported that they have begun an effort to consolidate low enrollment and duplicative Medicare Advantage plans for 2010. They have also revised their Medicare Marketing Guidelines, which are expected to be finalized in the next month. They also provided information about a proposal to send joint letters with state departments of insurance to directors of facilities with residents at high risk for agent marketing abuses. 

• Received a federal update on issues of importance to the Task Force, including new changes to Medicare supplement plans being considered by the Senate, potential Medicare reforms, and new long-term care legislation. 

Action Items:

• Adopted revisions to the Long Term Care Insurance Model Act and Regulation that provide for independent review of benefit trigger determinations and provide for the prompt payment of claims.

• Accepted revisions to the Medicare Supplement Compliance Manual and forwarded to the Health and Managed Care Committee with a recommendation that they be adopted.