[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1614 Introduced in House (IH)]







104th CONGRESS
  1st Session
                                H. R. 1614

   To amend the provisions of title XVIII of the Social Security Act 
 relating to Medigap policies to eliminate age rating in premiums, and 
                          for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 11, 1995

Mr. Durbin (for himself, Mr. Kleczka, Mr. Meek of Florida, Mr. Pallone, 
  Mr. Ackerman, Mr. Waxman, Mr. McDermott, Ms. Pelosi, Mr. Frost, Mr. 
  Kennedy of Rhode Island, Ms. Kaptur, Mr. Stark, Mr. Olver, Mr. Gene 
Green of Texas, Mr. Coleman, Mr. Gonzalez, Mr. Oberstar, Mr. Yates, and 
Mr. Hilliard) introduced the following bill; which was referred to the 
                         Committee on Commerce

_______________________________________________________________________

                                 A BILL


 
   To amend the provisions of title XVIII of the Social Security Act 
 relating to Medigap policies to eliminate age rating in premiums, and 
                          for other purposes.
    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medigap Consumer Protection Act of 
1995''.
SEC. 2. ELIMINATING ATTAINED AGE RATING FOR INCREASES IN PREMIUMS FOR 
              MEDIGAP POLICIES.

    Section 1882(r) of the Social Security Act (42 U.S.C. 1395ss(r)) is 
amended--
            (1) in paragraph (1)--
                    (A) by striking ``and'' at the end of subparagraph 
                (A),
                    (B) by striking the period at the end of 
                subparagraph (B) and inserting ``; and'', and
                    (C) by inserting after subparagraph (B) the 
                following:
            ``(C) the premium for the policy does not increase in any 
        way on the basis of the age attained after enrollment by the 
        policyholder or certificateholder.'';
            (2) by redesignating paragraph (6) as paragraph (7);
            (3) by inserting after paragraph (5) the following new 
        paragraph:
    ``(6) In the case of a medicare supplemental policy in effect on 
the effective date of regulations to carry out paragraph (1)(C), and 
which does not meet the requirements of such paragraph on such date, 
the policy shall be considered to meet the requirement of such 
paragraph only if the issuer of the policy makes available to the 
policyholder the option of replacing such policy at the time of the 
policyholder's next renewal period with a medicare supplemental policy 
which meets the requirements of paragraph (1)(C) and all other 
applicable requirements of this subsection.''; and
            (4) in paragraph (7)(A) (as redesignated by paragraph (2)), 
        by inserting ``or the requirements of paragraph (1)(C) or 
        paragraph (6)'' after ``the loss ratio requirements of this 
        subsection''.

SEC. 3. EFFECTIVE DATE.

    (a) NAIC Standards.--If, within 6 months after the date of the 
enactment of this Act, the National Association of Insurance 
Commissioners (in this subsection referred to as the ``NAIC'') makes 
changes in the 1991 NAIC Model Regulation (as defined in section 
1882(p)(1)(A) of the Social Security Act) to incorporate the additional 
requirements imposed by the amendments made by this Act, section 
1882(g)(2)(A) of such Act shall be applied in each State, effective for 
policies issued to policyholders on and after the date specified in 
subsection (c) (or, with respect to the requirements imposed by section 
1882(r)(6) of such Act, effective as of the date specified in 
subsection (c) for policies issued before such date), as if the 
reference to the Model Regulation adopted on June 6, 1979, were a 
reference to the 1991 NAIC Model Regulation (as so defined) as changed 
under this paragraph (such changed Regulation referred to in this 
section as the ``1995 NAIC Model Regulation'').
    (b) Secretary Standards.--If the NAIC does not make changes in the 
1991 NAIC Model Regulation (as so defined) within the 6-month period 
specified in subsection (a), the Secretary of Health and Human Services 
(in this section as the ``Secretary'') shall promulgate within 90 days 
of the end of such period a regulation and section 1882(g)(2)(A) of the 
Social Security Act shall be applied in each State, effective for 
policies issued to policyholders on and after the date specified in 
subsection (c) (or, with respect to the requirements imposed by section 
1882(r)(6) of such Act, effective as of the date specified in 
subsection (c) for policies issued before such date), as if the 
reference to the Model Regulation adopted in June 6, 1979, were a 
reference to the 1991 NAIC Model Regulation (as so defined) as changed 
by the Secretary under this subsection (such changed Regulation 
referred to in this section as the ``1995 Federal Regulation'').
    (c) Date Specified.--
            (1) In general.--Subject to paragraph (2), the date 
        specified in this subsection for a State is the earlier of--
                    (A) the date the State adopts the 1995 NAIC Model 
                Regulation or the 1995 Federal Regulation; or
                    (B) 1 year after the date the NAIC or the Secretary 
                first adopts such regulations.
            (2) Additional legislative action required.--In the case of 
        a State which the Secretary identifies, in consultation with 
        the NAIC, as--
                    (A) requiring State legislation (other than 
                legislation appropriating funds) in order for medicare 
                supplemental policies to meet the 1995 NAIC Model 
                Regulation or the 1995 Federal Regulation, but
                    (B) having a legislature which is not scheduled to 
                meet in 1996 in a legislative session in which such 
                legislation may be considered,
        the date specified in this subsection is the first day of the 
        first calendar quarter beginning after the close of the first 
        legislative session of the State legislature that begins on or 
        after January 1, 1996. For purposes of the previous sentence, 
        in the case of a State that has a 2-year legislative session, 
        each year of such session shall be deemed to be a separate 
        regular session of the State legislature.
                                 <all>