§431:10A-307 - Disclosure standards.

     §431:10A-307  Disclosure standards.  (a)  In order to provide for full and fair disclosure in the sale of medicare supplement policies, no medicare supplement policy or certificate shall be delivered or issued for delivery in this State unless an outline of coverage is delivered to the applicant at or prior to the time application is made.

     (b)  The commissioner shall prescribe the format and content of the outline of coverage required by subsection (a).  For the purposes of this section, format means style, arrangement and overall appearance, including such items as the size, color, prominence of type, and the arrangement of text and captions.  The outline of coverage shall include:

     (1)  A description of the principal benefits and coverage provided in the policy;

     (2)  A statement of the renewal provisions including any reservation by the issuer of a right to change premiums; and disclosure of the existence of any automatic renewal premium increases based on the policyholder's age; and

     (3)  A statement that the outline of coverage is a summary of the policy issued or applied for and that the policy should be consulted to determine governing contractual provisions.

     (c)  The commissioner may prescribe by rule a standard form and contents of an informational brochure for persons eligible for medicare which is intended to improve the buyer's ability to select the most appropriate coverage and improve the buyer's understanding of medicare.  Except in the case of direct response insurance policies, the commissioner may require by rule that the informational brochure be provided to any prospective insureds eligible for medicare concurrently with delivery of the outline of coverage.  With respect to direct response insurance policies, the commissioner may require by rule that the prescribed brochure be provided upon request to any prospective insureds eligible for medicare, but in no event later than the time of policy delivery.

     (d)  The commissioner may adopt reasonable rules for captions or notice requirements, determined to be in the public interest and designed to inform prospective insureds that particular insurance coverages are not medicare supplement coverages, for all accident and health or sickness insurance policies sold to persons eligible for medicare, other than:

     (1)  Medicare supplement policies; or

     (2)  Disability income policies.

     (e)  The commissioner may adopt reasonable rules to govern the full and fair disclosure of information in connection with the replacement of accident and health or sickness insurance policies, subscriber contracts, or certificates by persons eligible for medicare. [L 1987, c 347, pt of §2; am L 1990, c 84, §6; am L 1992, c 195, §6; am L 1996, c 28, §5; am L 2002, c 155, §64]