# COMAR Title 31 — Maryland Insurance Administration

## Subtitle 10 — Health Insurance — General

### Chapter 06 — Standards for Medicare Supplement Policies

#### Regulation .22 Disclosure Statements.

*COMAR 31.10.06.22*

A. Instructions.

  (1) Section 1882(d) of the federal Social Security Act (42 U.S.C. 1395ss) prohibits the sale of a health insurance policy (the term policy includes certificate) to Medicare beneficiaries that duplicates Medicare benefits unless it will pay benefits without regard to a beneficiary's other health coverage and it includes the prescribed disclosure statement on or together with the application for the policy.

  (2) All types of health insurance policies that duplicate Medicare shall include one of the attached disclosure statements, according to the particular policy type involved, on the application or together with the application. The disclosure statement may not vary from the attached statements in terms of language or format (type size, type proportional spacing, bold character, line spacing, and usage of boxes around text).

  (3) State and federal law prohibits insurers from selling a Medicare supplement policy to a person that already has a Medicare supplement policy except as a replacement.

  (4) Property/casualty and life insurance policies are not considered health insurance.

  (5) Disability income policies are not considered to provide benefits that duplicate Medicare.

  (6) Long-term care insurance policies that coordinate with Medicare and other health insurance are not considered to provide benefits that duplicate Medicare.

  (7) The federal law does not preempt state laws that are more stringent than the federal requirements.

  (8) The federal law does not preempt existing state form filing requirements.

  (9) Section 1882 of the federal Social Security Act was amended in subsection (d)(3)(A) to allow for alternative disclosure statements. The disclosure statements already in §B of this regulation remain. Carriers may use either disclosure statement with the requisite insurance product. However, carriers shall use either the original disclosure statements or the alternative disclosure statements and not use both simultaneously.

  (10) Insurers shall use the disclosure statements found in §§B and C of this regulation if the disclosure statement was printed before January 1, 2006.

B. Original Disclosure Statements.

  (1) Accidental Injury Only Policies. The following is an original disclosure statement for policies that provide benefits for expenses incurred for an accidental injury only:

  (2) Specified Limited Services Policies. The following is an original disclosure statement for policies that provide benefits for specified limited services:

  (3) Expense Incurred Specified Disease Policies. The following is an  original disclosure statement for policies that reimburse expenses incurred for specified disease(s) or other specified impairment(s). This includes expense incurred cancer, specified disease and other types of health insurance policies that limit reimbursement to named medical conditions.

  (4) Fixed Dollar Specified Disease Policies. The following is an original disclosure statement for policies that pay fixed dollar amounts for specified diseases or other specified impairments. This includes cancer, specified disease, and other health insurance policies that pay a scheduled benefit or specific payment based on diagnosis of the conditions named in the policy.

  (5) Policies Providing Both Expense Incurred and Fixed Indemnity Benefits. The following is an Original disclosure statement for policies that provide benefits for both expenses incurred and fixed indemnity basis:

  (6) Policies Providing Fixed Dollar Benefits. The following is an original disclosure statement for indemnity policies and other policies that pay a fixed dollar amount per day, excluding long-term care policies:

  (7) Other Health Insurance Policies. The following is an original disclosure statement for other health insurance policies not specifically identified in the previous statements:

C. Alternative Disclosure Statements.

  (1) Accidental Injury Only Policies. The following is an alternative disclosure statement for policies that provide benefits for expenses incurred for an accidental injury only:

  (2) Specified Limited Services Policies. The following is an alternative disclosure statement for policies that provide benefits for specified limited services:

  (3) Expense Incurred Specified Disease Policies. The following is an alternative disclosure statement for policies that reimburse expenses incurred for specified diseases or other specified impairments. This includes expense-incurred cancer, specified disease, and other types of health insurance policies that limit reimbursement to named medical conditions.

  (4) Fixed Dollar Specified Disease Policies. The following is an alternative disclosure statement for policies that pay fixed dollar amounts for specified diseases or other specified impairments. This includes cancer, specified disease, and other health insurance policies that pay a scheduled benefit or specific payment based on diagnosis of the conditions named in the policy.

  (5) Policies Providing Both Expense Incurred and Fixed Indemnity Benefits. The following is an alternative disclosure statement for policies that provide benefits upon both an expense-incurred and fixed indemnity basis:

  (6) Policies Providing Only Fixed Dollar Benefits. The following is an alternative disclosure statement for indemnity policies and other policies that pay a fixed dollar amount per day, excluding long-term care policies:

  (7) Other Health Insurance Policies. The following is an alternative disclosure statement for other health insurance policies not specifically identified in the preceding statements: