HEARING - U.S. Senate Special Committee on Aging
HEARING - U.S. Senate Special Committee on Aging HEARING - U.S. Senate Special Committee on Aging
55 -7- regulators accelerated aient enforcement proceOures to curtail sales acuses. In 1979 HIA'As president wrote all eeier capenies end insurarce regulators cflno for Joint efforts to remedy sales abses by a few, but nevertheless emarrassing n-mber of agents. That sane year, the National Association of hsurance Omissioners appointed a special cols.mer-oriented Advisory Cmmittee on this isste, which 2 clued representatives from M, the FTC, cormsmer and senior citizen groups, and meibers of the insurance industry. As a result of the Advisory Cinittee's efforts, the NAIC then adopteo medel state standards later entraced on the federal level in the 1980 Baucus Amendment. Consequently, virtually all Medicare Supplement policies now on the market meet or exceed those standards. Additionally, this multi-interested Akvisory Cam:ittee developed the Guide to Fealth Insurance for People with Medicare, presently available through HCFA. Current state law reguires that this smplified buyers' guide be provided to purchasers of Medicare Supplement coverage, along with an outline of coverage depicting gaps in Medicare coverage and how particular Medicare Supplement policy benefits relate to these gaps. Also, current law reguires delivery of a special notice when replacement or addition to existing coverage is involved. The HIAA wuld be glad to furnish the toimittee with examples of these materials upon req#est. Further, state law reqirements dealing with Medicare Supplement policies offer the beneficiary the opportunity to return a policy within 30 days of purchase, as well as receive a full refund. Also, state laws dealing with Medicare Supplesent policies reqgre high loss ratios, truth in advertising, fair trade practices (incluclng sales, unaerwriting and clams practices, and simplified policy language requirements), and other valuable consumer protections.
56 To ensure that all of these controls are adequate, an NAIC subcsmmittee recently surveyed state insurance departments regarding citizens' complaints related to Meadigap insurance. This survey indicated that the limited number of camplaints were not the result of any deficiency in NA1C model laws. This same type of process outlined tor Medicare Supplement in protecting the aged is being unoertaken by the insurance industry and the NAIC regarding private long term care insurance. Qarrent efforts center upon developing regulations that will appropriately control the marketplace, yet facilitate experimentation and exploration of what consurers want to purchase in the long term care field. WHAT MEDIGAP POLICIE5 COVER Private Medicare Supplemental policies typically cover such out-of-pocket costs under Medicare as co-payments and deductibles for hespital and doctor services. In keeping with the Baucus Andeent to the 1980 Social Security Disability Act (P.L. 96-265), the states now recpre Medicare Supplement policies to meet certain minimum standards, as follows: - Coverage of Part A coinsurance for Medicare eligible expenses for hospi- talization from the 61st day through the 9Cth day in any Medicare benefit period; - Cverage of Part A coinsurance for Medicare eligible expenses incurred during use of Medicare's lifetime hospital inpatient reserve days;
- Page 7 and 8: 4 So the question before us is how
- Page 9 and 10: 6 the elderly, long-term health car
- Page 11 and 12: 8 ments for our retirement. I might
- Page 13 and 14: 10 Mrs. YELINECK. Well, it would be
- Page 15 and 16: 12 As I understand it, you have not
- Page 17 and 18: 14 Mrs. YELINECK. One does not expe
- Page 19 and 20: 16 Senator BURDICK. Well, thank you
- Page 21 and 22: 18 Mrs. YEL.INECK. No. I started ou
- Page 23 and 24: 20 Therefore-I am supposed to take
- Page 25 and 26: 22 Chairman MELCHER. Well, I am ple
- Page 27 and 28: 24 month. Let us assume it costs $1
- Page 29 and 30: 26 STATEMENT BY SENATOR PETE WILSON
- Page 31 and 32: 28 Mrs. RIEGER. We have; we have wo
- Page 33 and 34: 30 Four years ago this August was w
- Page 35 and 36: 32 she has only 50 percent vision i
- Page 37 and 38: 34 Senator HEINZ. So it is both a p
- Page 39 and 40: 36 rich. Indeed, in the academic co
- Page 41 and 42: 38 pointedly in the comment from Mr
- Page 43 and 44: 40 finding out is that it is very l
- Page 45 and 46: 42 industry's role in providing cat
- Page 47 and 48: 44 Senator HEINZ. So things are wor
- Page 49 and 50: 46 Chairman MELCHER. In exactly the
- Page 51 and 52: 48 plement policy, what should that
- Page 53 and 54: 50 - 2 - I am Robert Shapland, Vice
- Page 55 and 56: 52 - 4 - CATASTRIPC PROTECTION IiDE
- Page 57: 54 -6- MiCIGAP INSJRANCE: A RPL1C/P
- Page 61 and 62: 58 - 10 - The HJAA also endorses Me
- Page 63 and 64: 60 - 12 - Finally, given that Congr
- Page 65 and 66: 62 - 14 - A recent HLAA survey of o
- Page 67 and 68: 64 Chairman MELCHER. Senator Heinz.
- Page 69 and 70: 66 Mr. SHAPLAND. I think we are in
- Page 71 and 72: 68 Those problems are real problems
- Page 73 and 74: 70 Mr. SHAPLAND. Oh, no. There are
- Page 75 and 76: 72 comprehension, and it is growing
- Page 77 and 78: 74 that educational process, and we
- Page 79 and 80: 76 So we have supported and activel
- Page 81 and 82: 78 Mr. SHIAPLAND. How much would nu
- Page 83 and 84: 80 rently being offered by the indu
- Page 85 and 86: 82 Recently, Karri Lynn has started
- Page 87 and 88: 84 Mr. Chairman and Members of the
- Page 89 and 90: 86 standards for voluntary certific
- Page 91 and 92: 88 non-group subscribers of reporti
- Page 93 and 94: 90 We believe a new federal program
- Page 95 and 96: 92 However, public awareness is nee
- Page 97 and 98: 94 Item 3 Testi~ony of GAIL SHEARER
- Page 99 and 100: 96 to Secretary Bowen's proposals c
- Page 101 and 102: 98 -4- most-states do not monitor t
- Page 103 and 104: 100 Catastrophic Protection within
- Page 105 and 106: 102 - a - participants and in part
- Page 107 and 108: 104 - 2-- Consumers Union suV orts
55<br />
-7-<br />
regulators accelerated aient enforcement proceOures to curtail sales acuses.<br />
In 1979 HIA'As president wrote all eeier capenies end insurarce regulators<br />
cflno for Joint efforts to remedy sales abses by a few, but nevertheless<br />
emarrassing n-mber of agents. That sane year, the Nati<strong>on</strong>al Associati<strong>on</strong> of<br />
hsurance Omissi<strong>on</strong>ers appointed a special cols.mer-oriented Advisory<br />
Cmmittee <strong>on</strong> this isste, which 2 clued representatives from M, the FTC,<br />
cormsmer and senior citizen groups, and meibers of the insurance industry. As<br />
a result of the Advisory Cinittee's efforts, the NAIC then adopteo medel<br />
state standards later entraced <strong>on</strong> the federal level in the 1980 Baucus<br />
Amendment. C<strong>on</strong>sequently, virtually all Medicare Supplement policies now <strong>on</strong><br />
the market meet or exceed those standards.<br />
Additi<strong>on</strong>ally, this multi-interested Akvisory Cam:ittee developed the Guide<br />
to Fealth Insurance for People with Medicare, presently available through<br />
HCFA. Current state law reguires that this smplified buyers' guide be<br />
provided to purchasers of Medicare Supplement coverage, al<strong>on</strong>g with an outline<br />
of coverage depicting gaps in Medicare coverage and how particular Medicare<br />
Supplement policy benefits relate to these gaps. Also, current law reguires<br />
delivery of a special notice when replacement or additi<strong>on</strong> to existing coverage<br />
is involved. The HIAA wuld be glad to furnish the toimittee with examples of<br />
these materials up<strong>on</strong> req#est.<br />
Further, state law reqirements dealing with Medicare Supplement policies<br />
offer the beneficiary the opportunity to return a policy within 30 days of<br />
purchase, as well as receive a full refund. Also, state laws dealing with<br />
Medicare Supplesent policies reqgre high loss ratios, truth in advertising,<br />
fair trade practices (incluclng sales, unaerwriting and clams practices, and<br />
simplified policy language requirements), and other valuable c<strong>on</strong>sumer<br />
protecti<strong>on</strong>s.