Administrative Rule Review Report  #AR09-027

Legislative Service Office

01-June-09

AGENCY: Wyoming Insurance Department.

DATE SUBMITTED: May 19, 2009.

SUBJECT: Chapter 35, Medicare Supplement Regulation.

NATURE OF RULES:                        Legislative.

STATUTORY AUTHORITY:            W.S. 26-38-203(b).

DETERMINATION OF PROCEDURAL COMPLIANCE BASED UPON INFORMATION SUBMITTED BY THE AGENCY TO LSO:      Apparently complete to date.

SUMMARY OF RULES:           The amendments to these rules are required under federal law.  Recent changes to the federal Medicare Improvements for Patients and Providers Act (MIPPA) and the Genetic Information Nondiscrimination Act (GINA) require the department to update these rules to retain primacy in regulation of Medicare supplement products in this state.  The amendments provide differing standards for products approved prior to the Omnibus Budget Reconciliation Act of 1990, for products approved between 1990 and 2010, and for products approved after June 1, 2010.  For products approved after June 1, 2010 a new section 8.1 of the rules provides the standards for those policies.  In contrast to the standards for policies approved between 1990 and 2010, there are no standards for the following benefits, which have been eliminated or are no longer applicable:  80% coverage of the Part B excess charge, basic outpatient prescription drug benefits, extended outpatient prescription drug benefits, preventative medical care benefits and at-home recovery benefits.

With respect to different plans offered, some plans have changed under federal law and the rules reflect those changes.  Additionally, under the recent changes to MIPPA, medigap carriers wishing to offer Medicare supplemental plans must at least offer Plan A.  If the provider wishes to provide any additional plans, they must at least provide Plan C or F.

The Secretary of State’s Rules on Rules provide that an agency need not provide a full strikeout and underline version of the rules if the changes are substantial.  The department of insurance did not provide a strikeout and underline version of these rules, but did provide a succinct synopsis of the changes reflected in the rules.  A copy of this synopsis is attached to the rule packet.

FINDINGS:  The rules appear to be within the scope of statutory authority and legislative intent.

STAFF RECOMMENDATION:  That the rules be placed on the Consent List and be approved by the Council as submitted by the Agency.

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Lynda Cook

Staff Attorney

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David K. Gruver

Assistant Director