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SF 71

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2025 Regular Session Introduced by Ocean Andrew and 6 co-sponsors

SF 71 broadens Medicare supplement open enrollment protections by banning health-status underwriting and permitting moves to policies with equal or fewer benefits during open enrol

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Bill Summary · SF 71

Summary of Senate File 71 (SF 71)

SF 71 is a bill relating to Medicare supplement (Medigap) policies and the annual open enrollment period. The measure is sponsored by Rozenboom (primary) and, as of the latest actions, the Subcommittee recommended passage.

Purpose and intent

  • Strengthen consumer protections during the annual open enrollment period for Medicare supplement policies.
  • Extend open enrollment rights to a broader group by defining eligible applicants to include individuals under age 65 who qualify for Medicare due to disability, end-stage renal disease (ESRD), or exposure to an environmental hazard.
  • Allow applicants flexibility to switch to a policy with the same or fewer benefits than their current policy at the start of open enrollment.

Key provisions and changes

  • Open enrollment protections during the annual period:

    • Issuers may not deny, or condition the issuance or effectiveness, of any Medicare supplement policy available in the state.
    • Prohibits medical underwriting or any health-status-based pricing discrimination for applicants during open enrollment.
    • Prohibits exclusion of benefits based on an applicant’s preexisting condition.

  • Rights during open enrollment:

    • An applicant may choose a Medicare supplement policy or certificate with the same or lesser benefits than the current policy/certificate at the start of open enrollment.
    • Issuers must provide notice of the annual open enrollment period in a form prescribed by the Commissioner of Insurance at the time an applicant applies for a Medicare supplement policy or certificate.

  • Definitions:

    • “Applicant” includes individuals under age 65 who qualify for Medicare due to disability, ESRD, or exposure to an environmental hazard.
    • “Medicare supplement policy” and “Issuer” are defined terms (as used in the bill) to standardize application and underwriting rules.
    • The bill also references “group Medicare supplement policy,” indicating applicability to group offerings as defined in state law.

Who is affected

  • Individuals seeking Medicare supplement coverage, including:
    • Those under age 65 who qualify for Medicare due to disability, ESRD, or environmental hazard exposure.
    • All applicants during the annual open enrollment period.
  • Insurance issuers offering Medicare supplement policies (and group plans) operating in the state.
  • The State’s Commissioner of Insurance, which would prescribe enrollment notices.

Procedural and timeline aspects

  • Introduced: January 21, 2025.
  • Legislative actions:
    • Subcommittee meeting on January 29, 2025, with a hearing scheduled for February 3, 2025.
    • Subcommittee recommendation: passage on February 3, 2025.
  • Status: Subcommittee recommends passage; bill would move to further committee consideration.

Impact and considerations

  • Expected impact includes broader protection against underwriting and pricing discrimination during open enrollment, potential disruption to existing underwriting practices, and clearer communication requirements for applicants.
  • Insurers may need to adjust notice forms and ensure compliance with the annual open enrollment protections and eligibility definitions.

Compiled from official sources — confirm details with the bill’s official record.

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