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Section 5 - Right to Coverage; Conversion of Policies; Renewability; Cancellation

MA Gen L ch 176k § 5 (2019) (N/A)
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Section 5. Any eligible person who applies on or after a date set by the commissioner pursuant to regulation for a policy for medicare supplement insurance or medicare select insurance or a policy issued pursuant to a risk or cost contract from any carrier participating in the market in the commonwealth, during the six month period beginning at the time the person became initially eligible for coverage shall have the right to any of the policies for medicare supplement insurance or medicare select insurance authorized in the commissioner's regulations from any carrier that provides policies issued pursuant to a medicare supplement insurance or medicare select insurance contract, and shall have the right to the policy issued pursuant to a risk or cost contract authorized in the commissioner's regulations from any carrier that provides a policy issued pursuant to a risk or cost contract. The commissioner may require every carrier that participates in the market for medicare supplement insurance to offer more than a single type of benefit plan to an eligible person.

Notwithstanding any provision of this chapter concerning guaranteed renewability, the commissioner may by regulation establish a process for the conversion of every carrier's business in force as of a date established in such regulations into the policy for medicare supplement insurance or medicare select insurance or policy issued pursuant to a risk or cost contract authorized by section four. The commissioner may by regulation require that this conversion process be completed by the end of the third calendar quarter of nineteen hundred and ninety-four and implemented through a required special open enrollment period prior to July first, nineteen hundred and ninety-four, during which period eligible persons may enroll without a surcharge for late enrollment and upgrading.

Every policy for medicare supplement insurance or medicare select insurance or policy issued pursuant to a risk or cost contract authorized to be offered, sold, issued, delivered, or otherwise made effective, or renewed on or after a date established by the commissioner pursuant to this chapter shall be a guaranteed renewable plan with respect to an eligible person at the option of the eligible person. A carrier that participated in the market may, however, in its discretion and to the extent permitted by OBRA 90, refuse to offer, sell, issue, deliver, or otherwise make effective, or renew a medicare supplement insurance policy, medicare select insurance policy, or a policy issued pursuant to a risk or cost contract to, or upon reasonable notice, cancel such a plan of any person due to non-payment of premium or material misrepresentation, or because the person does not live in or has moved out of the health maintenance organization service area, or has not resided in the commonwealth for the past six months, or for any other cause which may be approved by the commissioner.

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Section 5 - Right to Coverage; Conversion of Policies; Renewability; Cancellation