North Dakota Code 26.1-36.1-05 – Medicare supplement policy disclosure standards
1. To provide for full and fair disclosure in the sale of Medicare supplement policies, no Medicare supplement policy or certificate may be delivered or issued for delivery in this state unless an outline of coverage is delivered to the applicant at the time application is made.
Terms Used In North Dakota Code 26.1-36.1-05
- Rule: includes regulation. See North Dakota Code 1-01-49
- State: when applied to the different parts of the United States, includes the District of Columbia and the territories. See North Dakota Code 1-01-49
2. The commissioner shall prescribe the format and content of the outline of coverage required by subsection 1. For purposes of this section, “format” means style, arrangement, and overall appearance, including such items as the size, color, and prominence of type and the arrangement of text and captions. The outline of coverage must include:
a. A description of the principal benefits and coverage provided in the policy.
b. A statement of the exceptions, reductions, and limitations contained in the policy. c. A statement of the renewal provisions, including any reservation by the insurer of a right to change premiums.
d. A statement that the outline of coverage is a summary of the policy issued or applied for and that the policy should be consulted to determine governing contractual provisions.
3. The commissioner may prescribe by rule a standard form and the contents of an informational brochure for persons eligible for Medicare which is intended to improve the buyer’s ability to select the most appropriate coverage and improve the buyer’s understanding of Medicare. Except in the case of direct response insurance policies, the commissioner may require by rule that the information brochure be provided to any prospective insureds eligible for Medicare concurrently with the delivery of the outline of coverage. With respect to direct response insurance policies, the commissioner may require by rule that the prescribed brochure be provided upon request to any prospective insureds eligible for Medicare, but in no event later than the time of policy delivery.
4. The commissioner may adopt rules for captions or notice requirements, determined to be in the public interest and designed to inform prospective insureds that particular insurance coverages are not Medicare supplement coverages, for all accident and health insurance policies sold to persons eligible for Medicare, other than:
a. Medicare supplement policies; or b. Disability income policies.
5. The commissioner may also adopt rules to govern the full and fair disclosure of the information in connection with the replacement of accident and sickness policies, subscriber contracts, or certificates by persons eligible for Medicare.