KRS 304.14-525: Restrictions on denying, conditioning, or discriminating in pricing of

Medicare supplement policies for applicants who meet requirements relating

to age, health conditions, and enrollment.

(1) As used in this section:

(a) "Non-age eligible person":

1. Means a person who is:

a. Under the age of sixty-five (65); and

b. Eligible for Medicare by reason other than age; and

2. Includes persons entitled to benefits under 42 U.S.C. sec. 426(b) or 426 -

1, as amended; and

(b) "Weighted average age d premium rate" means a premium rate calculated as

follows:

1. First, multiply the premium rate for each age band, age sixty -five (65)

and over, by the number of Kentucky insureds in -force in that age band

to arrive at the total Kentucky premium for each a ge band age sixty-five

(65) and over;

2. Then, calculate the sum of the Kentucky premium for all age bands age

sixty-five (65) and over to arrive at the total Kentucky premium for all

age bands age sixty-five (65) and over;

3. Then, calculate the sum of the Kentucky insureds in -force for all age

bands age sixty -five (65) and over to arrive at the total number of

Kentucky insureds in -force for all age bands age sixty -five (65) and

over; and

4. Last, divide the total determined under subparagraph 2. of this paragraph

by the total determined under subparagraph 3. of this paragraph to arrive

at the weighted average aged premium rate.

(2) Except as provided in subsection (3)(b)1. of this section, an insurer shall not deny,

condition the issuance or effectiveness of, or discriminate in the pricing of a

Medicare supplement policy available for sale in this state because of the health

status, claims experience, receipt of health care, or medical condition of an

applicant if the applicant:

(a) Submits an application for the policy prior to or during the six (6) month

period beginning on the first day of the first month in which the applicant is

both:

1. Sixty-five (65) years of age or older; and

2. Timely enrolled for benefits under Medicare Part B without penalty

under federal law;

(b) Is a non-age eligible person and:

1. Submits an application for the policy prior to or during the six (6) month

period beginning on the first day of the first month in which the non -age

eligible person is enrolled for benefits under Medicare Part B; or

2. Satisfies both of the following requirements:

a. The applicant was enrolled for benefits under Medicare Part B

prior to January 1, 2024; and

b. Either:

i. The applicant submits an application for the policy during

the six (6) month period beginning on January 1, 2024; or

ii. If an application is not available for the applicant to submit

under subpart i. of this subdivision on or before January 1,

2024, the applicant makes a request for an application for the

policy during the six (6) month period beginning on January

1, 2024; or

(c) Satisfies all of the following requirements:

1. At the time the application is submitted, the applicant is insured under a

Medicare supplement policy;

2. The application for the policy is submitted:

a. To an insurer that is different than the insurer that issued the

applicant's current Medicare supplement policy; and

b. Within sixty (60) days of the applicant's birthday date; and

3. The applicant seeks to maintain the same Medicare supplement plan.

(3) (a) Subject to paragraph (b) of this subsection, a ll Medicare supplement policies

available for sale in this state shall be made available to the applicants

referenced in subsection (2)(b) of this section.

(b) For policies made available to applicants referenced in subsection (2)(b) of

this section:

1. The applicant shall not be charged more than the weighted average aged

premium rate for the policy;

2. The insurer shall demonstrate compliance with subparagraph 1. of this

paragraph; and

3. The policy shall not contain any waiting period or pre-existing condition

limitation or exclusion.