Section R590-146-6 - Policy Provisions(1) Except for a permitted preexisting condition clause, a policy or certificate may not be advertised, solicited, or issued for delivery as a Medicare supplement insurance policy if the policy or certificate contains a preexisting limitation or exclusion that is more restrictive than those of Medicare.(2) A policy or certificate may not use waivers to exclude, limit, or reduce coverage or benefits for specifically named or described preexisting diseases or physical conditions.(3) A policy or certificate may not contain benefits that duplicate benefits provided by Medicare.(4)(a) Subject to Subsections R590-146-7(1)(d), R590-146-7(1)(e), R590-146-7(1)(g), R590-146-8(1)(d), and R590-146-8(1)(e), a policy with benefits for outpatient prescription drugs in existence before January 1, 2006, shall be renewed for current policyholders who do not enroll in Medicare Part D at the option of the policyholder.(b) A policy with benefits for outpatient prescription drugs may not be issued after December 31, 2005.(c) After December 31, 2005, a policy with benefits for outpatient prescription drugs may not be renewed after the policyholder enrolls in Medicare Part D unless: (i) the policy is modified to eliminate outpatient prescription coverage for expenses of outpatient prescription drugs incurred after the effective date of the individual's coverage under a Medicare Part D plan; and(ii) premiums are adjusted to reflect the elimination of outpatient prescription coverage as of Medicare Part D enrollment, accounting for any claims paid.Utah Admin. Code R590-146-6
Amended by Utah State Bulletin Number 2019-13, effective 6/7/2019Adopted by Utah State Bulletin Number 2024-16, effective 8/7/2024