4. Detailed explanation of statutory authority for the rule (including the statutory citation and language):
Wis. Stat. § 632.81 provides “the commissioner may by rule establish minimum standards for benefits, claims payments, marketing practices, compensation arrangements and reporting practices for medicare supplement policies, medicare replacement policies and long-term care insurance policies.” Federal law provides that state regulation of Medicare supplemental policies must meet or exceed the NAIC model standards. 42 U.S.C. 7 § 1935ss (k) (3) provides that no Medicare supplemental policy may be certified by the Secretary, no certification shall remain in effect, and no state regulatory program shall be found to meet or continue to meet requirements “unless such policy meets (or such program provides for the application of standards equal to or more stringent than) the standards set forth in the amended NAIC Model Regulation…” NAIC recently published an updated NAIC Model Act and guidelines in 2017.
5. Estimate of amount of time that state employees will spend developing the rule and of other resources necessary to develop the rule:
50 hours
6. List with description of all entities that may be affected by the proposed rule:
Entities that are affected include: insurance companies providing Medicare supplemental insurance policies or Medicare cost insurance policies, insurance agents selling Medicare supplemental insurance policies or Medicare cost insurance policies, and consumers who will be eligible for Medicare coverage on or after January 1, 2020.
7. Summary and preliminary comparison with any existing or proposed federal regulation that is intended to address the activities to be regulated by the proposed rule:
The NAIC Model Act implements MACRA and previous federal Medicare supplement and Medicare replacement regulations. MACRA requires specific standards for Medicare supplement policies or certificates issued to individuals who are newly eligible for Medicare on or after January 1, 2020.
8. Anticipated economic impact of implementing the rule:
Insurers will need to produce, submit and create new forms for use by the companies and their authorized representatives. Once reviewed and approved by the Commissioner, these forms are frequently published online reducing the on-going cost with the new and modified forms. The rule is unlikely to have a significant impact on small businesses as insurance intermediaries will have little to no cost access to the new policy forms.
