1084

LAWS OF MARYLAND

Ch. 268

(4) (I) AFTER EXHAUSTION OF ALL MEDICARE
INPATIENT HOSPITAL COVERAGE, INCLUDING THE LIFETIME RESERVE
DAYS, COVERAGE, FOR A PERIOD OF 365 DAYS, OF 90 PERCENT OF
ALL MEDICARE PART A ELIGIBLE EXPENSES FOR HOSPITALIZATION
NOT COVERED BY MEDICARE; AND

(5) (II) COVERAGE OF THE INITIAL ANNUAL
DEDUCTIBLE AND OF 20 PERCENT OF THE AMOUNT OF MEDICARE
ELIGIBLE EXPENSES UNDER MEDICARE PART B REGARDLESS OF
HOSPITAL CONFINEMENT, WHICH COVERAGE MAY BE SUBJECT TO A
DEDUCTIBLE NOT IN EXCESS OF $200 IN ANY CALENDAR YEAR, AND
MAY BE SUBJECT TO A MAXIMUM BENEFIT IN ANY CALENDAR YEAR
NOT LESS THAN $5,000.

(C)  A MEDICARE SUPPLEMENT POLICY SHALL PROVIDE THAT
BENEFITS DESIGNED TO COVER DEDUCTIBLES OR COINSURANCE
AMOUNTS UNDER MEDICARE WILL BE CHANGED AUTOMATICALLY TO
COINCIDE WITH ANY CHANGES IN THE APPLICABLE MEDICARE
DEDUCTIBLE AND COPAYMENT PROVISIONS. SUBJECT TO APPROVAL BY
THE INSURANCE COMMISSIONER, THE INSURER MAY RESERVE THE
RIGHT TO CHANGE PREMIUMS TO CORRESPOND WITH THESE CHANGES IN
BENEFITS.

(D)  (1) PAYMENT OF A BENEFIT FOR A MEDICARE ELIGIBLE
EXPENSE UNDER A MEDICARE SUPPLEMENT POLICY MAY BE
CONDITIONED ON THE SAME OR LESS RESTRICTIVE PAYMENT
CONDITIONS, INCLUDING DETERMINATION OF MEDICAL NECESSITY, AS
ARE APPLICABLE TO A MEDICARE CLAIM.

(2) COVERAGE UNDER A MEDICARE SUPPLEMENT POLICY
MAY NOT BE SUBJECT TO ANY EXCLUSIONS, LIMITATIONS, OR
REDUCTIONS NOT CONSISTENT WITH THE EXCLUSIONS, LIMITATIONS,
OR REDUCTIONS UNDER MEDICARE, EXCEPT:

(I)  THE POLICY MAY SHALL PROVIDE THAT, TO
THE EXTENT A BENEFIT IS AVAILABLE TO THE INSURED PERSON
UNDER MEDICARE, COVERAGE IS NOT DUPLICATED FOR THE BENEFIT;
AND

(II)  AS OTHERWISE EXPRESSLY PERMITTED
UNDER THIS ARTICLE OR UNDER THE RULES AND REGULATIONS
ADOPTED BY THE COMMISSIONER UNDER THIS ARTICLE.

(E)  A MEDICARE SUPPLEMENT POLICY MAY NOT BE OFFERED AT
AN INTRODUCTORY PREMIUM RATE, UNLESS APPROVED BY THE
COMMISSIONER.

468D.

(A)  IN THIS SECTION "LOSS RATIO" MEANS THE RATIO OF
LOSSES INCURRED TO PREMIUMS EARNED ON POLICIES ISSUED,
DELIVERED, OR RENEWED IN THIS STATE.

(B)  THE COMMISSIONER SHALL ESTABLISH A REASONABLE
MINIMUM LOSS RATIO IN ACCORDANCE WITH GENERALLY ACCEPTED
ACTUARIAL PRINCIPLES WITH RESPECT TO MEDICARE SUPPLEMENT
POLICIES FOR THE PURPOSE OF ADMINISTERING §§ 375, 375A, AND
376 OF THIS ARTICLE.