Which change may a Medicare supplement issuer make unilaterally to a Medicare supplement policy while the policy is in force?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
Under New York's Medicare supplement standards, a guaranteed renewable policy may not be changed by the issuer while it is in force except in narrow ways: benefits designed to cover Medicare cost-sharing amounts may be adjusted to coincide with changes in the applicable Medicare deductible and copayment amounts, the policy may be amended to meet minimum Medicare supplement standards, and premium rates may be revised on a class basis. Adjusting cost-sharing benefits to track Medicare's own changes is therefore the only unilateral change listed that is permitted.
Why the other options are wrong
- A) Adding a new exclusion for a condition developed after issue is not among the permitted changes; the issuer has no unilateral right to reduce in-force coverage that way.
- B) Premiums may be revised only on a class basis; an individual rate increase tied to one insured's claims is prohibited.
- D) Age is not a permissible cancellation or nonrenewal ground; only nonpayment of premium or material misrepresentation supports nonrenewal.
Memory hook
Issuer's only unilateral Medigap changes: track Medicare cost-sharing, meet minimum standards, class-rate premiums.