State RegulationsTN specificDifficulty 3/5
A Tennessee insurer adds eligibility conditions to its Medicare supplement product that go beyond the standards established in state law and refuses applicants who meet the statutory criteria. How should this practice be characterized?
Select an option to reveal the answer and the full 3-part explanation — free, no signup.
Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
T.C.A. § 56-7-1453, implemented through Tenn. Comp. R. & Regs. 0780-1-58-.13 and -.14, establishes who is eligible for Medicare supplement coverage in Tennessee. An applicant who meets those standards cannot be turned away on extra conditions the insurer invented, because the statutory and departmental criteria define eligibility and the Tennessee Department of Commerce & Insurance enforces them.
Why the other options are wrong
- A) Stricter-than-statutory eligibility conditions are not permitted; the statute and rules set the operative criteria.
- C) Printing nonconforming conditions in an outline of coverage does not make them lawful.
- D) The impropriety is not limited to preexisting-condition conditions; any extra hurdle that defeats statutory eligibility is improper.
Memory hook
Statutory eligibility is a floor, not a suggestion.