Plan N Underwriting and Application Changes
As claim experience continues to be higher than expected on Plan N, Mutual of Omaha and its affiliates are taking action to prevent continued poor experience and limit future rate increases. Planned changes to the underwriting requirements for Medicare supplement Plan N enrollments will still offer an alternative to a fully underwritten Medicare supplement product. The requirements are being standardized for ALL Mutual, United World and United of Omaha states where Plan N is currently offered with the exception of New York. In New York, no health questions may be asked, per state regulations. Also note that no health questions are asked when an individual is in an Open enrollment period or Guarantee Issue situation. These underwriting changes required the filing and approval of a new Medicare supplement application. The time frame for implementation of these underwriting changes is contingent on the approval of the new application. For the states listed, the new application has been approved and the new underwriting guidelines below will be effective with applications signed on or after February 16, 2011.
United World- AL, MT, ND, NM, PA, UT and WY
United of Omaha- AR, AZ, IA, IL, IN, KY, LA, MI, MO, NH, OH, OK, OR, SC, TN, TX, WV and WI
Underwriting Changes for Plan N:
1. All Plan N applicants will be subject to normal requirements for:
• Tobacco rates
• Height/weight rate ups or declines using the BMI calculation (United of Omaha states only)
2. All Plan N applicants will be subject to pharmaceutical screens. A HIPAA authorization is required
3.When outside Open Enrollment or Guarantee Issue: (Directions as to which questions must be answered appear on the application at the start of the Health Questions Sections) • Plan N applicants with no prior coverage will be required to answer all of the “normal” health questions, same questions as those required for all other plans
• Plan N applicants replacing other coverage (includes Medicare supplement, Medicare Advantage, group medical, etc.) only have to answer the limited number of health questions below:
1)Are you currently hospitalized or confined to a nursing facility; or, are you bedridden or confined to a wheelchair?
2)Have you been advised by a physician to have surgery, medical tests, treatment or therapy that has not been performed?
3)Have you been diagnosed with any of the following: a)Kidney disease requiring dialysis? b)Chronic obstructive pulmonary disease (COPD) or other chronic pulmonary disorders?
4)Within the past two years have you been treated for or been advised by a physician to have treatment for a heart attack; heart, coronary, or carotid artery disease; or heart rhythm disorders?
NOTE:
Plan N applications (in the states noted above) that are signed on or after February 16th using the old application will be returned and the applicant will be subjected to the new underwriting requirements
