Medicare Supplement Year-End Checklist

Management of a Medicare Supplement (Med Supp) block of business requires several financial reporting exhibits and filings to be completed at year-end.  For actuaries and financial professionals, completing the following items will keep you in compliance with state requirements.

1. Annual Statement Exhibits

Due Date:        March 1st

Purpose:
The Annual Statement serves as the core of the statutory reporting process.  For a Med Supp block, the exhibits show the earned premiums, incurred claims, policy counts, reserves, and administrative expenses generated by the business.  Some exhibits also reflect the impact of reinsurance assumed and ceded.

 Key Data Needed:

• Written, Collected and Earned Premium

• Incurred Claims

• Policy Count Details

• Statutory Reserves

• Expense Allocations

• Investment Income Allocations

2. Multi-Policy Reports

Due Date:       March 1st

Purpose:
Regulations prohibit carriers from issuing a Medicare supplement policy to individuals that results in multiple policies covering the same individual.  While carriers cannot validate that their customers aren’t covered by a policy issued by another insurer, they can validate that they do not have multiple policies covering the same customer.

Key Data Needed:

• Policyholder-level data

3. Medicare Supplement Insurance Experience Exhibit (MSIEE)

Due Date:        April 1st

Purpose:
The MSIEE provides a standardized, Med Supp–specific breakdown of experience by state, plan and issue year group. It is a key report for evaluating block performance and is often referenced in annual loss ratio and rate increase filings.

Key Data Needed:

• Earned Premium

• Incurred Claims

• In Force Policy Counts

• Issue-year segmentation

• State and Plan segmentation

4. Premium Refund and Credit Reports

Due Date:       May 31st

Purpose:
Under federal Med Supp regulations (42 U.S.C. § 1395ss), insurers must meet minimum loss ratio requirements (i.e., 65% for individual and 75% for group).  If a cohort fails to meet these requirements, a refund or premium credit must be issued.  Refund filings demonstrate minimum loss ratio compliance and ensure fairness to policyholders.

Key Data Needed:

• Earned Premium

• Paid Claims and Claim Reserve by Incurred Year

• Life Years of Exposure

• State and Plan segmentation

Conclusion

Completing these reporting requirements accurately and on time will keep your Med Supp blocks in compliance with regulatory officials.  If you have any questions about the timing or content of these items, our staff can help.