January 2020 Comments on Model 171

Summary

Dated January 8, 2020, this letter from NAIC Consumer Representatives discusses the definition of “pre-existing condition” in Model #171. The representatives propose changes to ensure the definition is clear and consumer-friendly, such as basing it on medical advice received rather than a “prudent person” standard and shortening the look-back period. They emphasize the importance of transparency and consumer protection in the underwriting process.

Commen.Ltr_-Def-of-Pre-x-condition-in-Model-171_01.2020
January 2020 Comments on Model 171

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Prescription drugs
Other health
Other
Mental and behavioral health
Major reports
Long term care
Health equity
Appeals, denials, and prior authorization