Due to the confusing landscape of choosing a Medicare Supplement, recipients should be able to change their carrier or plan without penalty of medical insurance underwriting. Some plans, Plan C and Plan F, are being phased out and therefore the population of these plan participants will be getting older and therefore more expensive. The individuals should be able to choose a new plan as their plans may soon become cost prohibitive. Among individual lettered plans there are many carriers with a wide range of premiums. This changes annually and everyone should be able to choose the lowest premium available in their area without underwriting of their pre-existing conditions. This would encourage a more competitive market and better service. At age 65, I chose Anthem because my agent said it was the largest carrier in VA and therefore, they would be able to keep premium increases low. Unfortunately, this has not held true and now there are numerous plans that have lower premiums that I would like to avail myself of. Presently because we cannot switch, there is no pressure to keep prices low. Doug Gray from the insurance industry stated in his Senate testimony that insurance brokers, which his plans pay commissions, would be unlikely to provide honest recommendations to Medicare recipients in reference to the hazards of switching policies. So why should we believe him that this would adversely affect insurance premiums when the difference in overall expenditures between the different carriers or plans is marginal at best. Here in VA, most Medicare recipients choose the broadest coverage. 43.5% are enrolled in Plan F which is no longer available, 42.4% in Plan G, 7.2 % in Plan N and all the lesser plans make up less than 7%. So, seniors are not going to give up their broad coverage unnecessarily. They just want to get the lowest premium for their healthcare services. Many states have loosened restrictions on allowing Medicare recipients to switch plans and carriers with open enrollment and guaranteed issue under a variety of circumstances. 29 states allow recipients to change when they lose retirement benefits, 10 states when they lose Medicaid eligibility, and 12 allow guarantee issue rights for current Medigap policyholders like myself. And 4 states allow either continuous or annual guaranteed issue rights for all including Medicare Advantage members. The cost of premiums has not shown a relationship between the loosening of these restrictions among the various states that have passed these more consumer-friendly policies. Matter of fact some of these states now have premiums that are lower than we have here in Virginia. Let’s remember these plans cover every physician and hospital in the United States. Each lettered plan covers the same exact services no matter which carrier you choose without prior authorization. Thank you.

Comments Document

January 30, 2025 Delegate Jeion Ward Chair, Labor and Commerce Committee The Honorable Chair Ward, Vice Chair Herring and Members of the Labor and Commerce Committee: RE: HB 2100 -- Medicare supplement policies; annual open enrollment period Position: SUPPORT My name is Lindsay Jack, and I am the Managing Director of Advocacy at the ALS Association. I am writing today in support of HB 2100, Medicare supplement policies, annual open enrollment period. ALS is a fatal progressive neurodegenerative disease that that affects nerve cells in the brain and spinal cord, it slowly robs a person’s ability to walk, talk, eat, and eventually breathe. There is no cure for ALS (also commonly known as Lou Gehrig’s disease), every diagnosis is lethal. Every 90 minutes, someone is diagnosed with the disease, and someone passes away from it. HB 2100 would make Medicare supplemental insurance policies, known as “Medigap,” more accessible and affordable for people living with ALS. Medigap plans, sold by private companies, are intended to cover gaps in Medicare coverage, such as copayments, deductibles, and other healthcare costs. Virginia would join 12 other states to provide a once a year 60-day guaranteed access open enrollment window for current Medigap plan enrollees who wish to switch insurance carriers, but not their Medigap plan, to an insurance carrier offering a more affordable premium. The bill offers what is commonly called a “birthday rule” offering an additional annual open enrollment period commencing on the day of the individual’s birthday. This bill allows Medigap enrollees to switch the insurance carrier of their Medigap plan, but not switch their plan itself (i.e., someone could go from an Wellcare Plan A to an Anthem Plan A, but could not switch from a Wellcare Plan A to an Anthem Plan G). This provides enrollees with an option to change insurers to make sure premiums fit their financial circumstances while not allowing an enrollee to change their level of coverage. If an insurer has increased premiums to the point where enrollees are struggling to make premium payments, shouldn’t they be allowed to switch to another insurance carrier that offers lower premiums for the same Medigap plan without being medically underwritten? The 12 other states that have passed similar laws have dozens of insurers offering hundreds of Medigap plans in their states. Given the number of insurers offering hundreds of Medigap plans, one can reliably conclude that the Medigap insurance markets in states which have already passed laws like HB 2100 are an apparent success. For all these reasons, I respectfully request your support for HB 2100. Please contact me if you have any questions. Sincerely, Lindsay Jack Lindsay Jack Managing Director, Advocacy The ALS Association Lindsay.Jack@als.org

Support bill

Seniors should be able to freely change health plans based on their own health and budget, not denied for needing more coverage or having pre-existing conditions (when switching to Medicare from Medicare Advantage). This bill needs to apply to all Medicare recipients, including those switching from Medicare Advantage. Using the regular Medicare open enrollment period (Oct-Dec) is less confusing than using individual birthdays to permit supplemental policy changes. Please amend. We can do better for our seniors. Thank you.

This proposed “birthday bill” allowing Medigap subscribers to change plans in the month after their birthday may be quite beneficial to the health insurance industry, but doesn’t go nearly far enough ro protect Medicare recipients who missed the initial Medigap enrollment window or are trying to switch to traditional Medicare from a Medicare Advantage plan. I am calling on the committee to amend this bill so that it includes the following provisions: 1. Require Medicare supplement issuers to provide guaranteed issue rights for all Medicare recipients – without medical underwriting – during the annual Medicare open enrollment period (October 15 - December 7); 2. Allow enrollees to upgrade Medigap coverage to meet their future health needs, rather than limiting their choice only to Medigap plans with “equal or lesser coverage” to their current Medigap coverage during this open enrollment period; 3. Ensure that ALL Medicare recipients have guaranteed issue enrollment in a Medigap plan, including those transitioning from Medicare Advantage to traditional Medicare; and 4. Prohibit Medicare supplement issuers from imposing waiting periods, imposing higher premiums, or denying coverage to Medicare recipients based on age, pre-existing conditions, or disability. Virginia legislators have the opportunity to stand up for vulnerable seniors and disabled individuals in their communities against the powerful health insurance lobby. I hope you will also have the courage to do so.

Due to the confusing landscape of choosing a Medicare Supplement, recipients should be able to change their carrier or plan without penalty of medical insurance underwriting. Some plans, Plan C and Plan F, are being phased out and therefore the population of these plan participants will be getting older and therefore more expensive. The individuals should be able to choose a new plan as their plans may soon become cost prohibitive. Among individual lettered plans there are many carriers with a wide range of premiums. This changes annually and everyone should be able to choose the lowest premium available in their area without underwriting of their pre-existing conditions. This would encourage a more competitive market and better service. At age 65, I chose Anthem because my agent said it was the largest carrier in VA and therefore, they would be able to keep premium increases low. Unfortunately, this has not held true and now there are numerous plans that have lower premiums that I would like to avail myself of. Presently because we cannot switch, there is no pressure to keep prices low. Doug Gray from the insurance industry stated in his Senate testimony that insurance brokers, which his plans pay commissions, would be unlikely to provide honest recommendations to Medicare recipients in reference to the hazards of switching policies. So why should we believe him that this would adversely affect insurance premiums when the difference in overall expenditures between the different carriers or plans is marginal at best. Here in VA, most Medicare recipients choose the broadest coverage. 43.5% are enrolled in Plan F which is no longer available, 42.4% in Plan G, 7.2 % in Plan N and all the lesser plans make up less than 7%. So, seniors are not going to give up their broad coverage unnecessarily. They just want to get the lowest premium for their healthcare services. Many states have loosened restrictions on allowing Medicare recipients to switch plans and carriers with open enrollment and guaranteed issue under a variety of circumstances. 29 states allow recipients to change when they lose retirement benefits, 10 states when they lose Medicaid eligibility, and 12 allow guarantee issue rights for current Medigap policyholders let myself. And 4 states allow either continuous or annual guaranteed issue rights for all including Medicare Advantage members. The cost of premiums has not shown a relationship between the loosening of these restrictions among the various states that have passed these more consumer-friendly policies. Matter of fact some of these states now have premiums that are lower than we have here in Virginia. Let’s remember these plans cover every physician and hospital in the United States. Each lettered plan covers the same exact services no matter which carrier you choose without prior authorization. Thank you.

I am certain we all agree that the healthcare of your constituents is the most important consideration when it comes to health insurance. And that is exactly the issue before this Committee. I thus strongly recommend amending HB2100 to allow all Medicare enrollees the maximum choice to alternate between any Medicare plan without penalty; and I urge you to put the healthcare of Virginians first by supporting the amended bill. Thank you. Jay D. Brock, MD Fredericksburg 1/21/2025 Former Assistant Professor Faculty of Medicine Department of Family Medicine McGill University Montreal, Canada Past President Fredericksburg Area Medical Society Fredericksburg, Va

Dear Honorable Members of the Labor and Commerce Subcommittee, I am writing to you as a member of the Governor’s Fire Services Board and a staunch advocate for the fire service in the Commonwealth of Virginia. Over the course of numerous Fire and EMS studies conducted across Virginia, I have witnessed firsthand the severe financial hardships faced by fire departments, particularly those reliant on volunteers. These challenges not only hinder their ability to operate effectively but also pose a significant risk to public safety. The Commonwealth of Virginia’s fire service, as documented in the United States Fire Administration’s 2024 National Fire Department Registry Summary, consists of 556 registered fire departments. These departments are predominantly volunteer-based, with 70.7% being fully volunteer, 16.9% mostly volunteer, 5.4% mostly career, and only 7.0% fully career. Despite the critical role these volunteer departments play, the current allocation of Aid to Localities (ATL) funding is inequitable and insufficient to meet their needs. The ATL distribution system, which allocates funds based primarily on population, disproportionately benefits jurisdictions with larger tax bases while leaving smaller, predominantly volunteer departments severely underfunded. For example, in FY 2025, Fairfax County is eligible to receive $5,666,249, and Virginia Beach $2,354,749, while smaller towns receive a minimum of $4,000 and counties no less than $10,000, per Virginia Department of Fire Programs (VDFP) policy. While this ensures a baseline, it is far from sufficient to address the actual costs faced by these departments. To illustrate: Basic personal protective firefighting gear ranges from $3,000 to $10,000 per set and must be replaced every 10 years. Self-Contained Breathing Apparatus (SCBA) systems cost $3,000 to $5,000 each. A new fire engine can range from $800,000 to $1,200,000. The reliance on bake sales, Brunswick stew events, and raffles to fund such critical needs is no longer sustainable. During the 2024 Virginia State Firefighters Association meetings, the urgency of this funding crisis was emphasized. When I asked members when we should sound the alarm that the Commonwealth is in an emergency situation regarding the volunteer fire service, the unanimous response was, “Now!” The National Volunteer Fire Council highlights that departments are struggling to recruit and retain members due to increased demands on time, training requirements, and societal changes, such as the prevalence of two-income households. Without significant investment in recruitment and retention incentives for the volunteer fire service, the Commonwealth will face the monumental challenge of replacing 70.7% of its firefighting workforce with paid personnel—an outcome that would impose substantial financial burdens on local governments and taxpayers. I respectfully urge the subcommittee to take immediate action to increase ATL funding and revamp the current distribution system to ensure equitable and adequate support for all fire departments, especially those serving rural and volunteer-reliant communities. Addressing this issue now will help avert a crisis and ensure the safety and resilience of our communities. Thank you for your attention to this critical matter. I am available to discuss this issue further and provide additional insights based on my experiences. Sincerely, Dr. James Alan Calvert

Comments Document

Due to the confusing landscape of choosing a Medicare Supplement, recipients should be able to change their carrier or plan without penalty of medical insurance underwriting. Some plans, Plan C and Plan F, are being phased out and therefore the population of these plan participants will be getting older and therefore more expensive. The individuals should be able to choose a new plan as their plans may soon become cost prohibitive. Also as people get older they may not need to have the Foreign Travel Emergency coverage and could then choose a plan with lower premiums. Among individual lettered plans there are many carriers with a wide range of premiums. This changes annually and everyone should be able to choose the lowest premium available in their area without underwriting of their pre-existing conditions. This would encourage a more competitive market and better service. Presently because we cannot switch, there is no pressure to keep prices low. Doug Gray from the insurance industry stated in his Senate testimony that insurance brokers would be unlikely to provide honest recommendations to Medicare recipients in reference to the hazards of switching policies. So why should we believe him that this would adversely affect insurance premiums when the difference in overall expenditures between the different carriers or plans is marginal at best.

Please let me know about anything to do with ANY SOLAR or wind. Also why aren't you working on lowering this socialism health obamare that is failing! We pay double our house payment for healthcare. They do a certain percentage of what u make a year. I have to take money out of my 401k for healthcare that counts as income. It shouldn't count as income when you are taxing the heck out of us. We can't travel,most our prescriptions we use to take won't be covered and could go on and on about this robbery of people s hard earned money!