2024 Medicare Supplement Survey Only submit for multiple companies at the same time if all answers are uniform for all companies included. Question Title * 1. NAIC#(s) for companies included. Question Title * 2. Company Name(s): Question Title * 3. Please provide your company's toll-free number for prospective clients looking for Medicare Supplement Plan information. Question Title * 4. URL for Consumer contact page. Question Title * 5. Respondent Name Question Title * 6. Respondent Phone Number Question Title * 7. Respondent Email Even if you are no longer marketing and will answer no to question 10 please fill out questions 8 and 9 before submitting your survey response. Question Title * 8. How many policyholders does your company currently cover under age 65? A B C D F F-High Deductible G G-High Deductible K L M N Question Title * 9. How many policyholders does your company currently cover age 65 and over? A B C D F F-High Deductible G G-High Deductible K L M N Question Title * 10. Is your company currently marketing Medicare Supplement Insurance Plans in the State of Colorado? Yes - fill out all remaining questions. No - skip the remaining questions, go to the end and submit the survey now. Which Medicare Supplement insurance plan(s) does your company Market in the State of Colorado? (select all that apply) Question Title * 11. For policyholders under age 65 A B C D F F-High Deductible G G-High Deductible K L M N Question Title * 12. For policyholders age 65 and older A B C D F F-High Deductible G G-High Deductible K L M N Question Title * 13. Do you require membership in any kind of association to sell your Medicare Supplement to an individual? No Yes - List association membership required Provide monthly rates for each Medicare Supplement plan your company markets in Colorado according to the following criteria:Please enter only the cost rounded to the nearest dollar. Decimals, percentages, and non-numeric characters are not accepted. Question Title * 14. Male, non-smoking, age 65, resides in zip code 80202 A B C D F F-High Deductible G G-High Deductible K L M N Question Title * 15. Female, non-smoking, age 65, resides in zip code 80202 A B C D F F-High Deductible G G-High Deductible K L M N Question Title * 16. Male, non-smoking, age 70, resides in zip code 80202 A B C D F F-High Deductible G G-High Deductible K L M N Question Title * 17. Female, non-smoking, age 70, resides in zip code 80202 A B C D F F-High Deductible G G-High Deductible K L M N Question Title * 18. Male, non-smoking, age 75, resides in zip code 80202 A B C D F F-High Deductible G G-High Deductible K L M N Question Title * 19. Female, non-smoking, age 75, resides in zip code 80202 A B C D F F-High Deductible G G-High Deductible K L M N Question Title * 20. Male, non-smoking, age 80, resides in zip code 80202 A B C D F F-High Deductible G G-High Deductible K L M N Question Title * 21. Female, non-smoking, age 80, resides in zip code 80202 A B C D F F-High Deductible G G-High Deductible K L M N Question Title * 22. Male, non-smoking, under 65, with disability, resides in zip code 80202 A B C D F F-High Deductible G G-High Deductible K L M N Question Title * 23. Female, non-smoking, under 65, with disability, resides in zip code 80202 A B C D F F-High Deductible G G-High Deductible K L M N Question Title * 24. What are the minimum and maximum ages imposed by your company by gender at which a Colorado consumer may purchase a Medicare Supplement insurance plan outside the guaranteed enrollment period?If this is not applicable skip this question. Male Minimum age Female Minimum age Male Maximum age Female Maximum age Question Title * 25. How are your Medicare Supplement insurance plan premiums calculated/rated? Attained Age Issue Age Community Rating Other or a combination of the above methods. If selected please describe: Question Title * 26. Which Medicare Supplement plans does your company have an agreement with Medicare for automatic crossover of unassigned claims that Medicare does not already crossover? (Please check all that apply.) A B C D F F-High Deductible G G-High Deductible K L M N Question Title * 27. Has your company filed rate changes, increase or decrease, with the State of Colorado for Medicare Supplement plans that are waiting for approval? Yes No Question Title * 28. What commissions are paid, if any, on the Medicare Supplement plans your company offers? For under age 65 during open enrollment For under age 65 outside open enrollment For all others during open enrollment For all others outside open enrollment Question Title * 29. Mark the selections below that apply to your company. Company differentiates rates based on tobacco use. Company differentiates rates based on geographic area. Company provides a household or marital discount. Other Discount.Please explain other discounts, who qualifies, and the time periods involved below. Question Title * 30. Does your Company assess a policy fee? No Yes, if selected what is this fee? Question Title * 31. Does your company impose a limitation for pre-existing conditions outside of the guarantee issue period? No Yes, if selected how many months? Question Title * 32. Does your company offer any innovative benefits with your medicare supplements?If so, please list for which plan(s), and describe the innovative benefits in detail No Yes - please list plan letters and describe the innovative benefits in detail Question Title * 33. Outside of Open Enrollment and other guarantee issue situations does your company allow Medicare beneficiaries who currently have a Plan to change to a different letter plan within your company without underwriting?If so, under what circumstances and for what period of time? No Yes - please enter when and for what period below Question Title * 34. Do you market on "third-party retiree exchanges or other similar third-party marketplaces.?" No Yes - please list exchanges and marketplaces below Question Title * 35. Have you enrolled anyone to this point using the one-time SEP in 4-3-1? No Yes - please enter the number enrolled below Question Title * 36. Please provide any additional comments you may have related to this survey and it's process. This includes any clarifying statements related to information entered above, or possible improvements you feel could be made. Done