§ 15-408. Continuation coverage for divorced spouses and dependent children
West's Annotated Code of MarylandInsurance
MD Code, Insurance, § 15-408
§ 15-408. Continuation coverage for divorced spouses and dependent children
(b)(1) Each group contract in force on the date of the change in status shall provide continuation coverage in accordance with this section.
(c) Continuation coverage under this section shall begin on the date of the change in status and end on the earliest of the following:
(1) the date on which the qualified secondary beneficiary becomes eligible for hospital, medical, or surgical benefits under an insured or self-insured group health benefit program or plan, other than the group contract, that is written on an expense-incurred basis or is with a health maintenance organization;
(2) the date on which the qualified secondary beneficiary becomes entitled to benefits under Title XVIII of the Social Security Act;1
(d) Continuation coverage under this section shall be identical to the coverage offered under the group contract to similarly situated beneficiaries for whom there has not been a change in status.
(e)(1) From the date of the change in status until the date on which a termination statement is received by the employer, the insured shall pay to the employer, through payroll deduction or otherwise as determined by the employer, the sum of the employer's contribution for a qualified secondary beneficiary defined in subsection (a)(6)(i) of this section and the amount of contribution that would have been paid by the insured if there had not been a change in status.
(2) The additional costs payable by the insured under paragraph (1) of this subsection may be allocated between the insured and a qualified secondary beneficiary who was the insured's spouse or may be reimbursed in full to the insured by the qualified secondary beneficiary by agreement between the parties or, as equity may require, by court order under Title 10, Title 11, or Title 12 of the Family Law Article at the time of the change in status or after the change in status.
(f) Each certificate issued to an insured under a group contract shall include a statement, in a manner and form approved by the Commissioner, that advises the insured of the following:
(g) The Commissioner shall:
(h)(1) On request of a qualified secondary beneficiary, from the date of the change in status until the date on which a termination statement is received by the employer, the employer shall make available to the qualified secondary beneficiary forms for submitting claims to the group contract insurer.
(4) If the insured receives reimbursement from the group contract insurer for hospital, medical, or surgical expenses that a qualified secondary beneficiary has paid, the insured immediately shall pay the reimbursement to the qualified secondary beneficiary unless a written agreement or court order provides otherwise.
(i)(1) An employer that terminates continuation coverage after notice by the insured or qualified secondary beneficiary, or an insurer that terminates continuation coverage after notice by the employer, is not liable to the insured or qualified secondary beneficiary for benefits that otherwise would have been payable under this section if the termination:
(2) Notwithstanding paragraph (1) of this subsection, receipt by the employer of a termination statement is conclusive evidence of termination, and neither the employer nor the insurer is liable to the qualified secondary beneficiary or insured for benefits that otherwise would have been payable under this section.
Credits
Added by Acts 1997, c. 35, § 2, eff. Oct. 1, 1997.
Formerly Art. 48A, §§ 354GG, 477HH, 490H.
Footnotes
Aug. 14, 1935, ch. 531, 49 Stat. 620, codified at 42 U.S.C.A. § 301 et seq.
MD Code, Insurance, § 15-408, MD INSURANCE § 15-408
Current through legislation effective through April 9, 2023, from the 2024 Regular Session of the General Assembly. Some statute sections may be more current, see credits for details.
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