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§ 15-1A-18. Catastrophic plans

West's Annotated Code of MarylandInsuranceEffective: May 8, 2020

West's Annotated Code of Maryland
Insurance (Refs & Annos)
Title 15. Health Insurance
Subtitle 1a--Consumer Protections (Refs & Annos)
Effective: May 8, 2020
MD Code, Insurance, § 15-1A-18
§ 15-1A-18. Catastrophic plans
Currentness
Permitted
(a) A carrier may offer a catastrophic plan in the individual market in accordance with the requirements of this section.
Requirements
(b) A catastrophic plan may be offered only to individuals who:
(1) are under the age of 30 years before the beginning of the plan year; or
(2) hold certification for a hardship exemption or an affordability exemption as required in subsection (c) of this section.
Certification for a hardship exemption or an affordability exemption
(c)(1) Except as provided in paragraph (2) of this subsection, to be offered a catastrophic plan, an individual shall hold certification for a hardship exemption or an affordability exemption under 42 U.S.C. § 5000A.
(2) If the Maryland Health Benefit Exchange adopts regulations as described under subsection (d) of this section, an individual shall hold certification for a hardship exemption or an affordability exemption under the regulations adopted by the Exchange.
Regulations
(d) To the extent necessary, the Maryland Health Benefit Exchange shall adopt regulations that:
(1) establish a process for issuing hardship exemptions and affordability exemptions; and
(2) are consistent with 42 U.S.C. § 5000A and any corresponding federal rules and guidance as those provisions were in effect December 1, 2019.
Coverage
(e)(1) Subject to paragraph (2) of this subsection, a catastrophic plan shall provide coverage for essential health benefits.
(2) A catastrophic plan shall require a deductible that:
(i) is equal to the annual limit on cost-sharing described in § 15-1A-19 of this subtitle;
(ii) applies to essential health benefits;
(iii) does not apply to at least three primary care visits each plan year; and
(iv) does not apply to any covered benefits for which a deductible is prohibited under this title.

Credits

Added by Acts 2020, c. 620, § 1, eff. May 8, 2020; Acts 2020, c. 621, § 1, eff. May 8, 2020.
MD Code, Insurance, § 15-1A-18, MD INSURANCE § 15-1A-18
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.
End of Document