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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
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 all legislation from the 2022 Regular Session of the General Assembly. Some statute sections may be more current, see credits for details.
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