§ 15-1204. Carrier health benefit plan requirements and restrictions
West's Annotated Code of MarylandInsuranceEffective: January 1, 2014
Effective: January 1, 2014
MD Code, Insurance, § 15-1204
§ 15-1204. Carrier health benefit plan requirements and restrictions
(a) This section applies to a carrier with respect to any health benefit plan that is a grandfathered health plan, as defined in § 1251 of the Affordable Care Act.
Capacity to administer health benefit plan, satisfactory grievance procedure, and access to providers of health care
(b) In addition to any other requirement under this article, a carrier shall:
(c) A person may not offer a health benefit plan in the State unless the person offers at least the Standard Plan.
(d) A carrier may not offer a health benefit plan that has fewer benefits than those in the Standard Plan.
(e) A carrier may offer benefits in addition to those in the Standard Plan if:
(f) Notwithstanding subsection (c) of this section, a health maintenance organization may provide a point of service delivery system as an additional benefit through another carrier regardless of whether the other carrier also offers the Standard Plan.
(g) A carrier may offer coverage for dental care and services as an additional benefit.
(h)(1) In this subsection, “prominent carrier” means a carrier that insures at least 10% of the total lives insured in the small group market.
Credits
Added by Acts 1997, c. 35, § 2, eff. Oct. 1, 1997; Amended by Acts 2003, c. 93, § 1, eff. July 1, 2003; Acts 2004, c. 287, § 2, eff. July 1, 2004; Acts 2007, 1st Sp. Sess., c. 7, § 2, eff. Nov. 19, 2007; Acts 2012, c. 152, § 2, eff. Jan. 1, 2014.
Formerly Art. 48A, § 699.
MD Code, Insurance, § 15-1204, MD INSURANCE § 15-1204
Current with all legislation from the 2023 Regular Session of the General Assembly. Some statute sections may be more current, see credits for details.
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