Ch. 569                             MARVIN MANDEL, Governor                                1213

Commissioner certain authority over group health insurance rates and relating
generally to the disapproval of certain insurance forms by the Commissioner.

SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF

MARYLAND, That new Section 375A be and it is hereby added to Article 48A
of the Annotated Code of Maryland (1972 Replacement Volume), title "Insurance
Code," subtitle "22. Insurance Contracts Generally," to follow immediately after
Section 375 thereof; and that Section 376 of Article 48A of the Code, same title
and subtitle, be and it is hereby repealed and that new Section 376 be and it is
hereby enacted, in lieu thereof, to stand in the place of the section repealed; and all
to read as follows:

375A.

IN ORDER TO PREVENT FRAUD, THE ISSUANCE OF INSURANCE
ECONOMICALLY UNSOUND TO THE INSURED AND TO ENSURE
THAT CERTAIN MINIMUM BENEFITS OR COVERAGE IS MADE
AVAILABLE TO THE POLICY OR CERTIFICATE HOLDER, THE
INSURANCE COMMISSIONER MAY ORDER AND HOLD HEARINGS
TO DETERMINE IF HEALTH, ACCIDENT AND DISABILITY
INSURANCE POLICIES MEET THE REQUIREMENTS SET FORTH IN
SECTION 376 OF THIS SUBTITLE. THE INSURANCE COMMISSIONER,
AFTER ANY HEARINGS ARE HELD AND THE RESULTS THEREOF ARE
EVALUATED, SHALL ESTABLISH AND PROMULGATE MINIMUM
REQUIREMENTS AND RULES IN COMPLIANCE WITH SECTION 376
OF ARTICLE 48A IN ORDER TO ENSURE THAT MINIMUM BENEFITS
OR COVERAGE IS MADE AVAILABLE.

376.

[The Commissioner shall disapprove any form filed under § 375, or withdraw
any previous approval thereof, if the form:

(1)  Is in any respect in violation of or does not comply with this article; or

(2)  Contains or incorporates by reference, where said incorporation is otherwise
permissible, any inconsistent, ambiguous, or misleading clauses, or exceptions and
conditions which deceptively affect the risk purported to be assumed in the general
coverage of the contract; or

(3)  Has any title, heading, or other indication of its provisions which is likely to
mislead the policyholder or certificate holder; or

(4)   Contains an inequitable provision or provisions of insurance without
substantial benefit to the policyholder; or

(5)   Is printed or otherwise reproduced in such manner as to render any
provision of the form substantially illegible; or

(6)  If the benefits provided in any health insurance policy other than a group
policy are unreasonable in relation to the premium charged.]

(A)  THE COMMISSIONER SHALL DISAPPROVE ANY FORM FILED
UNDER SECTION 375 OF THIS SUBTITLE OR WITHDRAW ANY
PREVIOUS APPROVAL IF THE FORMS DO NOT MEET THE
REQUIREMENTS OF SUBSECTION (B) OF THIS SECTION.
FURTHERMORE, THE COMMISSIONER MAY SET FORTH
REASONABLE RULES AND REGULATIONS CONSISTENT WITH THE
REQUIREMENTS OF SUBSECTION (C) OF THIS SECTION IN ORDER
TO ESTABLISH MINIMUM BENEFITS AND COVERAGES AS MAY BE
REQUIRED.

(B)  THE COMMISSIONER SHALL DISAPPROVE ANY FORM FILED,
OR WITHDRAW ANY PREVIOUS APPROVAL, IF THE FORM: