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Ch. 113 1994 LAWS OF MARYLAND
(II) THE CHILD HAS BEEN OR WILL BE ENROLLED UNDER
COMPARABLE HEALTH INSURANCE COVERAGE WHICH WILL TAKE EFFECT NOT
LATER THAN THE EFFECTIVE DATE OF SUCH DISENROLLMENT; OR
(III) THE EMPLOYER HAS ELIMINATED FAMILY HEALTH COVERAGE
FOR ALL OF ITS EMPLOYEES.
(D) IF A CHILD HAS HEALTH INSURANCE COVERAGE THROUGH A HEALTH
INSURER OF A NONCUSTODIAL/INSURING PARENT, THE INSURER SHALL:
(1) PROVIDE THE NONINSURING PARENT WITH INFORMATION ON THE
ENROLLMENT OF THE CHILD IN THE FAMILY COVERAGE OF THE INSURING PARENT
NECESSARY FOR THE CHILD TO OBTAIN BENEFITS THROUGH SUCH COVERAGE; AND
(2) WHERE THE NONINSURING PARENT HAS INCURRED EXPENSES
RELATING TO HEALTH CARE PROVIDED TO THE CHILD, PROCESS THE CLAIMS FORM
AND MAKE THE APPROPRIATE PAYMENTS TO THE NONINSURING PARENT, THE
HEALTH CARE PROVIDER, OR THE DEPARTMENT OF HEALTH AND MENTAL
HYGIENE.
490X.
(A) (1) IN THIS SECTION THE FOLLOWING TERMS HAVE THE MEANINGS
INDICATED.
(2) "INSURER" MEANS;
(I) A COMMERCIAL INSURER, A NONPROFIT HEALTH SERVICE
ORGANIZATION, OR A HEALTH MAINTENANCE ORGANIZATION OPERATING IN THIS
STATE UNDER A CERTIFICATE OF AUTHORITY ISSUED BY THE MARYLAND
INSURANCE COMMISSIONER;
(II) A GROUP HEALTH PLAN, AS DEFINED IN § 607(1) OF THE
EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974; AND
(III) AN ENTITY OFFERING A SERVICE BENEFIT PLAN.
(3) "HEALTH INSURANCE COVERAGE" MEANS ANY TYPE OF HEALTH
CARE COVERAGE UNDER WHICH MEDICAL CARE SERVICES CAN BE PROVIDED TO
THE CHILD THROUGH AN INSURER.
(B) AN INSURER MAY NOT CONSIDER WHETHER AN INDIVIDUAL IS ELIGIBLE
FOR OR IS RECEIVING MEDICAL ASSISTANCE FROM THIS OR ANY OTHER STATE
UNDER 42 U.S.C. § 1369(A) WHEN:
(1) DETERMINING THE ELIGIBILITY OF THE INDIVIDUAL FOR
ENROLLMENT IN HEALTH INSURANCE COVERAGE; OR
(2) CALCULATING ANY PAYMENTS FOR BENEFITS FOR WHICH THE
INDIVIDUAL IS ELIGIBLE UNDER THE HEALTH INSURANCE COVERAGE.
(C) UPON PRESENTATION OF PROOF OF PAYMENT A CLAIM TO AN INSURER,
THE STATE SHALL BE REIMBURSED BY THE INSURER TO THE EXTENT THAT;
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