PARRIS N. GLENDENING, Governor

Ch. 35

In subsection (b) of this section, the reference to a "physician" is substituted
for the former reference to a "doctor of medicine" for consistency within this
subtitle.

Also in subsection (b) of this section, the former references to a "duly"
licensed psychologist are deleted as implicit in the concept of licensure.

Defined terms: "Health insurance" § 1-101
"Person" § 1-101
"Policy" § 1-101

SUBTITLE 8. REQUIRED HEALTH INSURANCE BENEFITS.
15-801. BENEFITS FOR ALZHEIMER'S DISEASE AND CARE OF ELDERLY INDIVIDUALS.

(A) " SCOPE OF SECTION.
THIS SECTION APPLIES TO:

(1) INSURERS THAT PROPOSE TO ISSUE OR DELIVER IN THE STATE
GROUP OR BLANKET HEALTH INSURANCE POLICIES THAT ARE WRITTEN ON AN
EXPENSE-INCURRED BASIS; AND

(2) NONPROFIT HEALTH SERVICE PLANS THAT PROPOSE TO ISSUE OR
DELIVER IN THE STATE GROUP MEDICAL OR MAJOR MEDICAL CONTRACTS THAT
ARE WRITTEN ON AN EXPENSE-INCURRED BASIS.

(B) REQUIRED OFFERING OF COVERAGE — ALZHEIMER'S DISEASE.

AN ENTITY SUBJECT TO THIS SECTION SHALL OFFER THE POLICYHOLDER THE
OPTION OF PROVIDING BENEFITS FOR EXPENSES ARISING FROM THE CARE,
INCLUDING NURSING HOME CARE AND INTERMEDIATE OR CUSTODIAL NURSING
CARE, OF INDIVIDUALS WHO HAVE ALZHEIMER'S DISEASE.

(C) SAME — CARE OF ELDERLY INDIVIDUALS.

AN ENTITY SUBJECT TO THIS SECTION SHALL OFFER THE POLICYHOLDER THE
OPTION OF PROVIDING BENEFITS FOR EXPENSES ARISING FROM THE CARE OF
ELDERLY INDIVIDUALS, INCLUDING NURSING HOME CARE AND INTERMEDIATE OR
CUSTODIAL NURSING CARE OF ELDERLY INDIVIDUALS WHO HAVE ANY DISEASE,
OTHER THAN ALZHEIMER'S DISEASE, THAT IS DESIGNATED IN REGULATIONS
ADOPTED BY THE COMMISSIONER.

(D) LIMITATIONS ON COVERAGE OFFERED.

AN ENTITY SUBJECT TO THIS SECTION MAY ESTABLISH REASONABLE LIMITS
ON THE BENEFITS OFFERED UNDER THIS SECTION, INCLUDING COPAYMENT AND
DEDUCTIBLE PROVISIONS AND MAXIMUM ANNUAL AND LIFETIME DOLLAR LIMITS.

REVISOR'S NOTE: This section is new language derived without substantive
change from former Art. 48A, §§ 354FF and 477GG.

In subsection (a)(1) of this section, the former reference to a "health" insurer

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