PARRIS N. GLENDENING, Governor

Ch. 35

(II) A COURT HAS ORDERED COVERAGE TO BE PROVIDED FOR A
SPOUSE OR MINOR CHILD UNDER A COVERED EMPLOYEE'S HEALTH BENEFIT PLAN;

OR

(III) A REQUEST FOR ENROLLMENT IS MADE WITHIN 30 DAYS
AFTER THE ELIGIBLE EMPLOYEE'S MARRIAGE OR THE BIRTH OR ADOPTION OF A

CHILD.

(2) NOTWITHSTANDING SUBSECTION (A) OF THIS SECTION, A LATE
ENROLLEE MAY BE SUBJECT TO A 12-MONTH PREEXISTING CONDITION PROVISION
OR A WAITING PERIOD UNTIL THE NEXT OPEN ENROLLMENT PERIOD NOT TO
EXCEED A 12-MONTH PERIOD.

(C) WAITING PERIOD.

A HEALTH BENEFIT PLAN THAT DOES NOT USE A PREEXISTING CONDITION
PROVISION MAY IMPOSE ON ENROLLEES:

(1) A WAITING PERIOD NOT TO EXCEED 90 DAYS; OR

(2) FOR 1 YEAR, A SURCHARGE NOT TO EXCEED 1.5 TIMES THE
COMMUNITY RATE ESTABLISHED IN ACCORDANCE WITH § 15-1205 OF THIS SUBTITLE.

(D) DEDUCTIBLES AND COST-SHARING.

FOR A PERIOD NOT TO EXCEED 6 MONTHS AFTER THE DATE AN INDIVIDUAL
BECOMES AN ELIGIBLE EMPLOYEE, A HEALTH BENEFIT PLAN MAY REQUIRE
DEDUCTIBLES AND COST-SHARING FOR BENEFITS FOR A PREEXISTING CONDITION
OF THE ELIGIBLE EMPLOYEE IN AMOUNTS NOT EXCEEDING 1.5 TIMES THE AMOUNT
OF THE STANDARD DEDUCTIBLES AND COST-SHARING OF OTHER ELIGIBLE
EMPLOYEES IF:

(1) THE EMPLOYEE WAS NOT PREVIOUSLY COVERED BY A PUBLIC OR
PRIVATE PLAN OF HEALTH INSURANCE OR ANOTHER HEALTH BENEFIT
ARRANGEMENT; AND

(2) THE EMPLOYEE WAS NOT PREVIOUSLY EMPLOYED BY THAT
EMPLOYER.

REVISOR'S NOTE: This section is new language derived without substantive
change from former Art. 48A, §§ 701 and 698(i)(2).

In subsection (a)(1) of this section, the former effective date "January 1, 1995"
is deleted as unnecessary since that date has passed.

The Insurance Article Review Committee notes, for consideration by the
General Assembly, that there is no provision for deductibles or cost-sharing in
connection with a preexisting condition of a spouse or dependent that is
comparable to subsection (d) of this section as it applies to an eligible
employee.

Defined terms: "Carrier" § 15-1201
"Eligible employee" § 15-1201

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