PARRIS N. GLENDENING, Governor

Ch. 35

(C) FINANCIAL IMPAIRMENT.

A CARRIER MAY NOT BE REQUIRED TO OFFER COVERAGE UNDER §§ 15-1209
AND 15-1213 OF THIS SUBTITLE FOR AS LONG AS THE COMMISSIONER FINDS THAT
THE COVERAGE WOULD PLACE THE CARRIER IN A FINANCIALLY IMPAIRED
CONDITION.

REVISOR'S NOTE: This section is new language derived without substantive
change from former Art. 48A, §§ 698(k) and 704(b) through (d) and (f) and

(g).

In subsection (a)(1)(ii) of this section, the former definition of "part-time
employee" is incorporated as a substantive provision because the defined term
was used only twice under former law. See § 15-1203(b)(3)(ii) of this subtitle
for the only other use of the term.

Also in subsection (a)(1)(ii) of this section, the reference to a normal
workweek for a part-time employee of at least 17 1/2 but "less than" 30 hours
per week is substituted for the former reference to a normal workweek of a
part-time employee of at least 17 1/2 but "not more" than 30 hours per week
to avoid an internal inconsistency with § 15-1201(e)(1)(i)2, which refers to an
employee who "works on a full-time basis and has a normal workweek of at
least 30 hours", and to reflect perceived legislative intent.

In subsection (a)(1)(iii) of this section, the reference to a public or private
plan of health "insurance" is substituted for the former reference to a public
or private health "benefit" plan for consistency with other similar references
in this subtitle and to avoid the inappropriate use of the defined term "health
benefit plan".

In subsection (b)(1)(iii) of this section, the former phrase "within the area",
which modified "capacity", is deleted as unnecessary in light of the use of the
phrase "within an area" at the beginning of that item.

In subsection (b)(2)(ii) of this section, the reference to the "area" in which a
health maintenance organization has the "capacity to deliver services to small
employer groups" is added for clarity.

Also in subsection (b)(2)(ii) of this section, the specific reference to a "health
maintenance organization" is substituted for the former general reference to a
"carrier" for consistency within that subsection.

Defined terms: "Carrier" § 15-1201
"Commissioner" § 1-101
"Eligible employee" § 15-1201
"Health benefit plan" § 15-1201
"Health insurance" § 1-101
"Small employer" § 15-1201

15-1211. APPROVAL OF PROPOSED HEALTH BENEFIT PLANS.
(A) FILING REQUIRED.

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