PARRIS N. GLENDENING, Governor

Ch. 57

In subsection (b)(2)(iii) of this section, the reference to "provisions governing
late enrollees and any other provisions of this subheading that apply to
coverage" is substituted for the former reference to "any late enrollee or other
provisions of this subtitle" for clarity.

Subsection (c)(1) of this section is revised to clarify that the only requirements
a carrier may impose on a group are the requirements in this section. This
revision is consistent with subsection (b) of this section, which guarantees
issuance of a health benefit plan to groups or individuals who meet those
requirements.

In subsection (d) of this section, the prohibition against requiring "an
employer to contribute to payment of premiums for a health benefit plan" is
substituted for the former prohibition against "minimum employer
contributions" to clarify the limitation placed on carriers with respect to
employer contributions.

Defined terms: "Carrier" § 1

"Commissioner" IN § 1-101
"Employer" § 1
"Health benefit plan" § 1
"Late enrollee" § 1
"Premium" IN § 1-101

8. Offering of coverage by carriers.

(a) In general.

A carrier that offers coverage to a group shall offer coverage to all of its members.

(b) Health maintenance organizations.

(1) A health maintenance organization need not offer coverage:

(i) to an individual or group that is outside of the health maintenance
organization's approved service areas;

(ii) to a member of a group who resides outside of the health
maintenance organization's approved service areas; or

(iii) within an area where the health maintenance organization
reasonably anticipates, and demonstrates to the satisfaction of the Commissioner, that it
will not have the capacity in its network of providers to deliver service adequately because
of obligations to existing group contract holders and enrollees.

(2) A health maintenance organization that does not offer coverage under
paragraph (1)(iii) of this subsection may not offer coverage in the applicable area to any
individuals or groups until the later of:

(i) 180 days after a refusal to do so; or

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