PARRIS N. GLENDENING, Governor

Ch. 294

755.

A CARRIER MAY NOT OFFER ANY INDIVIDUAL HEALTH BENEFIT PLANS IN THIS
STATE UNLESS THE CARRIER OFFERS, AND ACTIVELY MARKETS, THE POLICIES
REQUIRED BY THIS SUBTITLE.

756.

(A) UNLESS A CARRIER MAKES AN ELECTION UNDER § 757 OF THIS SUBTITLE,
THE CARRIER MAY NOT:

(1) DECLINE TO OFFER COVERAGE TO, OR DENY ENROLLMENT OF AN
ELIGIBLE INDIVIDUAL; OR

(2) IMPOSE ANY PREEXISTING CONDITION PROVISION ON AN ELIGIBLE
INDIVIDUAL

(B) (1) A CARRIER THAT MAKES AN ELECTION UNDER § 757 OF THIS
SUBTITLE MAY CHOOSE TO OFFER AT LEAST TWO DIFFERENT POLICY FORMS, BOTH
OF WHICH ARE DESIGNED FOR, MADE GENERALLY AVAILABLE TO, ACTIVELY
MARKETED TO, AND ENROLL, BOTH ELIGIBLE INDIVIDUALS AND OTHER
INDIVIDUALS.

(2) POLICY FORMS THAT HAVE DIFFERENT COST-SHARING
ARRANGEMENTS OR DIFFERENT RIDERS SHALL BE CONSIDERED TO BE DIFFERENT
POLICY FORMS.

(C) POLICY FORMS SHALL COMPLY WITH THE REQUIREMENTS OF THIS
SUBTITLE.

757.

(A) NO LATER THAN JULY 1, 1997, A CARRIER THAT INTENDS TO OFFER TWO
POLICY FORMS SHALL SUBMIT IN WRITING TO THE COMMISSIONER BOTH:

(1) AN ELECTION WHETHER TO OFFER:

(I) A HIGH LEVEL AND LOW LEVEL POLICY FORM, EACH OF
WHICH INCLUDES BENEFITS SUBSTANTIALLY SIMILAR TO OTHER INDIVIDUAL
HEALTH INSURANCE COVERAGE OFFERED BY THE CARRIER IN THIS STATE; OR

(II) POLICY FORMS WITH THE LARGEST AND NEXT TO LARGEST
PREMIUM VOLUME OF ALL POLICY FORMS OFFERED BY THE CARRIER IN THIS
STATE; AND

(2) AN ELECTION WHETHER TO USE THE WEIGHTED AVERAGE
VALUATION DESCRIBED IN § 752(T)(1)(I) OR (II) OF THIS SUBTITLE

(B) (1) AN ELECTION MADE UNDER THIS SECTION SHALL BE BINDING FOR
A 2-YEAR PERIOD.

(2) AFTER THE INITIAL 2-YEAR PERIOD, AND FOR EACH SUBSEQUENT
2-YEAR PERIOD, CARRIERS SHALL AGAIN MAKE THE ELECTIONS REQUIRED BY THIS
SECTION.

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