Ch. 294

1997 LAWS OF MARYLAND

(B) A CARRIER IS SUBJECT TO THE REQUIREMENTS OF § 15-1403 OF THIS
TITLE IN CONNECTION WITH HEALTH BENEFIT PLANS ISSUED UNDER THIS
SUBTITLE.

SUBTITLE 13. MARYLAND HEALTH INSURANCE PORTABILITY AND
ACCOUNTABILITY ACT — INDIVIDUAL MARKET REFORMS.

15-1301.

(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS
INDICATED.

(B) "ACTUARIAL CERTIFICATION" MEANS A WRITTEN STATEMENT IN A FORM
APPROVED BY THE COMMISSIONER, SIGNED BY A MEMBER OF THE AMERICAN
ACADEMY OF ACTUARIES OR OTHER INDIVIDUAL ACCEPTABLE TO THE
COMMISSIONER THAT A CARRIER IS IN COMPLIANCE WITH THE PROVISIONS OF THIS
SUBTITLE.

(C) "AFFILIATION PERIOD" MEANS A PERIOD OF TIME BEGINNING ON THE
DATE OF ENROLLMENT AND NOT TO EXCEED 2 MONTHS, OR 3 MONTHS IN THE CASE
OF A LATE ENROLLEE. DURING WHICH A HEALTH MAINTENANCE ORGANIZATION
DOES NOT COLLECT PREMIUM, AND COVERAGE ISSUED DOES NOT BECOME
EFFECTIVE.

(D) "ASSOCIATION" OR "BONA FIDE ASSOCIATION" MEANS, AN ASSOCIATION
THAT:

(1) HAS BEEN ACTIVELY IN EXISTENCE FOR AT LEAST 5 YEARS;

(2) HAS BEEN FORMED AND MAINTAINED IN GOOD FAITH FOR
PURPOSES OTHER THAN OBTAINING INSURANCE AND DOES NOT CONDITION
MEMBERSHIP ON THE PURCHASE OF ASSOCIATION-SPONSORED INSURANCE;

(3) DOES NOT CONDITION MEMBERSHIP IN THE ASSOCIATION ON ANY
HEALTH STATUS-RELATED FACTOR RELATING TO AN INDIVIDUAL, AND STATES SO
CLEARLY IN ALL MEMBERSHIP AND APPLICATION MATERIALS;

(4) MAKES HEALTH INSURANCE COVERAGE OFFERED THROUGH THE
ASSOCIATION AVAILABLE TO ALL MEMBERS REGARDLESS OF ANY HEALTH
STATUS-RELATED FACTOR RELATING TO THE MEMBERS OR INDIVIDUALS ELIGIBLE
FOR COVERAGE AND STATES SO CLEARLY IN ALL MEMBERSHIP AND APPLICATION
MATERIALS;

(5) DOES NOT MAKE HEALTH INSURANCE COVERAGE OFFERED
THROUGH THE ASSOCIATION AVAILABLE OTHER THAN IN CONNECTION WITH
MEMBERSHIP IN THE ASSOCIATION, AND STATES SO CLEARLY IN ALL MARKETING
AND APPLICATION MATERIALS; AND

(6) PROVIDES AND ANNUALLY UPDATES INFORMATION NECESSARY
FOR THE COMMISSIONER TO DETERMINE WHETHER OR NOT THE ASSOCIATION
MEETS THE DEFINITION OF BONA FIDE ASSOCIATION BEFORE QUALIFYING AS AN
ASSOCIATION UNDER THIS SUBTITLE.

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