Ch. 294

1997 LAWS OF MARYLAND

(B) THIS SUBTITLE DOES NOT APPLY TO A CARRIER THAT OFFERS ONLY
CONVERSION POLICIES AS REQUIRED BY LAW.

(C) THIS SUBTITLE DOES NOT APPLY TO A CARRIER THAT OFFERS HEALTH
INSURANCE COVERAGE ONLY IN CONNECTION WITH GROUP HEALTH PLANS OR
THROUGH ONE OR MORE BONA FIDE ASSOCIATIONS, OR BOTH.

15-1303.

IN ADDITION TO ANY OTHER REQUIREMENTS UNDER THIS ARTICLE, A
CARRIER THAT OFFERS INDIVIDUAL HEALTH BENEFIT PLANS IN THIS STATE SHALL:

(1) HAVE DEMONSTRATED THE CAPACITY TO ADMINISTER THE
INDIVIDUAL HEALTH BENEFIT PLANS, INCLUDING ADEQUATE NUMBERS AND TYPES
OF ADMINISTRATIVE STAFF;

(2) HAVE A SATISFACTORY GRIEVANCE PROCEDURE AND ABILITY TO
RESPOND TO CALLS, QUESTIONS, AND COMPLAINTS FROM ENROLLEES OR
INSUREDS; AND

(3) DESIGN POLICIES TO HELP ENSURE THAT ENROLLEES OR INSUREDS
HAVE ADEQUATE ACCESS TO PROVIDERS OF HEALTH CARE.

15-1304.

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.

15-1305.

(A) UNLESS A CARRIER MAKES AN ELECTION UNDER § 15-1306 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 § 15-1306 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.

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