PARRIS N. GLENDENING, Governor

S.B. 843

15-1308.

(A)     SUBJECT TO SUBSECTIONS (C) AND (G) OF THIS SECTION, A CARRIER
SHALL ISSUE THE INDIVIDUAL HEALTH BENEFIT PLAN ELECTED UNDER § 15-1305 OR
§ 15-1306(A)(1) OF THIS SUBTITLE TO ANY ELIGIBLE INDIVIDUAL.

(B)     (1) A CARRIER MAY NOT LIMIT COVERAGE UNDER ANY INDIVIDUAL
HEALTH BENEFIT PLAN ISSUED TO AN ELIGIBLE INDIVIDUAL UNDER A
PREEXISTING CONDITION PROVISION.

(2) A CARRIER MAY IMPOSE A PREEXISTING CONDITION PROVISION ON
AN INDIVIDUAL WHO HAS HAD A PERIOD OF AT LEAST 63 DAYS DURING ALL OF
WHICH THE INDIVIDUAL WAS NOT COVERED UNDER ANY CREDITABLE COVERAGE
AND WHO WOULD OTHERWISE HAVE BEEN AN ELIGIBLE INDIVIDUAL.

(C)     A CARRIER MAY REFUSE TO ISSUE AN INDIVIDUAL HEALTH BENEFIT
PLAN TO AN ELIGIBLE INDIVIDUAL, IF THE CARRIER DEMONSTRATES TO THE
SATISFACTION OF THE COMMISSIONER THAT:

(1)      IT DOES NOT HAVE THE POLICYHOLDER SURPLUS NECESSARY TO
UNDERWRITE ADDITIONAL COVERAGE; AND

(2)      IT IS APPLYING THIS SECTION UNIFORMLY TO ALL INDIVIDUALS IN
THE INDIVIDUAL MARKET IN THIS STATE WITHOUT REGARD TO:

(I)       ANY HEALTH STATUS-RELATED FACTOR; AND

(II)     WHETHER THE INDIVIDUALS ARE ELIGIBLE INDIVIDUALS.

(D)     A CARRIER THAT DENIES INDIVIDUAL HEALTH INSURANCE COVERAGE
UNDER SUBSECTION (C) OF THIS SECTION MAY NOT OFFER COVERAGE IN THE
INDIVIDUAL MARKET UNTIL THE LATER OF:

(1)      A PERIOD OF 180 DAYS AFTER THE DATE THE COVERAGE IS DENIED;
OR

(2)      UNTIL THE CARRIER HAS DEMONSTRATED, TO THE
COMMISSIONER'S SATISFACTION THAT THE CARRIER .HAS SUFFICIENT
POLICYHOLDER SURPLUS TO UNDERWRITE ADDITIONAL COVERAGE

(E)     A CARRIER MAY ELECT NOT TO RENEW ALL INDIVIDUAL HEALTH
BENEFIT PLANS IN THE STATE

(F)      WHEN A CARRIER ELECTS NOT TO RENEW ALL INDIVIDUAL HEALTH
BENEFIT PLANS IN THE STATE, THE CARRIER:

(1)      SHALL GIVE NOTICE OF ITS DECISION TO THE AFFECTED
INDIVIDUALS AT LEAST 180 DAYS BEFORE THE EFFECTIVE DATE OF NONRENEWAL;

(2)      AT LEAST 30 WORKING DAYS BEFORE THAT NOTICE, SHALL GIVE
NOTICE TO THE COMMISSIONER; AND

- 4655 -