PARRIS N. GLENDENING, Governor

Ch. 35

(1) A CLEAR AND COMPLETE STATEMENT IF A CONTRACT, OR A
REASONABLY COMPLETE SUMMARY IF A CERTIFICATE, OF:

(I) THE DENTAL SERVICES AND THE INSURANCE OR OTHER
BENEFITS, IF ANY, TO WHICH ENROLLEES ARE ENTITLED;

(II) ANY LIMITATIONS ON THE SERVICES OR KIND OF BENEFITS TO
BE PROVIDED, INCLUDING ANY CHARGE, DEDUCTIBLE, OR COPAYMENT FEATURE;
AND

(III) WHERE AND IN WHAT MANNER INFORMATION IS AVAILABLE
ABOUT HOW SERVICES MAY BE OBTAINED; AND

(2) A CLEAR AND UNDERSTANDABLE DESCRIPTION OF THE DENTAL
PLAN ORGANIZATION'S METHOD FOR RESOLVING ENROLLEE COMPLAINTS.

(E) SUBSEQUENT CHANGE.

A DENTAL PLAN ORGANIZATION, INSURER, OR MEDICAL OR DENTAL SERVICE
CORPORATION THAT MAKES A CHANGE IN EVIDENCE OF COVERAGE OR THE
AMOUNT OR PERCENTAGE OF PAYMENT THAT THE ENROLLEE MUST PAY, SHALL
ISSUE TO THE ENROLLEE EVIDENCE OF THE CHANGE IN A SEPARATE DOCUMENT.

REVISOR'S NOTE: This section is new language derived without substantive
change from former Art. 48A, § 587.

In subsection (a) of this section, the former reference to a "certificate" is
deleted as included in the defined term "evidence of coverage".

Also in subsection (a) of this section, the former reference to the "evidence
of" the total amount or percentage of payment is deleted as surplusage.

In subsection (b)(2) of this section, the former phrase "whether by option or
otherwise" is deleted as surplusage.

In subsection (c) of this section, the reference to an amendment to "evidence
of coverage" is added for clarity.

In subsection (e) of this section, the reference to a "dental plan organization,
insurer, or medical or dental service corporation" that makes a change in
evidence of coverage is added for greater precision and to conform with
subsection (c) of this section.

Defined terms: "Commissioner" § 1-101
"Dental plan organization" § 14-401
"Dental service" § 14-401
"Enrollee" § 14-401
"Evidence of coverage" § 14-401
"Insurance" § 1-101
"Insurer" § 1-101
"Policy" § 1-101

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