PARRIS N. GLENDENING, Governor

Ch. 35

15-104. NONDUPLICATION AND COORDINATION PROVISIONS IN POLICIES.

(A) DEFINITIONS.

(1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS
INDICATED.

(2) "INTENSIVE CARE POLICY" MEANS A HEALTH INSURANCE POLICY
THAT PROVIDES BENEFITS ONLY FOR TREATMENT RECEIVED IN THE SPECIFICALLY
DESIGNATED FACILITY OF A HOSPITAL THAT PROVIDES THE HIGHEST LEVEL OF
CARE AND IS RESTRICTED TO PATIENTS WHO ARE PHYSICALLY AND CRITICALLY
ILL OR INJURED.

(3) "SPECIFIED DISEASE POLICY" HAS THE MEANING STATED IN § 15-109
OF THIS SUBTITLE.

(B) AUTHORIZED.

IN ACCORDANCE WITH REGULATIONS THAT THE COMMISSIONER ADOPTS, THE
COMMISSIONER SHALL ALLOW HEALTH INSURANCE POLICIES AND POLICIES OF
NONPROFIT HEALTH SERVICE PLANS TO CONTAIN NONDUPLICATION PROVISIONS
OR PROVISIONS TO COORDINATE COVERAGE WITH:

(1) . OTHER HEALTH INSURANCE POLICIES, INCLUDING COMMERCIAL
INDIVIDUAL, GROUP, AND BLANKET POLICIES AND POLICIES OF NONPROFIT
HEALTH SERVICE PLANS;

(2) SUBSCRIBER CONTRACTS THAT ARE ISSUED BY HEALTH
MAINTENANCE ORGANIZATIONS; AND

(3) OTHER ESTABLISHED PROGRAMS UNDER WHICH THE INSURED MAY
MAKE A CLAIM.

(C) EXCEPTION.

NOTWITHSTANDING SUBSECTION (B) OF THIS SECTION OR ANY OTHER
PROVISION OF THIS ARTICLE, AN INDIVIDUAL, GROUP, OR BLANKET HEALTH
INSURANCE POLICY, NONPROFIT HEALTH INSURANCE POLICY, OR NONPROFIT
HEALTH SERVICE PLAN MAY NOT CONTAIN A NONDUPLICATION PROVISION OR
PROVISION TO COORDINATE COVERAGE WITH AN INDIVIDUALLY UNDERWRITTEN
AND ISSUED, GUARANTEED RENEWABLE, SPECIFIED DISEASE POLICY OR INTENSIVE
CARE POLICY, THAT DOES NOT PROVIDE BENEFITS ON AN EXPENSE-INCURRED
BASIS.

REVISOR'S NOTE: This section is new language derived without substantive
change from former Art. 48A, §§ 361F, 470S, and 477Y.

Subsection (a)(1) of this section is revised in the standard introductory
language used in a definition subsection.

In the introductory language of subsection (b) of this section, the reference to
allowing health insurance policies "and policies of nonprofit health service

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