PARRIS N. GLENDENING, Governor Ch. 35

(4) "PROVIDER PANEL" MEANS THE PROVIDERS THAT CONTRACT WITH
A CARRIER TO PROVIDE DENTAL SERVICES TO THE CARRIER'S INSUREDS,
ENROLLEES, OR OTHER COVERED PERSONS UNDER THE CARRIER'S DENTAL
BENEFIT PLAN.

(B) POINT-OF-SERVICE OPTION REQUIRED.

(1) IF AN EMPLOYER, ASSOCIATION, OR OTHER PRIVATE GROUP
ARRANGEMENT OFFERS DENTAL BENEFIT PLAN COVERAGE TO EMPLOYEES OR
OTHER INDIVIDUALS ONLY THROUGH A CARRIER'S PROVIDER PANEL, THE
CARRIER OF THE EMPLOYER, ASSOCIATION, OR OTHER PRIVATE GROUP
ARRANGEMENT SHALL OFFER, OR CONTRACT WITH ANOTHER CARRIER TO OFFER,
A DENTAL POINT-OF-SERVICE OPTION TO THE EMPLOYER, ASSOCIATION, OR
OTHER PRIVATE GROUP ARRANGEMENT AS AN ADDITIONAL BENEFIT FOR AN
EMPLOYEE OR OTHER INDIVIDUAL, TO ACCEPT OR REJECT AT THE EMPLOYEE'S OR
OTHER INDIVIDUAL'S OPTION.

(2) IF A CARRIER'S DENTAL PROVIDER PANEL IS THE SOLE DELIVERY
SYSTEM OFFERED TO EMPLOYEES BY AN EMPLOYER, THE CARRIER:

(I) SHALL OFFER THE EMPLOYER A DENTAL POINT-OF-SERVICE
OPTION FOR THE INDIVIDUAL EMPLOYEE TO ACCEPT OR REJECT;

(II) MAY NOT IMPOSE A MINIMUM PARTICIPATION LEVEL ON THE
DENTAL POINT-OF-SERVICE OPTION; AND

(III) AS PART OF THE GROUP ENROLLMENT APPLICATION, SHALL
PROVIDE TO EACH EMPLOYER A DISCLOSURE STATEMENT FOR EACH DENTAL
POINT-OF-SERVICE OPTION OFFERED THAT CONFORMS TO REGULATIONS, FOR THE
POINT-OF-SERVICE OPTION REQUIRED UNDER § 19-710.2 OF THE HEALTH -
GENERAL ARTICLE, ADOPTED BY:

1. THE HEALTH CARE ACCESS AND COST COMMISSION FOR
THE SMALL GROUP MARKET; AND

2. THE ADMINISTRATION FOR THE NON-SMALL GROUP

MARKET.

(C) COST OF ADDITIONAL COVERAGE.

(1) AN EMPLOYER, ASSOCIATION, OR OTHER PRIVATE GROUP
ARRANGEMENT MAY REQUIRE AN EMPLOYEE OR OTHER INDIVIDUAL WHO
ACCEPTS THE ADDITIONAL COVERAGE UNDER A DENTAL POINT-OF-SERVICE
OPTION UNDER SUBSECTION (B) OF THIS SECTION TO PAY A PREMIUM OVER THE
AMOUNT OF THE PREMIUM FOR THE DENTAL BENEFIT COVERAGE OFFERED BY THE
CARRIER ONLY THROUGH ITS PROVIDER PANEL.

(2) A CARRIER MAY IMPOSE DIFFERENT COST SHARING PROVISIONS
FOR THE DENTAL POINT-OF-SERVICE OPTION BASED ON WHETHER THE DENTAL
SERVICE IS PROVIDED THROUGH THE CARRIER'S PROVIDER PANEL OR OUTSIDE
THE CARRIER'S PROVIDER PANEL.

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