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Ch. 15 2000 LAWS OF MARYLAND
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(D) (1) A BENEFIT OFFERED IN ADDITION TO THE STANDARD PLAN TO
LOWER THE COST-SHARING ARRANGEMENT IN THE STANDARD PLAN IN
ACCORDANCE WITH § 15-301.1 OF THE HEALTH - GENERAL ARTICLE IS SUBJECT TO:
(I) GUARANTEED ISSUANCE;
(II) GUARANTEED RENEWAL;
(III) ADJUSTED COMMUNITY RATING; AND
(IV) THE PROHIBITION ON PREEXISTING CONDITION LIMITATIONS.
(2) A CARRIER THAT OFFERS A BENEFIT UNDER THIS SUBSECTION
SHALL BE REQUIRED TO GUARANTEE ISSUANCE AND GUARANTEE RENEWAL OF THE
ADDITIONAL BENEFIT ONLY TO EMPLOYERS WHO ARE PARTICIPATING IN THE MCHP
PRIVATE OPTION PLAN ESTABLISHED UNDER § 15-301.1 OF THE HEALTH - GENERAL
ARTICLE.
15-1406.
(a) A carrier may not establish rules for eligibility of an individual to enroll
under a group health benefits plan based on any health status-related factor.
(b) Subsection (a) of this section does not:
(1) require a carrier to provide particular benefits other than those
provided under the terms of the particular health benefit plan; or
(2) prevent a carrier from establishing limitations or restrictions on the
amount, level, extent, or nature of the benefits or coverage for similarly situated
individuals enrolled in the health benefit plan.
(c) Rules for eligibility to enroll under a plan includes rules defining any
applicable waiting periods for enrollment.
(d) A carrier shall allow an employee or dependent who is eligible, but not
enrolled, for coverage under the terms of a group health benefits plan to enroll for
coverage under the terms of the plan if;
(1) the employee or dependent was covered under an employer-sponsored
plan or group health benefits plan at the time coverage was previously offered to the
employee or dependent;
(2) the employee states in writing, at the time coverage was previously
offered, that coverage under an employer-sponsored plan or group health benefits plan
was the reason for declining enrollment, but only if the plan sponsor or issuer requires
the statement and provides the employee with notice of the requirement; and
(3) the employee's or dependent's coverage described in item (1) of this
subsection:
(i) was under a COBRA continuation provision, and the coverage
under that provision was exhausted; or
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