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Ch. 16
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2000 LAWS OF MARYLAND
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(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
(ii) was not under a COBRA continuation provision, and either the
coverage was terminated as a result of loss of eligibility for the coverage, including
loss of eligibility as a result of legal separation, divorce, death, termination of
employment, or reduction in the number of hours of employment, or employer
contributions towards the coverage were terminated; AND
(4) THE EMPLOYEE'S DEPENDENT IS ELIGIBLE FOR COVERAGE IN
ACCORDANCE WITH § 15-301.1 OF THE HEALTH GENERAL ARTICLE.
(E) A CARRIER SHALL ALLOW AN EMPLOYEE OR DEPENDENT WHO IS
ELIGIBLE, BUT NOT ENROLLED, FOR COVERAGE UNDER THE TERMS OF A GROUP
HEALTH BENEFIT PLAN TO ENROLL FOR COVERAGE UNDER THE TERMS OF THE
PLAN IF THE EMPLOYEE OR DEPENDENT REQUESTS ENROLLMENT WITHIN 30 DAYS
AFTER THE EMPLOYEE OR DEPENDENT IS DETERMINED TO BE ELIGIBLE FOR
COVERAGE UNDER THE MCHP PRIVATE OPTION PLAN IN ACCORDANCE WITH §
15-301.1 OF THE HEALTH - GENERAL ARTICLE.
27-220.
An agent, broker, or insurer may not refer an individual employee or dependent
of an employee to the [Children and Families Health Care Program] MARYLAND
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- 182 -
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