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PARRIS N. GLENDENING, Governor
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Ch. 32
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annual open enrollment period for self-employed individuals established by the
carrier in accordance with regulations adopted by the Commissioner.
[(h)] (I) "Pool" means the Maryland Small Employer Health Reinsurance Pool
established under this subtitle.
[(i) (J) "Preexisting condition" means:
(1) a condition existing during a specified period immediately preceding
the effective date of coverage, that would have caused an ordinarily prudent person to
seek medical advice, diagnosis, care, or treatment; or
(2) a condition for which medical advice, diagnosis, care, or treatment
was recommended or received during a specified period immediately preceding the
effective date of coverage.
[(j)] (K) "Preexisting condition provision" means a provision in a health
benefit plan that denies, excludes, or limits benefits for an enrollee for expenses or
services related to a preexisting condition.
[(k)] (L) "Reinsuring carrier" means a carrier that participates in the Pool.
[(l)] (M) "Risk-assuming carrier" means a carrier that does not participate in
the Pool.
[(m)] (N) "Small employer" means:
(1) an employer described in § 15-1203 of this subtitle; or
(2) an entity that leases employees from a professional employer
organization, coemployer, or other organization engaged in employee leasing and that
otherwise meets the description of § 15-1203 of this subtitle.
(O) "SPECIAL ENROLLMENT PERIOD" MEANS A PERIOD DURING WHICH A
GROUP HEALTH PLAN SHALL PERMIT CERTAIN INDIVIDUALS WHO ARE ELIGIBLE
FOR COVERAGE, BUT NOT ENROLLED, TO ENROLL FOR COVERAGE UNDER THE
TERMS OF THE GROUP HEALTH BENEFIT PLAN.
[(n)] (P) "Standard Plan" means the Comprehensive Standard Health Benefit
Plan adopted by the Commission in accordance with § 15-1207 of this subtitle and
Title 19, Subtitle 1 of the Health - General Article.
15-1208.
(a) (1) A carrier may not limit coverage under a health benefit plan for a
preexisting condition.
(2) An exclusion of coverage for preexisting conditions may not be
applied to health care services furnished for pregnancy or newborns.
(b) (1) This subsection does not apply to a late enrollee if:
(i) the individual requests enrollment within 30 days after
becoming an eligible employee;
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- 383 -
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