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Ch. 32
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PARRIS N. GLENDENING, Governor
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(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] BENEFIT 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] BENEFIT 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]
BENEFIT 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) UNDER THE TERMS OF THE PLAN, THE EMPLOYEE REQUESTS
ENROLLMENT NOT LATER THAN 30 DAYS AFTER:
(I) THE DATE OF EXHAUSTION OF COVERAGE DESCRIBED IN ITEM
(3)(I) OF THIS SUBSECTION; OR
(II) TERMINATION OF COVERAGE OR TERMINATION OF EMPLOYER
CONTRIBUTIONS DESCRIBED IN ITEM (3)(II) OF THIS SUBSECTION.
15-1406.1.
(A) IN THIS SECTION, "INDIVIDUAL" "ELIGIBLE EMPLOYEE" MEANS:
(1) A PARTICIPANT UNDER THE GROUP HEALTH BENEFIT PLAN; OR
(2) A PERSON AN INDIVIDUAL WHO:
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- 389 -
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