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H.B. 91
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VETOES
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15-1208.1.
(A) A CARRIER SHALL PROVIDE THE SPECIAL ENROLLMENT PERIODS
DESCRIBED IN THIS SECTION IN EACH SMALL EMPLOYER HEALTH BENEFIT PLAN.
(B) IF THE SMALL EMPLOYER ELECTS UNDER § 15-1210(A)(III) OF THIS
SUBTITLE TO OFFER COVERAGE TO ALL OF ITS EMPLOYEES WHO ARE COVERED
UNDER ANOTHER PUBLIC OR PRIVATE PLAN OF HEALTH INSURANCE OR ANOTHER
HEALTH BENEFIT ARRANGEMENT, A CARRIER SHALL ALLOW AN EMPLOYEE OR
DEPENDENT WHO IS ELIGIBLE, BUT NOT ENROLLED, FOR COVERAGE UNDER THE
TERMS OF THE EMPLOYER'S HEALTH 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 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 BENEFIT PLAN WAS THE REASON FOR DECLINING ENROLLMENT,
BUT ONLY IF THE PLAN SPONSOR OR CARRIER REQUIRES THE STATEMENT AND
PROVIDES THE EMPLOYEE WITH NOTICE OF THE REQUIREMENT;
(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.
(C) ALL SMALL EMPLOYER HEALTH BENEFIT PLANS SHALL PROVIDE A
SPECIAL ENROLLMENT PERIOD DURING WHICH THE FOLLOWING PERSONS
INDIVIDUALS MAY BE ENROLLED UNDER THE HEALTH BENEFIT PLAN:
(1) A PERSON AN INDIVIDUAL WHO BECOMES A DEPENDENT OF THE
ELIGIBLE EMPLOYEE THROUGH MARRIAGE, BIRTH, ADOPTION, OR PLACEMENT FOR
ADOPTION;
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- 4256 -
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