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Session Laws, 2007
Volume 803, Page 1674   View pdf image
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Ch. 243 2007 Laws of Maryland
(ii) indicates the Standard Plan is the only plan required by State law; and (iii) specifies that all enhancements to the Standard Plan are not
required by State law. (e) Notwithstanding subsection (b) of this section, a health maintenance
organization may provide a point of service delivery system as an additional benefit
through another carrier regardless of whether the other carrier also offers the
Standard Plan. (f) A carrier may offer coverage for dental care and services as an additional benefit. (G) NOTWITHSTANDING ANY OTHER PROVISION OF THIS SUBTITLE, A
CARRIER MAY OFFER A HEALTH BENEFIT PLAN PREFERRED PROVIDER OPTION WITH IN-NETWORK AND OUT OF NETWORK DEDUCTIBLES OR OUT OF POCKET MAXIMUMS THAT DIFFER FROM THE STANDARD PLAN IF: (1) THE ARITHMETIC TOTAL OF THE IN NETWORK PLUS
OUT OF NETWORK DEDUCTIBLE OR OUT OF POCKET MAXIMUMS IS GREATER
THAN THE COMBINED IN NETWORK AND OUT OF NETWORK DEDUCTIBLE OR
OUT OF POCKET MAXIMUMS OF THE STANDARD PLAN; ACT (2) THE VALUE OF THE HEALTH BENEFIT PLAN EXCEEDS THE
VALUE OF THE STANDARD PLAN. 15-1205. (a) (1) In establishing a community rate for a health benefit plan, a
carrier shall use a rating methodology that is based on the experience of all risks
covered by that health benefit plan without regard to health status or occupation or
any other factor not specifically authorized under this subsection. (2) A carrier may adjust the community rate only for: (i) age; and (ii) geography based on the following contiguous areas of the State: 1. the Baltimore metropolitan area; 2. the District of Columbia metropolitan area;
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Session Laws, 2007
Volume 803, Page 1674   View pdf image
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