Title 15. Health Insurance — Subtitle 11. Miscellaneous Health Insurance Policies and Contracts and Health Benefit Plans
Statutes in effect as of October 1, 2026.
Md. Code Ann., Ins. § 15-1102 (2026)
Title 15. Health Insurance
Subtitle 11. Miscellaneous Health Insurance Policies and Contracts and Health Benefit Plans
§ 15–1102LinkCopy Citation
(a)
In this section, “employee” includes:
(1)
an officer, manager, or retired employee of an employer;
(2)
a sole proprietor if the employer is a sole proprietorship; and
(3)
a partner if the employer is a partnership.
(b)
Health insurance on a franchise plan is the form of health insurance:
(1)
that is issued to:
(i)
three or more employees of a corporation, partnership, sole proprietorship, or governmental corporation, agency, or department; or
(ii)
ten or more members, employees, or employees of members of a labor union, or trade, professional, or other association, that is organized in good faith for purposes other than obtaining insurance, has a constitution or bylaws, and has had an active existence for at least 2 years;
(2)
under which the individuals insured, with or without their dependents, are issued the same form of an individual policy that varies only as to amounts and kinds of coverage applied for; and
(3)
under which the premiums on the individual policies may be paid to the insurer periodically by:
(i)
the employer, with or without payroll deductions;
(ii)
the labor union or association for its members; or
(iii)
a designated person acting on behalf of the employer, labor union, or association.
Md. Code Ann., Ins. § 15-1103 (2026)
Title 15. Health Insurance
Subtitle 11. Miscellaneous Health Insurance Policies and Contracts and Health Benefit Plans
§ 15–1103LinkCopy Citation
(a)
In this section, “transportation ticket policy” means a ticket policy of health insurance that:
(1)
has as its dominant feature the protection of the insured from a transportation hazard; and
(2)
is sold at transportation stations, ticket offices, or travel bureaus by:
(i)
vending machines;
(ii)
employees of railroads, steam lines, airlines, or other organizations engaged in transporting individuals on common carriers;
(iii)
individuals or employees of persons engaged in selling transportation on common carriers; or
(iv)
other qualified agents.
(b)
A transportation ticket policy may not be issued or delivered in the State unless it conforms to the requirements and provisions of §§ 15-102, 15-201, 15-202, 15-203, 15-205, and 15-207 through 15-226 of this title, subject to § 15-202(c) of this title that relates to inapplicable or inconsistent provisions.
Md. Code Ann., Ins. § 15-1104 (2026)
Title 15. Health Insurance
Subtitle 11. Miscellaneous Health Insurance Policies and Contracts and Health Benefit Plans
§ 15–1104LinkCopy Citation
(a)
(1)
In this section the following words have the meanings indicated.
(2)
“Employer sponsored health benefit plan” means any plan, fund, or program that:
(i)
is established or maintained by an employer under the Employee Retirement Income Security Act of 1974;
(ii)
offers coverage for health benefits; and
(iii)
is treated by the employer or any eligible employee or dependent as part of a plan, fund, or program under the United States Internal Revenue Code, 26 U.S.C. § 106, § 125, or § 162.
(3)
“Group health insurance” has the meaning stated in § 15–302 of this title.
(4)
“Limited benefit group health insurance contract” means a group health insurance contract that provides health insurance benefits, but is not required to provide all the benefits required under Subtitles 7 and 8 of this title.
(5)
“Special eligible employee” means an employee who:
(i)
is eligible for health coverage under the terms of an employer sponsored health benefit plan;
(ii)
works:
(1)
on a temporary or substitute basis; or
(2)
less than 30 hours in a normal workweek; and
(iii)
is not eligible for coverage under any group health insurance contract, nonprofit health service plan contract, or health maintenance organization contract issued to the employee’s employer because the employee meets the criteria of item (ii) of this paragraph.
(b)
A limited benefit group health insurance contract may be issued only by an insurer or nonprofit health service plan to an employer if the limited group health insurance contract is issued to provide health coverage only for:
(1)
special eligible employees; or
(2)
special eligible employees and their dependents.
(c)
An insurer or nonprofit health service plan that sells a limited benefit group health insurance contract, as a condition of sale, may require the employer to:
(1)
collect payment for premiums due under the limited benefit group health insurance contract through payroll deduction;
(2)
contribute to the premium payments applicable to the coverage of a special eligible employee; and
(3)
offer coverage to any dependent of a special eligible employee.
(d)
A limited benefit group health insurance contract shall comply with:
(1)
this title, except Subtitles 7 and 8 of this title; and
(2)
notwithstanding item (1) of this subsection, §§ 15–802, 15–812, 15–815, 15–830, 15–831, 15–832, and 15–833 of this title.
(e)
An insurer or nonprofit health service plan shall disclose in the group certificate and in enrollment material provided to each special eligible employee that the limited benefit group health insurance contract does not provide comprehensive health coverage.
Md. Code Ann., Ins. § 15-1106 (2026)
Title 15. Health Insurance
Subtitle 11. Miscellaneous Health Insurance Policies and Contracts and Health Benefit Plans
§ 15–1106LinkCopy Citation
(a)
(1)
In this section the following words have the meanings indicated.
(2)
“Carrier” means:
(i)
an insurer;
(ii)
a nonprofit health service plan; or
(iii)
a health maintenance organization.
(3)
“Evidence of individual insurability” has the meaning stated in § 15–1105 of this subtitle.
(4)
“Health benefit plan” has the meaning stated in § 15–1301 of this title.
(b)
If a carrier conditions coverage for a health benefit plan on evidence of individual insurability, the carrier may not rescind a contract or a certificate on the basis of written information submitted on or with, or omitted from, an application for the health benefit plan unless the carrier completed medical underwriting and resolved all reasonable medical questions related to the written information submitted on or with, or omitted from, the application before issuing the health benefit plan.
(c)
The carrier shall have the burden of persuasion that its rescission of a health benefit plan complies with subsection (b) of this section.