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<subtitle article="gin" title_number="15" subtitle_number="11" title_name="Health Insurance" subtitle_name="Miscellaneous Health Insurance Policies and Contracts and Health Benefit Plans">
  <section article="gin" article_name="Insurance" number="15-1102" title_number="15" title_name="Health Insurance" subtitle_number="11" subtitle_name="Miscellaneous Health Insurance Policies and Contracts and Health Benefit Plans">
    <level label="a">
      <text>In this section, “employee” includes:</text>
      <level label="1">
        <text>an officer, manager, or retired employee of an employer;</text>
      </level>
      <level label="2">
        <text>a sole proprietor if the employer is a sole proprietorship; and</text>
      </level>
      <level label="3">
        <text>a partner if the employer is a partnership.</text>
      </level>
    </level>
    <level label="b">
      <text>Health insurance on a franchise plan is the form of health insurance:</text>
      <level label="1">
        <text>that is issued to:</text>
        <level label="i">
          <text>three or more employees of a corporation, partnership, sole proprietorship, or governmental corporation, agency, or department; or</text>
        </level>
        <level label="ii">
          <text>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;</text>
        </level>
      </level>
      <level label="2">
        <text>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</text>
      </level>
      <level label="3">
        <text>under which the premiums on the individual policies may be paid to the insurer periodically by:</text>
        <level label="i">
          <text>the employer, with or without payroll deductions;</text>
        </level>
        <level label="ii">
          <text>the labor union or association for its members; or</text>
        </level>
        <level label="iii">
          <text>a designated person acting on behalf of the employer, labor union, or association.</text>
        </level>
      </level>
    </level>
  </section>
  <section article="gin" article_name="Insurance" number="15-1103" title_number="15" title_name="Health Insurance" subtitle_number="11" subtitle_name="Miscellaneous Health Insurance Policies and Contracts and Health Benefit Plans">
    <level label="a">
      <text>In this section, “transportation ticket policy” means a ticket policy of health insurance that:</text>
      <level label="1">
        <text>has as its dominant feature the protection of the insured from a transportation hazard; and</text>
      </level>
      <level label="2">
        <text>is sold at transportation stations, ticket offices, or travel bureaus by:</text>
        <level label="i">
          <text>vending machines;</text>
        </level>
        <level label="ii">
          <text>employees of railroads, steam lines, airlines, or other organizations engaged in transporting individuals on common carriers;</text>
        </level>
        <level label="iii">
          <text>individuals or employees of persons engaged in selling transportation on common carriers; or</text>
        </level>
        <level label="iv">
          <text>other qualified agents.</text>
        </level>
      </level>
    </level>
    <level label="b">
      <text>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.</text>
    </level>
  </section>
  <section article="gin" article_name="Insurance" number="15-1104" title_number="15" title_name="Health Insurance" subtitle_number="11" subtitle_name="Miscellaneous Health Insurance Policies and Contracts and Health Benefit Plans">
    <level label="a">
      <level label="1">
        <text>In this section the following words have the  meanings indicated.</text>
      </level>
      <level label="2">
        <text>“Employer sponsored health benefit plan” means any  plan, fund, or program that:</text>
        <level label="i">
          <text>is established or maintained by an employer  under the Employee Retirement Income Security Act of 1974;</text>
        </level>
        <level label="ii">
          <text>offers coverage for health benefits; and</text>
        </level>
        <level label="iii">
          <text>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.</text>
        </level>
      </level>
      <level label="3">
        <text>“Group health insurance” has the meaning stated in § 15–302 of this title.</text>
      </level>
      <level label="4">
        <text>“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.</text>
      </level>
      <level label="5">
        <text>“Special eligible employee” means an employee who:</text>
        <level label="i">
          <text>is eligible for health coverage under the terms of an employer sponsored health benefit plan;</text>
        </level>
        <level label="ii">
          <text>works:</text>
          <level label="1">
            <text>on a temporary or substitute basis; or</text>
          </level>
          <level label="2">
            <text>less than 30 hours in a normal workweek;  and</text>
          </level>
        </level>
        <level label="iii">
          <text>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.</text>
        </level>
      </level>
    </level>
    <level label="b">
      <text>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:</text>
      <level label="1">
        <text>special eligible employees; or</text>
      </level>
      <level label="2">
        <text>special eligible employees and their dependents.</text>
      </level>
    </level>
    <level label="c">
      <text>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:</text>
      <level label="1">
        <text>collect payment for premiums due under the limited benefit group health insurance contract through payroll  deduction;</text>
      </level>
      <level label="2">
        <text>contribute to the premium payments applicable to  the coverage of a special eligible employee; and</text>
      </level>
      <level label="3">
        <text>offer coverage to any dependent of a special  eligible employee.</text>
      </level>
    </level>
    <level label="d">
      <text>A limited benefit group health insurance contract shall  comply with:</text>
      <level label="1">
        <text>this title, except Subtitles 7 and 8 of this title; and</text>
      </level>
      <level label="2">
        <text>notwithstanding item (1) of this subsection, §§ 15–802, 15–812, 15–815, 15–830, 15–831, 15–832, and 15–833 of this title.</text>
      </level>
    </level>
    <level label="e">
      <text>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.</text>
    </level>
  </section>
  <section article="gin" article_name="Insurance" number="15-1106" title_number="15" title_name="Health Insurance" subtitle_number="11" subtitle_name="Miscellaneous Health Insurance Policies and Contracts and Health Benefit Plans">
    <level label="a">
      <level label="1">
        <text>In this section the following words have the meanings indicated.</text>
      </level>
      <level label="2">
        <text>“Carrier” means:</text>
        <level label="i">
          <text>an insurer;</text>
        </level>
        <level label="ii">
          <text>a nonprofit health service plan; or</text>
        </level>
        <level label="iii">
          <text>a health maintenance organization.</text>
        </level>
      </level>
      <level label="3">
        <text>“Evidence of individual insurability” has the meaning stated in § 15–1105 of this subtitle.</text>
      </level>
      <level label="4">
        <text>“Health benefit plan” has the meaning stated in § 15–1301 of this title.</text>
      </level>
    </level>
    <level label="b">
      <text>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.</text>
    </level>
    <level label="c">
      <text>The carrier shall have the burden of persuasion that its rescission of a health benefit plan complies with subsection (b) of this section.</text>
    </level>
  </section>
</subtitle>