# Insurance (GIN)

## Title 15. Health Insurance

### Subtitle 11. Miscellaneous Health Insurance Policies and Contracts and Health Benefit Plans

#### Section 15-1104

(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. Sec. 106, Sec. 125, or Sec.  162.

  (3) "Group health insurance" has the meaning stated in Sec. 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, Sec.Sec. 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.

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Md. Code Ann., Ins. (as displayed at mgaleg.maryland.gov, October 16, 2026)