§ 15–1A-09
Statutes in effect as of October 1, 2026.
Md. Code Ann., Ins. § 15-1A-09 (2026)
Title 15. Health Insurance
Subtitle 1A. Consumer Protections
§ 15–1A-09LinkCopy Citation
(a)
Except as provided in subsections (b) through (d) of this section, a carrier shall accept every employer and individual in the State that applies for a health benefit plan, subject to the following provisions of this article:
(1)
Subtitle 4 of this title;
(2)
§§ 15–1206(c), 15–1208.1, 15–1208.2, 15–1209, and 15–1210 of this title;
(3)
§§ 15–1316 and 15–1318 of this title; and
(4)
§§ 15–1406 and 15–1406.1 of this title.
(b)
(1)
Except as provided in paragraph (2) of this subsection, a carrier may restrict enrollment to open or special enrollment periods.
(2)
A carrier that offers a large group plan shall allow an employer eligible to purchase a large group plan to purchase a large group plan at any time during the year.
(c)
If a carrier uses a network for a health benefit plan under which the financing and delivery of medical care are provided, in whole or in part, through a defined set of providers under contract with the carrier, the carrier:
(1)
(i)
may limit the employers that may apply for coverage to employers of eligible individuals who live, work, or reside in the service area for the network; and
(ii)
if the carrier is a health maintenance organization, may limit the individuals who may apply for coverage in the individual market to those who live or reside in the service area for the network; or
(2)
may deny coverage within a service area if the carrier:
(i)
demonstrates to the Commissioner that:
(1)
the carrier does not have the capacity to deliver adequate services to additional enrollees of groups or additional individuals because of its obligations to existing group contract holders and enrollees; and
(2)
the carrier applies the denial of coverage uniformly to all employers and individuals without regard to the claims experience or any health status–related factor; and
(ii)
does not offer coverage within the service area for at least 180 days after the date the carrier denied coverage in the service area.
(d)
A carrier may deny coverage if the carrier:
(1)
demonstrates to the Commissioner that:
(i)
the carrier does not have the financial reserves necessary to underwrite additional coverage; and
(ii)
the carrier applies the denial of coverage uniformly to all employers and individuals without regard to the claims experience or any health status–related factor; and
(2)
unless a later date is otherwise authorized by the Commissioner, does not offer the denied coverage for at least 180 days after the date the carrier denied the coverage.