<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".03" citation="COMAR 31.10.10.03" title_num="31" subtitle_num="10" chapter_num="10" heading="Summary Form.">
  <paragraph num="A.">
    <text>An insurer which provides benefits for inpatient hospitalization or outpatient surgical care on an expense-incurred basis shall provide claimants annually a consolidated summary explanation regarding benefits claimed for those services during each calendar year.</text>
  </paragraph>
  <paragraph num="B.">
    <text>The summary shall identify the provider by name and shall state the:</text>
    <paragraph num="(1)">
      <text>Date of the service;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Amount claimed;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Amount which was paid or is payable by the insurer on claims processed during the year; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Balance to be paid by the covered individual, if the balance is determinable from the claim forms submitted.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>The summary referred to in §B of this regulation shall be provided by insurers to claimants between January 1 and February 15 for claims made during the preceding calendar year.</text>
  </paragraph>
  <paragraph num="D.">
    <text>At the insurer's option, the summary may include information pertaining to benefits other than those specified in §A of this regulation.</text>
  </paragraph>
</regulation>