Chapter 11. Small Employer Group Health Insurance — Disclosure Statement
Regulation .01 Scope.LinkCopy Citation
This chapter applies to all carriers that offer the Comprehensive Standard Health Benefit Plan to the small employer market.
Regulation .02 Definitions.LinkCopy Citation
A.
In this chapter, the following terms have the meanings indicated.
B.
Terms Defined.
(1)
“Additional benefits” means benefits offered in addition to the Comprehensive Standard Health Benefit Plan that:
(a)
Are offered separately from the plan;
(b)
Are priced separately from the plan;
(c)
Are guarantee issued subject to the provisions of Insurance Article, §15-1213, Annotated Code of Maryland;
(d)
Are guarantee renewed subject to the provisions of Insurance Article, §15-1212, Annotated Code of Maryland;
(e)
Are community rated subject to the provisions of Insurance Article, §15-1205, Annotated Code of Maryland; and
(f)
Do not duplicate any of the benefits in the Comprehensive Standard Health Benefit Plan.
(2)
“Carrier” has the meaning stated in Insurance Article, §15-1201, Annotated Code of Maryland.
(3)
“Comprehensive Standard Health Benefit Plan” means the health benefit plan adopted by the Maryland Health Care Commission in accordance with Insurance Article, §15-1207, and Health-General Article, Title 19, Subtitle 1, Annotated Code of Maryland.
(4)
“Small employer” has the meaning stated in Insurance Article, §15-1201, Annotated Code of Maryland.
Regulation .03 Required Notice — Initial Purchase of Coverage.LinkCopy Citation
A.
At the time of the initial purchase of coverage, a carrier who offers benefits additional to the benefits offered in the Comprehensive Standard Health Benefit Plan shall obtain a signed disclosure statement certifying that:
(1)
The small employer was offered the Standard Comprehensive Health Benefit Plan; and
(2)
Additional benefits were offered and priced separately.
B.
The disclosure statement required in §A of this regulation shall be in at least 12-point type and shall read as follows:
C.
The disclosure statement required by §A of this regulation may be included on the carrier's sales proposal sheet.
D.
The carrier or insurance producer shall maintain the signed disclosure statement for not less than 5 years.
Regulation .04 Required Notice — Renewal of Coverage.LinkCopy Citation
A.
At the time of renewal of coverage, a carrier who offers benefits additional to the benefits offered in the Comprehensive Standard Health Benefit Plan shall provide a disclosure statement that:
(1)
Indicates that, except as described in §A(4) of this regulation, the Comprehensive Standard Health Benefit Plan is the only plan required by State law;
(2)
Identifies any additional benefits offered by the carrier at renewal;
(3)
Identifies the cost of any additional benefits offered by the carrier at renewal; and
(4)
Specifies that all additional benefits to the Comprehensive Standard Health Benefit Plan are not required by State law, with the exception of the additional benefit for compliance with the federal Mental Health Parity and Addiction Equity Act of 2008 for small employers subject to the federal Mental Health Parity and Addiction Equity Act of 2008.
B.
The disclosure statement required by §A of this regulation may be included on the renewal notice or another document.
Chapter annotations
Authority: Insurance Article, §§2-109 and 15-1204, Annotated Code of Maryland
History: Effective date: May 10, 2004 (31:9 Md. R. 713)
History: Regulation .03B amended effective March 21, 2011 (38:6 Md. R. 397)
History: Regulation .04A amended effective March 21, 2011 (38:6 Md. R. 397)