# COMAR Title 31 — Maryland Insurance Administration

## Subtitle 12 — Health Maintenance Organizations; Entities That Act as Health Insurers

### Chapter 01 — Health Maintenance Organizations — Certificate of Authority and Fiscal Requirements

#### Regulation .14 Insurance — Catastrophic or Back-Up Coverage.

*COMAR 31.12.01.14*

A. Unless the Commissioner grants an exemption from the requirements of this section, the HMO shall secure insurance coverage to provide:

  (1) Payments or services required to be made or furnished under the health care contract to those enrollees who are injured or become ill outside the geographic limits served by the HMO; and

  (2) Reinsurance protection to the HMO in event of catastrophic or unusual losses which would be in excess of the levels of loss which the HMO assumes in the basis of its calculation of premium charges.

B. Any exemption to requirements of §A of this regulation shall be for a period of 1 year, and may be renewed from year to year thereafter. Any requests for renewal shall be made by the HMO at least 90 days before the expiration date of the then current exemption.

C. With the approval of the Commissioner, the HMO may reinsure any portion or aspect of its operation.