<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".03" citation="COMAR 31.12.02.03" title_num="31" subtitle_num="12" chapter_num="02" heading="Submittals.">
  <paragraph num="A.">
    <text>Submittals of Forms to Commissioner.</text>
    <paragraph num="(1)">
      <text>An HMO shall submit to the Commissioner for approval every form that it intends to use in Maryland.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The Commissioner shall either approve or disapprove the form for use within 60 days of the receipt of the form in the Commissioner's office.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>An HMO may not use a form before the Commissioner's approval unless the Commissioner has not acted at the end of the 60-day period described in §A(2) of this regulation.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>The Commissioner may withdraw the Commissioner's prior approval or may disapprove a form previously permitted to be used if the Commissioner gives the HMO at least 30 days' notice before the effective date of the Commissioner's action disapproving the form.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Duplicate Forms Required For Nonelectronic Form Submissions.</text>
    <paragraph num="(1)">
      <text>An HMO shall submit duplicate copies of each nonelectronic form the HMO intends to use in Maryland to the Commissioner for approval.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>If the Commissioner approves the nonelectronic form submitted by or on behalf of the HMO, the Commissioner shall:</text>
      <paragraph num="(a)">
        <text>Retain one copy; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Return to the HMO one copy, with an appropriate notation indicating approval.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Each form submitted for approval shall be accompanied by:</text>
    <paragraph num="(1)">
      <text>A current transmittal form developed by:</text>
      <paragraph num="(a)">
        <text>The Maryland Insurance Administration; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The National Association of Insurance Commissioners (NAIC);</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>A filing fee in accordance with Insurance Article, §2-112, Annotated Code of Maryland;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Except for electronic form filings, a self-addressed, stamped envelope; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>A cover letter listing the forms submitted for approval by form number, with a brief description of each form filed for approval.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>The HMO may not use a form disapproved by the Commissioner.</text>
  </paragraph>
  <paragraph num="E.">
    <text>If a printed form has been disapproved, the HMO may resubmit the form with modifications made by imprinting, multigraph, mimeograph, multilith, electronic printer, or rubber stamp. The HMO may not resubmit a form with handwritten or typewritten changes, interlineations, or deletions.</text>
  </paragraph>
  <paragraph num="F.">
    <text>Submission of Forms.</text>
    <paragraph num="(1)">
      <text>Except as provided in §F(2) of this regulation, an HMO shall submit forms for approval with the Commissioner.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>A third party may submit a form for approval on behalf of an HMO, if the third party includes a written authorization from the HMO to make the form filing.</text>
    </paragraph>
  </paragraph>
  <paragraph num="G.">
    <text>Representative Specimen Data. Except for applications filed for approval, an HMO shall complete each form filed for approval with representative specimen data.</text>
  </paragraph>
  <paragraph num="H.">
    <text>Contracts with Insert Pages.</text>
    <paragraph num="(1)">
      <text>An HMO may file for approval of a contract on an insert page basis, only if:</text>
      <paragraph num="(a)">
        <text>Each insert page is identified by a unique form number appearing in the lower left corner of the insert page; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The HMO includes the following information in the filing submission:</text>
        <paragraph num="(i)">
          <text>A description of how the various insert pages will be combined;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>A listing of the insert pages that can be substituted for other specific insert pages; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>The filing fee required under Insurance Article, §2-112, Annotated Code of Maryland, for each insert page with a unique form number.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>An HMO may not file for approval of insert pages for use with a previously approved contract, if the previously approved contract was not approved on an insert page basis.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>If an HMO files for approval of insert pages for a previously approved contract, the submission shall:</text>
      <paragraph num="(a)">
        <text>Identify by form number and date of approval any insert pages that the new insert pages will replace; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Include a copy of the currently approved contract, unless the Commissioner waives the requirement or determines that a copy is not necessary to review the submission.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="I.">
    <text>Contracts Comprised of Sections.</text>
    <paragraph num="(1)">
      <text>An HMO may file for approval of a contract on a sectional basis, only if:</text>
      <paragraph num="(a)">
        <text>Each section is identified by a unique form number appearing in the lower left corner of the first page of the section; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The HMO includes the following information in the filing submission:</text>
        <paragraph num="(i)">
          <text>A description of how the various sections will be combined;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>A listing of the sections that can be substituted for other specific sections; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>The filing fee required under Insurance Article, §2-112, Annotated Code of Maryland, for each section with a unique form number.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>An HMO may not file for approval of sections for use with a previously approved contract, if the previously approved contract was not approved on a sectional basis.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>If an HMO files for approval of sections for a previously approved contract, the submission shall:</text>
      <paragraph num="(a)">
        <text>Identify by form number and date of approval any sections that the new sections will replace; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Include a copy of the currently approved contract, unless the Commissioner waives the requirement or determines that a copy is not necessary to review the submission.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>