<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".04" citation="COMAR 31.12.02.04" title_num="31" subtitle_num="12" chapter_num="02" heading="Variable Information.">
  <paragraph num="A.">
    <text>Individual Contracts.</text>
    <paragraph num="(1)">
      <text>Except as specified in §A(2) of this regulation, an HMO may not include variable material in an individual contract, or in a form to be used with an individual contract.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>An HMO may include variable material, in an individual contract or in a form to be used with an individual contract in the following portions of the form:</text>
      <paragraph num="(a)">
        <text>The specifications, data, or schedule page;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The product marketing name;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The address of the HMO;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Signatures of officers of the HMO;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Descriptions of copayment amounts, deductibles, coinsurance amounts, out-of-pocket limits, annual maximums, or lifetime maximums;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Specific dates, such as effective dates and termination dates; and</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Descriptions of benefit amounts or benefit limits.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>If an individual contract or a form to be used with an individual contract contains variable material as permitted under §A(2) of this regulation, the HMO shall:</text>
      <paragraph num="(a)">
        <text>Bracket the variable material or otherwise mark the variable material to denote variability; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Include a statement of variability, in duplicate, that discusses how each variable item may change.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>If an individual contract or a form to be used with an individual contract is approved with variable material, an HMO may not submit a new statement of variability to be used with the previously approved contract or form, except for the following:</text>
      <paragraph num="(a)">
        <text>Copayment amounts;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Coinsurance amounts;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Deductible amounts;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Out-of-pocket limits;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Annual maximums;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Lifetime maximums;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Benefit amounts; or</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Benefit limits.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>An HMO shall include the following with a new statement of variability filing for a previously approved form:</text>
      <paragraph num="(a)">
        <text>A cover letter identifying the HMO and the HMO's National Association of Insurance Commissioners company code number; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The form number and date of approval of the form for which new variable material is being submitted.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Group Contracts.</text>
    <paragraph num="(1)">
      <text>An HMO may include variable material in a group contract or in a form to be used with a group contract, if the HMO:</text>
      <paragraph num="(a)">
        <text>Brackets the variable material or otherwise marks the variable material to denote variability; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Includes a statement of variability, in duplicate, that discusses how each variable item may change, including all textual variations that are intended.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>If a group contract or a form to be used with a group contract is approved with variable material, an HMO may not submit a new statement of variability to be used with the previously approved group contract or form, except for the following:</text>
      <paragraph num="(a)">
        <text>Copayment amounts;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Coinsurance amounts;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Deductible amounts;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Out-of-pocket limits;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Annual maximums;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Lifetime maximums;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Benefit amounts; or</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Benefit limits.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>An HMO shall include the following with a new statement of variability filing for a previously approved form:</text>
      <paragraph num="(a)">
        <text>A cover letter identifying the HMO and the HMO's National Association of Insurance Commissioners company code number; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The form number and date of approval of the form for which new variable material is being submitted.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>