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<regulation prefix="Regulation" num=".09" citation="COMAR 31.12.04.09" title_num="31" subtitle_num="12" chapter_num="04" heading="Contract Forms.">
  <paragraph num="A.">
    <text>The dental plan organization:</text>
    <paragraph num="(1)">
      <text>Shall provide a written dental benefit contract to each group contract holder;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Shall provide a written evidence of coverage to each individual covered under a group dental benefit contract;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Shall provide a written dental benefit contract to each individual who applies for individual dental coverage;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Shall execute a written provider contract with each of the dental plan organization's plan dentists;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>May not deliver or issue for delivery in this State any of the following forms unless the form has been filed with and approved by the Insurance Commissioner:</text>
      <paragraph num="(a)">
        <text>Dental benefit contract,</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Evidence of coverage,</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Provider contract,</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Application form, and</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Riders or endorsement forms.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>The Commissioner shall disapprove any form filed, or withdraw any previous approval, if the form:</text>
    <paragraph num="(1)">
      <text>Contains or incorporates by reference, when the incorporation is otherwise permissible, any inconsistent, ambiguous, or misleading clauses, or exceptions and conditions which deceptively affect the risk purported to be assumed in the general coverage of the contract;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Has any title, heading, or other indication of its provisions which is likely to mislead the contract holder or individual;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Contains an inequitable provision or a provision without substantial benefit to the contract holder;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Is printed or otherwise reproduced in a manner as to render any provision of the form substantially illegible;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Includes benefit provisions which are unreasonable in relation to the premium or subscription fee charged; or</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Is a provider contract which does not provide for the rendering of covered services in a reasonable manner.</text>
    </paragraph>
  </paragraph>
</regulation>