Maryland Insurance Section 15-1209

CAUTION: READ FULL TEXT OF SECTION FOR SPECIAL NOTE

      (a)      This section does not apply to any insurance enumerated in § 15-1201(f)(3)(i) through (xiii) of this subtitle.

      (b)      A carrier shall issue its health benefit plans to each small employer that meets the requirements of this section.

      (c)      (1)      A carrier that offers insurance in the small group market shall offer the Standard Plan to each small employer that meets the requirements of this section.

            (2)      (i)      In this paragraph, "prominent carrier" means a carrier that insures at least 10% of the total lives insured in the small group market.

                  (ii)      A prominent carrier that offers insurance in the small group market shall offer, and any other carrier that offers insurance in the small group market may offer, the Limited Benefit Plan, but only to a small employer:

                        1.      that has not provided the Standard Plan during the 12-month period preceding the date of application or, if the small employer has existed for less than 12 months, from the date the small employer commenced its business; and

                        2.      for which the average annual wage of the employees of the small employer does not exceed 75% of the average annual wage in the State.

                  (iii)      A small employer that qualifies for and chooses the Limited Benefit Plan may renew the Limited Benefit Plan even if the average annual wage of the employees of the small employer exceeds 75% of the average annual wage in the State at the time of renewal.

      (d)      For small employers that qualify for and choose the Limited Benefit Plan, a carrier:

            (1)      must offer coverage for all eligible employees and dependents under the Limited Benefit Plan; and

            (2)      may not offer the Standard Plan for any employees of the small employer.

      (e)      (1)      Nothing in this subsection requires a small employer to contribute to the premium payments for coverage of a dependent of an eligible employee.

            (2)      To be covered under a health benefit plan offered by a carrier, a small employer shall:

                  (i)      elect to be covered;

                  (ii)      agree to pay the premiums;

                  (iii)      agree to offer coverage to any dependent of an eligible employee when coverage is sought by the eligible employee, in accordance with provisions governing late enrollees and any other provisions of this subtitle that apply to coverage;

                  (iv)      agree to collect payments for premiums through payroll deductions for coverage of eligible employees and dependents and transmit those payments to the carrier; and

                  (v)      satisfy other reasonable provisions of the health benefit plan as approved by the Commissioner.

      (f)      (1)      In determining whether a small employer satisfies the requirements of this section, a carrier shall apply its requirements uniformly among all small employers with the same number of eligible employees who apply for or receive coverage from the carrier, including a requirement that a minimum percentage of eligible employees of the small employer participate in the health benefit plan.

            (2)      A carrier may vary application of minimum participation of eligible employees only by the size of the group of the small employer.

      (g)      A carrier may not require a small employer to contribute to payment of premiums for a health benefit plan.

// SPECIAL NOTE: THE ABOVE SECTION WAS CHANGED BY CHAPTER 287 OF 2004 AND WILL REMAIN IN EFFECT UNTIL JUNE 30, 2008 //

      (a)      This section does not apply to any insurance enumerated in § 15-1201(f)(3)(i) through (xiii) of this subtitle.

      (b)      A carrier shall issue its health benefit plans to each small employer that meets the requirements of this section.

      (c)      (1)      Nothing in this subsection requires a small employer to contribute to the premium payments for coverage of a dependent of an eligible employee.

            (2)      To be covered under a health benefit plan offered by a carrier, a small employer shall:

                  (i)      elect to be covered;

                  (ii)      agree to pay the premiums;

                  (iii)      agree to offer coverage to any dependent of an eligible employee when coverage is sought by the eligible employee, in accordance with provisions governing late enrollees and any other provisions of this subtitle that apply to coverage;

                  (iv)      agree to collect payments for premiums through payroll deductions for coverage of eligible employees and dependents and transmit those payments to the carrier; and

                  (v)      satisfy other reasonable provisions of the health benefit plan as approved by the Commissioner.

      (d)      (1)      In determining whether a small employer satisfies the requirements of this section, a carrier shall apply its requirements uniformly among all small employers with the same number of eligible employees who apply for or receive coverage from the carrier, including a requirement that a minimum percentage of eligible employees of the small employer participate in the health benefit plan.

            (2)      A carrier may vary application of minimum participation of eligible employees only by the size of the group of the small employer.

      (e)      A carrier may not require a small employer to contribute to payment of premiums for a health benefit plan.