Maryland Insurance Section 15-415

Article - Insurance

§ 15-415.

      (a)      (1)      In this section the following words have the meanings indicated.

            (2)      "Group contract" means a health insurance contract or policy that:

                  (i)      is issued or delivered in the State to an employer by an insurer or nonprofit health service plan;

                  (ii)      provides hospital, medical, or surgical benefits on an expense-incurred basis; and

                  (iii)      covers a group of 100 or fewer individuals.

            (3)      "Succeeding policy" means a group contract that:

                  (i)      replaces or succeeds a group contract; and

                  (ii)      takes effect within 65 days after the date on which the replaced or succeeded group contract terminates.

            (4)      "Succeeding insurer" means the insurer or nonprofit health service plan that issues a succeeding policy.

      (b)      (1)      Before entering into a group contract, a succeeding insurer shall provide the employer with a written statement that:

                  (i)      describes any waiting periods for preexisting conditions, exclusions, or similar policy provisions in the succeeding policy that limit or exclude coverage; and

                  (ii)      identifies each individual who is covered under the replaced or succeeded group contract but who is ineligible for full coverage under the succeeding policy.

            (2)      The statement required under paragraph (1) of this subsection must be sufficiently clear and specific so that an individual of average intelligence can understand the statement without making further inquiry to the succeeding insurer.



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