2013 Maryland Code
INSURANCE
§ 15-403 - Coverage for grandchildren

§15-403.

(a) This section applies to:

(1) each individual health insurance policy that:

(i) provides coverage on an expense-incurred basis; and

(ii) provides coverage for a family member of the insured;

(2) each group health insurance policy that:

(i) provides coverage on an expense-incurred basis for employees of an employer or employers or members of a union or unions; and

(ii) provides coverage for a family member of a covered employee or member; and

(3) each individual service or indemnity contract that:

(i) is issued by a nonprofit health service plan; and

(ii) provides coverage for a family member of the subscriber.

(b) Each policy or contract subject to this section shall provide that the same health insurance benefits and eligibility guidelines that apply to any covered dependent are available, on request of the insured, subscriber, employee, or member, to a grandchild who:

(1) is unmarried;

(2) is in the court-ordered custody of the insured, subscriber, employee, or member;

(3) resides with the insured, subscriber, employee, or member;

(4) is the dependent of the insured, subscriber, employee, or member; and

(5) has not attained the limiting age under the terms of the policy or contract.

(c) On request, an insurer that issues an individual or group health insurance policy that provides coverage on an expense-incurred basis or a nonprofit health service plan shall offer family members’ coverage to an insured or subscriber regardless of the marital status of the insured or subscriber.

(d) (1) An insurer or nonprofit health service plan may require proof that the insured or subscriber is the grandparent of the grandchild.

(2) If the insurer or nonprofit health service plan requires proof under this subsection, the insurer or nonprofit health service plan shall pay the cost of the proof.

§ 15-403 - 1. Coverage for individuals under guardianship

(a) Scope of section. -- This section applies to:

(1) each individual health insurance policy that:

(i) provides coverage on an expense-incurred basis; and

(ii) provides coverage for a family member of the insured;

(2) each group health insurance policy that:

(i) provides coverage on an expense-incurred basis for employees of an employer or employers or members of a union or unions; and

(ii) provides coverage for a family member of a covered employee or member; and

(3) each individual service or indemnity contract that:

(i) is issued by a nonprofit health service plan; and

(ii) provides coverage for a family member of the subscriber.

(b) In general. -- Each policy or contract subject to this section shall provide that the same health insurance benefits and eligibility guidelines that apply to any covered dependent are available, on request of the insured, subscriber, employee, or member, to an individual who:

(1) is unmarried;

(2) is under testamentary or court appointed guardianship, other than temporary guardianship of less than 12 months duration, of the insured, subscriber, employee, or member;

(3) resides with the insured, subscriber, employee, or member;

(4) is the dependent of the insured, subscriber, employee, or member; and

(5) has not attained the limiting age under the terms of the policy or contract.

(c) Marital status immaterial. -- On request, an insurer that issues an individual or group health insurance policy that provides coverage on an expense-incurred basis or a nonprofit health service plan shall offer family members' coverage to an insured or subscriber regardless of the marital status of the insured or subscriber.

(d) Required proof. --

(1) An insurer or nonprofit health service plan may require proof that the insured or subscriber is a guardian under court or testamentary appointment.

(2) If the insurer or nonprofit health service plan requires proof under this subsection, the insurer or nonprofit health service plan shall pay the cost of the proof.

§ 15-403 - 2. Coverage for child dependent of domestic partner.

(a) "Child dependent of the domestic partner" defined. -- In this section, "child dependent of the domestic partner" means an individual who:

(1) is:

(i) the natural child, stepchild, adopted child, or grandchild of the domestic partner of an insured;

(ii) a child placed with the domestic partner of an insured for legal adoption; or

(iii) a child who is under testamentary or court appointed guardianship, other than temporary guardianship of less than 12 months' duration, of the domestic partner of an insured;

(2) is a dependent, as that term is used in 26 U.S.C. §§ 104, 105, and 106, and any regulations adopted under those sections, of the domestic partner of an insured;

(3) resides with the insured;

(4) is unmarried; and

(5) is under the age of 25 years.

(b) Scope. -- This section applies to each individual or group policy or contract that:

(1) allows family coverage; and

(2) is issued by:

(i) an insurer or nonprofit health service plan that provides inpatient hospital, medical, or surgical benefits to individuals or groups on an expense-incurred basis under health insurance policies or contracts that are issued or delivered in the State; or

(ii) a health maintenance organization that provides inpatient hospital, medical, or surgical benefits to individuals or groups under contracts that are issued or delivered in the State.

(c) In general. -- Each policy or contract subject to this section shall provide that the same health insurance benefits and eligibility guidelines that apply to any covered dependent are available to a domestic partner of an insured or a child dependent of the domestic partner of an insured at the request of:

(1) an insured under an individual policy or contract that is subject to this section; or

(2) the group policyholder of a group policy or contract that is subject to this section.

(d) Required proof. -- An insurer, nonprofit health service plan, or health maintenance organization may require a group policyholder that requests coverage for a domestic partner or child dependent of the domestic partner of an insured under subsection (c)(2) of this section to provide proof of the eligibility of the domestic partner or child dependent of the domestic partner for coverage under this section.

(e) Regulations. -- The Commissioner shall adopt regulations to implement this section.