2013 Maryland Code
INSURANCE
§ 27-221 - Prohibition against reunderwriting.

§27-221.

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

(2) “Carrier” means a person that is:

(i) an insurer that holds a certificate of authority in the State and provides health insurance in the State;

(ii) a health maintenance organization that holds a certificate of authority to operate in the State; or

(iii) a nonprofit health service plan that holds a certificate of authority to operate in the State.

(3) “Health coverage” means any of the following:

(i) a health insurance contract that is issued or delivered in the State by an insurer;

(ii) a contract that is issued or delivered in the State by a nonprofit health service plan; or

(iii) a contract that is issued or delivered in the State by a health maintenance organization.

(4) “Health status-related factor” has the meaning stated in § 15-1301 of this article.

(5) “Individual contract” means a contract between a carrier and an individual covering:

(i) the individual;

(ii) the individual and the individual’s family members; or

(iii) the family members of the individual.

(6) (i) “Reunderwrite” means to reevaluate any health status-related factor, occupation, hobby, or activity of an individual for the purpose of:

1. terminating health coverage of the individual; or

2. moving the individual from a more favorable rate class to a less favorable rate class.

(ii) “Reunderwrite” does not include:

1. moving an individual from one rate tier to another rate tier solely due to the addition or deletion of a family member under the health coverage;

2. increasing the premium under an attained age rated contract solely due to the increasing age of the individual covered under the health coverage;

3. on receipt of an application from an insured to increase the benefits under an existing contract, evaluating the health status-related factors, occupation, hobbies, or activities of the insured for the purpose of increasing the benefits under the contract; or

4. during the period in which a carrier has the right to contest a policy, denying a claim, amending the policy, making an adjustment to the premium, or rescinding the policy based on a material misrepresentation or fraud in the application.

(b) A carrier may not reunderwrite an individual for health coverage under an individual contract after the individual contract has been issued.