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


MD Ins Code § 27-221 (2013) What's This?

§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.

Disclaimer: These codes may not be the most recent version. Maryland may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.