2019 Maryland Code
Insurance
Title 15 - Health Insurance
Subtitle 8 - Required Health Insurance Benefits
§ 15-826.2. Coverage for male sterilization

    (a)    (1)    In this subsection, “group” means a group that is not a group covered under a health insurance policy or contract or under a health maintenance organization contract issued or delivered to a small employer, as defined in § 31–101 of this article.

        (2)    This subsection applies to:

            (i)    insurers and nonprofit health service plans that provide hospital, medical, or surgical benefits to groups on an expense–incurred basis under health insurance policies or contracts that are issued or delivered in the State; and

            (ii)    health maintenance organizations that provide hospital, medical, or surgical benefits to groups under contracts that are issued or delivered in the State.

        (3)    This subsection does not apply to an organization that requests and receives an exclusion from coverage under § 15–826(c) of this subtitle.

        (4)    An entity subject to this subsection shall provide coverage for male sterilization.

    (b)    (1)    This subsection applies to:

            (i)    insurers and nonprofit health service plans that provide coverage for male sterilization under individual, group, or blanket health insurance policies or contracts that are issued or delivered in the State; and

            (ii)    health maintenance organizations that provide coverage for male sterilization under individual or group contracts that are issued or delivered in the State.

        (2)    Except as provided in paragraph (3) of this subsection and except with respect to a health benefit plan that is a grandfathered health plan, as defined in § 1251 of the Affordable Care Act, an entity subject to this subsection may not apply a copayment, coinsurance requirement, or deductible to coverage for male sterilization.

        (3)    If an insured or enrollee is covered under a high–deductible health plan, as defined in 26 U.S.C. § 223, an entity subject to this subsection may subject male sterilization to the deductible requirement of the high–deductible health plan.