§ 15-1409
295 words·~1 min read·
/md/insurance/15-1409A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
§15–1409.
(a)In this section, “product” means a discrete package of health benefits that are offered using a particular product network type within a geographic service area.
(b)A carrier that elects not to renew all of a particular product in the State shall:
(1)provide notice of the nonrenewal at least 90 days before the date of the nonrenewal to each affected:
(i)policyholder;
(ii)plan sponsor;
(iii)participant; and
(iv)beneficiary;
(2)offer to each affected plan sponsor the option to purchase any other health insurance coverage currently being offered by the carrier; and
(3)act uniformly without regard to the claims experience of any affected plan sponsor, or any health status–related factor of any affected individual.
(c)A carrier may elect not to renew all group health benefit plans in the State.
(d)When a carrier elects not to renew all group health benefit plans in the State, the carrier:
(1)shall give notice of its decision to the affected individuals at least 180 days before the effective date of nonrenewal;
(2)at least 30 working days before that notice, shall give notice to the Commissioner; and
(3)may not write new business for groups in the State for a 5–year period beginning on the date of notice to the Commissioner.
(e)A health maintenance organization need not offer coverage to an individual who does not live, reside, or work within the health maintenance organization’s approved service areas.
(f)A carrier may make a uniform modification of coverage for a product only at the time of renewal of a health benefit plan.
(g)A carrier will not be considered to have elected not to renew all group health benefit plans in the State if the carrier complies with 45 C.F.R. § 147.106(d)(3).