Md. Code, Ins. §§ 15-1201 through 15-1225: Maryland Health Insurance Reform Act – Maryland

Status: Enacted
Year Enacted: 1997
Year Amended: 2018
File: Download

Health benefit plans must set rates in compliance with this provision, and a carrier shall use a rating methodology that is based on the experience of all risks covered by that health benefit plan without regard to any factor not specifically authorized by this provision. A carrier may not arbitrarily transfer a small employer involuntarily into or out of a health benefit plan. With approval from the commisioner, a carrier may impose reasonable minimum participation requirements. Licensed insurance producers must disclose information about wellness benefits and small employer tax deductions, and may discuss CHIP and Medicaid with the employer. Insurers must provide information in advertisements about the possibilty of rate changes and preexisting conditions. In establishing cost-sharing as part of the Standard Plan, the Commission shall include cost-sharing and other incentives to help prevent consumers from seeking unnecessary services; balance the effect of cost-sharing in reducing premiums and in affecting utilization of appropriate services; and limit the total cost-sharing that may be incurred by an individual in a year.


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