Health Insurance, second half

What this document is

Maryland Insurance Article Title 15 - Health Insurance, second half (Secs. 15-816 through 15-1704) is a state statute published by Maryland General Assembly, Department of Legislative Services (mgaleg.maryland.gov). It is one of the Maryland documents that insurance license exam questions are written from, including maryland life & health practice questions. This page summarizes it and points to the official version, which is the text to rely on.

Sections cited in practice questions

Each practice answer shows the exact passage it comes from. These are sections of this document that questions cite, with a short excerpt from the source text.

• Md. Code Ann., Ins. Title 15 § 15-1606 (Agreements With Unregistered Pharmacy Benefits Managers)

  “A carrier may not enter into an agreement with a pharmacy benefits manager that has not registered with the Commissioner.”

• Md. Code Ann., Ins. Title 15 § 15-826 (Religious Organization Exclusion from Contraceptive Coverage)

  “(c) (1) A religious organization may request and an entity subject to this section shall grant the request for an exclusion from coverage under the policy, plan, or contract for the coverage required under subsection (b) of this section if the required coverage conflicts with the religious...”

• Md. Code Ann., Ins. Title 15 § 15-822 (Diabetes Coverage; Test Strip Cost Sharing)

  “(3) (i) Except as provided in subparagraph (ii) of this paragraph, an entity subject to this section may not impose a deductible, copayment, or coinsurance requirement on diabetes test strips. (ii) If an insured or enrollee is covered under a high–deductible health plan, as defined in 26 U.S.C. §...”

• Md. Code Ann., Ins. Title 15 § 15-1407 (Premium or Contribution Discrimination Prohibited)

  “A carrier may not require an individual member of a group to pay a premium or contribution that is greater than the premium or contribution for a similarly situated individual, based on any health status-related factor.”

• Md. Code Ann., Ins. Title 15 § 15-1409(b) (Discontinuance of a Product in the Group Market)

  “(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...”

• Md. Code Ann., Ins. Title 15 § 15-1210(b)(2) (HMO Network Capacity Exception, Small Employer Coverage)

  “A health maintenance organization that does not offer coverage under paragraph (1)(iii) of this subsection may not offer coverage in the applicable area to any employer groups until the later of: (i) 180 days after a refusal to do so; or (ii) the date on which the health maintenance organization...”

• Md. Code Ann., Ins. Title 15 § 15-1214 (Hospital Reimbursement Rates for Small Employer Plans)

  “Notwithstanding any other provision of this subtitle, health benefit plans shall reimburse hospitals in accordance with rates approved by the State Health Services Cost Review Commission.”

• Md. Code Ann., Ins. Title 15 § 15-1006 (Written Notice of Claim Denial on Individual Policies)

  “On written request of the claimant, an insurer that denies a claim made on an individual health insurance policy shall give written notice to the claimant that states fully the reason for the denial. (b) The reason given by an insurer for denial of a claim shall not act as an estoppel or limit the...”

• Md. Code Ann., Ins. Title 15 § 15-1314 (Frequency of Individual Premium Increases)

  “(a) Except as provided in subsection (c) of this section, a carrier may not increase an individual’s premium on an individual health benefit plan more frequently than once every 12 months. (b) An increase in an individual’s premium described in subsection (a) of this section includes an increase...”

• Md. Code Ann., Ins. Title 15 § 15-824 (Maintenance Drug Supply in a Single Dispensing)

  “(d) (1) An entity subject to this section shall allow an insured or enrollee, if authorized by an authorized prescriber, to receive up to a 90-day supply of a maintenance drug in a single dispensing of the prescription. (2) The provisions of paragraph (1) of this subsection do not apply to the...”

• Md. Code Ann., Ins. Title 15 § 15-1209(e) (Small Employer Availability; Employer Premium Contribution)

  “A carrier may not require a small employer to contribute to payment of premiums for a health benefit plan.”

• Md. Code Ann., Ins. Title 15 § 15-1610 (Delivery Through a Nonresident Pharmacy)

  “A pharmacy benefits manager may not ship, mail, or deliver prescription drugs or devices to a person in the State through a nonresident pharmacy unless the nonresident pharmacy holds a permit issued in accordance with the provisions of § 12–403 of the Health Occupations Article.”

Practice this material

Questions about this source

More Maryland sources

• Md. Code, Insurance s. 10-104 - License required; insurance producerState statute
• Md. Code, Insurance s. 10-126 - Grounds for denial, suspension, or revocation of licenseState statute
• Md. Code, Insurance s. 27-208 - Unfair discrimination between individuals of the same class in life rates, dividends and benefitsState statute
• Md. Code, Insurance s. 27-209 - Prohibited inducements and rebates not specified in the contractState statute
• Md. Code, Insurance s. 27-216 - Rebating and inducements; willful collection of excess premiumState statute
• Md. Code, Insurance s. 27-405 - Fraudulent insurance act: acting without a licence or certificationState statute
• Maryland Insurance Article Title 10 - Insurance Producers and Other Insurance Professionals (103 sections)State statute
• Maryland Insurance Article Title 15 - Health Insurance, first half (Secs. 15-101 through 15-815)State statute