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31.04.17.00.htm 31.04.17.00. Title 31 MARYLAND INSURANCE ADMINISTRATION Subtitle 04 INSURERS Chapter 17 Filing of Forms for Approval Authority: Insurance Article, §2-109, 8-433(a) 12-203(a)1)i) and (2) and (b) 13-110(a) 14-109(3)iv) 14-110(a)2)iii)1, 14-126, 14-405(b)8) and (9) 14-410(c) 15-904, and 16-504(e) Annotated Code of Maryland
31.04.17.01.htm 31.04.17.01. 01 Applicability.. The submission of any form required to be filed under Insurance Article, §8-433(a) 12-203, 13-110(a) 14-109(3)iv) 14-110(a)2)iii) 14-126, 14-405(b)8) and (9) or 14-410(c) Annotated Code of Maryland as amended to date, shall be in compliance with the regulations in this chapter, except to the extent that a regulation or portion of a regulation is not applicable to a particular form.
31.04.17.02.htm 31.04.17.02. 02 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) "Carrier" means:. a) An insurer;. b) A nonprofit health service plan;. c) A dental plan organization; or. d) A fraternal benefit society.. 2) "Commissioner" means the Maryland Insurance Commissioner.. 3) Contract on an Insert Page Basis.. a) "Contract on an insert page basis" means a contract that is composed of insert pages, with each insert page being identifi
31.04.17.03.htm 31.04.17.03. 03 Filing of Forms for Approval.. A. Duplicate Forms Required For Nonelectronic Form Submissions.. 1) A carrier shall submit duplicate copies of each form the carrier intends to use in Maryland to the Commissioner for approval.2) If the Commissioner approves the form submitted by or on behalf of the carrier, the Commissioner shall:a) Retain one copy; and. b) Return to the carrier one copy, with an appropriate notation indicating approval.. B. A carrier submitting f
31.04.17.04.htm 31.04.17.04. 04 Variable Materials, Insert Pages, and Contracts Comprised of Sections.. A. Variable Information.. 1) Individual Contracts.. a) Except as specified in §A(1)b) of this regulation, a carrier may not include variable material in an individual contract, or in a form to be used with an individual contract.b) A carrier may include variable material in an individual contract or in a form to be used with an individual contract in the following portions of the form:
31.04.17.05.htm 31.04.17.05. 05 Failure to Respond to the Commissioner's Correspondence.. A. The Commissioner shall deem a filing withdrawn by the carrier if the carrier fails to respond to correspondence from the Commissioner regarding the filing within 90 days of the date of the correspondence from the Commissioner.B. If a carrier resubmits a form for approval after 90 days of the date of the Commissioner's correspondence regarding the filing in which the form was included, the carrier shall:
31.04.17.06.htm 31.04.17.06. 06 Contents of Application Forms.. A. An application form shall stipulate the plan and amount of insurance and any added optional benefits being applied for.B. If the carrier uses an application form which contains language substantially as follows, "Except that no change in amount, classification, plan of insurance or benefits shall be effective unless agreed to in writing by the applicant" with an additional statement that this exception is effective only in certain states, t
31.04.17.07.htm 31.04.17.07. 07 Advertising Material Within a Form.. A. A form may not contain any advertising material.. B. A carrier may use a marketing name, registered trademark, or logo in a form, if the logo, registered trademark, or marketing name does not mislead as to the identity of the carrier.C. A carrier may include text such as "50th Anniversary Year" "Established over 100 Years" or "Incorporated 1860" in a form.
31.04.17.08.htm 31.04.17.08. 08 Proxy.. A statement may not appear in the application with respect to a proxy through which one or more members of the board of directors is authorized to vote in the election of directors.
31.04.17.09.htm 31.04.17.09. 09 Life Insurance Policies.. A. In the case of term policies, the insurer shall indicate in clear, unambiguous language, whether or not coverage is granted if loss occurs on the term expiry date. Some examples of acceptable language are:1) If death occurs on or before the 5th anniversary of the policy, etc.. 2) If death occurs before but not including, the 5th anniversary of the policy, etc.. 3) This policy shall terminate on the 5th anniversary of the date of issue
31.04.17.10.htm 31.04.17.10. 10 General Requirements for Forms.. A. If a carrier embodies a brief description on the filing back of a form, the brief description shall be identical in language with that embodied on the first page of the form.B. An application, policy, or contract may not require a warranty of the state of health of the insured or that the good health of the insured be a condition precedent to the policy or contract.
31.04.17.11.htm 31.04.17.11. 11 Self-Destruction or Self-Inflicted Injury.. A. In any group life insurance policy, or in any provisions in either a life insurance policy or a certificate relating to additional disability benefits or to additional benefits in the event of death by accident or accidental means:1) If the insurer desires to exclude self-destruction or self-inflicted injury, or both, regardless whether intentional or unintentional, language such as "self-destruction and/or self-inflicted injur
31.04.17.12.htm 31.04.17.12. 12 Military Service Exclusion.. A. Except as provided in §B of this regulation, a contract shall provide for a refund of premium upon request of the policyholder of pro rata unearned premium for any period during which the insured is not covered if:1) Coverage terminates for an individual when the individual enters military service; or. 2) The contract excludes any coverage while the individual is in military service..
31.04.17.13.htm 31.04.17.13. 13 Prohibited Coverage.. A. Health Insurance Coverage Prohibited in Individual Life Insurance Policies. An ordinary or industrial life insurance policy may not include a health insurance benefit, except for the following types of benefits:1) Long-term care coverage;. 2) Accidental death and dismemberment coverage;. 3) Waiver of premium for permanent disability coverage;. 4) Acceleration of death benefit for terminal illness or chronic condition;.
31.04.17.14.htm 31.04.17.14. 14 Standard Nonforfeiture Value Method.. The expression "standard nonforfeiture value method" is acceptable for the description of the method of determining a cash value by deducting from the present value of future benefits, the present value of future nonforfeiture factors or adjusted premiums. When using this expression, it is necessary to state the amount of the nonforfeiture factor for the particular policy. If the nonforfeiture factor is identical with the
31.04.17.15.htm 31.04.17.15. 15 Recommendations of National Association of Insurance Commissioners.. The Commissioner shall be guided by recommendations made by a subcommittee of the National Association of Insurance Commissioners in those instances where:A. The question of the computation of minimum cash values for a particular type of policy or type of insurance coverage has been made the subject of a study by the subcommittee of the National Association of Insurance CommissB. Maryland does not have
31.04.17.16.htm 31.04.17.16. 16 Use of Dividends.. In a participating life insurance policy or certificate, if dividends may be used to purchase additional term or paid-up insurance, the policy shall specify the basis of the maximum charge for the purchase of this insurance.
31.04.17.17.htm 31.04.17.17. 17 Riots and Altercations.. A. Life Insurance. If a life insurance form excludes liability for injury or accidental death arising out of:1) A riot, the exclusion shall be confined to cases in which the insured is participating in the riot; and2) An altercation, the exclusion shall be confined to cases in which the insured provoked the altercation.B. Health Insurance. Exclusions or limitations for riots or altercations in health insurance and nonprofit health service pla
31.04.17.18.htm 31.04.17.18. 18 Health Insurance―Pre-Existing Condition Exclusions.. For health insurance contracts or contracts issued by a nonprofit health service plan, a carrier may not impose a pre-existing condition exclusion that exceeds 1 year if the application does not include medical questions or health history questions.
31.04.17.9999.htm 31.04.17.9999. Administrative History Effective date: June 1, 1967. Amended effective May 1, 1968. Regulations .01 and .02I amended effective September 23, 1985 (12:19 Md. R. 1848). Regulation .01 amended effective July 19, 1993 (20:14 Md. R. 1169). Regulation .02A-1 adopted effective July 19, 1993 (20:14 Md. R. 1169) ―. Chapter recodified from COMAR 09.30.45 to COMAR 31.04.17, July 1998 ―. Chapter revised effective April 25, 2005 (32:8 Md. R. 743).
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