Skip to Main Content
<< Back | Return to Main COMAR Search Page

13 records match your request.

FileAbstract
31.10.05.00.htm 31.10.05.00. Title 31 MARYLAND INSURANCE ADMINISTRATION Subtitle 10 HEALTH INSURANCE ― GENERAL Chapter 05 Minimum Standards for Medicare Supplement Policies Authority: Insurance Article, §2-109 and Title 15, Subtitle 9; Health-General Article, §19-705 and 19-706; Annotated Code of Maryland
31.10.05.01.htm 31.10.05.01. 01 Purpose.. The purpose of this chapter is to provide for the reasonable standardization of coverage and simplification of terms and benefits of Medicare supplement policies, to facilitate public understanding and comparison of these policies, to eliminate policy provisions which may be misleading or confusing in connection with the purchase of the policies or with the settlement of claims, and to provide for full disclosures in the sale of health insurance
31.10.05.02.htm 31.10.05.02. 02 Authority.. This chapter is issued pursuant to the authority given the Insurance Commissioner under Insurance Article, §2-109 and TItle 15, Subtitle 9, and Health-General Article, 19-705 and 19-706, Annotated Code of Maryland.
31.10.05.03.htm 31.10.05.03. 03 Applicability and Scope.. Except as otherwise specifically provided, this chapter applies to all:. A. Medicare supplement policies and subscriber contracts delivered or issued for delivery in this State before July 1, 1992; andB. Certificates issued under group Medicare supplement policies or subscriber contracts if the certificates were delivered or issued for delivery in this State before July 1, 1992.
31.10.05.04.htm 31.10.05.04. 04 Definitions.. A. Whenever used in this chapter or in a Medicare supplement policy subject to these regulations, or in any advertisement soliciting a Medicare supplement policy, the following terms shall have the meanings indicated.B. Terms Defined.. 1) "Applicant" means, in the case of:. a) An individual Medicare supplement policy or subscriber contract, the person who seeks to contract for insurance benefits; and
31.10.05.05.htm 31.10.05.05. 05 Policy Definitions and Terms.. A. An insurance policy, subscriber contract, or certificate may not be advertised, marketed, solicited, or issued for delivery in this State as a Medicare supplement policy unless it contains definitions or terms which conform to the requirements of this regulation, or definitions which are more favorable to the insured person or certificate holder.B. Terms To Be Defined in the Policy.. 1) Accident.. a) "Accident" "accidental
31.10.05.06.htm 31.10.05.06. 06 Prohibited Policy Provisions.. A. Waivers may not be included in or attached to a Medicare supplement policy if the effect of the waivers is to exclude, limit, or reduce coverage or benefits for specifically named or described diseases or physical conditions.B. A Medicare supplement policy or subscriber contract may not be advertised, solicited, or issued for delivery in this State as a Medicare supplement policy or subscriber contract if the policy or contract limits or excludes
31.10.05.07.htm 31.10.05.07. 07 Minimum Benefit Standards.. A. A health insurance policy, contract, or certificate may not be advertised, marketed, solicited, or issued for delivery in this State as a Medicare supplement policy or as a Medigap policy unless it meets the following general and minimum standards and unless the insurer and its agents adhere to the requirements of the Maryland statutes and regulations regarding the sale of Medicare supplement policies. The minimum standards do not preclude the
31.10.05.08.htm 31.10.05.08. 08 Standards for Claims Payment.. A. Each insurer providing Medicare supplement policies or contracts shall comply with all provisions of §4081 of the Omnibus Budget Reconciliation Act of 1987 (P.L. 100-203) and with applicable rules and regulations issued under the Act by the Secretary of the federal Department of Health and Human Services. Some of the provisions of the Act require each insurer issuing Medicare supplement policies to:
31.10.05.09.htm 31.10.05.09. 09 Loss Ratio Standards.. As soon as practicable, but before the effective date of Medicare benefit changes, each insurer issuing or delivering Medicare supplement policies or subscriber contracts in this State shall file with the Commissioner, in accordance with applicable filing procedures:A. Appropriate premium adjustments necessary to produce loss ratios as originally anticipated for the applicable policies or certificates. Supporting documents necessary to ju
31.10.05.10.htm 31.10.05.10. 10 Filing Requirements for Out-of-State Group Policies.. A. Each insurer providing group Medicare supplement insurance benefits to a resident of this State under a group policy issued elsewhere shall file a copy of the master policy and any certificate used in this State in accordance with the filing requirements and procedures applicable to group Medicare supplement policies issued in this State.B. If the out-of-State group policy is issued to an employer having a home
31.10.05.11.htm 31.10.05.11. 11 Required Disclosure Provisions.. A. General.. 1) Medicare supplement policies shall contain a clearly worded provision regarding the right of the policyholder to renew or continue the policy. This provision shall be appropriately captioned and shall be printed on the first page of the policy.2) Except for riders or endorsements by which the insurer effectuates a request made in writing by the insured or exercises a specifically reserved right under a Medicare supp
31.10.05.9999.htm 31.10.05.9999. Administrative History Effective date:. Regulations .01―09, Appendixes A―C adopted as an emergency provision effective July 1, 1982 (9:13 Md. R. 1340) adopted permanently effective October 1, 1982 (9:17 Md. R. 1707)Regulation .01 amended, Regulations .02―09 and Appendices A―C repealed, and new Regulations .02―14 and Appendices A―C adopted as an emergency provision effective July 25, 1989 (16:16 Md. R. 1738) emergency status extended at 16:26 Md. R. 2782 and 17:
<< Back | Return to Main COMAR Search Page