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31.10.13.00.htm 31.10.13.00. Title 31 MARYLAND INSURANCE ADMINISTRATION Subtitle 10 HEALTH INSURANCE ― GENERAL Chapter 13 Return of Premium, Cash Surrender, or Other Nonforfeiture Benefits in Health Insurance Policies Authority: Insurance Article, §2-109 and 12-203―12-205, Annotated Code of Maryland
31.10.13.01.htm 31.10.13.01. 01 Preface.. The issuance or delivery of health insurance policies in Maryland in any manner not in compliance with this chapter shall be deemed to constitute the transaction of insurance business hazardous to policyholders and the public and contrary to the public interest and otherwise contrary to requirements of the Insurance Article. Insurance Article, §2-109, Annotated Code of Maryland, authorizes the Commissioner to make reasonable regulations necessary
31.10.13.02.htm 31.10.13.02. 02 Applicability.. This chapter applies to individual policies of health insurance and its application varies with the types of benefit provided by a policy. For this purpose, the benefits which have been found to appear in individual policies of health insurance are classified as follows:A. Type 1: A benefit payable if an event involving a morbidity risk occurs or commences during the premium paying period of the policy. Most accident and health insurance bene
31.10.13.03.htm 31.10.13.03. 03 Purpose.. The purpose of this chapter is to serve the interests of continuing policyholders and to afford reasonable protection to the interests of those policyholders who are forced to discontinue their policies prematurely by regulating the design of the policies in a manner which is equitable to the policyholder and which provides benefits reasonable in relation to the premium charged and which provides benefits of economic value to the insured.
31.10.13.04.htm 31.10.13.04. 04 Construction.. The classification in Regulation .02 of this chapter applies to the benefit rather than to the policy. A policy may contain benefits of more than one type. Benefits of Type 2 and Type 3 are deemed supplementary to Type 1 benefits. Premiums for Type 2 benefits and Type 3 benefits are normally payable at the same time as premiums for other benefits of the policy, but payments of Type 2 and and Type 3 benefits will normally be made only after the pa
31.10.13.05.htm 31.10.13.05. 05 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) "Guaranteed renewable" when used in connection with an individual health insurance policy means that the insured has the right to continue the policy in force by the timely payment of premiums:a) Until at least age 50; or. b) In the case of a policy issued after age 44, for at least 5 years from its date of issue, during which period the insurer has no right to make unil
31.10.13.06.htm 31.10.13.06. 06 Type 1 Benefit.. Provision for a withdrawal benefit in connection with a nondeferred benefit, Type 1, is not required. However, provision for a withdrawal benefit in connection with a Type 1 benefit may be used at the insurer's option, if any payment under it is not greater than an amount corresponding to a reserve which might properly be held at the time of withdrawal with respect to the Type 1 benefit to which it is related.
31.10.13.07.htm 31.10.13.07. 07 Type 2 or Type 3 Benefit.. A. No deferred benefit of Type 2 or Type 3, or any provision for a withdrawal benefit, may be used in any individual policy of health insurance unless the policy is guaranteed renewable.B. An individual policy containing a provision for a Type 2 or Type 3 benefit shall make further provision for a withdrawal benefit. In the event of discontinuance by the policyholder on or after the fifth anniversary of the effective date of the pol
31.10.13.08.htm 31.10.13.08. 08 Combining Withdrawal Provisions.. If a policy provides for withdrawal benefits in connection with more than one benefit or more than one type of benefit, provision for these withdrawal benefits may be combined in a single part of the policy.
31.10.13.09.htm 31.10.13.09. 09 Death of an Insured.. Any cash withdrawal benefit provided by a policy shall be payable on death of an insured..
31.10.13.10.htm 31.10.13.10. 10 Policies Insuring More Than One Life.. If a policy covers more than one life, any provision of the regulation defining a minimum withdrawal benefit shall be construed, when appropriate, to be applicable separately to each covered life. The benefit provision shall be specific in regard to the determination of the amount of benefits under these cases.
31.10.13.11.htm 31.10.13.11. 11 Dividends.. For purposes of this chapter, dividends to policyholders may not be regarded as claims paid, but may be regarded as reductions of premiums paid.
31.10.13.12.htm 31.10.13.12. 12 Premium Waiver.. For purposes of this chapter, a waived premium shall be regarded both as a premium paid and a claim paid.
31.10.13.13.htm 31.10.13.13. 13 Premium Notices.. The insurer shall send the policyholder timely advance notice of each premium as it comes due, unless the premium installments are payable on a payroll savings or salary deduction plan, or by a series of preauthorized checks or bank drafts, or a similar plan.
31.10.13.14.htm 31.10.13.14. 14 Advertising.. A sales presentation or advertising concerning any Type 2 or Type 3 benefit may not state, or in any manner indicate or imply, or tend to cause the policyholder to believe, that any withdrawal benefit is provided free or without additional cost or charge to the policyholder.
31.10.13.9999.htm 31.10.13.9999. Administrative History Effective date: August 10, 1979 (6:16 Md. R. 1330) ―. Chapter recodified from COMAR 09.30.46 to COMAR 31.10.13, July 1998.
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