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31.10.32.00.htm 31.10.32.00. Title 31 MARYLAND INSURANCE ADMINISTRATION Subtitle 10 HEALTH INSURANCE ― GENERAL Chapter 32 Nonprofit Health Service Plans ― Material Modification Authority: Insurance Article, §2-109(a)1) and 14-115(d)11)ii) Annotated Code of Maryland
31.10.32.01.htm 31.10.32.01. 01 Scope.. This chapter applies to each nonprofit health service plan that is subject to Insurance Article, §14-115(d) Annotated Code of Maryland.
31.10.32.02.htm 31.10.32.02. 02 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) "Baltimore metro region" means Anne Arundel County, Baltimore City, Baltimore County, Carroll County, Harford County, and Howard County.2) "Cost-sharing arrangement" includes:. a) A deductible;. b) A co-insurance amount;. c) A co-payment amount;. d) An annual limit;. e) A lifetime limit; and. f) An out-of-pocket maximum..
31.10.32.03.htm 31.10.32.03. 03 Material Modification.. For purposes of Insurance Article, §14-115(d)11)i) Annotated Code of Maryland, a modification is material if it modifies:A. The options available in a health benefit plan marketed in the State in a manner that results in a change of 20 percent or more in the actuarial benefit value of the health benefit plan;B. A provider network in a manner that results in a change of:.
31.10.32.04.htm 31.10.32.04. 04 Marketing Plan.. A. Development and Submission of Marketing Plan. Each year, a nonprofit health service plan shall:. 1) Develop a marketing plan; and. 2) Submit the marketing plan and any changes to the marketing plan to the board of directors of the nonprofit health service plan for approval.B. Contents of Marketing Plan. A nonprofit health service plan shall include in the marketing plan all of the nonprofit health service plan's marketing goals and objectives in
31.10.32.05.htm 31.10.32.05. 05 Evaluation Report.. One year after the effective date of this chapter, the board of directors of a nonprofit health service plan shall submit to the Commissioner an evaluation report that contains:A. The number of items that were required to be submitted to the board during the preceding year under each category contained in Regulation .03 of this chapter; andB. An evaluation of whether Regulation .03 of this chapter is effective in ensuring that the board o
31.10.32.06.htm 31.10.32.06. 06 Fiduciary Duty.. Compliance with Insurance Article, §14-115(d)11)i) Annotated Code of Maryland, and this chapter does not relieve the board of directors of a nonprofit health service plan or the individual members of the board from taking or refraining from taking any action otherwise required to comply with their fiduciary duties.
31.10.32.9999.htm 31.10.32.9999. Administrative History Effective date: September 26, 2005 (32:19 Md. R. 1588).
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