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31.11.02.00.htm 31.11.02.00. Title 31 MARYLAND INSURANCE ADMINISTRATION Subtitle 11 HEALTH INSURANCE ― GROUP Chapter 02 Group Health Insurance ― Continuation of Coverage of Divorced Spouses Authority: Insurance Article, §2-109, 15-407―15-409, and 15-412; Health-General Article, §19-703; Annotated Code of Maryland
31.11.02.01.htm 31.11.02.01. 01 Purpose.. The purpose of this chapter is to provide standards for implementing requirements of the Insurance Article and of Health-General Article, Annotated Code of Maryland, with respect to providing or continuing coverage for certain divorced spouses and dependent children.
31.11.02.02.htm 31.11.02.02. 02 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) "Applicable change in status" means the divorce of the insured and the insured's spouse.. 2) "Dependent child" means an individual who:. a) Is a child of the insured; and. b) Either was covered under the group contract as a qualified or eligible dependent of the insured immediately preceding the applicable change in status, or was born to a qualified secondary beneficia
31.11.02.03.htm 31.11.02.03. 03 Applicability.. A. These regulations shall be applicable to all group health insurance policies or contracts issued or delivered in this State to the employer of the insured which provide hospital, surgical, medical, or major medical benefits on an expense-incurred basis whether issued by a nonprofit health service plan or by any other insurer and to all group policies or contracts issued or delivered in this State to an employer of an insured by a health mainte
31.11.02.04.htm 31.11.02.04. 04 Eligibility.. A. Beginning with an applicable change in status and until the occurrence of an event described in Regulation .07 of this chapter, the qualified secondary beneficiary shall be entitled to the benefits provided under the group contract.B. Section A of this regulation may not be applicable to any period during which the insured is not covered by a group contract.
31.11.02.05.htm 31.11.02.05. 05 Coverage Provided.. A. The coverage provided to a qualified secondary beneficiary shall be identical to the coverage which would have been provided under the group contract for the benefit of the qualified secondary beneficiary if the individual had remained an eligible dependent of the insured employee and there had been no applicable change in status.B. If modifications are made in the employer's group contract, the coverage provided to the qualified secondary beneficiary s
31.11.02.06.htm 31.11.02.06. 06 Conditions of Coverage.. A. In order to receive the benefits provided under the group contract, an insured employee, or the divorced spouse of the insured employee, shall notify the employer of the applicable change in status not later than:1) 60 days after the applicable change in status if on the date of the applicable change in status the employee is covered under the employer's group contract or under another group contract issued to the same employer replac
31.11.02.07.htm 31.11.02.07. 07 Termination.. A. Coverage for a qualified secondary beneficiary will terminate when the coverage under the group contract terminates with respect to the insured employee.B. Even though the insured employee continues to be covered under the group contract, coverage with respect to any individual qualified secondary beneficiary shall terminate on the date of occurrence of any of the following:1) The date on which the qualified secondary beneficiary becomes eligible f
31.11.02.08.htm 31.11.02.08. 08 Conversion and Continuation ― Repealed..
31.11.02.09.htm 31.11.02.09. 09 Notification Requirements.. A. Each group contract to which these regulations are applicable shall include a statement as provided in §B of this regulation.B. The statement shall disclose the availability of the benefits provided under these regulations and shall provide a summary of the eligibility requirements, the duration and general description of the benefits.C. Each group contract issued before the effective date of these regulations, to which these regulat
31.11.02.10.htm 31.11.02.10. 10 Termination Statement.. A. The termination statement shall be in language substantially as indicated in this regulation.. B. If the termination statement is signed by the insured and a qualified secondary beneficiary:. To _ (name of employer). This is to advise that _ (name or names of qualified secondary beneficiaries) is/are no longer to be covered under our group health insurance contract effective _date)The reason for this termination is _ (reason). Date:.
31.11.02.9999.htm 31.11.02.9999. Administrative History Effective date: September 19, 1988 (15:19 Md. R. 2247) ―. Chapter recodified from COMAR 09.30.77 to COMAR 31.11.02, July 1998. Regulation .08 repealed effective June 22, 2015 (42:12 Md. R. 764).
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