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

13 records match your request.

FileAbstract
31.11.04.00.htm 31.11.04.00. Title 31 MARYLAND INSURANCE ADMINISTRATION Subtitle 11 HEALTH INSURANCE ― GROUP Chapter 04 Group Health Insurance ― Continuation of Coverage for Terminated Employees Authority: Insurance Article, §2-109, 14-124(b) and 15-409; Health-General Article, §19-703; Labor and Employment Article, §8-805 and 8-806; Annotated Code of Maryland
31.11.04.01.htm 31.11.04.01. 01 Purpose.. The purpose of this chapter is to provide standards for implementing requirements of the Insurance Article, Health-General Article, and Unemployment Insurance Law, Annotated Code of Maryland, with respect to continuation of coverage for certain terminated employees.
31.11.04.02.htm 31.11.04.02. 02 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) Applicable Change in Status.. a) "Applicable change in status" means the termination of the insured's employment other than for cause.b) "Applicable change in status" includes:. i) Involuntary termination of the insured's employment other than for cause; and. ii) Voluntary termination of the insured's employment by the insured.. 2) "Employer" means an em
31.11.04.03.htm 31.11.04.03. 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 by a health maintenance organiza
31.11.04.04.htm 31.11.04.04. 04 Eligibility.. Entitlement to continuation benefits shall begin with an applicable change in status and last until the occurrence of an event described in Regulation .06 of this chapter.
31.11.04.05.htm 31.11.04.05. 05 Coverage Provided.. A. The coverage provided shall be identical to the coverage offered under the group contract to similarly situated individuals for whom there has been no applicable change in status.B. If the group policy provides benefits for spouses and dependent children, the coverage provided shall be available to the insured's:1) Spouse if the spouse was covered under the group policy before the applicable change in status; and2) Dependent children if
31.11.04.06.htm 31.11.04.06. 06 Conditions of Coverage.. A. In order to receive the benefits provided under the group contract, an insured shall elect coverage not later than 45 days after the applicable change in status.B. The coverage shall be retroactive to the applicable change in status.. C. The request to the employer under §A of this regulation shall be in writing and signed by the insured.D. Continuation coverage shall be provided without evidence of insurability or additional waiting periods.
31.11.04.07.htm 31.11.04.07. 07 Termination.. Coverage for the insured shall terminate on the earliest of any of the following:. A. 18 months after the date of the applicable change in status;. B. The date on which the insured becomes eligible for hospital, surgical, medical, or major medical benefits under any insured group contract or any health maintenance organization group contract or any self-insured group health benefit program or plan provided:
31.11.04.08.htm 31.11.04.08. 08 Conversion and Continuation ― Repealed..
31.11.04.09.htm 31.11.04.09. 09 Notification Requirements.. A. Every group contract to which this chapter is applicable shall include a statement as provided in §B of this regulation.B. The statement shall disclose the availability of the benefits provided under this chapter and shall provide a summary of the eligibility requirements, the duration, and general description of the benefits.C. Every group contract issued before the effective date of this chapter, to which this chapter is applicable, shall be amend
31.11.04.10.htm 31.11.04.10. 10 Election Statement.. The form which the insured shall use to elect coverage under these regulations shall be in language substantially as indicated in this regulation:To _ ( name of employer ). I _ whose Social Security ( name of employee ). number is _ have been ( number ). terminated as an employee on _ (date of termination). Before termination I was covered under the employer's group health insurance contract (check one). for myself.. for myself and dependents..
31.11.04.11.htm 31.11.04.11. 11 Termination Statement.. The termination statement shall be in language substantially as indicated in this regulation.. To _ (name of employer). This is to advise that _ and (name of insured). covered dependants, if any, are no longer to be covered under our group health insurance contract effective _date)The reason for this termination is _ _ (reason). Date: _. Signature of Insured: _.
31.11.04.9999.htm 31.11.04.9999. Administrative History Effective date: December 14, 1987 (14:25 Md. R. 2659). Regulation .10 amended effective April 27, 1992 (19:8 Md. R. 804) ―. Chapter recodified from COMAR 09.30.84 to COMAR 31.11.04 effective September 7, 1998 (25:18 Md. R. 1439)Regulation .01 amended effective September 27, 2004 (31:19 Md. R. 1434). Regulation .02B amended effective September 27, 2004 (31:19 Md. R. 1434). Regulation .08 repealed effective June 22, 2015 (42:12 Md. R. 764).
<< Back | Return to Main COMAR Search Page