§ 15-1A-02

Maryland § 15-1A-02

• Jurisdiction: Maryland
• Article gin: Insurance
• Title: 15

Text

(a) The Commissioner may enforce:

(1) the provisions of this subtitle; and

(2) notwithstanding any other provisions of law, the following provisions of Title 1, Subtitles A, C, and D of the Affordable Care Act as they apply to individual health insurance coverage and health insurance coverage offered in the small group and large group markets as those terms are defined in the federal Public Health Service Act, issued or delivered in the State by an authorized insurer, nonprofit health service plan, or health maintenance organization:

(i) coverage of children up to the age of 26 years;

(ii) preexisting condition exclusions;

(iii) policy rescissions;

(iv) bona fide wellness programs;

(v) lifetime limits;

(vi) annual limits for essential benefits;

(vii) waiting periods;

(viii) designation of primary care providers;

(ix) access to obstetrical and gynecological services;

(x) emergency services;

(xi) summary of benefits and coverage explanation;

(xii) minimum loss ratio requirements and premium rebates;

(xiii) disclosure of information;

(xiv) annual limitations on cost–sharing;

(xv) child–only plan offerings in the individual market;

(xvi) minimum benefit requirements for catastrophic plans;

(xvii) health insurance premium rates;

(xviii) coverage for individuals participating in approved clinical trials;

(xix) contract requirements for stand–alone dental plans sold on the Maryland Health Benefit Exchange;

(xx) guaranteed availability of coverage;

(xxi) prescription drug benefit requirements; and

(xxii) preventive and wellness services and chronic disease management.

(b) The Commissioner may enforce the provisions identified under subsection (a) of this section under any applicable powers granted to the Commissioner under this article.