(a)Except as provided in subsections (b) through (d) of this section, a carrier shall accept every employer and individual in the State that applies for a health benefit plan, subject to the following provisions of this article:
(1)Subtitle 4 of this title;
(2)§§ 15–1206(c), 15–1208.1, 15–1208.2, 15–1209, and 15–1210 of this title;
(3)§§ 15–1316 and 15–1318 of this title; and
(4)§§ 15–1406 and 15–1406.1 of this title.
(b)(1) Except as provided in paragraph (2) of this subsection, a carrier may restrict enrollment to open or special enrollment periods.
(2)A carrier that offers a large group plan shall allow an employer eligible to purchase a large group plan to purchase a large group plan at any time during the
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(a) Except as provided in subsections (b) through (d) of this section, a carrier shall accept every employer and individual in the State that applies for a health benefit plan, subject to the following provisions of this article:
(1) Subtitle 4 of this title;
(2) §§ 15–1206(c), 15–1208.1, 15–1208.2, 15–1209, and 15–1210 of this title;
(3) §§ 15–1316 and 15–1318 of this title; and
(4) §§ 15–1406 and 15–1406.1 of this title.
(b) (1) Except as provided in paragraph (2) of this subsection, a carrier may restrict enrollment to open or special enrollment periods.
(2) A carrier that offers a large group plan shall allow an employer eligible to purchase a large group plan to purchase a large group plan at any time during the year.
(c) If a carrier uses a network for a health benefit plan under which the financing and delivery of medical care are provided, in whole or in part, through a defined set of providers under contract with the carrier, the carrier:
(1) (i) may limit the employers that may apply for coverage to employers of eligible individuals who live, work, or reside in the service area for the network; and
(ii) if the carrier is a health maintenance organization, may limit the individuals who may apply for coverage in the individual market to those who live or reside in the service area for the network; or
(2) may deny coverage within a service area if the carrier:
(i) demonstrates to the Commissioner that:
1. the carrier does not have the capacity to deliver adequate services to additional enrollees of groups or additional individuals because of its obligations to existing group contract holders and enrollees; and
2. the carrier applies the denial of coverage uniformly to all employers and individuals without regard to the claims experience or any health status–related factor; and
(ii) does not offer coverage within the service area for at least 180 days after the date the carrier denied coverage in the service area.
(d) A carrier may deny coverage if the carrier:
(1) demonstrates to the Commissioner that:
(i) the carrier does not have the financial reserves necessary to underwrite additional coverage; and
(ii) the carrier applies the denial of coverage uniformly to all employers and individuals without regard to the claims experience or any health status–related factor; and
(2) unless a later date is otherwise authorized by the Commissioner, does not offer the denied coverage for at least 180 days after the date the carrier denied the coverage.