Section 15-403.1 – Coverage for Individuals Under Guardianship
(a) This section applies to: (1) each individual health insurance policy that: (i) provides coverage on an expense–incurred basis; and (ii) provides coverage for a family member of the insured; (2) each group health insurance policy that: (i) provides coverage on an expense–incurred basis for employees of an employer or employers or members of a union or unions; and (ii) provides coverage […]
Section 15-403.2 – Coverage for Child Dependent of Domestic Partner
(a) In this section, “child dependent of the domestic partner” means an individual who: (1) is: (i) the natural child, stepchild, adopted child, or grandchild of the domestic partner of an insured; (ii) a child placed with the domestic partner of an insured for legal adoption; or (iii) a child who is under testamentary or court appointed guardianship, other than […]
Section 15-404 – Addition of Children After Death of Spouse
(a) This section applies to: (1) each group or blanket health insurance policy that is issued or delivered in the State and provides coverage on an expense-incurred basis; and (2) each group medical or major medical contract or certificate that is issued or delivered in the State by a nonprofit health service plan. (b) Each policy, contract, or certificate […]
Section 15-405 – Enrollment of Child Under Coverage of Insuring Parent
(a) (1) In this section the following words have the meanings indicated. (2) “Carrier” means: (i) an insurer that holds a certificate of authority in the State and provides health insurance in the State; (ii) a health maintenance organization that is licensed to operate in the State; or (iii) a nonprofit health service plan that is licensed to operate in the […]
Section 15-406 – Medical Assistance
(a) In this section, “health insurance coverage” means health care coverage under which medical care services can be provided to a child. (b) This section applies to: (1) commercial insurers, nonprofit health service plans, and health maintenance organizations that operate in the State under a certificate of authority; (2) group health plans, as defined in § 607(1) of the […]
Section 15-407 – Continuation Coverage for Surviving Spouses and Dependent Children
(a) (1) In this section the following words have the meanings indicated. (2) “Dependent child” means a child of the insured who: (i) was covered under a group contract as a qualified or eligible dependent of the insured immediately before the death of the insured; or (ii) was born to a qualified secondary beneficiary defined in paragraph (5)(i) of this […]
Section 15-408 – Continuation Coverage for Divorced Spouses and Dependent Children
(a) (1) In this section the following words have the meanings indicated. (2) “Change in status” means the divorce of the insured and the insured’s spouse. (3) “Dependent child” means a child of the insured who: (i) was covered under a group contract as a qualified or eligible dependent of the insured immediately before the change in status; or (ii) was […]
Section 15-409 – Continuation Coverage for Terminated Employees
(a) (1) In this section the following words have the meanings indicated. (2) (i) “Change in status” means the termination of the insured’s employment other than for cause. (ii) “Change in status” includes: 1. involuntary termination of the insured’s employment other than for cause; and 2. voluntary termination of the insured’s employment by the insured employee. (3) “Group contract” means: (i) an insurance contract […]
Section 15-409.1 – Continuation Coverage for Involuntarily Terminated Employees — Small Employers
(a) (1) In this section the following words have the meanings indicated. (2) “Act” means the federal American Recovery and Reinvestment Act of 2009 (P.L. 111–5). (3) “Carrier” means: (i) an insurer; (ii) a nonprofit health service plan; or (iii) a health maintenance organization. (4) “Small employer” has the meaning stated in § 15–1201 of this title. (b) This section applies to a carrier […]
Section 15-411 – Open Enrollment of Involuntarily Terminated Spouse Losing Coverage
(a) Each group health insurance contract or policy that is issued by an insurer or nonprofit health service plan shall provide continuous open enrollment for the purpose of allowing a married employee who is enrolled under the contract or policy to alter the terms of the employee’s coverage to include the employee’s spouse or children if […]