Md. Code Regs. 31.04.17.04

Current through Register Vol. 51, No. 22, November 1, 2024

Section 31.04.17.04 - Variable Materials, Insert Pages, and Contracts Comprised of Sections

A. Variable Information.

(1) Individual Contracts.

(a) Except as specified in §A(1)(b) of this regulation, a carrier may not include variable material in an individual contract, or in a form to be used with an individual contract.

(b) A carrier may include variable material in an individual contract or in a form to be used with an individual contract in the following portions of the form:

(i) The specifications, data, or schedule page;

(ii) The product marketing name;

(iii) The address of the carrier;

(iv) Signatures of officers of the carrier;

(v) Descriptions of copayment amounts, deductibles, coinsurance amounts, out-of-pocket limits, annual maximums, or lifetime maximums;

(vi) Specific dates, such as effective dates and termination dates; and

(vii) Descriptions of benefit amounts, benefit limits, waiting periods or elimination periods.

(c) If an individual contract or a form to be used with an individual contract contains variable material as permitted under §A(1)(b) of this regulation, the carrier shall:

(i) Bracket the variable material or otherwise mark the variable material to denote variability; and

(ii) Include a statement of variability, in duplicate, that discusses how each variable item may change.

(d) After an individual contract or a form to be used with an individual contract is approved with variable material, a carrier may not submit a new statement of variability to be used with the previously approved individual contract or form, except for the following:

(i) Copayment amounts;

(ii) Coinsurance amounts;

(iii) Deductible amounts;

(iv) Out-of-pocket limits;

(v) Annual maximums;

(vi) Lifetime maximums;

(vii) Benefit amounts;

(viii) Benefit limits;

(ix) Waiting periods; or

(x) Elimination periods.

(e) A carrier shall include the following with a new statement of variability filing for a previously approved individual contract or form:

(i) A cover letter identifying the carrier and the carrier's National Association of Insurance Commissioners company code number; and

(ii) The form number and date of approval of the form for which new variable material is being submitted.

(2) Group Contracts.

(a) A carrier may include variable material in a group contract or in a form to be used with a group contract, if the carrier:

(i) Brackets the variable material or otherwise marks the variable material to denote variability; and

(ii) Includes a statement of variability, in duplicate, that discusses how each variable item may change, including all textual variations that are intended.

(b) After a group contract or a form to be used with a group contract is approved with variable material, a carrier may not submit a new statement of variability to be used with the previously approved group contract or form, except for the following:

(i) Copayment amounts;

(ii) Coinsurance amounts;

(iii) Deductible amounts;

(iv) Out-of-pocket limits;

(v) Annual maximums;

(vi) Lifetime maximums;

(vii) Benefit amounts;

(viii) Benefit limits;

(ix) Waiting periods; or

(x) Elimination periods.

(c) A carrier shall include the following with a new statement of variability filing for a previously approved group contract or form:

(i) A cover letter identifying the carrier and the carrier's National Association of Insurance Commissioners company code number; and

(ii) The form number and date of approval of the form for which new variable material is being submitted.

B. Contracts with Insert Pages.

(1) A carrier may file for approval of a contract on an insert page basis, only if:

(a) Each insert page is identified by a unique form number appearing in the lower left corner of the insert page; and

(b) The carrier includes the following in the filing submission:

(i) A description of how the various insert pages will be combined;

(ii) A listing of the insert pages that can be substituted for other specific insert pages; and

(iii) The filing fee required under Insurance Article, § 2-112, Annotated Code of Maryland, for each insert page with a unique form number.

(2) A carrier may not file for approval of insert pages for use with a previously approved contract, if the previously approved contract was not approved on an insert page basis.

(3) If a carrier files for approval of insert pages for a previously approved contract, the submission shall:

(a) Identify by form number and date of approval any insert pages that the new insert pages will replace; and

(b) Include a copy of the currently approved contract, unless the Commissioner waives the requirement or determines that a copy is not necessary to review the submission.

C. Contracts Comprised of Sections.

(1) A carrier may file for approval of a contract on a sectional basis, only if:

(a) Each section is identified by a unique form number appearing in the lower left corner of the first page of the section; and

(b) The carrier includes the following in the filing submission:

(i) A description of how the various sections will be combined;

(ii) A listing of the sections that can be substituted for other specific sections; and

(iii) The filing fee required under Insurance Article, § 2-112, Annotated Code of Maryland, for each section with a unique form number.

(2) A carrier may not file for approval of sections for use with a previously approved contract, if the previously approved contract was not approved on a sectional basis.

(3) If a carrier files for approval of sections for a previously approved contract, the submission shall:

(a) Identify by form number and date of approval any sections that the new sections will replace; and

(b) Include a copy of the currently approved contract, unless the Commissioner waives the requirement or determines that a copy is not necessary to review the submission.

Md. Code Regs. 31.04.17.04