Md. Code Regs. 31.11.02.07

Current through Register Vol. 51, No. 12, June 14, 2024

Section 31.11.02.07 - Termination

A. Coverage for a qualified secondary beneficiary will terminate when the coverage under the group contract terminates with respect to the insured employee.

B. Even though the insured employee continues to be covered under the group contract, coverage with respect to any individual qualified secondary beneficiary shall terminate on the date of occurrence of any of the following:

(1) The date on which the qualified secondary beneficiary 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 the:

(a) Group contract or the self-insured program or plan is on an expense-incurred basis, and

(b) Eligibility does not result from the provisions of these regulations;

(2) The date on which the insured becomes entitled to benefits under Title XVIII of the Social Security Act;

(3) The date on which a qualified secondary beneficiary who is a dependent child would no longer have been covered under the group contract if there had been no applicable change in status;

(4) The date of remarriage of an individual who is a qualified secondary beneficiary by reason of having been the divorced spouse of the insured employee;

(5) The date on which the qualified secondary beneficiary becomes insured under a non-group policy or contract or under a non-group health maintenance organization contract which provides coverage for hospital, surgical, medical, or major medical benefits on an expense-incurred basis;

(6) The effective date of an election by a qualified secondary beneficiary to no longer be covered under the group contract;

(7) The date the employer receives a duly executed notice of termination, or the effective date of the notice if later;

(8) The premium due date on which the premium payable to the employer by or on behalf of the qualified secondary beneficiary is not timely made.

Md. Code Regs. 31.11.02.07