Md. Code Regs. 31.11.10.03

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

Section 31.11.10.03 - Required Standard Provisions

A. A group health insurance contract may not be delivered in Maryland unless it contains in substance the provisions:

(1) Listed in Regulation .04 of this chapter; or

(2) Which in the opinion of the Commissioner, as compared to the provisions in Regulation .04 of this chapter, are:

(a) More favorable to the individuals insured, or

(b) At least as favorable to the individuals insured and more favorable to the policyholder.

B. A blanket health insurance contract may not be delivered in Maryland unless it contains in substance the provisions:

(1) Listed in Regulation .05 of this chapter; or

(2) Which in the opinion of the Commissioner, as compared to the provisions in Regulation .05 of this chapter, are:

(a) More favorable to the individuals insured, or

(b) At least as favorable to the individuals insured and more favorable to the policyholder.

C. Inapplicable and Inconsistent Provisions. If a provision required by Regulation .04 or .05 of this chapter is wholly or partly inapplicable to or inconsistent with the coverage provided by a particular contract, the carrier shall:

(1) Omit from the contract the inapplicable provision or part of the provision; or

(2) Modify the inconsistent provision or part of the provision to make it consistent with the coverage provided by the contract.

Md. Code Regs. 31.11.10.03