Md. Code Regs. 31.17.03.09

Current through Register Vol. 51, No. 21, October 18, 2024

Section 31.17.03.09 - Determination of Plan Benefits and Plan Structure

A. The Board shall establish at least two standard benefit packages to be offered by the Plan.

B. The Board may choose to establish the standard benefit packages with the only difference between each standard benefit package being in the area of the cost-sharing requirements.

C. The standard benefit packages established by the Board shall be described in the contract between the Plan administrator and the Board and shall include:

(1) A list of covered benefits;

(2) A list of exclusions and limitations; and

(3) A description of the cost-sharing arrangements, including any deductibles, copayments, coinsurance, and annual or lifetime maximums.

D. Review of Standard Benefit Packages.

(1) The standard benefit packages shall be reviewed by the Board from time to time.

(2) All changes made in the standard benefit packages pursuant to the review described in §D(1) of this regulation shall be effective for contracts issued or renewed on or after the first July 1 that follows the date the Board makes the changes.

Md. Code Regs. 31.17.03.09

Regulations .09 adopted as an emergency provision effective April 8, 2003 (30:9 Md. R. 609); emergency text amended effective July 1, 2003 (30:16 Md. R. 1072); adopted permanently effective December 22, 2003 (30:25 Md. R. 1851)