Md. Code Regs. 31.17.03.13

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

Section 31.17.03.13 - Certificates of Coverage

A. The Plan administrator shall issue certificates of coverage to individuals covered under the Plan that describe the essential features of the Plan including:

(1) Benefits;

(2) Exclusions and limitations;

(3) Cost-sharing requirements;

(4) Any annual or lifetime maximums;

(5) Termination provisions; and

(6) Any utilization review or precertification requirements.

B. If dependents are included in the coverage, only one certificate shall be issued for each family unit.

Md. Code Regs. 31.17.03.13

Regulations .13 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)