Current with changes from the 2024 Legislative Session
Section 15-1315 - Plans issued through Individual Exchange(a)(1) In this section the following words have the meanings indicated.(2) "Individual Exchange" has the meaning stated in § 31-101 of this article.(3) "Qualified health plan" has the meaning stated in § 31-101 of this article.(4) "Qualified individual" has the meaning stated in § 31-101 of this article.(b) This section applies to a qualified health plan that is issued on or after January 1, 2014, by a carrier through the Individual Exchange.(c) A qualified health plan subject to this section shall include a grace period provision applicable to a qualified individual who:(1) is receiving advance payments of federal premium tax credits; and(2) fails to pay premiums timely.(d) The grace period provision shall:(1) provide a grace period of 3 consecutive months after the initial premium payment to begin coverage has been paid;(2) apply to qualified health plans renewed in accordance with § 15-1309 of this subtitle without the qualified individual having to pay the first month's premium following renewal; and(3) be in addition to any other grace period provision required by any other applicable State law.(e) During the grace period, a carrier that issues a qualified health plan subject to this section:(1) shall pay all appropriate claims for services rendered to the qualified individual during the first month of the grace period;(2) may pend claims for services rendered to the qualified individual in the second and third months of the grace period;(3) shall notify the federal Department of Health and Human Services that the qualified individual is in the grace period; and(4) shall notify providers of the possibility that claims may be denied when a qualified individual is in the second and third months of the grace period.Amended by 2016 Md. Laws, Ch. 122,Sec. 1, eff. 6/1/2016.Added by 2013 Md. Laws, Ch. 368,Sec. 2, eff. 1/1/2014.