Maryland Statutes
Subtitle 1A - Consumer Protections
Section 15-1A-04 - Criteria for Health Benefit Plans -- Consistent With Federal Law

For purposes of this subtitle, to the extent necessary, the Commissioner shall adopt regulations that:
        (1)    establish criteria that a health benefit plan must meet to be considered a health benefit plan that covers essential health benefits; and
        (2)    are consistent with 45 C.F.R. Part 156 Subpart B and any corresponding federal rules and guidance as those provisions were in effect December 1, 2019.

Structure Maryland Statutes

Maryland Statutes

Insurance

Title 15 - Health Insurance

Subtitle 1A - Consumer Protections

Section 15-1A-01 - Definitions

Section 15-1A-02 - Enforcement of Provisions by Commissioner

Section 15-1A-03 - Adoption of Regulations -- Application to Health Benefit Plan -- Grandfathered Plans

Section 15-1A-04 - Criteria for Health Benefit Plans -- Consistent With Federal Law

Section 15-1A-05 - Application to Grandfathered Plans -- Prohibition on Certain Exclusions or Denials

Section 15-1A-06 - Certain Factors Prohibited in Consideration -- Extra Premiums Prohibited

Section 15-1A-07 - Premium Rates Review -- Basis -- Ratio of Premium Rate Variation

Section 15-1A-08 - Coverage Available for Dependent Child Until Age of 26 Years -- Relationship to Insured

Section 15-1A-09 - Acceptance of All Employers and Individuals -- Exceptions

Section 15-1A-10 - Coverages Required and Additional Charges Prohibited -- Out-of-Network Charges -- Services Recommended or Not by Task Force

Section 15-1A-11 - Lifetime or Annual Limits on Benefits

Section 15-1A-12 - Limit on Waiting Period for Otherwise Eligible Individual

Section 15-1A-13 - Identification of Participating Primary Care Provider -- Children -- Obstetrical or Gynecological Care

Section 15-1A-14 - Emergency Services -- Coverages

Section 15-1A-15 - Summary of Benefits and Coverage Explanation -- Regulations by Commissioner -- Uniform Definitions -- Periodic Review

Section 15-1A-16 - Acceptable Medical Loss Ratio -- Calculation

Section 15-1A-17 - Required Information Provided by Carrier -- Disclosures -- Hardship Exemptions -- Catastrophic Plans

Section 15-1A-18 - Catastrophic Plans -- Regulations Governing

Section 15-1A-19 - Annual Limitations on Cost Sharing for Essential Health Benefits Covered -- Regulations

Section 15-1A-20 - Prescription Drug Essential Health Benefits for Individual and Small Group Plans

Section 15-1A-21 - Rescission of Coverage Under Health Benefit Plans -- Exceptions

Section 15-1A-22 - Carriers May Refuse or Deny Coverage for Non-Discriminatory Reasons -- Discrimination Based on Sexual Orientation or Gender Identity Prohibited