(a) This section applies to all grandfathered plans except grandfathered plans that are individual plans and to every health benefit plan that is not a grandfathered plan.
(b) A carrier may not:
(1) exclude or limit benefits because a health condition was present before the effective date of coverage; or
(2) deny coverage because a health condition was present before or on the date of denial.
(c) The prohibition in subsection (b) of this section applies whether or not:
(1) any medical advice, diagnosis, care, or treatment was recommended or received for the condition; or
(2) the health condition was identified as a result of:
(i) a pre–enrollment questionnaire or physical examination given to an individual; or
(ii) a review of records relating to the pre–enrollment period.
Structure Maryland Statutes
Subtitle 1A - Consumer Protections
Section 15-1A-01 - Definitions
Section 15-1A-02 - Enforcement of Provisions by Commissioner
Section 15-1A-04 - Criteria for Health Benefit Plans -- Consistent With Federal Law
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-09 - Acceptance of All Employers and Individuals -- Exceptions
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-14 - Emergency Services -- Coverages
Section 15-1A-16 - Acceptable Medical Loss Ratio -- Calculation
Section 15-1A-18 - Catastrophic Plans -- Regulations Governing
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