Maryland Statutes
Subtitle 5 - Prohibited Denials, Exclusions, and Reductions of Coverage
Section 15-508.1 - Exclusionary Provisions

(a)    (1)    In this section the following words have the meanings indicated.
        (2)    “Carrier” means an insurer or a nonprofit health service plan.
        (3)    “Exclusionary rider” means an endorsement to an individual health benefit plan that excludes benefits for one or more named conditions that are discovered by a carrier during the underwriting process.
        (4)    “Health benefit plan” has the meaning stated in § 15–1301 of this title.
        (5)    “Individual health benefit plan” means a health benefit plan issued by a carrier that insures:
            (i)    only one individual; or
            (ii)    one individual and one or more family members of the individual.
    (b)    This section applies to individual health benefit plans that are issued or delivered in the State before March 23, 2010.
    (c)    A carrier may not attach an exclusionary rider to an individual health benefit plan unless the carrier obtains the prior written consent of the policyholder.
    (d)    A carrier may impose a preexisting condition exclusion or limitation on an individual for a condition that was not discovered during the underwriting process for an individual health benefit plan only if the exclusion or limitation:
        (1)    relates to a condition of the individual, regardless of its cause, for which medical advice, diagnosis, care, or treatment was recommended or received within the 12–month period immediately preceding the effective date of the individual’s coverage; and
        (2)    extends for a period of not more than 12 months after the effective date of the individual’s coverage.

Structure Maryland Statutes