Contract Filings - Small Group Carriers

BULLETIN To: Small Group Carriers Re: Contract Filings Date: September 17, 1999 Bulletin: Life and Health 99-18 We would like to bring to your attention revisions that will be required of small group contracts issued or renewed on or after November 1, 1999. These revisions are the result of emergency changes to COMAR 31.11.06. We recommend that these changes be made through an amendment rider which will be attached to the group policy and certificate. Please specify the form number and date of approval of the policy to which the amendment rider will be attached. To ensure approval by November 1, 1999, the filings must be received by this Administration by October 15, 1999. Revisions Required by Emergency Changes to COMAR 31.11.06 • New benefit for home visits for covered persons who receive less than 48 hours of inpatient hospitalization following a mastectomy or removal of a testicle or who undergo a mastectomy or removal of a testicle on an outpatient basis. See COMAR 31.11.06.03A(11)(b). • For carriers that do not allow direct access to specialists, a benefit for a standing referral to a specialist pursuant to the requirements of §15-829(b) of House Bill 182, Chapter 120 of the Acts of 1999. See COMAR 31.11.06.09D(1). • For carriers that use provider panels, a benefit for a referral to a specialist who is not a part of the carrier’s panel pursuant to the requirements of §15-829(c) of House Bill 182, Chapter 120 of the Acts of 1999. See COMAR 31.11.06.09D(2). We are enclosing copies of the emergency changes to the small group regulations. Carriers should refer to the 1999 Chapter Laws of Maryland for complete drafts of the laws. It is each carrier’s responsibility to review the laws before amending contracts. Please contact Ellen Woodall, Supervisor, Managed Care Unit at (410) 468-2226 if you have any questions regarding these filings. _________________________ Donna B. Imhoff Associate Commissioner