MD Insurance Bulletin 03-07
2003 Legislation Signed by Governor Robert L. Ehrlich Jr.
STATE OF MARYLAND
MARYLAND INSURANCE ADMINISTRATION
525 St. Paul Place, Baltimore, Maryland 21202-2272
Writerโs Direct Dial: 410-468-2014
Facsimile Number: 410-468-2020
e-mail: kloughran@mdinsurance.state.md.us
MIA/BULLETIN 03-7
May 2003
SUMMARY OF 2003 INSURANCE LEGISLATION
SIGNED INTO LAW BY GOVERNOR ROBERT L. EHRLICH, JR.
This bulletin is meant to place insurers authorized to write insurance in
Maryland on notice of the insurance laws (Insurance Article ยง 1-101 et seq.,
Annotated Code of Maryland) passed by the 2003 Maryland General Assembly.
The attached synopsis is intended to serve only as a guide. All insurers should
refer to the 2003 Chapter Laws of Maryland for complete drafts of the law.
Insurers are advised that other bills passed by the General Assembly and not
listed on the synopsis may also affect their business operations in Maryland.
For a copy of a specific law passed by the General Assembly during the
2003 legislative session, you may obtain a copy of the bill on the Internet at
http://mlis.state.md.us or contact the Department of Legislative Services at
(410) 946-5400. In addition, you may also obtain a copy of the 2003 Session
Review from Library and Information Services, Office of Policy Analysis,
Department of Legislative Services, 90 State Circle, Annapolis, Maryland 21401-
1991 or call (410) 946-5400.
For
additional
information
concerning
the
Maryland
Insurance
Administration's Summary of Legislation, please contact Kathleen Loughran,
Director of Government Affairs, at (410) 468-2014.
ROBERT L. EHRLICH, JR.
GOVERNOR
MICHAEL S. STEELE
LIEUTENANT GOVERNOR
STEVEN B. LARSEN
COMMISSIONER
DONNA B. IMHOFF
DEPUTY COMMISSIONER
KATHLEEN G. LOUGHRAN
DIRECTOR OF
GOVERNMENT AFFAIRS
ll (410) 946-5400.
For
additional
information
concerning
the
Maryland
Insurance
Administration's Summary of Legislation, please contact Kathleen Loughran,
Director of Government Affairs, at (410) 468-2014.
ROBERT L. EHRLICH, JR.
GOVERNOR
MICHAEL S. STEELE
LIEUTENANT GOVERNOR
STEVEN B. LARSEN
COMMISSIONER
DONNA B. IMHOFF
DEPUTY COMMISSIONER
KATHLEEN G. LOUGHRAN
DIRECTOR OF
GOVERNMENT AFFAIRS
2
2003 INSURANCE LEGISLATION
LIFE AND HEALTH
HOUSE BILL 17 (Chapter 270) - Maryland Pharmacy Assistance Program -
Eligibility
Requires the Secretary of the Department of Health and Mental Hygiene to
develop a program that will provide information to ineligible Maryland
Pharmacy Assistance Program applicants regarding the programs they may
be eligible for, including the Senior Prescription Drug Program established
under Title 14, Subtitle 5 of the Insurance Article.
Effective date: July 1, 2003
HOUSE BILL 211 (Chapter 4) / SENATE BILL 450 (Chapter 3) - Short-
Term Prescription Drug Subsidy Plan - Enrollment
Establishes that the Short-Term Prescription Drug Subsidy Plan shall provide
benefits to the maximum number of individuals eligible for enrollment in the
program.
Eliminates the cap that limits the program to 30,000 enrollees.
Effective date: April 8, 2003
HOUSE BILL 335 (Chapter 289) - Community Access Program Grants -
Coordination of Health Care Provider Reimbursements - Pilot
Programs
Establishes ยง 15-1601 of the Insurance Article for the purpose of allowing
recipients of a Community Access Program grant from the United States
Department of Health and Human Services to establish a pilot program to
coordinate health care provider reimbursements in order to test innovations in
payment for health care services to be permanently implemented if
successful.
Establishes certain requirements for the pilot program.
3
Establishes that a pilot program created under ยง 15-1601:
(1) Is not providing insurance as defined in ยง 1-101 of the Insurance Article;
n Services to establish a pilot program to
coordinate health care provider reimbursements in order to test innovations in
payment for health care services to be permanently implemented if
successful.
Establishes certain requirements for the pilot program.
3
Establishes that a pilot program created under ยง 15-1601:
(1) Is not providing insurance as defined in ยง 1-101 of the Insurance Article;
(2)
Is not subject to regulation by the Maryland Insurance Commissioner;
and
(3)
Shall not be considered an unauthorized insurer as defined in ยง 1-101 of
the Insurance Article.
A pilot program created under ยง 15-1601 of the Insurance Article shall report
to the Senate Finance Committee and House Health and Government
Operations Committee on or before June of each year.
Effective date: July 1, 2003 for a period of two years
HOUSE BILL 410 (Chapter 295) - Health Insurance - Private Review Agents
- Examination of Pharmacy Benefit Managers
Requires the Insurance Commissioner to conduct an examination, at least
once every three years, of any pharmacy benefit manager registered as a
private review agent to determine whether the pharmacy benefit manager is
acting in compliance with ยง 15-10B of the Insurance Article.
Requires the Insurance Commissioner to make a complete report of each
examination of a pharmacy benefit manager conducted under ยง 15-10B-20 of
the Insurance Article.
Requires a pharmacy benefit manager subject to an examination under
ยง 15-10B-20 of the Insurance Article to pay the expenses of the examination
as required under ยง 2-208 of the Insurance Article.
Establishes that a final report of an examination of a pharmacy benefit
manager will be issued in accordance with ยง 2-209 of the Insurance Article
conducted under ยง 15-10B-20 of
the Insurance Article.
Requires a pharmacy benefit manager subject to an examination under
ยง 15-10B-20 of the Insurance Article to pay the expenses of the examination
as required under ยง 2-208 of the Insurance Article.
Establishes that a final report of an examination of a pharmacy benefit
manager will be issued in accordance with ยง 2-209 of the Insurance Article.
Effective date: October 1, 2003
HOUSE BILL 498 (Chapter 41) - Health Insurance - Medicare Supplement
Contracts - Availability
Requires a carrier that offers a Medicare supplement policy C or a Medicare
supplement policy I to make those policies available to an individual who is
under the age of 65 years but is eligible for Medicare due to a disability during
the 6-month period following the applicant's enrollment in Part B of Medicare.
Effective date: July 1, 2003
4
HOUSE BILL 499 (Chapter 305) - Maryland Insurance Administration -
Disability Benefits - Adoption of Regulations
Defines "Disability Benefit" to mean a benefit that is payable based on the
disability of a covered individual.
Disability benefit does not include:
(1) Long-term care insurance;
(2) A benefit that is payable based solely on a dismemberment of a covered
individual;
(3) Benefits in a life insurance policy that operate to safeguard the contract
from lapse or to provide a special surrender value, special benefit, or
annuity in the event of total and permanent disability; or
(4) Benefits in a health insurance policy that operate to safeguard the
contract from lapse due to disability.
Defines "adverse benefit determination" to mean:
(1) A denial, reduction, or termination of a disability benefit;
(2) A failure to provide or make payment, in whole or in part, for a disability
benefit; or
e, special benefit, or
annuity in the event of total and permanent disability; or
(4) Benefits in a health insurance policy that operate to safeguard the
contract from lapse due to disability.
Defines "adverse benefit determination" to mean:
(1) A denial, reduction, or termination of a disability benefit;
(2) A failure to provide or make payment, in whole or in part, for a disability
benefit; or
(3) Any denial, reduction, termination, or failure to provide or make payment
that is based on a determination of an individual's eligibility for coverage
of a disability benefit.
Requires the Insurance Commissioner to adopt regulations that establish
standards governing the processing of claims by an insurer that issues or
delivers:
(1) Individual policies in the State that include a disability benefit, or
(2) Group policies in the State that include a disability benefit.
The regulations adopted under this law shall establish and maintain
reasonable claims procedures governing the filing of disability benefit claims.
Requires the claims procedures established under this law for individual
policies and group policies to be consistent with the provisions of the
Department of Labor's regulations entitled "Employee Retirement Income
5
Security Act of l974, Rules and Regulations for Administration and
Enforcement; Claims Procedure; Final Rule" (29 CFR 2560).
Establishes that the regulations adopted under ยง 15-1010(b)(1)(i) of the
Insurance Article governing individual disability benefit policies may not take
effect until July 1, 2004.
Effective date: October 1, 2003
HOUSE BILL 605 (Chapter 437) - Maryland Health Care Commission -
Evaluation of Mandated Health Insurance Services
Amends ยง 15-1502 of the Insurance Article to require the Maryland Health
Care Commission to conduct an evaluation of existing mandated health
insurance services and make recommendations to the General Assembly
regarding decision-making criteria for reducing the number of mandates or
the extent of coverage
437) - Maryland Health Care Commission -
Evaluation of Mandated Health Insurance Services
Amends ยง 15-1502 of the Insurance Article to require the Maryland Health
Care Commission to conduct an evaluation of existing mandated health
insurance services and make recommendations to the General Assembly
regarding decision-making criteria for reducing the number of mandates or
the extent of coverage.
Requires the Maryland Health Care Commission to consider certain factors
when evaluating existing mandated health insurance services.
Requires the Maryland Health Care Commission, beginning on January 1,
2004, and every four years after, to submit a report of its findings to the
General Assembly.
Effective date: July 1, 2003
HOUSE BILL 656 (Chapter 440) - Health Maintenance Organizations -
Definition of Covered Service
Alters the definition of "covered service" to mean a health care service
included in the benefit package of the health maintenance organization and
rendered to a member or subscriber of the health maintenance organization
by:
(1) A provider under contract with the health maintenance organization, when
the service is obtained in accordance with the terms of the benefit
contract of the member or subscriber; or
(2) A noncontracting provider under ยง 19-710.1 of the Insurance Article when
the service is:
(I)
Obtained in accordance with the terms of the benefit contract of the
member or subscriber;
intenance organization
by:
(1) A provider under contract with the health maintenance organization, when
the service is obtained in accordance with the terms of the benefit
contract of the member or subscriber; or
(2) A noncontracting provider under ยง 19-710.1 of the Insurance Article when
the service is:
(I)
Obtained in accordance with the terms of the benefit contract of the
member or subscriber;
6
(II)
Obtained pursuant to a verbal or written referral by:
1. The health maintenance organization of the member or
subscriber; or
2. A provider under written contract with the health maintenance
organization of the member or subscriber; or
(III)
Preauthorized or otherwise approved either verbally or in writing by:
1. The health maintenance organization of the member or
subscriber; or
2. A provider under written contract with the health maintenance
organization of the member or subscriber.
Under ยง 19-710(p)(3)(ii) of the Insurance Article, clarifies that a health care
provider or a representative of a health care provider may collect or attempt to
collect from a subscriber or enrollee "any payment or charges for services
that are not covered services."
Effective date: October 1, 2003
HOUSE BILL 700 (Chapter 321) - Health Insurance - Private Review Agents
- Certification
Allows the Insurance Commissioner to consider an applicant for certification
as a private review agent to have met certain certification requirements under
ยง 15-10B of the Insurance Article if:
(1) The applicant has obtained utilization management accreditation from an
approved accrediting organization as determined by the Insurance
Commissioner;
(2) The approved accrediting organization has requirements that meet or
exceed the particular requirement in ยง 15-10B of the Insurance Article;
and
agent to have met certain certification requirements under
ยง 15-10B of the Insurance Article if:
(1) The applicant has obtained utilization management accreditation from an
approved accrediting organization as determined by the Insurance
Commissioner;
(2) The approved accrediting organization has requirements that meet or
exceed the particular requirement in ยง 15-10B of the Insurance Article;
and
(3) The applicant demonstrates that the applicant meets or exceeds the
particular requirement under ยง 15-10B of the Insurance Article.
Prohibits the Insurance Commissioner from issuing a certificate to an
applicant with utilization management accreditation by an approved
accrediting organization unless the applicant meets all the requirements of
ยง 15-10B of the Insurance Article and all applicable regulations of the
Insurance Commissioner.
7
Establishes that a report of an approved accrediting organization used by the
Insurance Commissioner as evidence that the applicant has met a particular
requirement for a private review agent certificate shall be made available by
the Insurance Commissioner to the public on request.
Effective date: October 1, 2003
HOUSE BILL 729 (Chapter 323) - Health Insurance - Managed Behavioral
Health Care Services - Reports
Among other things, requires the Insurance Commissioner to develop a form
to implement the requirements of ยง 15-127(D) of the Insurance Article.
Amends ยง 15-127 of the Insurance Article to define certain terms.
Establishes that the provisions of ยง 15-127 of the Insurance Article do not
apply to a person that, for an administrative fee only, solely arranges a
provider panel for a carrier for the provision of behavioral health care services
on a discounted fee-for-service basis.
Requires a carrier that owns or contracts with a managed behavioral health
care organization to:
(1) Include information on behavioral health care providers in the list of
providers on the carrier's provider panel required under ยง 15-112(j) of the
Insurance Article.
arranges a
provider panel for a carrier for the provision of behavioral health care services
on a discounted fee-for-service basis.
Requires a carrier that owns or contracts with a managed behavioral health
care organization to:
(1) Include information on behavioral health care providers in the list of
providers on the carrier's provider panel required under ยง 15-112(j) of the
Insurance Article.
(2) Provide the same information on behavioral health care providers that is
required for other providers under ยง 15-112(j) of the Insurance Article.
Amends ยง 15-127(c) to require a carrier that contracts with a managed
behavioral health care organization to require the managed behavioral health
care organization to provide to the carrier on an annual basis a report on the
direct behavioral health care expenses of the managed behavioral health care
organization.
The report required to be provided under ยง 15-127(c)(4) of the Insurance
Article shall be made publicly available by the carrier.
Under ยง 15-127(e)(2) of the Insurance Article, a carrier required to make a
form publicly available under ยง 15-127(c)(4) of the Insurance Article may
charge a fee.
Effective date: October 1, 2003
8
HOUSE BILL 803 (Chapter 1) - Maryland Health Insurance Plan and
Senior Prescription Drug Program - Modifications and Clarifications
Among other things, amends ยง 14-504 of the Insurance Article to require the
Plan administrator to deposit all premiums for plan enrollees in a separate
account, titled in the name of the State of Maryland, for the Maryland Health
Insurance Plan.
Establishes that the Plan administrator may use the money in the account
only to pay claims for plan enrollees.
Requires the Plan administrator to keep complete and accurate records of all
transactions for the separate account.
Allows the Maryland Health Insurance Plan Board to adjust the premium rate
based on member age under certain circumstances
nd, for the Maryland Health
Insurance Plan.
Establishes that the Plan administrator may use the money in the account
only to pay claims for plan enrollees.
Requires the Plan administrator to keep complete and accurate records of all
transactions for the separate account.
Allows the Maryland Health Insurance Plan Board to adjust the premium rate
based on member age under certain circumstances.
Amends ยง 14-513 of the Insurance Article to allow the Board to determine
whether premiums collected for the Program shall be deposited:
(1) To a segregated account in the Fund established under ยง 14-504 of the
Insurance Article; or
(2) To a separate account for the Program established by the carrier that
administers the Program.
For the final quarter of fiscal year 2003, establishes that the Health Services
Cost Review Commission shall determine the amount equal to the value of
the SAAC purchaser differential for each hospital for which rates have been
approved by the Commission.
Effective date: April 8, 2003
HOUSE BILL 894 (Chapter 338) - Health Insurance - Reimbursement for
Provider Services - Professional Counselors and Therapists
Applies to each individual, group, or blanket health insurance policy, contract,
or certificate of an insurer or nonprofit health service plan that :
(1)
(I) Is delivered or issued for delivery in the State;
(II)
Is issued to a group that is incorporated or has a main office in
the State; or
(III) Covers individuals who reside or work in the State; and
9
Professional Counselors and Therapists
Applies to each individual, group, or blanket health insurance policy, contract,
or certificate of an insurer or nonprofit health service plan that :
(1)
(I) Is delivered or issued for delivery in the State;
(II)
Is issued to a group that is incorporated or has a main office in
the State; or
(III) Covers individuals who reside or work in the State; and
9
(2)
Is issued, renewed, amended, or reissued on or after October 1,
2003.
Establishes that if a policy, contract, or certificate subject to this law provides
for reimbursement for a service that is within the lawful scope of practice of a
licensed clinical professional counselor, a licensed clinical marriage and
family therapist, or a licensed clinical alcohol and drug counselor, the insured
or any other person covered by the policy or certificate is entitled to
reimbursement for the service.
Effective date: October 1, 2003
HOUSE BILL 974 (Chapter 461) / SENATE BILL 687 (Chapter 261) - Health
Maintenance Organizations - Patient Access to Choice of Provider
Amends ยง 19-705.1(b) of the Health-General Article to require the Secretary
of the Department of Health and Mental Hygiene to include in the standards
of quality of care a requirement that each member of a health maintenance
organization shall have an opportunity to select a primary physician or a
certified nurse practitioner from among those available to the health
maintenance organization.
Under ยง 19-705.1(c), provides that a member of a health maintenance
organization may select a certified nurse practitioner as the member's primary
care provider if:
(1) The certified nurse practitioner provides services at the same location as
the certified nurse practitioner's collaborating physician; and
d nurse practitioner from among those available to the health
maintenance organization.
Under ยง 19-705.1(c), provides that a member of a health maintenance
organization may select a certified nurse practitioner as the member's primary
care provider if:
(1) The certified nurse practitioner provides services at the same location as
the certified nurse practitioner's collaborating physician; and
(2) The collaborating physician provides the continuing medical
management required under ยง 19-705.1(b)(5) of the Health-General
Article.
Under ยง 19-705.1(c) of the Health-General Article, a member who selects a
certified nurse practitioner as a primary care provider must be provided the
name and contact information of the certified nurse practitioner's collaborating
physician.
In accordance with ยง 19-705.1(c)(3) of the Health-General Article, a health
maintenance organization is not required to include certified nurse
practitioners on the health maintenance organization's provider panel as
primary care providers.
Effective date: October 1, 2003
10
HOUSE BILL 1100 (Chapter 2) - Health Insurance Coverage Availability
Act of 2003
Amends ยง 14-501 of the Insurance Article by expanding the definition of
โmedically uninsurable individual" to include individuals "eligible for the tax
credit for health insurance costs under ยง 35 of the Internal Revenue Code."
Amends ยง 14-503 of the Insurance Article to add two members to the
Maryland Health Insurance Plan Board of Directors, appointed by the
Insurance Commissioner, of which one member shall be a representative of
carriers operating in the State and one member shall be a representative of
insurance producers selling insurance in the State
ealth insurance costs under ยง 35 of the Internal Revenue Code."
Amends ยง 14-503 of the Insurance Article to add two members to the
Maryland Health Insurance Plan Board of Directors, appointed by the
Insurance Commissioner, of which one member shall be a representative of
carriers operating in the State and one member shall be a representative of
insurance producers selling insurance in the State.
Under ยง14-503(L) of the Insurance Article, the bill requires that for members
enrolled in the Plan based on eligibility for the federal tax credit for health
insurance costs under ยง 35 of the Internal Revenue Code, the Board shall
report to the Governor and General Assembly by December 1 of each year
the number of members enrolled and the cost to the Plan associated with
providing coverage to these members.
The bill also requires that a carrier that issues Medigap shall issue any
Medigap policy the carrier sells in the State to an individual eligible for
Medicare if:
(1) The individual is enrolled under an employee welfare benefit plan that
provides health benefits;
(2) The employee welfare benefit plan in which the individual is enrolled
terminates;
(3) Solely because of eligibility for Medicare, the individual is not eligible for
credit for health insurance costs under ยง 35 of the Internal Revenue Code
and enrollment in the Maryland Health Insurance Plan under ยง 14-501(f)
of the Insurance Article, as enacted by Section 1 of this Act; and
es health benefits;
(2) The employee welfare benefit plan in which the individual is enrolled
terminates;
(3) Solely because of eligibility for Medicare, the individual is not eligible for
credit for health insurance costs under ยง 35 of the Internal Revenue Code
and enrollment in the Maryland Health Insurance Plan under ยง 14-501(f)
of the Insurance Article, as enacted by Section 1 of this Act; and
(4) The individual applies for the Medigap policy no later than 63 days after
the employee welfare benefit plan terminates.
Requires the Maryland Insurance Administration to issue notice of the
requirements regarding Medigap to each affected carrier in the State.
Requires the Maryland Insurance Administration, on or before October 1,
2003, to notify the Centers for Medicare and Medicaid Services that the State
has established the Plan and requests that the Plan be approved as an
acceptable "alternative mechanism" under the Federal Health Insurance
Portability and Accountability Act - 45 CFR 148.128(e).
11
Effective date: April 8, 2003
HOUSE BILL 1179 (Chapter 357) / SENATE BILL 772 (Chapter 356) - Health
Insurance - Nonprofit Health Service Plans - Reform
Establishes that the purpose of ยง 14-102 of the Insurance Article is to:
(1) Regulate the formation and operation of nonprofit health service plans in
the State; and
(2) To promote the formation and existence of nonprofit health service plans
in the State that:
(I)
Are committed to a nonprofit corporate structure;
(II)
Seek to provide individuals, businesses, and other groups with
affordable and accessible health insurance; and
(III)
Recognize a responsibility to contribute to the improvement of the
overall health status of Maryland residents.
Establishes that a nonprofit health service plan that complies with the
provisions of ยง 14-102 of the Insurance Article is declared to be a public
benefit corporation that is exempt from taxation as provided by law
other groups with
affordable and accessible health insurance; and
(III)
Recognize a responsibility to contribute to the improvement of the
overall health status of Maryland residents.
Establishes that a nonprofit health service plan that complies with the
provisions of ยง 14-102 of the Insurance Article is declared to be a public
benefit corporation that is exempt from taxation as provided by law.
Under ยง 14-102(c) of the Insurance Article, establishes the mission of the
nonprofit health service plan.
Under ยง 14-102(d) of the Insurance Article, requires a nonprofit health service
plan to:
(1) Develop goals, objectives, and strategies for carrying out its statutory
mission;
(2) For a certain period of time, report quarterly, for the preceding quarter, to
the Joint Nonprofit Health Service Plan Oversight Committee on the
nonprofit health service plan's compliance with the provisions of Title 14
of the Insurance Article; and
(3) Provide to the Joint Nonprofit Health Service Plan Oversight Committee
any other information necessary for the Committee to meet the goals
outlined under ยง 2-10A-08 of the State Government Article.
Applies to:
12
(1) A nonprofit health service plan that is issued a certificate of authority in
the State, whether or not organized under the laws of the State; and
(2) An insurer or health maintenance organization, whether or not organized
as a nonprofit corporation, that is wholly owned or controlled by a nonprofit
health service plan that is issued a certificate of authority in the State.
Under ยง 14-102(h) of the Insurance Article, exempts certain nonprofit health
service plans from the provisions of the law.
Under ยง 14-106(c) of the Insurance Article, amends the manner in which a
nonprofit health service plan may satisfy the public service requirement.
Under ยง 14-106(d) of the Insurance Article, requires a nonprofit health service
plan that is subject to this law and issues comprehensive health care benefits
in the State to:
ts certain nonprofit health
service plans from the provisions of the law.
Under ยง 14-106(c) of the Insurance Article, amends the manner in which a
nonprofit health service plan may satisfy the public service requirement.
Under ยง 14-106(d) of the Insurance Article, requires a nonprofit health service
plan that is subject to this law and issues comprehensive health care benefits
in the State to:
(1) Offer health care products in the individual market;
(2) Offer health care products in the small employer group market in
accordance with Title 15, Subtitle 12 of the Insurance Article; and
(3) Administer and subsidize the Senior Prescription Drug Program
established under Title 14, Subtitle 5, Part II of the Insurance Article.
Effective date: May 22, 2003
SENATE BILL 39 (Chapter 59) - Health Insurance - Coverage for Home
Visits After Mastectomy or Surgical Removal of a Testicle -
Extension of Sunset
Extends the sunset provision in ยง 15-832 of the Insurance Article.
Provides for ยง 15-832 of the Insurance Article to sunset on September 30,
2006.
Effective date: October 1, 2003
SENATE BILL 148 (Chapter 15) - Health Insurance - Medical Clinical
Trials - Reporting Requirements
Repeals uncodified language from Chapter 119 of the Acts of 1998 that
required each insurer, nonprofit health service plan, and health maintenance
13
organization subject to the Act to submit to the Insurance Commissioner a
report that describes the clinical trials covered during the previous year.
Repeals uncodified language from Chapter 119 of the Acts of 1998 that
required the Insurance Commissioner to compile an annual summary report
based on certain information provided to the Insurance Commissioner on
clinical trials.
Effective date: June 1, 2003
SENATE BILL 252 (Chapter 224) - Health Insurance - Task Force to Study
Access to Mental Health Services
Establishes a task force to study and make recommendations regarding:
er 119 of the Acts of 1998 that
required the Insurance Commissioner to compile an annual summary report
based on certain information provided to the Insurance Commissioner on
clinical trials.
Effective date: June 1, 2003
SENATE BILL 252 (Chapter 224) - Health Insurance - Task Force to Study
Access to Mental Health Services
Establishes a task force to study and make recommendations regarding:
(1) Whether any changes should be made to the mental health parity
requirements under ยง 15-802 of the Insurance Article and ยง 19-703.1 of
the Health-General Article;
(2) The systematic barriers experienced by commercially insured individuals
when attempting to access community treatment;
(3) How to ensure that commercially-insured individuals have access to
medically necessary mental health treatment;
(4) The difference in mental health services coverage provided by the public
mental health system, commercial health insurers, and commercial health
maintenance organizations;
(5) The structure and effectiveness of the public and private mental health
care delivery systems in the State; and
(6) The impact on the cost of health care coverage in the State of any
recommended changes to the coverage or delivery of mental health care
services.
Requires the Task Force to issue a preliminary report of its findings on or
before December 31, 2003 and a final report of its findings on or before
December 31, 2004.
Requires the Maryland Insurance Administration and the Department of
Health and Mental Hygiene to jointly staff the Task Force.
Establishes the membership of the Task Force, including the Insurance
Commissioner or his designee.
14
Requires the Insurance Commissioner to appoint two members of the Task
Force:
December 31, 2003 and a final report of its findings on or before
December 31, 2004.
Requires the Maryland Insurance Administration and the Department of
Health and Mental Hygiene to jointly staff the Task Force.
Establishes the membership of the Task Force, including the Insurance
Commissioner or his designee.
14
Requires the Insurance Commissioner to appoint two members of the Task
Force:
(i) One representative of the commercial health insurance industry; and
(ii) One representative of a commercial health maintenance organization.
Effective date: July 1, 2003
SENATE BILL 333 (Chapter 82) - Individual Deferred Annuities - Minimum
Nonforfeiture Amount - Interest Rate on Accumulations
Amends ยง 16-504 of the Insurance Article so that the minimum nonforfeiture
amount, under certain circumstances, is at an interest rate of 1.5% per year.
Imposes a two-year sunset provision so that the law expires May 31, 2005.
Effective date: June 1, 2003
SENATE BILL 477 (Chapter 93) - Small Business Health Insurance
Affordability Act
Amends ยง 15-1204 of the Insurance Article to permit a carrier to offer benefits
in addition to those in the Standard Plan if, among other things, the carrier:
(1) Clearly distinguishes the Standard Plan from other offerings of the carrier;
(2) Indicates the Standard Plan is the only plan required by State law; and
(3) Specifies that all enhancements to the Standard Plan are not required by
State law.
Amends ยง 15-1207 of the Insurance Article to lower the rate cap for the
Standard Plan from 12% to 10%.
Requires the Maryland Health Care Commission, in consultation with the
Maryland Insurance Administration, to conduct an analysis of and make
recommendations on the administrative cost of health plans in the small
group market, including:
(1) The total amount and distribution of administrative costs;
(2) The strategies of lowering administrative costs; and
15
r the
Standard Plan from 12% to 10%.
Requires the Maryland Health Care Commission, in consultation with the
Maryland Insurance Administration, to conduct an analysis of and make
recommendations on the administrative cost of health plans in the small
group market, including:
(1) The total amount and distribution of administrative costs;
(2) The strategies of lowering administrative costs; and
15
(3) The appropriateness of the medical loss ratios specified in ยง 15-605(c)(1)
of the Insurance Article.
Effective date: July 1, 2003
SENATE BILL 658 (Chapter 400) - Life Insurance - Prohibited Use of
Terrorism Exclusions
Amends ยง 16-215 of the Insurance Article to clarify that a policy of individual
life insurance may not be delivered or issued for delivery in the State if the
policy excludes or restricts liability for death that is the result of an act of
terrorism that the covered person did not commit and in which the covered
person did not participate.
Amends ยง 17-101 of the Insurance Article to prohibit the delivery or issuance
for delivery in the State of a policy of group life insurance if the policy
excludes or restricts liability for death that is the result of an act of terrorism
that the covered person did not commit and in which the covered person did
not participate.
Effective date: July 1, 2003
SENATE BILL 672 (Chapter 259) - Health Insurance - Provider Panels -
Lists of Providers
Amends ยง 15-112(j) of the Insurance Article to:
(1) Require a carrier to make available to prospective enrollees on the
Internet and, on request of a prospective enrollee, in printed form:
(I) A list of providers on the carrier's provider panel; and
(II) Information on providers that are no longer accepting new patients.
Chapter 259) - Health Insurance - Provider Panels -
Lists of Providers
Amends ยง 15-112(j) of the Insurance Article to:
(1) Require a carrier to make available to prospective enrollees on the
Internet and, on request of a prospective enrollee, in printed form:
(I) A list of providers on the carrier's provider panel; and
(II) Information on providers that are no longer accepting new patients.
(2) Require a carrier to notify each enrollee at the time of initial enrollment
and renewal how to obtain the following information on the Internet and in
printed form:
(I)
A list of providers on the carrier's provider panel; and
(II) Information on providers that are no longer accepting new patients.
Effective date: October 1, 2003
16
PROPERTY AND CASUALTY
HOUSE BILL 641 (Chapter 439) - Motor Vehicle Liability Insurance -
Valuation of Motor Vehicles
Under ยง 27-304.1 of the Insurance Article, requires the Insurance
Commissioner to adopt regulations that establish standards and procedures
for:
(1) The settlement of claims involving the total loss of a private passenger
motor vehicle; and
(2) The determination of the private passenger motor vehicle's total loss
value.
Effective date: October 1, 2003
HOUSE BILL 1125 (Chapter 472) - Private Passenger Motor Vehicle
Insurance - Underwriting Standards - Statistical Validation
Amends ยง 27-501(I)(1)(vi) of the Insurance Article to clarify that a violation of
ยง 21-902(a), (c), or (d) of the Transportation Article does not require statistical
validation for an insurer to cancel or refuse to underwrite or renew an
insurance risk pursuant to ยง 27-501 of the Insurance Article.
Effective date: June 1, 2003
HOUSE BILL 1153 (Chapter 355) - Insurance - Maryland Property
Insurance Availability Act
Amends ยง 25-405(f)(1) of the Insurance Article to increase the maximum limit
of liability from $500,000 to $1,500,000 on real or personal property
comprised of or contained in a single building
derwrite or renew an
insurance risk pursuant to ยง 27-501 of the Insurance Article.
Effective date: June 1, 2003
HOUSE BILL 1153 (Chapter 355) - Insurance - Maryland Property
Insurance Availability Act
Amends ยง 25-405(f)(1) of the Insurance Article to increase the maximum limit
of liability from $500,000 to $1,500,000 on real or personal property
comprised of or contained in a single building.
Repeals ยง 25-405(f)(1)(ii), which subjects contiguous parcels of land to the
maximum limit of liability.
Effective date: October 1, 2003
17
SENATE BILL 167 (Chapter 69) - Insurance - Premium Finance -
Agreements
Under ยง 23-301.1 of the Insurance Article, authorizes a premium finance
agreement to include any:
(1) Premium receipts tax that a surplus lines broker is required to charge
under ยง 3-324 of the Insurance Article and pay to the Insurance
Commissioner under ยง 3-325 of the Insurance Article;
(2) Policy fee that a surplus lines broker is allowed to charge under
ยง 27-216 of the Insurance Article; and
(3) Inspection fee that a surplus lines broker is allowed to charge under
ยง 27-216 of the Insurance Article.
Amends ยง 23-304 of the Insurance Article to require the finance charge to be
computed on the amount of the entire premium loan advanced, including any
taxes or fees that are financed under ยง 23-301.1 of the Insurance Article.
Effective date: October 1, 2003
MISCELLANEOUS
HOUSE BILL 114 (Chapter 119) - Insurance - Reinsurance - Ceding
Insurers
Establishes under ยง 5-904 of the Insurance Article that credit may not be
allowed, as an asset or deduction from liability, to a ceding insurer for
reinsurance, unless:
(I)
The reinsurer is authorized to transact insurance business in the State
or is a solvent insurer approved or accepted by the Insurance
Commissioner for the purpose of reinsurance; and
(II)
The reinsurance contract provides, in substance, that in the event of the
insolvency of the ceding insurer the reinsurance shall be payable under
the terms of a contract reinsured by the reinsurer on the
ess:
(I)
The reinsurer is authorized to transact insurance business in the State
or is a solvent insurer approved or accepted by the Insurance
Commissioner for the purpose of reinsurance; and
(II)
The reinsurance contract provides, in substance, that in the event of the
insolvency of the ceding insurer the reinsurance shall be payable under
the terms of a contract reinsured by the reinsurer on the basis of
reported claims allowed by the court in a liquidation proceeding, without
diminution because of the insolvency of the ceding insurer.
Section 5-904(a)(2) requires that payments made by a reinsurer in
accordance with ยง 5-904(a)(1)(II) to be made directly to the ceding insurer or
its domiciliary receiver unless:
18
(I) The reinsurance contract or other written agreement specifically provides
another payee of the reinsurance in the event of the insolvency of the
ceding insurer; or
(II)
Subject to any contractual or statutory requirement of consent by the
policyholder, the reinsurer has assumed the policy obligations of the
ceding insurer as direct obligations of the reinsurer to the payees under
the policies and in substitution for the ceding insurer's obligations to the
payees.
Under ยง 5-904(a)(3), establishes the rights and obligations of a reinsurer in
the event that a life and health guaranty association has elected to succeed
the rights and obligations of an insolvent insurer.
Under ยง 5-904(B) of the Insurance Article, provides a reinsurer with certain
rights, including the right to investigate a claim and interpose, in the
liquidation proceeding, any defense that it determines is available to the
insolvent ceding insurer or its receiver.
Effective date: October 1, 2003
HOUSE BILL 200 (Chapter 35) - Insurance - Regulation of Insurance
Producers
Amends ยง 2-112 of the Insurance Article to repeal the current fee for approval
by the Insurance Commissioner of continuing education courses
a claim and interpose, in the
liquidation proceeding, any defense that it determines is available to the
insolvent ceding insurer or its receiver.
Effective date: October 1, 2003
HOUSE BILL 200 (Chapter 35) - Insurance - Regulation of Insurance
Producers
Amends ยง 2-112 of the Insurance Article to repeal the current fee for approval
by the Insurance Commissioner of continuing education courses.
Amends ยง 10-110 of the Insurance Article to allow the Insurance
Commissioner to appoint an advisory board for life and health insurance and
an advisory board for property and casualty insurance.
Amends ยง 10-116 of the Insurance Article to allow the Insurance
Commissioner to review continuing education courses and approve or
disapprove continuing education courses.
Amends ยง 10-118 of the Insurance Article to require insurers to maintain a
producer register in lieu of filing a notice of every producer appointment or
termination with the Insurance Commissioner.
Effective date: July 1, 2003*
(*The provisions in ยง 10-118 of the Insurance Article take effect on January 1,
2004.)
19
HOUSE BILL 711 (Chapter 173) - Insurance - Offers of Educational or
Promotional Materials or Articles of Merchandise
Amends ยง 27-209(4) of the Insurance Article to prohibit a person from
knowingly offering, promising or giving any valuable consideration not
specified in the contract, except for educational materials, promotional
materials, or articles of merchandise that cost less than $10, regardless of
whether a policy is purchased.
Amends ยง 27-212 of the Insurance Article to prohibit a person from knowingly
offering, promising, or giving any valuable consideration not specified in the
contract, except for educational materials, promotional materials, or articles of
merchandise that cost less than $10, regardless of whether a policy is
purchased
rchandise that cost less than $10, regardless of
whether a policy is purchased.
Amends ยง 27-212 of the Insurance Article to prohibit a person from knowingly
offering, promising, or giving any valuable consideration not specified in the
contract, except for educational materials, promotional materials, or articles of
merchandise that cost less than $10, regardless of whether a policy is
purchased.
Effective date: October 1, 2003
HOUSE BILL 1037 (Chapter 193) - Life Insurers - Board of Directors -
Investments Practices
Amends ยง 5-505 of the Insurance Article to require certain insurers and their
boards to behave in a certain manner when making investments or loans.
Amends ยง 5-511 of the Insurance Article to allow insurers to invest in certain
classes of investments.
Amends ยง 5-511 to define limits on an insurer's ability to invest in mediumgrade and lower-grade securities.
Effective date: October 1, 2003
SENATE BILL 85 (Chapter 60) - Injured Workers' Insurance Fund - Risk
Based Capital - Exemption from Excessive Premium Growth Charge
Amends ยง 10-125(f) of the Labor and Employment Article so that the Fund is
not subject to the excessive premium growth charge or any other penalty
associated with premium growth in any risk based capital calculation.
Section 10-125(f) of the Labor and Employment Article is effective until
January 1, 2005.
Effective date: October 1, 2003
20
SENATE BILL 601 (Chapter 106) - Life Insurance - Separate Investment
Accounts - Asset Holding Requirements
Amends ยง 5-512(k)(2) of the Insurance Article so that if a separate investment
account provides a fixed guaranteed return that is not subject to market value
adjustment, a life insurer is required to hold assets that equal or exceed the
reserve amount that would be required if the separate investment account
was an obligation of the life insurer's general account.
Requires an asset held under ยง 5-512(k)(2)((I) to be valued in accordance
with ยงยง 5-401 and 5-402 of the Insurance Article
ides a fixed guaranteed return that is not subject to market value
adjustment, a life insurer is required to hold assets that equal or exceed the
reserve amount that would be required if the separate investment account
was an obligation of the life insurer's general account.
Requires an asset held under ยง 5-512(k)(2)((I) to be valued in accordance
with ยงยง 5-401 and 5-402 of the Insurance Article.
Effective date: October 1, 2003
SENATE BILL 652 (Chapter 399) - Insurers - Assets and Investments -
Location
Exempts a domestic insurer from keeping certain assets in the State.
Under ยง 4-115(c)(1)(ii)(4) of the Insurance Article, exempts securities held
either by the insurer or in compliance with regulations adopted by the
Insurance Commissioner.
Under ยง 4-115(c)(1)(ii)(5) of the Insurance Article, exempts transactions or
securities involved in transactions authorized by ยง 5-111(n) and (o) of the
Insurance Article or any other transactions exempted by the Insurance
Commissioner from this paragraph.
Repeals ยง 4-115(d) of the Insurance Article, which prohibits a domestic
insurer from keeping more than 15% of the domestic insurer's admitted
assets outside of the State.
Amends ยง 5-511(o)(2)(ii)(1.) of the Insurance Article to require the board of
directors to approve a derivative use plan that, among other things:
"Describes investment objectives and risk constraints, such as counterparty
exposure amounts and collateral arrangements supporting derivative
transactions".
Effective date: October 1, 2003