Required Report Regarding Declined Individuals

STATE OF MARYLAND MARYLAND INSURANCE ADMINISTRATION 525 ST. PAUL PLACE, BALTIMORE, MARYLAND 21202-2272 WRITER’S DIRECT DIAL: 410-468-2205 Facsimile Number: 410-468-2204 e-mail: hmax@mdinsurance.state.md.us BULLETIN To: Carriers Selling Individual Health Benefit Plans in Maryland Re: Required Report Regarding Declined Individuals Date: June 20, 2003 Bulletin: Life and Health # 03-11 The purpose of this bulletin is to notify carriers selling individual health benefit plans in Maryland of a new quarterly reporting requirement. Chapter 153 of the Acts of 2002 (House Bill 1228) added a new paragraph (b) to §15-1303 of Insurance Article, which becomes effective July 1, 2003. This paragraph requires each carrier that offers an individual health benefit plan in Maryland, as defined in Insurance Article, §15- 1301, Annotated Code of Maryland, to report the following information on a quarterly basis to the Commissioner:
The number of applications submitted to the carrier for individual coverage during the quarter; and
The number of declinations issued by the carrier for individual coverage. In reporting declinations of coverage, we are requesting that carriers differentiate between (1) applications that are rejected entirely and (2) applications which either result in an offer of coverage at a substandard premium rate or result in an offer of coverage, but only if the applicant accepts a waiver rider. A copy of the reporting form that can be used to provide this information is attached. ROBERT L. EHRLICH, JR. GOVERNOR MICHAEL S. STEELE LIEUTENANT GOVERNOR ALFRED W. REDMER, JR. COMMISSIONER DONNA B. IMHOFF DEPUTY COMMISSIONER Page 2 The law requires that the report be provided no later than 30 days after the last day of the quarter for which the information is provided. The first report will be for the period of July 1, 2003 through September 30, 2003. Therefore, the first quarterly report is due October 30, 2003. Any questions about this bulletin should be directed to Brenda A. Wilson, Chief of Health Insurance and Managed Care, at bwilson@mdinsurance.state.md.us or 410-468-2170. _________________________ Howard Max Acting Associate Commissioner Life and Health Attachment *Health Benefit Plan has the meaning defined in Insurance Article, §15-1301, Annotated Code of Maryland MARYLAND INSURANCE ADMINISTRATION QUARTERLY REPORT INDIVIDUAL HEALTH BENEFIT PLAN* APPLICATIONS AND DECLINATIONS Company Name _____________________________________________________ Reporting Quarter (Check one)
January--March
April--June
July--Sept
October--December Reporting Year 200___ 1. Number of individual applications for Health Benefit Plans received in Reporting Quarter:___________________ 2. Number of applications for Health Benefit Plans declined in Reporting Quarter: ______________________ (Do not include applications that result in an offer of coverage at a substandard rate or with a waiver rider. These are counted in #3 below.) 3. Number of applications declined in Reporting Quarter, but with offer of coverage at a substandard rate or with the addition of a waiver rider: _______________ Individual Completing Reporting Form: ____________________________________ Title: ____________________________________ Telephone Number: ____________________________________ Email Address: _____________________________________ Date: _____________________________________ Return form to Brenda A. Wilson, Chief of Health Insurance and Managed Care, Maryland Insurance Administration, 525 St. Paul Street, Baltimore, Maryland 21202 or fax to (410) 468-2204 by the 30th day following the end of the Reporting Quarter.