Maryland Code, INSURANCE 27-221
Terms Used In Maryland Code, INSURANCE 27-221
- Contract: A legal written agreement that becomes binding when signed.
- Fraud: Intentional deception resulting in injury to another.
- Person: includes an individual, receiver, trustee, guardian, personal representative, fiduciary, representative of any kind, corporation, partnership, business trust, statutory trust, limited liability company, firm, association, or other nongovernmental entity. See
- state: means :
(1) a state, possession, territory, or commonwealth of the United States; or
(2) the District of Columbia. See
(2) “Carrier” means a person that is:
(i) an insurer that holds a certificate of authority in the State and provides health insurance in the State;
(ii) a health maintenance organization that holds a certificate of authority to operate in the State; or
(iii) a nonprofit health service plan that holds a certificate of authority to operate in the State.
(3) “Health coverage” means any of the following:
(i) a health insurance contract that is issued or delivered in the State by an insurer;
(ii) a contract that is issued or delivered in the State by a nonprofit health service plan; or
(iii) a contract that is issued or delivered in the State by a health maintenance organization.
(4) “Health status-related factor” has the meaning stated in § 15-1301 of this article.
(5) “Individual contract” means a contract between a carrier and an individual covering:
(i) the individual;
(ii) the individual and the individual’s family members; or
(iii) the family members of the individual.
(6) (i) “Reunderwrite” means to reevaluate any health status-related factor, occupation, hobby, or activity of an individual for the purpose of:
1. terminating health coverage of the individual; or
2. moving the individual from a more favorable rate class to a less favorable rate class.
(ii) “Reunderwrite” does not include:
1. moving an individual from one rate tier to another rate tier solely due to the addition or deletion of a family member under the health coverage;
2. increasing the premium under an attained age rated contract solely due to the increasing age of the individual covered under the health coverage;
3. on receipt of an application from an insured to increase the benefits under an existing contract, evaluating the health status-related factors, occupation, hobbies, or activities of the insured for the purpose of increasing the benefits under the contract; or
4. during the period in which a carrier has the right to contest a policy, denying a claim, amending the policy, making an adjustment to the premium, or rescinding the policy based on a material misrepresentation or fraud in the application.
(b) A carrier may not reunderwrite an individual for health coverage under an individual contract after the individual contract has been issued.