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Statutes Text

Article - Insurance




§15–1A–18.

    (a)    A carrier may offer a catastrophic plan in the individual market in accordance with the requirements of this section.

    (b)    A catastrophic plan may be offered only to individuals who:

        (1)    are under the age of 30 years before the beginning of the plan year; or

        (2)    hold certification for a hardship exemption or an affordability exemption as required in subsection (c) of this section.

    (c)    (1)    Except as provided in paragraph (2) of this subsection, to be offered a catastrophic plan, an individual shall hold certification for a hardship exemption or an affordability exemption under 42 U.S.C. § 5000A.

        (2)    If the Maryland Health Benefit Exchange adopts regulations as described under subsection (d) of this section, an individual shall hold certification for a hardship exemption or an affordability exemption under the regulations adopted by the Exchange.

    (d)    To the extent necessary, the Maryland Health Benefit Exchange shall adopt regulations that:

        (1)    establish a process for issuing hardship exemptions and affordability exemptions; and

        (2)    are consistent with 42 U.S.C. § 5000A and any corresponding federal rules and guidance as those provisions were in effect December 1, 2019.

    (e)    (1)    Subject to paragraph (2) of this subsection, a catastrophic plan shall provide coverage for essential health benefits.

        (2)    A catastrophic plan shall require a deductible that:

            (i)    is equal to the annual limit on cost–sharing described in § 15–1A–19 of this subtitle;

            (ii)    applies to essential health benefits;

            (iii)    does not apply to at least three primary care visits each plan year; and

            (iv)    does not apply to any covered benefits for which a deductible is prohibited under this title.



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