§ 27-221. Prohibition against reunderwriting.

MD Ins Code § 27-221 (2019) (N/A)
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(a)    (1)    In this section the following words have the meanings indicated.

(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.