Current as of December 31, 2021 | Updated by FindLaw Staff
Welcome to FindLaw's Cases & Codes, a free source of state and federal court opinions, state laws, and the United States Code. For more information about the legal concepts addressed by these cases and statutes, visit FindLaw's Learn About the Law.
(a) This section applies to insurers and nonprofit health service plans that propose to issue or deliver individual, group, or blanket health insurance policies or contracts or to administer health benefit programs that provide hospital, medical, or surgical benefits on an expense-incurred basis.
(b) Each entity subject to this section shall provide to an insured individual who has filed a claim described in subsection (c) of this section an annual summary explanation of benefits that covers the preceding 12-month period.
(c) The summary explanation of benefits required under subsection (b) of this section shall provide a summary of:
(1) all claims filed by health care providers for services rendered to the insured individual or covered dependent of the insured individual during an inpatient hospitalization or an outpatient surgical procedure;
(2) the amount paid by the entity for each claim filed; and
(3) the balance owed by the insured individual for each claim filed.
(d) The explanation of benefits required under this section is subject to 45 C.F.R. § 164.522(b).
Cite this article: FindLaw.com - Maryland Code, Insurance § 15-1007 - last updated December 31, 2021 | https://codes.findlaw.com/md/insurance/md-code-insurance-sect-15-1007/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature or via Westlaw before relying on it for your legal needs.
Was this helpful?