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(a)(1) In this section the following words have the meanings indicated.
(2) “Individual Exchange” has the meaning stated in § 31-101 of this article.
(3) “Qualified health plan” has the meaning stated in § 31-101 of this article.
(4) “Qualified individual” has the meaning stated in § 31-101 of this article.
(b) This section applies to a qualified health plan that is issued on or after January 1, 2014, by a carrier through the Individual Exchange.
(c) A qualified health plan subject to this section shall include a grace period provision applicable to a qualified individual who:
(1) is receiving advance payments of federal premium tax credits; and
(2) fails to pay premiums timely.
(d) The grace period provision shall:
(1) provide a grace period of 3 consecutive months after the initial premium payment to begin coverage has been paid;
(2) apply to qualified health plans renewed in accordance with § 15-1309 of this subtitle without the qualified individual having to pay the first month's premium following renewal; and
(3) be in addition to any other grace period provision required by any other applicable State law.
(e) During the grace period, a carrier that issues a qualified health plan subject to this section:
(1) shall pay all appropriate claims for services rendered to the qualified individual during the first month of the grace period;
(2) may pend claims for services rendered to the qualified individual in the second and third months of the grace period;
(3) shall notify the federal Department of Health and Human Services that the qualified individual is in the grace period; and
(4) shall notify providers of the possibility that claims may be denied when a qualified individual is in the second and third months of the grace period.
Cite this article: FindLaw.com - Maryland Code, Insurance § 15-1315 - last updated December 31, 2021 | https://codes.findlaw.com/md/insurance/md-code-insurance-sect-15-1315/
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