Sec. 31.11.10.03. Required Standard Provisions  


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  • A. A group health insurance contract may not be delivered in Maryland unless it contains in substance the provisions:

    (1) Listed in Regulation .04 of this chapter; or

    (2) Which in the opinion of the Commissioner, as compared to the provisions in Regulation .04 of this chapter, are:

    (a) More favorable to the individuals insured, or

    (b) At least as favorable to the individuals insured and more favorable to the policyholder.

    B. A blanket health insurance contract may not be delivered in Maryland unless it contains in substance the provisions:

    (1) Listed in Regulation .05 of this chapter; or

    (2) Which in the opinion of the Commissioner, as compared to the provisions in Regulation .05 of this chapter, are:

    (a) More favorable to the individuals insured, or

    (b) At least as favorable to the individuals insured and more favorable to the policyholder.

    C. Inapplicable and Inconsistent Provisions. If a provision required by Regulation .04 or .05 of this chapter is wholly or partly inapplicable to or inconsistent with the coverage provided by a particular contract, the carrier shall:

    (1) Omit from the contract the inapplicable provision or part of the provision; or

    (2) Modify the inconsistent provision or part of the provision to make it consistent with the coverage provided by the contract.