Chapter 24 Discount Medical Plan Organizations and Discount Drug Plan Organizations

Chapter 24 Discount Medical Plan Organizations and Discount Drug Plan Organizations | Library of Maryland Regulations

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Code of Maryland Regulations

Title 31 MARYLAND INSURANCE ADMINISTRATION

Subtitle 10 HEALTH INSURANCE — GENERAL

Chapter 24 Discount Medical Plan Organizations and Discount Drug Plan Organizations

Code of Maryland Regulations

Chapter 24 Discount Medical Plan Organizations and Discount Drug Plan Organizations

Administrative History Effective date: Regulations .01 — .04 adopted as an emergency provision effective October 1, 2008 (35:22 Md. R. 1955); adopted permanently effective January 26, 2009 (36:2 Md. R. 103) Authority Insurance Article, §2-109 and Title 14, Subtitle 6; Annotated Code of Maryland

.01 Scope. This chapter applies to discount medical plans and discount drug plans sold, marketed, or solicited in Maryland in accordance with the requirements of Insurance Article, Title 14, Subtitle 6, Annotated Code of Maryland .

.02 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) "Discount drug plan" has the meaning stated in Insurance Article, §14-601(b), Annotated Code of Maryland . (2) "Discount drug plan organization" has the meaning stated in Insurance Article, §14-601(c), Annotated Code of Maryland . (3) "Discount medical plan" has the meaning stated in Insurance Article, §14-601(d), Annotated Code of Maryland . (4) "Discount medical plan organization" has the meaning stated in Insurance Article, §14-601(e), Annotated Code of Maryland . (5) "Medical services" has the meaning stated in Insurance Article, §14-601(g), Annotated Code of Maryland . (6) "Nominal fee" means the fee that may be retained by a discount drug plan organization or a discount medical plan organization if a plan member's membership in a discount drug plan or discount medical plan is canceled within the first 30 calendar days after the effective date of enrollment. (7) "Plan member" has the meaning stated in Insurance Article, §14-601(i), Annotated Code of Maryland .

.03 Cancellations. A. A discount drug plan organization or discount medical plan organization shall reimburse all monies collected from a plan member if the plan member cancels membership in the discount drug plan or the discount medical plan within the first 30 calendar days after the effective date of enrollment. B. If electronic fund transfer is employed as a method of payment for discount drug plan or discount medical plan membership and membership is canceled within the first 30 calendar days after the effective date of enrollment, the discount drug plan organization or discount medical plan organization has 30 days from the date of cancellation in which to reverse the electronic fund transfer less the applicable nominal fee for this period.

.04 Nominal Fee. A. Notwithstanding the provisions of Regulation .03 of this chapter , a discount drug plan organization or a discount medical plan organization may retain a nominal fee if a plan member cancels membership in the discount drug plan or discount medical plan within the first 30 calendar days after the effective date of enrollment, if: (1) The discount drug plan organization or the discount medical plan organization has filed the applicable nominal fee with the Insurance Commissioner prior to use; and (2) The nominal fee does not exceed the lesser of $5, or the actual expenses incurred for issuing a plan member's discount drug plan card or discount medical plan card. B. A discount drug plan or discount medical plan shall disclose the amount of the nominal fee and the circumstances when the discount drug plan organization or discount medical plan organization may retain the nominal fee in writing in 12 point type and in all marketing materials relating to an application or contract soliciting prospective members, including all: (1) Printed materials; (2) Brochures; and (3) Websites.

Previous Chapter 23 Penalties for Failure to Make Prompt Payment of Claims

Next Chapter 25 Required Standard Provisions for Individual Nonprofit Health Service Plan Contracts

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