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2023 Maryland Statutes › Insurance › Title 17 - Group Life Insurance › Subtitle 2 - Group Policy Requirements › Section 17-205 - Public Employers or Public Employees Associations

(a)    (1)    In this section the following words have the meanings indicated.
(2)    “Public employees association” means an association of federal, State, county, or municipal corporation employees.
(3)    “Public employer” means a county, municipal corporation, association of counties or municipal corporations, State college or university, or unit of State, county, or municipal corporation government.
(b)    (1)    Subject to the requirements of this section, the lives of a group of individuals may be insured under a policy issued to a public employer or public employees association to cover employees of the public employer or members of the public employees association for the benefit of persons other than the public employer or public employees association.
(2)    The public employer or public employees association to which the policy is issued is deemed the policyholder.
(c)    (1)    All employees of the public employer, all members of the public employees association, or all of any class or classes of employees or members determined by conditions pertaining to their employment or membership in the public employees association or both are eligible for insurance under a policy issued in accordance with this section.
(2)    A policy issued to insure employees of a public employer may provide that the term “employee” includes:
(i)    a retired employee; and
(ii)    an elected or appointed official.
(d)    (1)    The premium for the policy shall be paid from funds contributed by the public employer or public employees association, or by both, or from funds contributed by the covered persons or from both the covered persons and the public employer or public employees association.
(2)    Except as provided in paragraph (3) of this subsection, a policy on which no part of the premium is to be derived from funds contributed by the covered persons specifically for the insurance must insure all eligible persons, except those who reject the coverage in writing.
(3)    An insurer may exclude or limit the coverage on any person as to whom evidence of individual insurability is not satisfactory to the insurer.
(4)    A public employer may require written authorization from an employee to deduct from the employee’s salary the required contributions for the premium.
2023 Maryland Statutes › Insurance › Title 17 - Group Life Insurance › Subtitle 2 - Group Policy Requirements › Section 17-206 - Creditors

(a)    Subject to the requirements of this section, a policy may be issued to a creditor or its parent holding company or to a trustee or trustees or agent designated by two or more creditors, which creditor, holding company, affiliate, trustee, trustees, or agent shall be deemed the policyholder, to insure debtors of the creditor, or creditors.
(b)    (1)    The debtors eligible for insurance under the policy shall be all of the debtors of the creditor or creditors, or all of any class or classes of debtors.
(2)    The policy may provide that the term “debtors” shall include:
(i)    borrowers of money or purchasers or lessees of goods, services, or property for which payment is arranged through a credit transaction;
(ii)    the debtors of one or more subsidiary corporations; and
(iii)    the debtors of one or more affiliated corporations, proprietorships, or partnerships if the business of the policyholder and of the affiliated corporations, proprietorships, or partnerships is under common control.
(c)    (1)    The premium for the policy shall be paid either from the creditor’s funds, or from charges collected from the insured debtors, or from both.
(2)    Except as provided in paragraph (3) of this subsection, a policy on which no part of the premium is to be derived from the funds contributed by insured debtors specifically for their insurance must insure all eligible debtors.
(3)    An insurer may exclude any debtors as to whom evidence of individual insurability is not satisfactory to the insurer.
(d)    (1)    The amount of insurance on the life of any debtor shall at no time exceed the greater of the scheduled or actual amount of unpaid indebtedness to the creditor.
(2)    (i)    The insurance may be payable to the creditor or any successor to the right, title, and interest of the creditor.
(ii)    The payment shall reduce or extinguish the unpaid indebtedness of the debtor to the extent of the payment and any excess of the insurance shall be payable to the beneficiary named by the insured other than the creditor or to the estate of the insured.
(3)    Notwithstanding the provisions of paragraphs (1) and (2) of this subsection:
(i)    insurance on agricultural credit transaction commitments not exceeding a term of 1 year may be written up to the amount of the loan commitment on a nondecreasing or level term plan; and
(ii)    insurance on educational credit transaction commitments may be written up to the amount of the loan commitment less the amount of any repayments made on the loan.
2023 Maryland Statutes › Insurance › Title 17 - Group Life Insurance › Subtitle 2 - Group Policy Requirements › Section 17-207 - Credit Unions

(a)    (1)    Subject to the requirements of this section, the lives of a group of individuals may be insured under a policy issued to a credit union organized in accordance with State law or the Federal Credit Union Act to cover members of the credit union for the benefit of persons other than the credit union or its officials.
(2)    The credit union to which the policy is issued is deemed the policyholder.
(b)    All members of the credit union, or all of any class or classes of members determined by conditions pertaining to their age or membership in the credit union or both, are eligible for insurance under a policy issued in accordance with this section.
(c)    (1)    The premiums for the policy shall be paid from funds contributed by the credit union or insured members, or by both.
(2)    Except as provided in paragraph (3) of this subsection, a policy on which no part of the premium is to be derived from funds contributed by the insured member for the insurer must insure all eligible persons, except those who reject the coverage in writing.
(3)    An insurer may exclude or limit the coverage on any persons as to whom evidence of individual insurability is not satisfactory to the insurer.
2023 Maryland Statutes › Insurance › Title 17 - Group Life Insurance › Subtitle 2 - Group Policy Requirements › Section 17-208 - Volunteer Fire, Rescue Squad, or Ambulance Service Organizations

(a)    (1)    Subject to the requirements of this section, the lives of a group of individuals may be insured under a policy issued to a volunteer fire, rescue squad, or ambulance service organization to cover the registered members of the organization for the benefit of persons other than the organization.
(2)    The volunteer fire, rescue squad, or ambulance service organization to which the policy is issued is deemed the policyholder.
(b)    All registered members of a volunteer fire, rescue squad, or ambulance service organization are eligible for insurance under a policy issued in accordance with this section.
(c)    (1)    The premiums for the policy shall be paid from funds contributed by the volunteer fire, rescue squad, or ambulance service organization or funds contributed by the insured members or from both.
(2)    Except as provided in paragraph (3) of this subsection, a policy on which no part of the premium is to be derived from funds contributed by the insured member specifically for the insurance must insure all eligible persons, except those who reject the coverage in writing.
(3)    An insurer may exclude or limit the coverage on any person as to whom evidence of individual insurability is not satisfactory to the insurer.
2023 Maryland Statutes › Insurance › Title 17 - Group Life Insurance › Subtitle 2 - Group Policy Requirements › Section 17-209 - Insurance on Spouse or Child of Employee or Member

(a)    (1)    Insurance under a policy of group life insurance issued in accordance with §§ 17–201 through 17–205 of this subtitle may be extended to cover the spouse, domestic partner, or dependent children of each insured employee or member who elects to obtain the coverage.
(2)    The policy may provide that the term “dependent children” includes:
(i)    an insured employee’s or member’s child under 18 years of age; and
(ii)    an insured employee’s or member’s child 18 years of age or older who attends an educational institution and relies on the insured employee or member for financial support.
(3)    The term “domestic partner” has the meaning stated in the policy.
(4)    The insurance on the life of a spouse, domestic partner, or child may not exceed the amount of the insurance on the life of the insured employee or member.
(b)    The policyholder shall pay the premium for the insurance on the spouse, domestic partner, or child:
(1)    wholly from the funds of the policyholder or funds contributed by the policyholder;
(2)    wholly from funds contributed by the insured employees or members; or
(3)    partly from the funds of the policyholder or funds contributed by the policyholder and partly from funds contributed by the insured employees or members.
(c)    A spouse, domestic partner, or dependent child insured under this section is entitled to:
(1)    the rights of conversion under § 17–309 of this title, if employment of the employee or membership in the class or classes eligible for insurance under the policy is terminated; and
(2)    the rights of conversion under § 17–310 of this title, if the policy of group life insurance terminates or is amended to terminate the insurance of the spouse, domestic partner, or dependent child.
(d)    Notwithstanding § 17–308 of this title, only one certificate must be issued for each family unit if a statement about a dependent’s coverage is included in the certificate.
2023 Maryland Statutes › Insurance › Title 17 - Group Life Insurance › Subtitle 3 - Group Life Insurance Policy Provisions › Section 17-301 - Standard Provisions Required; Exceptions

(a)    Except as provided in subsection (b) of this section, a policy of group life insurance may not be delivered in the State unless it contains in substance:
(1)    the provisions of §§ 17-302 through 17-311 of this subtitle; or
(2)    provisions that in the opinion of the Commissioner are:
(i)    more favorable to the insureds; or
(ii)    at least as favorable to the insureds and more favorable to the policyholder.
(b)    (1)    Sections 17-307 through 17-311 of this subtitle do not apply to policies issued to a creditor to insure debtors of the creditor.
(2)    The standard provisions required for individual life insurance policies do not apply to policies of group life insurance.
(3)    If a policy of group life insurance is on a plan other than the term plan, the policy:
(i)    shall contain a nonforfeiture provision that in the opinion of the Commissioner is equitable to the insured and the policyholder; but
(ii)    need not contain the same nonforfeiture provisions required for individual life insurance policies.
2023 Maryland Statutes › Insurance › Title 17 - Group Life Insurance › Subtitle 3 - Group Life Insurance Policy Provisions › Section 17-302 - Grace Period

(a)    Each policy of group life insurance shall contain a provision that the policyholder is entitled to a grace period of 31 days for payment of any premium due except the first premium.
(b)    The death benefit coverage continues in force during the grace period unless the policyholder has given the insurer written notice of discontinuance before the date of discontinuance and in accordance with the terms of the policy.
(c)    The policy may provide that the policyholder is liable to the insurer for paying a pro rata premium for the time the policy was in force during the grace period.
2023 Maryland Statutes › Insurance › Title 17 - Group Life Insurance › Subtitle 3 - Group Life Insurance Policy Provisions › Section 17-303 - Incontestability

Each policy of group life insurance shall contain a provision that:
(1)    the policy is incontestable, except for nonpayment of premiums, after the policy has been in force for 2 years after its date of issue; and
(2)    a statement made by an insured under the policy about insurability may not be used to contest the validity of the insurance as to which the statement was made unless:
(i)    the insurance has been in force before the contest for less than 2 years during the insured’s lifetime; and
(ii)    the statement is in writing and signed by the insured.
2023 Maryland Statutes › Insurance › Title 17 - Group Life Insurance › Subtitle 3 - Group Life Insurance Policy Provisions › Section 17-304 - Copy of Application Attached to Policy; Effect of Statements

Each policy of group life insurance shall contain a provision that:
(1)    requires a copy of any application of the policyholder to be attached to the policy when issued;
(2)    the statements made by the policyholder or the insured are considered representations and not warranties; and
(3)    a statement made by an insured may not be used in a contest unless a copy of the instrument that contains the statement is provided to the insured or, in the event of death or incapacity of the insured, to the insured’s beneficiary.
2023 Maryland Statutes › Insurance › Title 17 - Group Life Insurance › Subtitle 3 - Group Life Insurance Policy Provisions › Section 17-306 - Misstatement of Age

Each policy of group life insurance shall contain a provision that:
(1)    specifies that an equitable adjustment of premiums or benefits or both will be made if the age of an insured is misstated; and
(2)    clearly states the method of adjustment to be used.
2023 Maryland Statutes › Insurance › Title 17 - Group Life Insurance › Subtitle 3 - Group Life Insurance Policy Provisions › Section 17-307 - Payment of Benefits

Each policy of group life insurance shall contain a provision that any sum due because of the death of the insured is payable to the beneficiary designated by the insured, subject to:
(1)    the provisions of the policy as to payment of all or part of the sum if a designated beneficiary is not alive at the death of the insured; and
(2)    any right that the insurer reserves in the policy and sets forth in the certificate to pay at its option a part of the sum, not exceeding $2,500, to a person that the insurer considers equitably entitled to it for having incurred funeral or other expenses incident to the insured’s death or last illness.
2023 Maryland Statutes › Insurance › Title 17 - Group Life Insurance › Subtitle 3 - Group Life Insurance Policy Provisions › Section 17-308 - Individual Certificates

Each policy of group life insurance shall contain a provision that requires the insurer to issue to the policyholder, for delivery to each insured, an individual certificate that states:
(1)    the insurance protection to which the insured is entitled;
(2)    each person to whom the insurance benefits are payable; and
(3)    the rights and conditions set forth in § 17–102 of this title and §§ 17–309 through 17–311 of this subtitle.
2023 Maryland Statutes › Insurance › Title 17 - Group Life Insurance › Subtitle 3 - Group Life Insurance Policy Provisions › Section 17-309 - Conversion of Group Policy -- Termination of Eligibility

(a)    Each policy of group life insurance shall contain a provision that if the insurance or any part of it on an insured ceases under the policy because of termination of employment or membership in the class or classes eligible for coverage under the policy, the insured is entitled to have issued by the insurer, without evidence of insurability, an individual policy of life insurance without disability or other supplementary benefits, subject to the following conditions:
(1)    subject to subsection (b) of this section, application for the policy must be made and the first premium must be paid to the insurer within 31 days after the termination of employment or membership;
(2)    the individual policy is, at the option of the insured, on any form, except term insurance, customarily issued by the insurer at the age and for the amount applied for;
(3)    the individual policy is in an amount that does not exceed the amount of life insurance that ceases because of the termination of employment or membership, less the amount of life insurance for which the insured is eligible under the same or another group policy within 31 days after the termination of employment or membership;
(4)    the premium on the individual policy is at the insurer’s customary rate applicable to:
(i)    the form and amount of the individual policy;
(ii)    the class of risk to which the insured belongs; and
(iii)    the age of the insured attained on the effective date of the individual policy; and
(5)    the insured is entitled to written notice of the insured’s rights under this section at least 15 days prior to the expiration of the conversion period provided for in item (1) of this subsection.
(b)    (1)    If the insured is not provided with the notice required under subsection (a)(5) of this section, the insured shall have an additional 15 days from the date on which written notice is received to make application for the individual policy and pay the first premium to the insurer.
(2)    In no event shall the additional period provided under paragraph (1) of this subsection extend beyond 60 days after the expiration of the conversion period provided for in subsection (a)(1) of this section.
(c)    For purposes of subsection (a)(3) of this section, insurance that matures on or before the date of the termination of employment or membership as an endowment payable to the insured, whether in one sum, in installments, or in the form of an annuity, may not be included in the amount of life insurance that is considered to cease because of the termination of employment or membership.
2023 Maryland Statutes › Insurance › Title 17 - Group Life Insurance › Subtitle 3 - Group Life Insurance Policy Provisions › Section 17-310 - Conversion of Group Policy -- Termination of Coverage

(a)    Subject to subsection (b) of this section, each policy of group life insurance shall contain a provision that if the group policy terminates or is amended so as to terminate the insurance of a class of insureds, each insured at the date of the termination whose insurance terminates and who has been insured for at least 5 years before the termination date is entitled to have issued to that insured by the insurer an individual policy of life insurance subject to the same conditions and limitations provided in § 17-309 of this subtitle.
(b)    The group policy may provide that the amount of an individual policy issued under this section may not exceed the lesser of:
(1)    the amount of the insured’s life insurance protection that has terminated, less the amount of life insurance for which the insured is or becomes eligible under a group policy issued or reinstated by the same or another insurer within 31 days after the termination; and
(2)    $10,000.
2023 Maryland Statutes › Insurance › Title 17 - Group Life Insurance › Subtitle 3 - Group Life Insurance Policy Provisions › Section 17-311 - Death Pending Conversion

Each policy of group life insurance shall contain a provision that if an insured under the policy dies while entitled to an individual policy under § 17-309 or § 17-310 of this subtitle but before the individual policy becomes effective, the amount of life insurance to which the insured would have been entitled shall be payable as a claim under the group policy, whether or not application for the individual policy or payment of the first premium has been made.
2023 Maryland Statutes › Insurance › Title 18 - Long-Term Care Insurance › Section 18-102 - Regulations

The Commissioner may adopt regulations about long-term care insurance with respect to:
(1)    form and content of disclosures;
(2)    terms of renewals;
(3)    initial and subsequent conditions of eligibility;
(4)    nonduplication of coverage provisions;
(5)    preexisting conditions;
(6)    renewability of coverage;
(7)    continuation and conversion;
(8)    probationary periods, limitation of coverage provisions, and recurrent conditions;
(9)    coverage of dependents;
(10)    loss ratio standards; and
(11)    any other matter that the Commissioner determines is in the best interest of the public.
2023 Maryland Statutes › Insurance › Title 18 - Long-Term Care Insurance › Section 18-103 - Compliance With Title Required; Advertising; Marketing

(a)    A carrier may not advertise, market, or offer a policy, contract, or certificate in the State as long-term care insurance or long-term nursing home insurance unless the policy or contract complies with this title.
(b)    (1)    Before a carrier advertises, on television or radio or in writing, a policy or contract of long-term care insurance or long-term nursing home insurance that is offered for sale in the State, the carrier shall submit a copy of the advertisement to the Commissioner for review.
(2)    The carrier shall retain each advertisement for 3 years after the date the advertisement first was used.
(3)    The Commissioner may exempt a carrier or a carrier’s advertising form or material from the requirements of this section if in the opinion of the Commissioner the requirements may not reasonably be applied.
(c)    A carrier that markets long-term care insurance in the State shall:
(1)    establish marketing procedures to ensure that any comparison of policies by insurance producers of the carrier will be fair and accurate;
(2)    establish marketing procedures to prevent the sale or issuance of excessive insurance;
(3)    establish procedures for verifying compliance with this subsection;
(4)    provide, to the extent possible, information on any senior citizen counseling program;
(5)    display prominently on the first page of the outline of coverage and the policy the following:
“Notice to buyer: This policy may not cover all the costs associated with long-term care incurred by the buyer during the period of coverage. The buyer is advised to review carefully all policy limitations.”; and
(6)    make every reasonable effort to identify whether a prospective applicant:
(i)    already has long-term care insurance and, if so, the types and amounts of the long-term care insurance;
(ii)    had long-term care insurance in force during the last 12 months;
(iii)    is covered under the medical assistance program; or
(iv)    intends to replace any existing medical or health insurance coverage with long-term care insurance.
(d)    An insurance producer who offers or sells policies or contracts of long–term care insurance in the State shall:
(1)    advise an individual considering the purchase of a long–term care insurance policy or contract about the availability and benefits of a policy that qualifies under the Qualified State Long–Term Care Insurance Partnership established under Title 15, Subtitle 4 of the Health – General Article;
(2)    provide a disclosure statement, approved by the Commissioner, to each applicant for long–term care insurance about the Qualified State Long–Term Care Insurance Partnership; and
(3)    make the disclosure statement required under item (2) of this subsection available to the Commissioner for inspection.
2023 Maryland Statutes › Insurance › Title 18 - Long-Term Care Insurance › Section 18-104 - Questions in Applications

(a)    Each application for long-term care insurance, except applications that are for long-term care insurance that is guaranteed issue, shall contain clear and unambiguous questions to ascertain the health condition of the applicant.
(b)    (1)    If an application for long-term care insurance asks whether the applicant has had medication prescribed by a physician, the application also shall ask the applicant to list the medication that has been prescribed.
(2)    If the carrier knew or should have known that the medication listed under paragraph (1) of this subsection at the time of application was directly related to a medical condition for which coverage would otherwise be denied, the policy or certificate of long-term care insurance may not be rescinded for that condition.
2023 Maryland Statutes › Insurance › Title 18 - Long-Term Care Insurance › Section 18-105 - Applicants at Least 80 Years Old

Before issuing a policy of long-term care insurance to an applicant who is at least 80 years old, unless the policy is guaranteed issue, the carrier shall obtain:
(1)    a report of a physical examination;
(2)    an assessment of functional capacity; or
(3)    copies of medical records.
2023 Maryland Statutes › Insurance › Title 18 - Long-Term Care Insurance › Section 18-106 - Outline of Coverage and Buyer's Guide

(a)    (1)    A carrier shall provide to each applicant an outline of coverage and buyer’s guide.
(2)    The carrier shall deliver the outline of coverage and buyer’s guide:
(i)    in the case of solicitation by the carrier or insurance producer of the carrier, before the presentation of an application or enrollment form; and
(ii)    in the case of direct response solicitation, with the application or enrollment form.
(b)    The outline of coverage shall include:
(1)    a description of the principal benefits and coverage provided in the policy or contract;
(2)    a statement of the principal exclusions, reductions, and limitations in the policy or contract;
(3)    a statement of the renewal provisions, including any reservation in the policy or contract of a right to change the schedule of premiums;
(4)    a statement that the outline of coverage is a summary of the policy or contract issued or applied for and the policy or contract should be consulted to determine the governing contractual provisions; and
(5)    any expected premium increases or additional premiums to pay for automatic or optional benefit increases, including a reasonable hypothetical or graphic demonstration of the potential premiums that the applicant will need to pay at age 75 for benefit increases.
(c)    The buyer’s guide shall include information about buying a policy of long–term care insurance, including a reference to the right of the buyer to cancel a policy during the first 30 days after the policy is delivered.
(d)    A carrier shall provide an applicant with a graphic comparison, over a period of at least 20 years, of the benefit levels of a policy that increases benefits over the policy or certificate period compared to the benefit levels of a policy that does not increase benefits.
2023 Maryland Statutes › Insurance › Title 18 - Long-Term Care Insurance › Section 18-107 - Contents of Certificates

A certificate that is issued under group long–term care insurance shall include:
(1)    a description of the principal benefits and coverage provided in the policy or contract;
(2)    a statement of the principal exclusions, reductions, and limitations of coverage in the policy or contract;
(3)    a statement that the group master policy or contract determines the governing contractual provisions; and
(4)    a statement as to whether the policy or contract is intended to qualify as a partnership policy under the Qualified State Long–Term Care Insurance Partnership under Title 15, Subtitle 4 of the Health – General Article.
2023 Maryland Statutes › Insurance › Title 18 - Long-Term Care Insurance › Section 18-108 - Summaries of Long-Term Care Benefits in Life Insurance Policies

(a)    If long-term care benefits are part of a life insurance policy or rider, the carrier shall provide a policy summary at the time of policy delivery.
(b)    The policy summary required to be delivered under subsection (a) of this section shall include:
(1)    information required to be included in an outline of coverage under § 18-106 of this title;
(2)    an explanation of how the long-term care benefits interact with other components of the life insurance policy, including deductions from death benefits;
(3)    an illustration of the amount of benefits, length of benefit, and guaranteed lifetime benefits if any, for each covered individual;
(4)    any exclusions, reductions, or limitations on benefits of long-term care; and
(5)    if applicable to the policy type:
(i)    a disclosure of the effects of exercising other rights under the policy;
(ii)    a disclosure of guarantees related to long-term care costs of insurance charges; and
(iii)    current and projected maximum lifetime benefits.
2023 Maryland Statutes › Insurance › Title 18 - Long-Term Care Insurance › Section 18-109 - Policy Limitations and Exclusions -- in General

(a)    Except as provided in subsection (b) of this section, a policy or certificate of long-term care insurance may not be delivered or issued for delivery in the State if the policy or certificate limits or excludes coverage by type of illness, treatment, medical condition, or accident.
(b)    A policy or certificate of long-term care insurance may limit or exclude coverage of:
(1)    preexisting conditions or diseases;
(2)    mental or nervous conditions or diseases other than Alzheimer’s disease;
(3)    alcohol or drug addiction;
(4)    unless otherwise provided by State or federal law, treatment provided in a government facility;
(5)    services provided by a member of the covered individual’s immediate family;
(6)    services for which a charge normally is not made in the absence of insurance;
(7)    services for which benefits are available under:
(i)    Medicare or other governmental programs except Medicaid; or
(ii)    a State or federal workers’ compensation, employer’s liability, or occupational disease law; and
(8)    illness, treatment, or medical conditions arising out of:
(i)    a declared or undeclared war or act of war;
(ii)    participation in a felony, riot, or insurrection;
(iii)    service in the armed forces or auxiliary units;
(iv)    suicide, attempted suicide, or intentionally self-inflicted injury; or
(v)    aviation, if the insured is a passenger who does not pay a fare.
(c)    This section does not prohibit:
(1)    exclusions and limitations by type of provider; or
(2)    limitations by territory.
2023 Maryland Statutes › Insurance › Title 18 - Long-Term Care Insurance › Section 18-110 - Policy Limitations and Exclusions -- Home Health Care Services

(a)    (1)    In this section, “home health care services” means medical or nonmedical services provided to ill, disabled, or infirm individuals in their residences.
(2)    “Home health care services” includes:
(i)    homemaker services;
(ii)    assistance with activities of daily living; and
(iii)    respite care services.
(b)    A policy or certificate of long-term care insurance that provides benefits for home health care services may not limit or exclude benefits by:
(1)    requiring that the insured would need care in a nursing facility if home health care services were not provided;
(2)    requiring that the insured first or simultaneously receive nursing or therapeutic services at home or in a community setting before home health care services are covered.
(3)    limiting eligible services provided by registered nurses or licensed practical nurses;
(4)    requiring that a nurse or therapist provide services covered by the policy or certificate of long-term care insurance that can be provided by a home health aide or other licensed or certified home care worker who acts within the scope of licensure or certification;
(5)    requiring that the insured have an acute condition before home health care services are covered; or
(6)    limiting benefits to services provided by Medicare-certified agencies or providers.
(c)    Coverage for home health care services may be applied to the coverage for other benefits provided in the policy or certificate of long-term care insurance when determining maximum coverage under the terms of the policy or certificate.
2023 Maryland Statutes › Insurance › Title 18 - Long-Term Care Insurance › Section 18-112 - Continuation of Coverage or Conversion of Policies

(a)    Each group policy of long-term care insurance shall provide covered individuals with a basis for continuation of coverage or conversion to an individual policy of long-term care insurance.
(b)    (1)    For purposes of this section, a group policy of long-term care insurance provides a basis for continuation of coverage if the group policy:
(i)    maintains coverage under the existing group policy when the coverage would otherwise terminate; and
(ii)    is subject only to the continued timely payment of premiums.
(2)    A group policy that restricts benefits and services to certain providers or facilities or contains incentives to use certain providers or facilities may provide continuation benefits that are substantially equivalent to the benefits of the existing group policy.
(c)    For purposes of this section, a group policy provides a basis for conversion of coverage if the group policy provides for issuance of a policy that provides benefits that are identical to, substantially equivalent to, or in excess of the benefits of the terminated group policy without evidence of insurability to each individual:
(1)    whose coverage under the group policy would otherwise be terminated for any reason; and
(2)    who has been continuously insured under the group policy for at least 6 months before the date of termination.
(d)    In determining whether benefits are substantially equivalent under this section, the Commissioner shall consider the difference between managed care plans and other plans.
2023 Maryland Statutes › Insurance › Title 18 - Long-Term Care Insurance › Section 18-113 - Replacement Policies

(a)    If a group policy of long-term care insurance is replaced by another group policy of long-term care insurance purchased by the same policyholder, the succeeding carrier shall offer coverage to each insured who was covered under the old group policy on its date of termination.
(b)    Coverage under the new group policy of long-term care insurance may not result in an exclusion for preexisting conditions that would have been covered under the group policy being replaced.
2023 Maryland Statutes › Insurance › Title 18 - Long-Term Care Insurance › Section 18-114 - Inflation Protection Option

(a)    The requirements of this section:
(1)    apply to individual and group policies of long-term care insurance; and
(2)    do not apply to life insurance policies or riders on life insurance policies that contain accelerated long-term care benefits.
(b)    (1)    A carrier may not offer a policy or certificate of long-term care insurance unless, at the time of purchase, the carrier also offers the applicant the option to purchase a policy or certificate with an inflation protection feature as described under paragraph (2) of this subsection.
(2)    The inflation protection feature under this subsection shall provide, in addition to any other inflation protection, that benefit levels will increase with benefit maximums or reasonable durations that are meaningful to account for reasonably anticipated increases in the costs of long-term care services covered by the policy or certificate.
(c)    The option to purchase a policy or certificate of long-term care insurance with an inflation protection feature under this section may not be less favorable than:
(1)    a policy or certificate that increases benefit levels annually in a manner so that the increases are compounded annually at a rate of at least 5%;
(2)    a policy or certificate that guarantees the insured the right to increase benefit levels periodically without providing evidence of insurability or health status so long as the option for the previous period has not been declined; or
(3)    a policy that covers a specific percentage of actual or reasonable charges and does not include a maximum specified indemnity amount or limit.
(d)    The amount of the additional benefit under subsection (c)(2) of this section may not be less than the difference between the benefit under an existing policy or certificate and that benefit compounded annually at a rate of at least 5% for the period beginning with the purchase of the existing benefit and extending until the year in which the offer is made.
2023 Maryland Statutes › Insurance › Title 18 - Long-Term Care Insurance › Section 18-115 - Evaluating Expected and Actual Loss Ratios

In evaluating the expected and actual loss ratios, the Commissioner shall consider:
(1)    the statistical credibility of incurred claims experience and earned premiums;
(2)    the period for which rates are computed to provide coverage;
(3)    experienced and projected trends;
(4)    the concentration of experience within early policy duration;
(5)    expected claim fluctuation;
(6)    experienced refunds, adjustments, or dividends;
(7)    renewability features;
(8)    all appropriate expense factors;
(9)    interest;
(10)    the experimental nature of the coverage;
(11)    policy reserves;
(12)    the mix of business by risk classification; and
(13)    product features, including long elimination periods, high deductibles, and high maximum limits.
2023 Maryland Statutes › Insurance › Title 18 - Long-Term Care Insurance › Section 18-116 - Increases to Premiums

(a)    Except as provided in subsection (b) of this section, a premium increase under long-term care insurance may not be based on the age of the insured or certificate holder.
(b)    A carrier may impose an across-the-board premium increase on policies or contracts of long-term care insurance that the carrier issues or delivers in the State after the carrier:
(1)    submits to the Commissioner an actuarial memorandum that supports the proposed premium increase; and
(2)    obtains the approval of the Commissioner.
(c)    This section does not prohibit age-banding.
2023 Maryland Statutes › Insurance › Title 18 - Long-Term Care Insurance › Section 18-116.1 - Contingent Benefit Upon Lapse

(a)    This section applies only to policies or contracts of long–term care insurance issued or delivered in the State before April 1, 2003, for which rate increase filings have been approved by the Commissioner on or after June 1, 2019.
(b)    Subject to subsection (c) of this section, a carrier shall provide to an insured under a policy or contract of long–term care insurance a contingent benefit upon lapse if:
(1)    the carrier increases the premium rate for the insured;
(2)    the insured has maintained the policy or contract of long–term care insurance through the carrier for at least 20 years; and
(3)    the insured terminates the policy or contract of long–term care insurance within 120 days after the date the premium rate increase becomes effective for the policy or contract of long–term care insurance maintained by the insured.
(c)    (1)    The contingent benefit upon lapse required under subsection (b) of this section shall be a paid–up coverage:
(i)    with no additional premiums due; and
(ii)    with a reduced lifetime maximum benefit equal to the sum of all premiums paid minus any claims paid.
(2)    Except for the maximum lifetime benefit calculated in accordance with paragraph (1) of this subsection, all other benefits of the policy or contract of long–term care insurance in effect on the date of the lapse of the policy or contract shall remain unchanged and may not be increased after the date of the lapse of the policy or contract.
2023 Maryland Statutes › Insurance › Title 18 - Long-Term Care Insurance › Section 18-117 - Reports About Benefits Funded by Acceleration of Death Benefits

(a)    Whenever a long-term care benefit that is funded through a life insurance vehicle by the acceleration of the death benefit is in benefit payment status, the carrier shall provide a monthly report to the policyholder.
(b)    A report under this section shall include:
(1)    any long-term care benefits paid out during the month;
(2)    an explanation of any changes in the policy, including changes to death benefits or cash values, that result from the payment of long-term care benefits; and
(3)    the amount of long-term care benefits that remain.
2023 Maryland Statutes › Insurance › Title 18 - Long-Term Care Insurance › Section 18-118 - Cancellation, Refusal to Renew, or Termination of Policies

(a)    (1)    A carrier may cancel, refuse to renew, or otherwise terminate long-term care insurance only for nonpayment of premiums or material misrepresentation.
(2)    A carrier may not cancel a policy of long-term care insurance under this subsection for nonpayment of premiums unless the carrier provides written notice to:
(i)    the insured; and
(ii)    an individual designated by the insured under subsection (b) of this section to receive notice of cancellation not later than the date on which the carrier sends a second notice of the cancellation.
(b)    (1)    A carrier may not deliver an individual policy of long-term care insurance to an insured until the carrier has notified the insured of the option to designate in writing one individual in addition to the insured who will receive notice of cancellation of the policy for nonpayment of premiums under subsection (a) of this section.
(2)    The insured may change the written designation under this subsection at any time.
(3)    The written designation shall be on a form provided by the carrier that states that the insured may:
(i)    designate one individual for receipt of notice of cancellation; and
(ii)    change the written designation at any time.
(c)    (1)    Termination of a policy or certificate of long-term care insurance shall be without prejudice to any benefits payable for institutionalization if the institutionalization began while the policy or certificate of long-term care insurance was in effect and continues without interruption after termination.
(2)    An extension of benefits beyond the period the policy of long-term care insurance was in effect may be:
(i)    limited to the duration of the benefit period, if any, or to payment of the maximum benefits; and
(ii)    subject to any policy waiting period and all other applicable provisions of the policy.
2023 Maryland Statutes › Insurance › Title 18 - Long-Term Care Insurance › Section 18-119 - Surrender of Policy

(a)    This section does not apply to plans under § 125 of the Internal Revenue Code.
(b)    (1)    An insured or certificate holder who is insured under a policy or contract of long–term care insurance may surrender the policy or contract within 30 days after delivery for a return of any premium paid by providing written notice of surrender to the carrier.
(2)    The right of surrender may not be waived.
(3)    A contract to purchase long–term care insurance shall contain the following statement:
“Notice to buyer: You may surrender the contract or policy of long–term care insurance without penalty or obligation within 30 days from the date of delivery of the policy. If you decide to surrender the contract or policy, you must provide notice of the surrender to the insurer. Any attempt to obtain a waiver of your right to surrender is unlawful. Surrender entitles you to a refund of all money within 30 business days after receipt of notice of surrender.”
(c)    A policy surrendered under this section is deemed void from its effective date.
2023 Maryland Statutes › Insurance › Title 19 - Property and Casualty Insurance › Subtitle 1 - General Provisions › Section 19-101 - Applicability of Other Laws

(a)    In addition to any requirement of this article and to the extent not inconsistent with this article, a workers’ compensation insurance policy is subject to Titles 9 and 10 of the Labor and Employment Article.
(b)    In addition to any requirement of this article and to the extent not inconsistent with this article, a motor vehicle liability insurance policy is subject to the Maryland Vehicle Law.
2023 Maryland Statutes › Insurance › Title 19 - Property and Casualty Insurance › Subtitle 1 - General Provisions › Section 19-102 - Provisions in Liability Policies for Payment of Loss and Bankruptcy of Insured

(a)    A liability insurance policy issued in the State may not require the insured to pay for liability or loss under the policy.
(b)    Each liability insurance policy issued in the State shall provide that:
(1)    the bankruptcy or insolvency of the insured does not release the insurer from liability; and
(2)    if an injured person or another person claiming by, through, or under the injured person is unable, after execution on a final judgment entered in an action against an insured, to recover the full amount of the final judgment, the person may bring an action against the insured’s insurer in accordance with the terms of the policy for the lesser of the amount of the judgment recovered in the action against the insured or the amount of the policy.
(c)    Notwithstanding anything to the contrary in the policy, each liability insurance policy issued in the State shall be construed to contain the provisions required by subsection (b) of this section.
2023 Maryland Statutes › Insurance › Title 19 - Property and Casualty Insurance › Subtitle 1 - General Provisions › Section 19-104 - Health Care Malpractice Insurance

(a)    Each policy that insures a health care provider against damages due to medical injury arising from providing or failing to provide health care shall contain provisions that:
(1)    are consistent with the requirements of Title 3, Subtitle 2A of the Courts Article; and
(2)    authorize the insurer, without restriction, to negotiate and effect a compromise of claims unless the settlement amount exceeds the limits of the insurer’s liability.
(b)    (1)    An insurer may make payments to or on behalf of claimants for reasonable hospital and medical costs, loss of wages, and expenses for rehabilitation services and treatment, within the limits of the insurer’s liability, before a final disposition of the claim.
(2)    A payment made under this subsection:
(i)    is not an admission of liability to or of damages sustained by a claimant; and
(ii)    does not prejudice the insurer or any other party with respect to any right, claim, or defense.
(c)    (1)    A policy issued or delivered under subsection (a) of this section may include coverage for the defense of a health care provider in a disciplinary hearing arising out of the practice of the health care provider profession if the cost of the included coverage is:
(i)    itemized in the billing statement, invoice, or declarations page for the policy; and
(ii)    reported to the Commissioner in a form and manner required by the Commissioner.
(2)    A policy providing coverage for the defense of a health care provider in a disciplinary hearing arising out of the practice of the health care provider’s profession may be offered and priced separately from a policy issued or delivered under subsection (a) of this section.
2023 Maryland Statutes › Insurance › Title 19 - Property and Casualty Insurance › Subtitle 1 - General Provisions › Section 19-105 - Liability Coverage -- for Individuals Assisting Fire and Rescue Departments and Companies

An insurer that provides a general liability insurance policy to a fire department, fire company, rescue department, or rescue company shall offer to provide coverage for:
(1)    a volunteer firefighter or volunteer ambulance rescue squad member who, in response to an emergency, provides assistance to the fire department, fire company, rescue department, or rescue company; and
(2)    any other individual who, in response to an emergency, provides assistance at the request and under the direction of the fire department, fire company, rescue department, or rescue company.
2023 Maryland Statutes › Insurance › Title 19 - Property and Casualty Insurance › Subtitle 1 - General Provisions › Section 19-106 - Liability Coverage -- for Family Child Care Providers

An insurer that issues or delivers a policy or contract of motor vehicle liability insurance in the State shall offer to provide to a policyholder, who is registered as a family child care provider under Title 5, Subtitle 5, Part V of the Family Law Article, coverage in at least the amount required under § 17–103 of the Transportation Article for liability that results from bodily injury:
(1)    to a family child care child while the child is a passenger in an automobile; and
(2)    that arises out of an insured’s activities as a family child care provider.