MD State Updates - 2015 Jan 14 No.01

On July 2, 2015, the Maryland Insurance Administration published Bulletin 15-20, which summarizes 2015 legislation signed into law by Gov. Hogan. Most of the legislation has been covered in previous editions of Compliance Corner; however, three recently-enacted bills have not yet been covered.

The first is SB 450, signed into law April 14, 2015, creating Chapter 35. This law requires insurers to permit an insured, subscriber or member seeking reimbursement for expenses to submit a claim by first-class mail and, at the election of the insurer, by fax or secure website. The law also requires insurers to provide a notice annually describing the methods for reimbursement submissions and instructions on how to submit a claim by fax or website. Insurers must comply with the law by Oct. 1, 2017.

The second is SB 606, signed into law May 12, 2015, creating Chapter 372. This law requires insurers that provide drug coverage to provide coverage for at least two brand-name (and if available, at least two generic) abuse-deterrent opioid analgesic drug products (each containing different analgesic ingredients). The opioid analgesic prescription drugs must be on the lowest cost tier for brand-name or generic prescription drugs on the insurer’s drug formulary, respectively. The new law is effective for plans issued or renewed on or after Jan. 1, 2016.

The third is HB 552, enacted May 30, 2015, creating Chapter 494. This law—relating to medical stop-loss insurance for small employers—increases the minimum specific attachment point for medical stop-loss insurance contracts from $10,000 to $22,500 and the aggregate attachment point from 115 percent to 120 percent of expected claims. There are exceptions for stop-loss policies issued or delivered before June 1, 2015, and for employers that on May 31, 2015, held a stop-loss policy that meets certain conditions. The new law also requires stop-loss insurers to guarantee rates for at least 12 months unless there is a change in benefits, ownership or control of the small employer or a change in the number of covered lives resulting from certain events. Lastly, the law requires employers to provide a notice to small employers describing the total costs, effective/termination dates, renewal provisions, attachment points and limitations on stop-loss coverage. The bill became effective June 1, 2015.

Bulletin 15-20 »
Chapter 35 »
Chapter 372 »
Chapter 494 »