§ 15-1315. Plans issued through Individual Exchange (Section effective January 1, 2014.)

   (a) Definitions. --

   (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) Scope of section. -- 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) Grace period provision. -- 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) has paid at least 1 full month's premium during the benefit year.

(d) Scope of grace period. -- The grace period provision shall:

   (1) provide a grace period of 3 consecutive months; and

   (2) be in addition to any other grace period provision required by any other applicable State law.

(e) Duties of carrier during grace period. -- 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.

HISTORY: 2013, ch. 368, § 2.