{"data":{"id":"us-md/md.-code-insurance-15-1a-09","jurisdiction":"us-md","citation":"Md. Code, Insurance § 15–1A–09","heading":"","body":"(a) Except as provided in subsections (b) through (d) of this section, a carrier shall accept every employer and individual in the State that applies for a health benefit plan, subject to the following provisions of this article:\n(1) Subtitle 4 of this title;\n(2) §§ 15–1206(c), 15–1208.1, 15–1208.2, 15–1209, and 15–1210 of this title;\n(3) §§ 15–1316 and 15–1318 of this title; and\n(4) §§ 15–1406 and 15–1406.1 of this title.\n(b) (1) Except as provided in paragraph (2) of this subsection, a carrier may restrict enrollment to open or special enrollment periods.\n(2) A carrier that offers a large group plan shall allow an employer eligible to purchase a large group plan to purchase a large group plan at any time during the year.\n(c) If a carrier uses a network for a health benefit plan under which the financing and delivery of medical care are provided, in whole or in part, through a defined set of providers under contract with the carrier, the carrier:\n(1) (i) may limit the employers that may apply for coverage to employers of eligible individuals who live, work, or reside in the service area for the network; and\n(ii) if the carrier is a health maintenance organization, may limit the individuals who may apply for coverage in the individual market to those who live or reside in the service area for the network; or\n(2) may deny coverage within a service area if the carrier:\n(i) demonstrates to the Commissioner that:\n1. the carrier does not have the capacity to deliver adequate services to additional enrollees of groups or additional individuals because of its obligations to existing group contract holders and enrollees; and\n2. the carrier applies the denial of coverage uniformly to all employers and individuals without regard to the claims experience or any health status–related factor; and\n(ii) does not offer coverage within the service area for at least 180 days after the date the carrier denied coverage in the service area.\n(d) A carrier may deny coverage if the carrier:\n(1) demonstrates to the Commissioner that:\n(i) the carrier does not have the financial reserves necessary to underwrite additional coverage; and\n(ii) the carrier applies the denial of coverage uniformly to all employers and individuals without regard to the claims experience or any health status–related factor; and\n(2) unless a later date is otherwise authorized by the Commissioner, does not offer the denied coverage for at least 180 days after the date the carrier denied the coverage.","path":["Article - Insurance"],"source_url":"https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=gin\u0026section=15-1A-09","current_through":"2026-01-01","vintage":"","retrieved_at":"2026-09-14T19:59:28Z","sha256":"5e01683668b1a9b5618531ad750e932d624e8788252380c5648c6791fca1e79c","source_id":"us-md","stale":false,"prev":"us-md/md.-code-insurance-15-1a-08","next":"us-md/md.-code-insurance-15-1a-10"},"notice":"GroundRules: Original legal text. Not legal advice."}