EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb0116*
HOUSE BILL 116
J5 5lr0090
(PRE–FILED) CF SB 211
By: Chair, Health and Government Operations Committee (By Request –
Departmental – Maryland Insurance Administration)
Requested: October 6, 2024
Introduced and read first time: January 8, 2025
Assigned to: Health and Government Operations
A BILL ENTITLED
AN ACT concerning 1
Health Insurance – Federal Conformity – Definitions of Health Benefit Plan 2
FOR the purpose of altering certain definitions of “health benefit plan” to conform to federal 3
regulatory requirements regarding hospital indemnity; and generally relating to 4
health insurance and conformity with federal law. 5
BY repealing and reenacting, without amendments, 6
Article – Insurance 7
Section 15–1201(a), 15–1301(a), 15–1401(a), and 31–101(a) 8
Annotated Code of Maryland 9
(2017 Replacement Volume and 2024 Supplement) 10
BY repealing and reenacting, with amendments, 11
Article – Insurance 12
Section 15–1201(i)(3)(ix), 15–1301(l)(2)(iv), 15–1401(h)(2)(iii), and 31–101(g)(4) 13
Annotated Code of Maryland 14
(2017 Replacement Volume and 2024 Supplement) 15
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 16
That the Laws of Maryland read as follows: 17
Article – Insurance 18
15–1201. 19
(a) In this subtitle the following words have the meanings indicated. 20
(i) (3) “Health benefit plan” does not include: 21
2 HOUSE BILL 116
(ix) hospital indemnity or other fixed indemnity insurance if[: 1
1. the benefits are provided under a separate policy, 2
certificate, or contract; 3
2. there is no coordination between the provision of the 4
benefits and an exclusion of benefits under any group health plan maintained by the same 5
employer; 6
3. the benefits are paid with respect to an event, without 7
regard to whether benefits are provided with respect to the event under any group health 8
plan maintained by the same employer; and 9
4. the benefits are payable in a fixed dollar amount per 10
period of time, regardless of the amount of expenses incurred] THE COVERAGE QUALIFI ES 11
FOR THE EXCEPTION DE SCRIBED IN 45 C.F.R. § 146.145(B)(4); or 12
15–1301. 13
(a) In this subtitle the following words have the meanings indicated. 14
(l) (2) “Health benefit plan” does not include: 15
(iv) hospital indemnity or other fixed indemnity insurance if[: 16
1. offered as independent, noncoordinated benefits; 17
2. the benefits are paid in a fixed dollar amount per period of 18
hospitalization, illness, or service, regardless of the amount of expenses incurred and of the 19
amount of benefits provided with respect to the event or service under any other health 20
coverage; and 21
3. a notice is displayed prominently in the application 22
materials, in at least 14 point type, that has the following language in capital letters: “This 23
is a supplement to health insurance and is not a substitute for major medical coverage. 24
Lack of major medical coverage (or other minimum essential coverage) may result in an 25
additional payment with your taxes.”] THE COVERAGE QUALIFI ES FOR THE EXCEPTION 26
DESCRIBED IN 45 C.F.R. § 148.220(B)(4); or 27
15–1401. 28
(a) In this subtitle the following words have the meanings indicated. 29
(h) (2) “Health benefit plan” does not include: 30
HOUSE BILL 116 3
(iii) the following benefits if offered as independent, noncoordinated 1
benefits: 2
1. coverage only for a specified disease or illness; and 3
2. hospital indemnity or other fixed indemnity insurance, if 4
the [benefits are payable in a fixed dollar amount per period of time, regardless of the 5
amount of expenses incurred] COVERAGE QUALIFIES F OR THE EXCEPTION DES CRIBED 6
IN 45 C.F.R. § 146.145(B)(4); or 7
31–101. 8
(a) In this subtitle the following words have the meanings indicated. 9
(g) (4) “Health benefit plan” does not include the following benefits if the 10
benefits are provided under a separate policy, certificate, or contract of insurance, there is 11
no coordination between the provision of the benefits and any exclusion of benefits under 12
any group health plan maintained by the same plan sponsor, and the benefits are paid with 13
respect to an event without regard to whether the benefits are provided under any group 14
health plan maintained by the same plan sponsor: 15
(i) coverage only for a specified disease or illness; OR 16
(ii) [group] hospital indemnity or other fixed indemnity insurance, 17
if the [benefits are payable in a fixed dollar amount per period of time, such as $100 per 18
day of hospitalization, regardless of the amount of expenses incurred; or 19
(iii) individual hospital indemnity or other fixed in demnity 20
insurance, if: 21
1. the benefits are paid in a fixed dollar amount per period of 22
hospitalization, illness, or service, regardless of the amount of expenses incurred and of the 23
amount of benefits provided with respect to the event or service under any other health 24
coverage; and 25
2. a notice is displayed prominently in the application 26
materials, in at least 14 point type, that has the following language in capital letters: “This 27
is a supplement to health insurance and is not a substitute for major medical coverage. 28
Lack of major medical coverage (or other minimum essential coverage) may result in an 29
additional payment with your taxes.”] COVERAGE QUALIFIES F OR THE EXCEPTION 30
DESCRIBED IN 45 C.F.R. § 146.145(B)(4) AND 45 C.F.R. § 148.220(B)(4). 31
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 32
October 1, 2025. 33