Maryland Code § IN-14-410

Section IN-14-410
Open in Lexace · Ask the AI about this section
(a) Each enrollee shall receive evidence of coverage that indicates
specifically the nature and extent of coverage and the total amount or percentage of
payment, if any, that the enrollee must pay for dental services.
(b) (1) Except as provided under paragraph (2) of this subsection, a
dental plan organization shall issue evidence of coverage to each enrollee of the dental
plan organization.
(2) If an individual enrollee obtains coverage through a policy or
through a contract issued by a medical or dental service corporation, the insurer that
issued the policy or the medical or dental service corporation shall issue evidence of
coverage.
(c) The dental plan organization, insurer, or medical or dental service
corporation may not issue or deliver evidence of coverage or an amendment to
evidence of coverage until a copy of the form of evidence of coverage or amendment is
filed with and approved by the Commissioner.
(d) The evidence of coverage shall contain:
(1) a clear and complete statement if a contract, or a reasonably
complete summary if a certificate, of:
(i) the dental services and the insurance or other benefits, if
any, to which enrollees are entitled;
(ii) any limitations on the services or kind of benefits to be
provided, including any charge, deductible, or copayment feature; and
(iii) where and in what manner information is available about
how services may be obtained; and
(2) a clear and understandable description of the dental plan
organization's method for resolving enrollee complaints.
(e) A dental plan organization, insurer, or medical or dental service
corporation that makes a change in evidence of coverage or the amount or percentage

of payment that the enrollee must pay, shall issue to the enrollee evidence of the
change in a separate document.

‹ Prev All Maryland sections Next ›


Lexace provides legal information, not legal advice, and no attorney–client relationship is created. Statute text is provided for general information and may not reflect the most recent amendments; verify against the official state code.