Maryland Code § IN-15-114

Section IN-15-114
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(a) (1) In this section the following words have the meanings indicated.

(2) "Carrier" means:
(i) an insurer;
(ii) a nonprofit health service plan;
(iii) a health maintenance organization;
(iv) a dental plan organization; or
(v) any other person that provides dental benefit plans subject
to regulation by the State.
(3) "Dental point-of-service option" means a delivery system that
allows an insured, enrollee, or other covered person under a dental benefit plan to
receive dental services outside a provider panel.
(4) "Provider panel" means the providers that contract with a carrier
to provide dental services to the carrier's insureds, enrollees, or other covered persons
under the carrier's dental benefit plan.
(b) (1) If an employer, association, or other private group arrangement
offers dental benefit plan coverage to employees or other individuals only through a
carrier's provider panel, the carrier of the employer, association, or other private
group arrangement shall offer, or contract with another carrier to offer, a dental
point-of-service option to the employer, association, or other private group
arrangement as an additional benefit for an employee or other individual, to accept
or reject at the employee's or other individual's option.
(2) If a carrier's dental provider panel is the sole delivery system
offered to employees by an employer, the carrier:
(i) shall offer the employer a dental point-of-service option
for the individual employee to accept or reject;
(ii) may not impose a minimum participation level on the
dental point-of-service option; and
(iii) as part of the group enrollment application, shall provide
to each employer a disclosure statement for each dental point-of-service option
offered that conforms to regulations, for the point-of-service option required under §
19-710.2 of the Health - General Article, adopted by:

1. the Maryland Health Care Commission for the small
group market; and
2. the Administration for the non-small group market.
(c) (1) An employer, association, or other private group arrangement
may require an employee or other individual who accepts the additional coverage
under a dental point-of-service option under subsection (b) of this section to pay a
premium over the amount of the premium for the dental benefit coverage offered by
the carrier only through its provider panel.
(2) A carrier may impose different cost-sharing provisions for the
dental point-of-service option based on whether the dental service is provided
through the carrier's provider panel or outside the carrier's provider panel.

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