(a) A carrier shall issue and deliver to at least one adult insured in each household residing in the commonwealth, upon enrollment, an evidence of coverage and any amendments thereto. Said evidence of coverage shall contain a clear, concise and complete statement of:

1. (1) the health care services and any other benefits which the insured is entitled to on a nondiscriminatory basis;
2. (2) the prepaid fee which must be paid by or on behalf of the insured;
3. (3) the limitations on the scope of health care services and any other benefits to be provided, including:

(4) the locations where, and the manner in which, health care services and other benefits may be obtained, including:

1. (i) an explanation that whenever a proposed admission, procedure or service that is a medically necessary covered benefit is not available to an insured within the carrier's network, the carrier shall cover the out-of-network admission, procedure or service and the insured will not be responsible to pay more than the amount which would be required for similar admissions, procedures or services offered within the carrier's network;
2. (ii) an explanation that whenever a location is part of the carrier's network, that the carrier shall cover medically necessary covered benefits delivered at that location and the insured shall not be responsible to pay more than the amount required for network services even if part of the medically necessary covered benefits are performed by out-of-network providers unless the insured has a reasonable opportunity to choose to have the service performed by a network provider; and (iii) a summary description of the insured's telehealth coverage and access to telehealth services, including, but not limited to, behavioral health services, chronic disease management and primary care services via telehealth, as well as the telecommunications technology available to access telehealth services.

(7) the requirement that an insured's coverage may be canceled, or its renewal refused, only in the following circumstances:

1. (i) failure by the insured or other responsible party to make payments required under the contract;
2. (ii) misrepresentation or fraud on the part of the insured;
3. (iii) commission of acts of physical or verbal abuse by the insured which pose a threat to providers or other insureds of the carrier and which are unrelated to the physical or mental condition of the insured; provided, that the commissioner prescribes or approves the procedures for the implementation of the provisions of this clause;
4. (iv) relocation of the insured outside the service area of the carrier; and (v) non-renewal or cancellation of the group contract through which the insured receives coverage;

(b) A dental or vision carrier shall issue and deliver to at least 1 adult insured in each household residing in the commonwealth, upon enrollment, an evidence of coverage and any amendments thereto, a summary of the information contained in the evidence of coverage or refer the insured to resources where the information can be accessed, including, but not limited to, an internet website. If the dental or vision carrier chooses to deliver an evidence of coverage, it shall contain a clear, concise and complete statement of:—

1. (1) the dental or vision care services and any other benefits which the insured is entitled to on a nondiscriminatory basis;
2. (2) the limitations on the scope of dental or vision care services and any other benefits to be provided, including an explanation of any deductible or copayment feature and all restrictions relating to preexisting condition exclusions;
3. (3) the locations where, and the manner in which, dental or health care services and other benefits may be obtained;
4. (4) the criteria by which an insured may be disenrolled or denied enrollment;
5. (5) a description of the carrier's method for resolving insured complaints;
6. (6) the requirement that an insured's coverage may be canceled, or its renewal refused, only in the following circumstances: