- A. An insurer which provides benefits for inpatient hospitalization or outpatient surgical care on an expense-incurred basis shall provide claimants annually a consolidated summary explanation regarding benefits claimed for those services during each calendar year.
B. The summary shall identify the provider by name and shall state the:
- (1) Date of the service;
- (2) Amount claimed;
- (3) Amount which was paid or is payable by the insurer on claims processed during the year; and
- (4) Balance to be paid by the covered individual, if the balance is determinable from the claim forms submitted.
- C. The summary referred to in §B of this regulation shall be provided by insurers to claimants between January 1 and February 15 for claims made during the preceding calendar year.
- D. At the insurer's option, the summary may include information pertaining to benefits other than those specified in §A of this regulation.
Authority: Insurance Article, §§2-109 and 15-1007, Annotated Code of Maryland
Effective date: December 1, 1993 (20:20 Md. R. 1570)
Chapter recodified from COMAR 09.30.95 to COMAR 31.10.10 effective September 7, 1998 (25:18 Md. R. 1439)