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Maryland - Compensation & Benefit Legislation

MARYLAND - AASHOWME

Demonstrates www.BenefitsReview.com™ site. Illustrates insurance carriers' coverages within the State.

 

MARYLAND - ADOPTED CHILD HEALTH CARE MANDATE

OBRA 1993 (Federal) requires group health plans to honor medical and child support orders. Also, plans must treat adopted children like biological children covered by the plan, and plans are precluded from applying pre-existing condition exclusions to an adopted child where no such exclusion applies to a newborn biological child. Health plans that covered the cost of pediatric vaccines as of May 1, 1993, and fail to continue that level of coverage, will be subject to an excise tax penalty applicable to plans that fail to meet the health care continuation coverage requirements under OBRA 1993.

 

Mandatory coverage of birth of adopted children and grandchildren is included in the state's newborn health care mandate. (Maryland Ann. Code art. 48A, Sections 438A, 471, 477l, 477P, 477BB, 477EE, 477KK, 490H.)

 

MARYLAND - ALCOHOLISM & DRUG ABUSE

Mandatory coverage.

 

Minimum yearly inpatient coverage: Same terms as for physical illness, with at least 60 days hospitalization.

 

Minimum yearly outpatient coverage: 80% coverage for first visits; 65% of 6 to 30 visits; 50% coverage for visits beyond 30.

 

Minimum lifetime coverage: Same as for physical illness.

 

(Maryland Ann. code art. 48A, Section 490V)

 

MARYLAND - CAFETERIA PLAN TAX LAWS

State income tax, unemployment insurance tax on salary reduction: Employee contributions under a cafeteria plan are excluded from Unemployment Insurance taxation if the payments would not be treated as wages outside the plan. Contributions to pay for group term life insurance are excluded from wages.

 

MARYLAND - CONTINUATION OF COVERAGE CONVERSIONS

Events Triggering Continuation of Coverage:

 

MARYLAND - COORDINATION OF BENEFITS

State reports no statutory requirements.

 

MARYLAND - COST-OF-LIVING

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian cost-of-living data and U.S. Automobile Cost Survey.

 

MARYLAND - DRUG TESTING AND EMPLOYEE ASSISTANCE BENEFITS

Who is Covered by Statute: All employers, employees, applicants, and contractors.

 

Applicant Testing: There is no restriction to testing.

 

Employee Testing: Employees and applicants may be tested without limitation, provided a certified laboratory is used.

 

How Test Results are Used: State has no statutory requirements.

 

Enforcement of Statutes: State has no statutory requirements.

 

Employee Remedies: State has no statutory requirements.

 

Employer Penalties: State has no statutory requirements.

 

Who Pays for Testing: State has no statutory requirements.

 

Employee Assistance Benefits: State has no statutory requirements.

 

Other Requirements: Principal purpose of statute is to ensure use to certified laboratories.

 

(Maryland Code Ann., Health-Gen. I Section 17-214.)

 

MARYLAND - GROUP HEALTH CODE ADDITIONS (MANDATED)

Adopted Children: Adopted children must be covered b the insured individual's policy from the date of adoptions decree or date of custody pending adoption. Such coverage is available to any insured or subscriber, regardless of marital status, family member's coverage. (Maryland Ann. Code art. 48A, Section 438A.)

 

Alcoholism and Drug Abuse Treatment: Group contract issued on an expense incurred basis must provide benefits of at least seven days of emergency care in an acute general hospital or licensed detoxification facility; 30 days of treatment in a licensed alcohol or drug abuse facility; 30 outpatient visits at a certified alcoholism and drug abuse treatment facility equal to the lesser of 100 percent of costs or $3,000. Total lifetime days and visits may be limited to 120. Group major medical contract providing benefits for both hospitalization and medical care must provide benefits equal to at least half of those described and must cover the lesser of 100 percent of the cost of such benefits or $3,000. (Maryland Ann. Code art. 48A, Section 490F.)

 

Blood Products: Policies may not exclude payments for blood products, both derivatives and components, otherwise covered by the policy. (Maryland Ann. Code art. 48A, Sections 345E, 470G, 477H.)

 

Breast Reconstruction: Non diseased Breast: Effective 10/1/96, health care insurers, including HMOs, must provide coverage for all stages of reconstructive breast surgery needed on a non diseased breast in order to establish symmetry with a diseased breast which has undergone reconstructive surgery resulting from a mastectomy. Reconstructive breast surgery includes augmentation mammoplasty, reduction mammoplasty, and mastoplexy (H119, S181, 1996) (Maryland Ann. Code art. 48A, Section 490FF.)

 

Cleft Palate: Policies must cover expenses for orthodontics, oral surgery, and otologic, audiological, and speech/language treatment involved in the management of a cleft lip or cleft palate. (Maryland Ann. Code art. 48A, Sections 354X, 470R, 477X.)

 

Coverage Continuation and Conversion: Policies must provide continuation benefits for surviving spouses of deceased employees; divorced spouses and dependent children of insured employees; and involuntarily terminated employees. (Maryland Ann. Code art. 48A, Sections 354GG, 477HH, 490G,H,I.) Policies must provide conversion rights to any insured and dependents whose insurance is terminated for any reason other than failure to pay required premiums. (Maryland Ann. Code art. 48A, Sections 354T, 477K, L.) Spouses: Policies providing conversions rights to the insured upon termination of employment or membership must extend such rights to covered spouses ceasing to be qualified family members. (Maryland Ann. Code art. 48A, Sections 354K, 477N.)

 

DES: Insurers may not deny coverage to a person solely because the person has been exposed to diethylstilbestrol (DES). (Maryland Ann. Code art. 48A, Sections 354V, 470P, 477C.)

 

Disclosure of Information: Health care insurers may not prohibit health care providers from communicating to patients, public officials, or other individuals information that is necessary or appropriate for the delivery of health care services. Information that may be disclosed covers patient treatment alternatives; proper provider patient relationships; patient's rights to appeal insurer's coverage determinations; or opinions about public policy issues. (H1374, 1996) (Maryland Ann. Code art. 48A., Sections 354RR, 470HH, 477RR, 490FF, 490DD, 19-706(1), 19-710(r), 19-710(s), Ch. 577 Sections 2, 3.)

 

Domestic Violence: Effective 10/1/96, information concerning an individual's status as a victim of domestic violence must not be used by a health insurer or an HMO to cancel, refile to renew, or refuse to issue a life or health insurance policy; to refuse to pay a claim, cancel, or terminate a policy of life or health insurance; to increase rates for a life or health insurance plan, to add a surcharge, apply a rating factor, or use any other practice that adversely takes into account the domestic violence issue. (S339, 1996) (Maryland Ann. Code art. 48A, Sections 234C, 234D, 19-706(g).)

 

Handicapped Dependents: Coverage for dependent children cannot be terminated while that dependent is incapable of self support because of mental or physical incapacity and chiefly dependent on the insured. (Maryland Ann. Code art. 48A, Section 471 (7).)

 

Health Maintenance Organizations: Emergency Services: HMOs must make reimbursements to hospital facilities (less any applicable co-payments) for medically necessary emergency services rendered to HMO patients if the treatment was authorized, directed, or referred by the HMO; if the treatment was necessitated by failure of an HMO to provide 24-hour access to quality care; or if medical screening services were rendered in order to meet requirements of the Federal Emergency Medical Treatment and Active Labor Act. HMOs, which already have paid such facility for patient "emergency treatment," may collect or attempt to collect reimbursements from the patient for payments made if the treatment is found to have been incorrectly labeled "emergency treatment." (H859, 1996) (Maryland Ann. Code Section 19-705.1(b), 19-716, 19-710(q), 19-712.5.)

 

In Vitro Fertilization: Policies that provide pregnancy related benefits may not exclude outpatient expenses arising from in vitro fertilization procedures if certain conditions are met. (Maryland Ann. Code art. 48A, Sections 354DD, 470W, 47EE.)

 

Mammography Screening: Each nonprofit health service plan, hospital, major medical, group or blanket health insurance policy shall provide coverage for a baseline mammography for women aged 35 to 39; a mammography for women age 40 to 49 every two years, or more frequently if recommended by a physician; an annual mammogram for women age 50 and over provided by a facility accredited by the American College of Radiology or certified or licensed under a program established by the state. (Maryland Ann. Code art. 48A, Sections 470Z, 477JJ.)

 

Maternity: Policies providing hospitalization benefits for normal pregnancy must cover the cost of hospitalization for childbirth to the same extent as it covers hospitalization for other illnesses. Such policies must provide maternity benefits to covered members regardless of marital status. (Maryland Ann. Code art. 48A, Sections 354F,G, 470H, I, 477I, J.) Pregnancy Disability: Insurers must offer group policyholders with temporary disability insurance optional coverage for temporary disability caused or contributed to be pregnancy or childbirth. (Maryland Ann. Code art. 48A, Section 477P.) Hospitalization for Birth: Health care insurers (including HMOs must cover costs of inpatient hospitalization services for a mother and newborn child for a minimum of 48 hours for a vaginal delivery and for a caesarean section. A mother may request and be granted a shorter hospital stay if her attending provider agrees that less time in the hospital is needed for recovery. In these instances, a mother and newborn child must be provided with one home visit by a qualified registered nurse within 24 hours of discharge; an additional home visit also may be prescribed by the attending provider. (H1271, 1996) (Maryland Ann. Code art. 48A, Sections 354F, 470H, 477-I.)

 

Mental Health: A standard benefits package for mental health and substance abuse is required for all but the small group market. Small employers (50 or fewer employees) would use the standard health plans offered just for them. (Maryland Ann. Code art. 48A, Section 698.)

 

Newborns: Policy providing family coverage must provide benefits for newborns from the moment of birth for injury or sickness including treatment of medically diagnosed congenital defects and birth abnormalities. (Maryland Ann. Code art. 48A, Section 438A.) Health insurers must cover up to an additional four days of hospitalization because she has been required to remain hospitalized for medical reasons after childbirth. (H1271, S433, 1996) (Maryland Ann. Code art. 48A, Sections 354F, 470H, and 477-I, 490FF, 19-703(g).)

 

Orthopedic Braces and Prosthetic Devices: Nonprofit health services plan contract must cover prosthetic devices and orthopedic braces. (Maryland Ann. Code art. 48A,Section 354Q.)

 

Outpatient Services and Second Opinion: Policies that provide coverage for an inpatient service in an acute general hospital must cover corresponding outpatient service furnished due to denial of a utilization review program. (Maryland Ann. Code art. 48A, Sections 354CC, 470U, 477DD.)

 

Point of Service Plans: HMOs and Dental Plans: Health insurers which offer employers health care benefits for employees only through an HMO also must offer through the HMO, a point of service option to the employer as an additional benefit for employees, to accept or reject. (Maryland Ann. Code art. 48A, Sections 490CC(a)(1), (2), (5)(b); 490EE(b); 19-710.2(b).)

 

Policies for Small Employers: Smaller employers with between two and 50 employees may purchase one or five standard benefit policies with limits on pre-existing condition, guaranteed renewals, and community rating. (Maryland Ann. Code art. 48A, Section 490-V.) To qualify for small employer health insurance coverage, an employer must agree to offer health care coverage to employees' dependents, and the insurer must include such requirement in its sales literature. The employer must also agree to collect premium payments from eligible employees through payroll deduction for coverage of employees and their dependents and to transmit those premium payments to the carrier. However, the employer is not required to make a contribution to the premium payments for dependent coverage. (Maryland Ann. Code art. 48A, Section 698-A.) Coverage for One Employee: In the event that all employees except one working for a nonprofit small employer have insurance coverage, an insurer must offer an employer benefits for a sole employee who does not have coverage if such employee normally works 20 or more hours per week. (Maryland Ann. Code art. 48A, Sections 698(a), 698, (g).)

 

Procedures Involving Bones of Face, Neck, or Head: Policies covering diagnostic or surgical procedures involving a bone or joint of the skeletal structure may not exclude coverage of such procedures necessary to treat congenital deformity, disease, or injury to bone or joint of face, neck, or head. (Maryland Ann. Code art. 48A.)

 

Providers: Nurse anesthetists, psychologists, podiatrists, optometrists, nurse midwives, social workers, and health care providers licensed under the Health Occupations Article (with limitations for dietitians, professional counselors, and physician assistance): Costs for services must be covered if the provider is licensed, the service is within the provider's scope of services, and the service is covered by the policy. (Maryland Ann. Code art. 48A, Sections 354L, Y, Z, 470A, K,T,U, 477F, O, Z, AA, 490, 490A, A-1, A-2.) Chiropractors: policies must provide compensation to licensed chiropractors for licensed services rendered to the insured. (Maryland Ann. Code art. 48A, Section 489.) Home Health Care: All health insurance policies covering inpatient hospital care on an expense-incurred basis must cover the cost of at least 40 home health care visits per year by a licensed provider. (Maryland Ann. Code art. 48A, Section 470J.) Obstetricians and Gynecologists: Effective 10/1/96, health care providers (including HMOs) may classify obstetricians and gynecologists as primary care physicians. Patients of obstetricians or gynecologists, who choose not to be classified as a primary care physicians, must be allowed to receive medically necessary care from such in network physicians without being required to first visit a primary care provider. These obstetricians and gynecologists, however, must confer with a primary care physician prior to performing any diagnostic procedures which are not classified as routine gynecological care, and must communicate any diagnosis or treatment rendered following each office visit. (H863, S392, 1996) (Maryland Ann. Code art. 48A, Sections 490Z(a), 19-707(k)(l).)

 

Substance Abuse: Insurers offering group or blanket hospital or major medical insurance must offer policyholders optional coverage for treatment of drug abuse for at least 21 days of inpatient treatment in a licensed facility and 80 percent of the cost of outpatient treatment up to $1,000 per year. (Maryland Ann.Code art. 48-A, Section 477S.)

 

Optional Benefits: Insurers must offer coverage to policyholders or subscribers for hospice care services; psychiatric care through partial hospitalization; expenses arising from care, treatment or services of a nurse midwife or certified nurse practitioner; and expenses arising from care for Alzheimer's disease. (Maryland Ann. Code art. 48-A, Sections 354J, N,FF, 361E, 470M, O, Q, 477M, R, W, GG, TT.)

 

MARYLAND - GROUP HEALTH FOR SMALL EMPLOYERS

For insurance plans offered to small employers:

 

MARYLAND - GROUP LIFE CODE ADDITIONS

Employer required to pay part of premium: Yes.

 

Percent of employees who must elect coverage (if employees pay part of premium): 75%.

 

Percent of employees who must be covered if employer pays all of premium: 100%.

 

Minimum number of employees in group plan: 10.

 

Employer prohibited as beneficiary: Yes.

 

Grace period (days): 31.

 

Mandatory conversion: Yes.

 

Other provisions: None.

 

(Maryland Ann. Code art. 48A, Sections 418, 427, 434)

 

MARYLAND - HOLIDAYS

January 1, Washington's Birthday (or 3rd Monday in February), Memorial Day (or last Monday in May), July 4, Labor Day (or 1st Monday in September), Veterans Day, and December 25 are state holidays in all 50 states and in the District of Columbia. Other holidays under State law include: Martin Luther King's birthday (or 3rd Monday in January), Lincoln's Birthday, Columbus Day (or 2nd Monday in October), Thanksgiving. Other: Any day appointed by the Governor or President. If holiday falls on Sunday, following Monday is a holiday. (Maryland Code of 1957, art. 1 Section 27)

 

MARYLAND - IMMIGRATION (PREVAILING WAGE POLICY)

See U.S. Federal General Administrative Letter 1-2000

 

MARYLAND - JURY DUTY & WITNESS TIME OFF

Employer Restriction For Discharging Employee For Taking Leave For Jury Service: Yes.

 

Remedies and Penalties: Violator may be fined up to $1,000.

 

Other Requirements: None reported. (Maryland Code Ann. Cts. & Jud. Proc. Sections 8-105, 9-205.)

 

Employer Restriction For Discharging Employee For Taking Leave to be a Witness: Yes.

 

Remedies and Penalties: Violator may be fined up to $1,000.

 

Other Requirements: None reported.

 

MARYLAND - LEAVES OF ABSENCE

Employers Subject to Leave Laws: State employers.

 

Criteria for Eligibility: For sick leave: must be a service employee in the State Personnel Management System. For family leave: must be in the executive branch of state government.

 

Maximum length of leave: Sick leave: accrues at rate of 15 days per year and may be used anytime. Up to 15 months of sick leave may be advanced to an employee. Family leave: up to 12 weeks in a 12 month period.

 

Paid Leave: Sick leave must be paid. Family leave is without pay.

 

Acceptable Reasons for Leave: For sick leave: illness/disability of employee, death, illness, or disability of a member of employee's immediate family, and birth or placement of a child with employee for adoption. For family leave: birth/adoption of child, adoption of foster child, illness or disability in employee's immediate family, or care for employee's school age child under 14 during school vacations.

 

Employment Guarantees After Leave: State reports no statutory requirements for sick leave. For family leave: guarantee of reinstatement in the same job.

 

Use of Vacation or other Time-off Benefits: No statutory requirements for sick leave. For family leave: employer may require employee to first use other leave benefits.

 

Certification Required: For sick leave: certification is required for employee illness of more than 4 days in a 30 day period. For family leave: State reports no statutory requirements.

 

Effect of Leave on Other Benefits: For sick leave: State reports no statutory requirements. For family leave: suspension of benefits except for health benefits.

 

Effect of Seniority Accrual During Leave: State reports no statutory requirements.

 

Minimum Requirements for Notification to Employer: For sick leave: State reports no statutory requirements. For family leave: prior approval is required.

 

Conditions for Denial of a Request For Leave: For sick leave: no statutory requirements exist. A request for family leave may be denied, depending on the disruption to the work unit.

 

(Maryland State Personnel Code Ann. Sections 7-502, 7-503, 7-505, 7-508, 7-509, 7-1000 - 7-1005.)

 

See U.S. Federal Family and Medical Leave Act

 

MARYLAND - LONG TERM DISABILITY CODE ADDITIONS

State does not require employer to provide long term disability benefits; although many employers do in order to remain competitive in hiring/retention of employees.

 

See LEAVES OF ABSENCE (above), WORKERS' COMPENSATION (below) and U.S. Federal Americans With Disabilities Act

 

MARYLAND - MANDATED PROVIDERS

Optometrists, psychologists, podiatrists, and social workers. Nurse practitioners and midwives are employer options. Mandatory coverage for nurse anesthetists. Direct access to an obstetrician/gynecologist is mandatory. (Maryland Ann. Code art. 48A, Sections 477F, 477O, 477R, 477T, 477Z, 490, 490A, 490Z)

 

MARYLAND - MENTAL HEALTH CARE

Mandatory coverage.

 

Minimum yearly inpatient coverage: Same terms as for physical illness with at least 60 days partial hospitalization.

 

Minimum yearly outpatient coverage: 80% coverage for first 5 visits; 65% of 6 to 30 visits; 50% coverage for visits beyond 30.

 

Minimum lifetime coverage: Same as for physical illness.

 

(Maryland Ann. Code art. 48A Section 490V)

 

MARYLAND - MINIMUM WAGE

Refer to the Federal minimum wage: $5.15 per hour (effective September 1, 1997).

 

Exemptions: Certain professionals, agriculture workers, outside sales, apprentices, and handicapped workers in special environments. (Maryland Labor Code Sections 3-403, 3-410, 3-412, 3-414)

 

See U.S. Minimum Wage

 

MARYLAND - NEW HIRE REPORTING

Who is required to report: All employers.

 

Who must be reported: All new employees and rehires.

 

Exempt from reporting: No exemptions.

 

Form(s) to file: W-4 form or by the employer’s own form if it contains the required information.

 

Filing deadline: Within 20 days of date employee begins work.

 

Employer information to be included: Name, address, federal EIN, and state unemployment insurance account number.

 

Employee information to be included: Name, address, SSN, and date of hire.

 

Penalty for failure to report: Written notice of delinquency for first violation followed by a fine of $20 per month in with subsequent violations occur. $500 if failure is result of conspiracy between employer and employee.

 

(Maryland Code Ann. Labor and Employment Section 8-626.1)

 

MARYLAND - NEWBORN CARE MANDATE

Mandated coverage.

 

Preventive care for children: Yes. (Maryland Ann. Code art. 48A, Sections 438A, 471, 477l, 477P, 477BB, 477EE, 477KK, 490H.)

 

MARYLAND - PARENTAL LEAVE

See U.S. Federal Family and Medical Leave Act

 

MARYLAND - PRE-EXISTING CONDITIONS

For insurance plans offered to small employers, coverage must not be limited due to pre-existing conditions. (Maryland Code art. 48A Sections 698 et seq.)

 

See U.S. Federal Health Insurance Portability & Accountability Act

 

MARYLAND - PROTECTED CLASSIFICATIONS

Age:  Yes.

Race:  Yes.

Color:   Yes.

National Origin: Yes.

Ancestry:  Yes.

Religion:  Yes.

Sex: Yes.

Pregnancy:  Yes.

Sexual Harassment:  No specific law. State has expressed policy against discrimination.

 

(Md. Ann. Code art. 49B, Sections 14, 16, 17.)

 

MARYLAND - SALARY SURVEY

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian wages & salaries (covering 3,000 positions).

 

MARYLAND - SHORT TERM DISABILITY CODE ADDITIONS

State does not require employer or employee participation in short term disability plans.

 

MARYLAND - TERMINATION & SEVERANCE PAY

Date pay is due if employee is discharged: Payday.

 

Date due if employee resigns: Payday.

 

Wages: Yes.

 

Vacation Pay: Yes. (Wages include fringes, though fringes are not specifically defined.)

 

Holiday: Yes. (Wages include fringes, though fringes are not specifically defined.)

 

Sick leave: Yes. (Wages include fringes, though fringes are not specifically defined.)

 

Severance: No.

 

(Maryland Code Ann., Labor and Employment Sections, 3-501, 3-505)

 

MARYLAND - UNEMPLOYMENT TAX

Employer Contributions:

 

 

Voluntary Contribution Provision: No. State reports no statutory requirements.

 

(Maryland Labor and Employment Code Ann. Sections 8-607 - 8-612.)

 

MARYLAND - VACATION PAY

See TERMINATION & SEVERANCE PAY (above)

 

MARYLAND - VOTING TIME OFF

2 hours unless the employee already had 2 consecutive hours of off-duty time while the polls are open. (Maryland Ann. Code art. 33 Section 24-26.)

 

MARYLAND - WORKERS' COMPENSATION

Private Employers: Mandatory as to all employments, including corporate officers. Elective as to partners or sole proprietors. Corporate farm officers who are 20% shareholders may reject coverage. Elective for officer owning 20% or more of a professional services corporation and performing professional services for that corporation.

 

Public Employers: Mandatory as to state, counties, cities, and their agencies; paid firefighters in certain counties; prisoners working for county roads boards; forest wardens; jockeys; (Note: Jockeys or their dependents who are covered employees, while performing a service in connection with training, are eligible to apply for payment from the Maryland Jockey Injury Compensation Fund.) crew persons and firefighters for Department of Forest and Parks; jurors for non-federal courts; including the state militia during both training and active duty.

 

Exceptions: Domestic workers who earn less than $250 in a quarter from a single household; certain maintenance workers not employed for 30 consecutive days around a private home; seasonal, migratory farm labor within 25 miles of residence who work no more than 13 weeks a year and who do not operate machinery or equipment; farmers who employ fewer than 3 or have a full-time payroll less than $15,000; commission-paid real estate salesperson or broker. Also, independent contractors and owner/operators of Class F tractors who are under agreement with a motor carrier.

 

Special Coverage Provisions: Voluntary as to excluded employments. Officers of a close corporation may reject coverage. Small employers of farm labor may be insured under a group policy. Certain volunteer firefighters and paramedics may be covered.

 

(U.S. Chamber of Commerce, 1994 Analysis of Workers' Compensation Laws.)