The Maryland Insurance Administration's Jurisdiction
The Maryland Insurance Administration (MIA) has jurisdiction over all insurers, insurance producers (agents or brokers) premium finance companies, motor clubs and HMOs authorized or licensed to conduct business in Maryland. Jurisdiction means that the MIA has the authority to regulate these entities and individuals, including the authority to issue licenses, review rates and policies, review financial statements, investigate complaints, conduct examinations and issue orders/penalties for violations of Maryland's insurance laws.
Although the MIA generally has jurisdiction over insurance contracts (or policies) issued or delivered in Maryland, the Agency does not regulate certain types of plans or programs, and has limited jurisdiction over other types of plans or polices. Generally, these include:
- Employer Self-Funded Plans
Under a self-funded plan, the employer pays for your medical expenses, though it may contract with a health plan to administer the plan. The U.S. Department of Labor's Employee Benefits Security Administration regulates self-funded plans and has the authority to investigate and resolve complaints against such plans. The MIA does however have jurisdiction over self-funded plans that qualify as a multiple employer welfare arrangement (MEWA) under federal law.
Insurance Contracts or Policies, or Health Benefit Plans Issued in Other States
Maryland law generally does not apply to insurance contracts (or policies) issued in other states. For example, if your policy was issued in Virginia, then Virginia law and not Maryland law applies to your coverage. In these instances, you will need to contact the Regulator in that state for assistance. Click here for a map of states and jurisdictions. There are some situations though where the MIA may still have jurisdiction to handle the complaint even though the policy was issued out of state, such as when the policy is issued to a Maryland resident and the complaint alleges the insurer engaged in an unfair trade practice.
Maryland's Medical Assistance Program (Medicaid)
The MIA has limited jurisdiction over this joint federal and state program, and can only accept complaints from providers regarding prompt payment of claims. If a beneficiary of Maryland's Medical Assistance program has the letters "MDH" written on their ID card, they may file complaints with the Maryland Department of Health.