MD| Bulletin 25-15, issued by the Maryland Insurance Administration, outlines updated carrier reporting requirements for adverse decisions and grievances as enacted by House Bill 820 and Senate Bill 474, effective October 1, 2025. Carriers are now required to identify the use of artificial intelligence, algorithms, or software tools in adverse decision reporting and must aggregate data by zip code, submitting granular geographic breakdowns along with calculated ratios against clean claims. The revised reporting form and online application must be used for the quarterly report due January 30, 2026, while prior forms remain valid for the immediate October 2025 cycle.
Key Points:
- Carriers must specify if AI or algorithms were used in adverse decisions when filing reports.
- Reporting must now include data aggregated by zip code, particularly highlighting the five most affected zip codes for both adverse and grievance decisions.
- New reporting requirements take effect for the October-December 2025 cycle, with compliance to be demonstrated in the January 2026 report; online filing systems will be updated accordingly.
