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§ 15-1A-01. Definitions

West's Annotated Code of MarylandInsuranceEffective: May 8, 2020

West's Annotated Code of Maryland
Insurance (Refs & Annos)
Title 15. Health Insurance
Subtitle 1a--Consumer Protections (Refs & Annos)
Effective: May 8, 2020
MD Code, Insurance, § 15-1A-01
§ 15-1A-01. Definitions
Currentness
In general
(a) In this subtitle the following words have the meanings indicated.
Carrier
(b) “Carrier” means:
(1) an insurer that holds a certificate of authority in the State and provides health insurance in the State;
(2) a health maintenance organization that is licensed to operate in the State;
(3) a nonprofit health service plan that is licensed to operate in the State; or
(4) any other person or organization that provides health benefit plans subject to State insurance regulation.
Child
(c) “Child” means:
(1) a natural child, a stepchild, a foster child, or an adopted child of the insured; or
(2) a child placed with the insured for legal adoption.
Essential health benefit
(d) “Essential health benefit” means a health benefit that:
(1) meets the criteria established under § 1302(b) of the Affordable Care Act; or
(2) if the Commissioner adopts regulations as described in § 15-1A-04 of this subtitle, meets the criteria established by the adopted regulations.
Grandfathered plan
(e) “Grandfathered plan” means a health benefit plan that:
(1) meets the criteria established under 45 C.F.R. § 147.140 and any corresponding federal rules and guidance as those provisions were in effect December 1, 2019; or
(2) if the Commissioner adopts regulations as described in § 15-1A-03 of the subtitle, meets the criteria established by the adopted regulations.
Group plan
(f) “Group plan” means a small group plan or a large group plan.
Health benefit plan
(g) “Health benefit plan” means an individual plan, a small group plan, or a large group plan.
Individual plan
(h) “Individual plan” means an individual health benefit plan as defined in § 15-1301(o) of this title.
Insured individual
(i) “Insured individual” means:
(1) an insured, an enrollee, a subscriber, a participant, a member, or a beneficiary of a health benefit plan; or
(2) any covered dependent of a health benefit plan.
Large group plan
(j) “Large group plan” means a health benefit plan as defined in § 15-1401 of this title.
Small group plan
(k) “Small group plan” means a health benefit plan as defined in § 15-1201 of this title.

Credits

Added by Acts 2020, c. 620, § 1, eff. May 8, 2020; Acts 2020, c. 621, § 1, eff. May 8, 2020.
MD Code, Insurance, § 15-1A-01, MD INSURANCE § 15-1A-01
Current through legislation effective through April 9, 2023, from the 2024 Regular Session of the General Assembly. Some statute sections may be more current, see credits for details.
End of Document