Md. Code Regs. 31.12.01.02

Current through Register Vol. 51, No. 17, August 23, 2024

Section 31.12.01.02 - Definitions

A. All terms defined in the Health Maintenance Organization Act of 1975 which are used in this chapter have the same meaning as in the Act unless the terms are defined differently in this chapter.

B. Terms Defined.

(1) "HMO" means a health maintenance organization.

(2) "Individual contract" means a contractual agreement for the provision of health care services on a prepaid basis entered into between an HMO and a subscriber, provided the contract covers only the following persons:

(a) The subscriber;

(b) The subscriber and the subscriber's dependents; or

(c) The subscriber's dependents.

(3) "Leasehold estate improvements" means improvements made to property which is leased by the HMO and used by it to provide health care directly.

(4) "Member" means the subscriber and any of the subscriber's dependents who are enrolled in the HMO.

(5) "Subscriber" means, for:

(a) Group HMO contracts, the person who is eligible to be covered under the contract, other than as a dependent, due to satisfaction of the eligibility requirements of the group; and

(b) Individual HMO contracts, the person who completes the application for coverage with the HMO.

Md. Code Regs. 31.12.01.02

Regulation .02A and C amended effective August 5, 1991 (18:15 Md. R. 1725)
Regulation .02D_F adopted effective August 5, 1991 (18:15 Md. R. 1725)
Regulation .02D amended effective November 9, 1992 (19:22 Md. R. 1988)