Md. Code Regs. 31.11.10.02

Current through Register Vol. 51, No. 25, December 13, 2024

Section 31.11.10.02 - Definitions

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) "Blanket health insurance" has the meaning stated in Insurance Article, § 15-305, Annotated Code of Maryland.

(2) "Carrier" means an insurer or nonprofit health service plan.

(2-1) "Coverage period" means the interval of time the blanket health insurance contract or group health insurance contract provides protection, in exchange for the payment of a particular premium.

(3) Group Health Insurance.

(a) "Group health insurance" has the meaning stated in Insurance Article, § 15-302, Annotated Code of Maryland.

(b) "Group health insurance" includes:

(i) A small employer health benefit plan as defined in Insurance Article, § 15-1201, Annotated Code of Maryland; and

(ii) A contract issued to a group policyholder by a nonprofit health service plan.

(4) "Group policyholder" means the entity to whom the group health insurance contract or blanket health insurance contract is issued.

(5) "Insured" means an individual covered under a group health insurance contract or blanket health insurance contract.

(6) "Preferred provider" means a provider that has entered into a provider service contract.

(7) "Preferred provider benefit" means a benefit that appears in a group health insurance contract or blanket health insurance contract under which health care services are to be provided to the insured by a preferred provider.

(8) "Provider service contract" means a contract between a provider and a carrier or other entity, under which the provider agrees to provide health care services on a preferential basis under contracts containing preferred provider benefits.

Md. Code Regs. 31.11.10.02

Regulation .02B amended effective October 18, 2010 (37:21 Md. R. 1438)