§ 15-1A-01

Maryland § 15-1A-01

• Jurisdiction: Maryland
• Article gin: Insurance
• Title: 15

Text

(a) In this subtitle the following words have the meanings indicated.

(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.

(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.

(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.

(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 31, 2024; or

(2) if the Commissioner adopts regulations as described in § 15–1A–03 of this subtitle, meets the criteria established by the adopted regulations.

(f) “Group plan” means a small group plan or a large group plan.

(g) “Health benefit plan” means an individual plan, a small group plan, or a large group plan.

(h) “Individual plan” means an individual health benefit plan as defined in § 15–1301(o) of this title.

(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.

(j) “Large group plan” means a health benefit plan as defined in § 15–1401 of this title.

(k) “Small group plan” means a health benefit plan as defined in § 15–1201 of this title.