Md. Code Regs. 31.04.02.02

Current through Register Vol. 51, No. 22, November 1, 2024

Section 31.04.02.02 - Definitions

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

B. Terms Defined.

(1) "Affiant" means an individual who certifies to the accuracy of statements made in a biographical affidavit.

(2) "Applicant" means a person who submits a biographical affidavit pursuant to Regulation .03A of this chapter.

(3) "Approved independent third party" means an independent third party as defined in §B(12) of this regulation that is on the currently approved independent third party list published by the NAIC on the Uniform Certificate of Authority website.

(4) "Background report" means documentation provided by an approved independent third party that complies with NAIC's "Best Practices for NAIC Background Investigations" and details information verified or discovered in the course of the background investigation, or both.

(5) "Biographical affidavit" means the current NAIC Form 11, "Biographical Affidavit", of the NAIC Uniform Certificate of Authority Application and must include a completed, state-specific "Disclosure and Authorization Concerning Background" form.

(6) "Certificate of authority" has the meaning stated in Insurance Article, § 1-101, Annotated Code of Maryland.

(7) "Control" has the meaning stated in Insurance Article, § 7-101, Annotated Code of Maryland.

(8) "Dental plan organization" has the meaning stated in Insurance Article, § 14-401(c), Annotated Code of Maryland.

(9) "Entity" includes an insurer, health maintenance organization, managed care organization, fraternal benefit society, nonprofit health service plan, and dental plan organization.

(10) "Fraternal benefit society" has the meaning stated in Insurance Article, § 8-402(a), Annotated Code of Maryland.

(11) "Health maintenance organization" has the meaning stated in Health-General Article, §19-701(g), Annotated Code of Maryland.

(12) "Independent third party" means a consumer reporting agency regulated by the Federal Trade Commission and, therefore, subject to the Fair Credit Reporting Act:

(a) That is able to verify information contained in the biographical affidavit through the use of domestic and international resources;

(b) Whose officers, directors, or both, have stock ownership amounting to 1 percent or less of the applicant's outstanding stock, unless the Commissioner grants written approval of an entity in which the officers, directors, or both, have more than 1 percent stock ownership; and

(c) That is at all times compliant with the "NAIC Background Investigation Guidelines" and Regulations .06 and .07 of this chapter relevant to the preparation of the background report and its submission to the Commissioner.

(13) "Insurer" has the meaning stated in Insurance Article, § 1-101, Annotated Code of Maryland.

(14) "Managed care organization" has the meaning stated in Health-General Article, §15-101(e), Annotated Code of Maryland.

(15) "NAIC" means the National Association of Insurance Commissioners.

(16) "Nonprofit health service plan " has the meaning stated in Insurance Article, § 14-102, Annotated Code of Maryland.

(17) "Person " has the meaning stated in Insurance Article, § 1-101, Annotated Code of Maryland.

(18) "Principal management" means any person, regardless of title, who exercises control of any substantial portion of the general business of the insurer and may include the:

(a) Chairman of the board;

(b) President;

(c) Vice president;

(d) Secretary;

(e) Treasurer;

(f) Controller or comptroller;

(g) Actuary;

(h) Directors; and

(i) Members of the executive committee.

(19) "Provider sponsored organization" has the meaning stated in Health-General Article, § 19-7 A-01(f), Annotated Code of Maryland.

(20) "Uniform Certificate of Authority Expansion Application " means the NAIC's uniform process, adopted by the Commissioner, for use by an entity that wishes to expand its operations into one or more states.

(21) "Uniform Certificate of Authority Primary Application" means the NAIC's uniform process, adopted by the Commissioner, for use in the formation of a new insurer to be domiciled in Maryland in order to obtain a certificate of authority, or for a foreign entity to use in making application to redomesticate to Maryland from another state.

Md. Code Regs. 31.04.02.02

Regulations .02 amended effective 43:18 Md. R. 1018, eff. 10/1/2016