Md. Code Regs. 31.10.37.02

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

Section 31.10.37.02 - Definitions

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

B. Terms Defined.

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

(2) "Carrier" means any of the following:

(a) An insurer;

(b) A nonprofit health service plan;

(c) A health maintenance organization; and

(d) A dental plan organization.

(3) "Certificate" or "summary plan description" means the benefit summary that sets forth the essential elements of a group contract and that is required to be provided by a carrier to individuals covered under a group contract.

(4) "Certificate holder" means an individual who is eligible to be covered under a group contract by reason of satisfying the eligibility requirements of the group contract, other than an individual who is covered under a group contract as the spouse, domestic partner, or dependent of the certificate holder.

(5) "Contract holder" means the entity to whom a contract is issued.

(6) "Group contract" means a health insurance contract, a nonprofit health service plan contract, a health maintenance organization contract, or a dental plan organization contract issued by a carrier to a group for the purpose of covering:

(a) Employees or members of the group;

(b) The dependents of employees or members of the group; or

(c) The employees, or members of the group, and the employee's, or member's dependents.

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

(8) "Individual contract" means a health insurance contract, a nonprofit health service plan contract, a health maintenance organization contract, or a dental plan organization contract issued by a carrier to a contract holder covering:

(a) The contract holder;

(b) The contract holder's dependents; or

(c) The contract holder, and the contract holder's dependents.

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

Md. Code Regs. 31.10.37.02