Code of Maryland Regulations (Last Updated: April 6, 2021) |
Title 31. Maryland Insurance Administration |
Subtitle 10. HEALTH INSURANCE—GENERAL |
Chapter 31.10.10. Summary Explanation of Benefits |
Sec. 31.10.10.02. Definitions
Latest version.
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A. In this chapter, the following terms have the meanings indicated.
B. Terms Defined.
(1) "Claimant" means an insured individual resident in Maryland making a claim against the insurer for benefits, who is a:
(a) Policyholder covered by an individual policy; or
(b) Certificate holder covered under a group policy or under an administration contract.
(2) "Service" means any service for which a charge is made which is covered under the policy or contract, including charges for, but not limited to:
(a) Fees of surgeons, anesthetists, and other physicians;
(b) Room and board charges;
(c) Operating room charges;
(d) Recovery room charges; and
(e) Nursing care charges.