Code of Maryland Regulations (Last Updated: April 6, 2021) |
Title 31. Maryland Insurance Administration |
Subtitle 10. HEALTH INSURANCE—GENERAL |
Chapter 31.10.25. Required Standard Provisions for Individual Nonprofit Health Service Plan Contracts |
Sec. 31.10.25.02. Definitions
-
A. In this chapter, the following terms have the meanings indicated.
B. Terms Defined.
(1) "Carrier" means a nonprofit health service plan.
(2) "Covered individual" means an individual covered under an individual contract.
(2-1) Coverage period means the interval of time the individual contract provides protection to the insured, in exchange for the payment of a particular premium.
(2-2) Health benefit plan has the meaning stated in Insurance Article, §15-1301, Annotated Code of Maryland.
(3) "Individual contract" means a contract issued by a nonprofit health service plan to a subscriber covering:
(a) The subscriber;
(b) The subscriber's dependents; or
(c) The subscriber and the subscriber's dependents.
(4) "Preferred provider" means a provider that has entered into a provider service contract.
(5) "Preferred provider benefit" means a benefit that appears in an individual contract under which health care services are to be provided to the covered individual by a preferred provider.
(6) "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.
(7) "Subscriber" means the individual to whom the nonprofit health service plan contract is issued.