Sec. 31.10.25.02. Definitions  


Latest version.
  • 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.