Maryland § 15-1A-01

§ 15-1A-01.

    (a)    In this subtitle the following words have the meanings indicated.

    (b)    “Carrier” means:

        (1)    an insurer that holds a certificate of authority in the State and provides health insurance in the State;

        (2)    a health maintenance organization that is licensed to operate in the State;

        (3)    a nonprofit health service plan that is licensed to operate in the State; or

        (4)    any other person or organization that provides health benefit plans subject to State insurance regulation.

    (c)    “Child” means:

        (1)    a natural child, a stepchild, a foster child, or an adopted child of the insured; or

        (2)    a child placed with the insured for legal adoption.

    (d)    “Essential health benefit” means a health benefit that:

        (1)    meets the criteria established under § 1302(b) of the Affordable Care Act; or

        (2)    if the Commissioner adopts regulations as described in § 15–1A–04 of this subtitle, meets the criteria established by the adopted regulations.

    (e)    “Grandfathered plan” means a health benefit plan that:

        (1)    meets the criteria established under 45 C.F.R. § 147.140 and any corresponding federal rules and guidance as those provisions were in effect December 31, 2024; or

        (2)    if the Commissioner adopts regulations as described in § 15–1A–03 of this subtitle, meets the criteria established by the adopted regulations.

    (f)    “Group plan” means a small group plan or a large group plan.

    (g)    “Health benefit plan” means an individual plan, a small group plan, or a large group plan.

    (h)    “Individual plan” means an individual health benefit plan as defined in § 15–1301(o) of this title.

    (i)    “Insured individual” means:

        (1)    an insured, an enrollee, a subscriber, a participant, a member, or a beneficiary of a health benefit plan; or

        (2)    any covered dependent of a health benefit plan.

    (j)    “Large group plan” means a health benefit plan as defined in § 15–1401 of this title.

    (k)    “Small group plan” means a health benefit plan as defined in § 15–1201 of this title.