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

2. B. Terms Defined.

   1. (1) “Carrier” means a nonprofit health service plan.
   2. (2) “Covered individual” means an individual covered under an individual contract.
   3. (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.
   4. (2-2) “Health benefit plan” has the meaning stated in Insurance Article, §15-1301, Annotated Code of Maryland.

   5. (3) “Individual contract” means a contract issued by a nonprofit health service plan to a subscriber covering:

      1. (a) The subscriber;
      2. (b) The subscriber's dependents; or
      3. (c) The subscriber and the subscriber's dependents.
   6. (4) “Preferred provider” means a provider that has entered into a provider service contract.
   7. (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.
   8. (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.
   9. (7) “Subscriber” means the individual to whom the nonprofit health service plan contract is issued.

Authority: Insurance Article, §12-203(g), Annotated Code of Maryland

Effective date: October 30, 2000 (27:21 Md. R. 1978)

Regulation .02B amended effective October 18, 2010 (37:21 Md. R. 1438); May 9, 2016 (43:9 Md. R. 532)

Regulation .04C amended effective November 7, 2005 (32:22 Md. R. 1760)

Regulation .04C, D amended effective May 9, 2016 (43:9 Md. R. 532)

Regulation .04M adopted effective October 18, 2010 (37:21 Md. R. 1438)

Regulation .04M amended effective April 22, 2019 (46:8 Md. R. 402)

Regulation .05A amended as an emergency provision effective May 9, 2003 (30:11 Md. R. 732); amended permanently effective October 27, 2003 (30:21 Md. R. 1531)