§ 14-501. Definitions [Amendment subject to contingency; amended version follows this section] (Abrogation of amendment effective June 30, 2015.)

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

(b) Administrator. -- "Administrator" means:

   (1) a person that is registered as an administrator under Title 8, Subtitle 3 of this article; or

   (2) a carrier as defined under subsection (d) of this section.

(c) Board. -- "Board" means the Board of Directors for the Maryland Health Insurance Plan.

(d) Carrier. -- "Carrier" means:

   (1) an authorized insurer that provides health insurance in the State;

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

   (3) a health maintenance organization that is licensed to operate in the State.

(e) Creditable coverage. -- "Creditable coverage" has the meaning stated in § 15-1301 of this article.

(f) Eligible individual. -- "Eligible individual" has the meaning stated in § 15-1301 of this article.

(g) Fund. -- "Fund" means the Maryland Health Insurance Plan Fund.

(h) Medically uninsurable individual. --

   (1) "Medically uninsurable individual" means an individual who is a resident of the State and who:

      (i) provides evidence that, for health reasons, a carrier has refused to issue substantially similar coverage to the individual;

      (ii) provides evidence that, for health reasons, a carrier has refused to issue substantially similar coverage to the individual, except at a rate that exceeds the Plan rate;

      (iii) satisfies the definition of "eligible individual" under § 15-1301 of this article;

      (iv) has a history of or suffers from a medical or health condition that is included on a list promulgated in regulation by the Board;

      (v) is eligible for the tax credit for health insurance costs under § 35 of the Internal Revenue Code;

      (vi) is a dependent of an individual who is eligible for coverage under this subsection; or

      (vii) satisfies the eligibility requirements established by federal law to enroll in a national temporary high risk pool program that is:

         1. established by the Secretary of Health and Human Services; and

         2. administered by the Plan for the State.

   (2) "Medically uninsurable individual" does not include an individual who is eligible for coverage under:

      (i) the federal Medicare program;

      (ii) unless the individual is eligible for a subsidy of Plan costs provided by the Department of Health and Mental Hygiene under a Medicaid waiver program, the Maryland Medical Assistance Program;

      (iii) the Maryland Children's Health Program; or

      (iv) an employer-sponsored group health insurance plan that includes benefits comparable to Plan benefits, unless the individual is eligible for the tax credit for health insurance costs under § 35 of the Internal Revenue Code.

(i) Medicare Part D coverage gap. -- "Medicare Part D coverage gap" means the gap in coverage under Medicare Part D:

   (1) above the initial coverage limit and before catastrophic coverage begins; and

   (2) during which an individual enrolled in Medicare Part D is responsible for 100% coinsurance costs.

(j) Plan. -- "Plan" means the Maryland Health Insurance Plan.

(k) Plan of operation. -- "Plan of operation" means the articles, bylaws, and operating rules and procedures adopted by the Board in accordance with § 14-503 of this subtitle.

2014, ch. 1.