§ 11-601. Definitions

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

(b) Carrier. -- "Carrier" means a person that:

   (1) offers a health benefit plan in the State; and

   (2) is:

      (i) an insurer;

      (ii) a nonprofit health service plan; or

      (iii) a health maintenance organization.

(c) Contract holder. -- "Contract holder" means a person to which a carrier has issued a health benefit plan.

(d) Health benefit plan. --

   (1) "Health benefit plan" means:

      (i) a health insurance contract, a nonprofit health service plan contract, or a health maintenance organization contract that includes benefits for medical care; or

      (ii) a certificate of health insurance issued or delivered to a Maryland resident under a contract issued to an association located in the State or any other state.

   (2) "Health benefit plan" does not include:

      (i) one or more, or any combination of the following:

         1. coverage only for accident or disability income insurance;

         2. coverage issued as a supplement to liability insurance;

         3. liability insurance, including general liability insurance and automobile liability insurance;

         4. workers' compensation or similar insurance;

         5. automobile medical payment insurance;

         6. credit-only insurance;

         7. coverage for on-site medical clinics; and

         8. other similar insurance coverage, as specified in federal regulations issued pursuant to P.L. 104-191, under which benefits for medical care are secondary or incidental to other insurance benefits;

      (ii) the following benefits if they are provided under a separate policy, certificate, or contract of insurance or are otherwise not an integral part of a health benefit plan:

         1. limited scope dental or vision benefits;

         2. benefits for long-term care, nursing home care, home health care, community-based care, or any combination of these benefits; and

         3. other similar limited benefits as specified in federal regulations issued pursuant to P.L. 104-191;

      (iii) the following benefits if offered as independent, noncoordinated benefits:

         1. coverage only for a specified disease or illness; and

         2. hospital indemnity or other fixed indemnity insurance; or

      (iv) the following benefits if offered as a separate policy, certificate, or contract of insurance:

         1. Medicare supplemental health insurance, as defined in § 1882(g)(1) of the Social Security Act;

         2. coverage supplemental to the coverage provided under Chapter 55 of Title 10, United States Code; and

         3. similar supplemental coverage provided to coverage under an employer sponsored plan.

(e) Medical care. -- "Medical care" means:

   (1) items or services for the diagnosis, cure, mitigation, treatment, or prevention of a disease, injury, or condition affecting any structure or function of the body; and

   (2) transportation primarily for and essential to medical care described in item (1) of this subsection.

HISTORY: 2012, chs. 513, 514.