§ 11–601
Statutes in effect as of October 1, 2026.
Md. Code Ann., Ins. § 11-601 (2026)
Title 11. Insurance Rating Law
Subtitle 6. Health Benefit Plan Premium Rate Review
§ 11–601LinkCopy Citation
(a)
In this subtitle the following words have the meanings indicated.
(b)
“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” means a person to which a carrier has issued a health benefit plan.
(d)
(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” 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.