# Insurance (GIN)

## Title 11. Insurance Rating Law

### Subtitle 6. Health Benefit Plan Premium Rate Review

#### Section 11-601

(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 Sec. 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.

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Md. Code Ann., Ins. (as displayed at mgaleg.maryland.gov, October 16, 2026)