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<regulation prefix="Regulation" num=".02" citation="COMAR 14.35.11.02" title_num="14" subtitle_num="35" chapter_num="11" heading="Definitions.">
  <paragraph num="A.">
    <text>In this chapter, the following terms have the meanings indicated.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Terms Defined.</text>
    <paragraph num="(1)">
      <text>“Administrative law judge” means an individual appointed by the Chief Administrative Law Judge under State Government Article, §9-1604, Annotated Code of Maryland, or designated by the Chief Administrative Law Judge under State Government Article, §9-1607, Annotated Code of Maryland, to adjudicate contested cases at the Maryland Office of Administrative Hearings.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“Affordable Care Act” means the Patient Protection and Affordable Care Act of 2010 (Pub.L. 111-148), as amended by the Health Care and Education Reconciliation Act of 2010 (Pub.L. 111-152), as amended by the Three Percent Withholding Repeal and Job Creation Act (Pub.L. 112-56).</text>
    </paragraph>
    <paragraph num="(3)">
      <text>“Appellant” means any individual who requests a fair hearing for the reasons specified in Regulation .03 of this chapter or that individual’s authorized representative, whether regarding an initial determination or a redetermination.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>“Authorized representative” has the same meaning as in Regulation .14 of this chapter.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>“Catastrophic plan” means a plan established under §1302(e) of the Affordable Care Act.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>“Consolidated Services Center” means the call center operated by the Maryland Health Benefit Exchange to assist consumers who apply for, or participate in, a qualified health plan or the insurance affordability programs offered through the Maryland Health Connection.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>“Delegate agency” means the Department of Human Services and its affiliate local departments which, under contractual agreements with the Department, determine initial and continuing eligibility in the Program.</text>
    </paragraph>
    <paragraph num="(8)">
      <text>“Department” means the Maryland Department of Health, the single State agency which, pursuant to Title XIX of the Social Security Act, implements fair hearing requirements for Program applicants and recipients.</text>
    </paragraph>
    <paragraph num="(9)">
      <text>“Individual Exchange” has the meaning stated in Insurance Article, §31-101(h), Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(10)">
      <text>“Insurance affordability program” means a program that is one of the following:</text>
      <paragraph num="(a)">
        <text>The Maryland State Medicaid program;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The Maryland Children’s Health Insurance Program (CHIP), including the program known as Maryland Children’s Health Program (MCHP) Premium;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>A State basic health program established under §1331 of the Affordable Care Act;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>A program that makes available to eligible individuals coverage in a qualified health plan through the Maryland Health Benefit Exchange with advance payments of the premium tax credit established under §36B of the Internal Revenue Code;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>A program that makes available to eligible individuals coverage in a qualified health plan through the Maryland Health Benefit Exchange with cost-sharing reductions established under §1402 of the Affordable Care Act; or</text>
      </paragraph>
      <paragraph num="(f)">
        <text>The State-Based Young Adult Health Insurance Subsidies Program established under Insurance Article, §31-122, Annotated Code of Maryland.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(11)">
      <text>“MAGI” means modified adjusted gross income, as calculated for purposes of determining or redetermining eligibility for insurance affordability programs under the Affordable Care Act, as defined in 26 CFR §1.36B-1(e)(2).</text>
    </paragraph>
    <paragraph num="(12)">
      <text>“Maryland Health Benefit Exchange” or “Exchange” means the unit of State government that determines initial and continuing eligibility for the MAGI-based insurance affordability programs, including, by delegation, certain eligibility in the Program.</text>
    </paragraph>
    <paragraph num="(13)">
      <text>“Maryland Health Connection” means the electronic eligibility system maintained by the Maryland Health Benefit Exchange.</text>
    </paragraph>
    <paragraph num="(14)">
      <text>“Program” means the Department’s Medical Assistance Program.</text>
    </paragraph>
    <paragraph num="(15)">
      <text>Qualified Health Plan.</text>
      <paragraph num="(a)">
        <text>“Qualified health plan” means a health benefit plan that has been certified by the Maryland Health Benefit Exchange to meet the criteria for certification described in §1311(c) of the Affordable Care Act and Insurance Article, §31-115, Annotated Code of Maryland.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Qualified health plan” includes a catastrophic plan.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>