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<regulation prefix="Regulation" num=".02" citation="COMAR 14.35.15.02" title_num="14" subtitle_num="35" chapter_num="15" 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>“Active carrier business agreement” means the most recent version of the carrier business agreement provided by the Exchange, signed by the Exchange and the carrier, and on file with the Exchange.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“Active non-exchange entity agreement” means the most recent version of the non-exchange entity agreement provided by the Exchange, signed by the Exchange and the carrier, and on file with the Exchange.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>“Authorized carrier” means a carrier that holds a current certification of authorization issued by the Exchange as set forth in Regulation .03 of this chapter.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>“Carrier business agreement” means the agreement between the Exchange and the carrier that contains terms and conditions governing compliance with the Annotated Code of Maryland, Exchange policies, and State and federal regulations.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>“Carrier reference manual” means the document developed by the Exchange that provides business rules and operational instructions to authorized carriers participating on the Exchange.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>“Health maintenance organization (HMO)” has the meaning stated in Health-General Article, §19-701(g), Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>“Member” means a qualified individual or qualified employee enrolled in a QHP with a particular authorized carrier through the Exchange.</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Member Level Report.</text>
      <paragraph num="(a)">
        <text>“Member level report” means a report of the carrier's QHP member enrollment files with the Exchange at a specified time.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Member level report” includes:</text>
        <paragraph num="(i)">
          <text>Information demonstrating the member enrolled through the Exchange;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>The coverage effective date;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>The coverage termination date, if applicable;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>The termination reason, if applicable;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>The premium amount; and</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>The amount of advanced premium tax credits, if applicable.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(9)">
      <text>“Metal level” means a QHP at the bronze, silver, gold, or platinum coverage level.</text>
    </paragraph>
    <paragraph num="(10)">
      <text>“Non-exchange entity agreement” means the agreement between the Exchange and the carrier that contains privacy and security provisions.</text>
    </paragraph>
    <paragraph num="(11)">
      <text>“SERFF binder” means the portfolio of information that State laws and regulations require carriers to submit to the Exchange through SERFF.</text>
    </paragraph>
    <paragraph num="(12)">
      <text>“System companion guide” means the document developed by the Exchange that provides instructions to authorized carriers to process enrollment information through electronic data transactions between the Exchange and the carrier.</text>
    </paragraph>
    <paragraph num="(13)">
      <text>“System for Electronic Rate and Form Filing (SERFF)” means the online system the Exchange and the Administration use to accept, review, and approve carrier product and rate filings.</text>
    </paragraph>
  </paragraph>
</regulation>