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<regulation prefix="Regulation" num=".02" citation="COMAR 31.04.19.02" title_num="31" subtitle_num="04" chapter_num="19" 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>“Accidental death policy” means a health insurance policy that limits benefits under it to benefits that are payable upon the accidental death of an insured.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“Accidental death and dismemberment policy” means a health insurance policy that limits benefits under it to benefits that are payable upon the accidental death or dismemberment of an insured.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>“Administration” means the Maryland Insurance Administration.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>“Annuity” has the meaning defined in Insurance Article, §1-101, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Application.</text>
      <paragraph num="(a)">
        <text>“Application” means the form used to apply for insurance.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Application” includes:</text>
        <paragraph num="(i)">
          <text>Group applications and enrollment forms; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Individual applications.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>Blanket Health Insurance.</text>
      <paragraph num="(a)">
        <text>“Blanket health insurance” has the meaning stated in Insurance Article, §15-305, Annotated Code of Maryland.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Blanket health insurance” does not include a contract or policy for which a covered individual is required to complete an application.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(7)">
      <text>“Commissioner” means the Maryland Insurance Commissioner.</text>
    </paragraph>
    <paragraph num="(8)">
      <text>“Credit life insurance” has the meaning stated in Insurance Article, §13-101, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Employer Retrospective Premium Arrangement.</text>
      <paragraph num="(a)">
        <text>“Employer retrospective premium arrangement” means a rider to an employer group health insurance contract that provides that the employer may pay a negotiated reduced premium during the plan year, in accordance with a methodology approved by the Administration, with an adjustment at the end of the plan year based on the actual experience of the employer's group.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Employer retrospective premium arrangement” does not include any rider used with a small employer health benefit plan.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(10)">
      <text>Expense Incurred.</text>
      <paragraph num="(a)">
        <text>“Expense incurred” means the benefits payable under the health insurance contract are based on the medical expenses the insured incurs.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>For the purposes of this chapter, a health insurance contract that includes both expense incurred benefits and indemnity benefits shall be considered to be written on an expense incurred basis.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(11)">
      <text>“File and use method” means the method prescribed by the Commissioner which permits an insurer to file forms prescribed in Regulation .05 of this chapter and begin using the form at the earlier of:</text>
      <paragraph num="(a)">
        <text>30 days after the date the forms are received by the Commissioner, provided the forms are not disapproved by the Commissioner within this 30 day period; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The date the insurer receives notice from the Commissioner that the filing has been accepted.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(12)">
      <text>“Final disposition” means approval, disapproval or withdrawal of a form submitted for approval.</text>
    </paragraph>
    <paragraph num="(13)">
      <text>Form.</text>
      <paragraph num="(a)">
        <text>“Form” means:</text>
        <paragraph num="(i)">
          <text>A policy;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>A certificate;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>A contract;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>A rider;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>An endorsement;</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>An amendment; or</text>
        </paragraph>
        <paragraph num="(vii)">
          <text>An application.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>“Form” includes:</text>
        <paragraph num="(i)">
          <text>An insert page to a contract, if the insurer complies with the insert page filing requirements for contractsS on an insert page basis found in COMAR 31.04.17.04B; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>A section of a contract, if the insurer complies with the section filing requirements for contracts on a sectional basis found in COMAR 31.04.17.04C.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(14)">
      <text>“Health benefit plan” has the meaning stated in Insurance Article, §15-1201, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(15)">
      <text>“Health insurance” has the meaning stated in Insurance Article, §1-101, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(16)">
      <text>“Indemnity” means the benefits payable under the health insurance contract are flat amounts that are not related to the expenses the insured incurs, such as a hospital indemnity contract that pays a flat fee for each day the insured is confined in a hospital regardless of the actual expenses the insured incurs during the hospital confinement.</text>
    </paragraph>
    <paragraph num="(17)">
      <text>“Insurer” has the meaning stated in Insurance Article, §1-101, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(18)">
      <text>“Life insurance” has the meaning stated in Insurance Article, §1-101, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(19)">
      <text>“Long term care insurance” has the meaning stated in Insurance Article, §18-101, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(20)">
      <text>“Medical stop-loss insurance” has the meaning stated in Insurance Article, §15-129(a), Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(21)">
      <text>“Medicare supplement policy” has the meaning stated in Insurance Article, §15-901, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(22)">
      <text>“Noncompliant” means a form is not in compliance with Maryland statutes and regulations.</text>
    </paragraph>
    <paragraph num="(23)">
      <text>“Prior approval method” means the method that insurers use to file forms with the Commissioner in which the forms may not be used in Maryland by the insurer until the forms are approved by the Commissioner.</text>
    </paragraph>
    <paragraph num="(24)">
      <text>“Small employer” has the meaning stated in Insurance Article, §31-101, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(25)">
      <text>“Wholesale life insurance” has the meaning stated in Insurance Article, §1-101, Annotated Code of Maryland.</text>
    </paragraph>
  </paragraph>
</regulation>