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<regulation prefix="Regulation" num=".02" citation="COMAR 31.10.09.02" title_num="31" subtitle_num="10" chapter_num="09" 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>“Bereavement counseling” means counseling provided to the immediate family or family caregiver of the insured after the insured's death to help the immediate family or family caregiver cope with the death of the insured.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“Carrier” means an insurer, a nonprofit health service plan, or a health maintenance organization.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Expense Incurred.</text>
      <paragraph num="(a)">
        <text>“Expense incurred” means the benefits payable under the contract are based on the medical expenses the insured incurs.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>For the purpose of this chapter, a contract which includes both expense-incurred benefits and indemnity benefits shall be considered to be written on an “expense-incurred” basis.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>“Family caregiver” means a relative by blood, marriage, or adoption who lives with or is the primary caregiver of the terminally ill insured.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>“Family counseling” means counseling given to the immediate family or family caregiver of the terminally ill insured for the purpose of learning to care for the insured and to adjust to the death of the insured.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>“Hospice care program” means a coordinated, interdisciplinary program of hospice care services for meeting the special physical, psychological, spiritual, and social needs of terminally ill individuals and their families, by providing palliative and supportive medical, nursing, and other health services through home or inpatient care during the illness and bereavement to:</text>
      <paragraph num="(a)">
        <text>Individuals who have no reasonable prospect of cure as estimated by a physician; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The immediate families or family caregivers of those individuals described in §B(6)(a) of this regulation.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(7)">
      <text>“Immediate family” means the spouse, parents, siblings, grandparents, and children of the terminally ill insured.</text>
    </paragraph>
    <paragraph num="(8)">
      <text>“Indemnity” means the benefits payable under the contract are flat amounts which are not related to the expenses the insured incurs, such as a hospital indemnity contract which 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="(9)">
      <text>“Insured” means a person who is covered under a:</text>
      <paragraph num="(a)">
        <text>Group, blanket, or individual health insurance policy written on an expense-incurred basis;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Nonprofit health service plan contract; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Health maintenance organization contract.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(10)">
      <text>“Respite care” means temporary care provided to the terminally ill insured to relieve the family caregiver from the daily care of the insured.</text>
    </paragraph>
    <paragraph num="(11)">
      <text>“Terminally ill” means a medical prognosis given by a physician that the insured's life expectancy is 6 months or less.</text>
    </paragraph>
  </paragraph>
</regulation>