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<regulation prefix="Regulation" num=".02" citation="COMAR 31.10.32.02" title_num="31" subtitle_num="10" chapter_num="32" 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>“Baltimore metro region” means Anne Arundel County, Baltimore City, Baltimore County, Carroll County, Harford County, and Howard County.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“Cost-sharing arrangement” includes:</text>
      <paragraph num="(a)">
        <text>A deductible;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>A co-insurance amount;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>A co-payment amount;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>An annual limit;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>A lifetime limit; and</text>
      </paragraph>
      <paragraph num="(f)">
        <text>An out-of-pocket maximum.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>“DC metro region” means Montgomery County and Prince George's County.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>“Eastern Shore region” means Caroline County, Cecil County, Dorchester County, Kent County, Queen Anne's County, Somerset County, Talbot County, Wicomico County, and Worcester County.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Health Benefit Plan.</text>
      <paragraph num="(a)">
        <text>“Health benefit plan” means a hospital or medical policy, contract, or certificate issued by a nonprofit health service plan.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Health benefit plan” includes:</text>
        <paragraph num="(i)">
          <text>A Medicare supplement policy, contract, or certificate;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>A long-term care policy, contract, or certificate; or</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>A stop loss contract.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>“Health care provider” has the meaning stated in Insurance Article, §14-101(b), Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>“Key specialty” means:</text>
      <paragraph num="(a)">
        <text>Cardiology;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Dermatology;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Family practice;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Gastroenterology;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Geriatrics;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Internal medicine;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Obstetrics/Gynecology (Ob/Gyn);</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Ophthalmology;</text>
      </paragraph>
      <paragraph num="(i)">
        <text>Orthopedic surgery; or</text>
      </paragraph>
      <paragraph num="(j)">
        <text>Pediatrics.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(8)">
      <text>“Market” means:</text>
      <paragraph num="(a)">
        <text>The individual Medigap market;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The individual non-Medigap market;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The small-employer market governed by Insurance Article, Title 15, Subtitle 12, Annotated Code of Maryland; or</text>
      </paragraph>
      <paragraph num="(d)">
        <text>The group market other than the small-employer market governed by Insurance Article, Title 15, Subtitle 12, Annotated Code of Maryland.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(9)">
      <text>“Nonprofit health service plan” means a corporation that:</text>
      <paragraph num="(a)">
        <text>Holds a certificate of authority from the Commissioner to act as a nonprofit health service plan; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Has been assigned a National Association of Insurance Commissioners (NAIC) company code number.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(10)">
      <text>“Option” means a benefit or cost-sharing arrangement that:</text>
      <paragraph num="(a)">
        <text>Is available in a health benefit plan; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>If chosen, would alter the cost of the health benefit plan.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(11)">
      <text>“Product” means a category of one or more health benefits plans sold by a nonprofit health service plan in a particular market.</text>
    </paragraph>
    <paragraph num="(12)">
      <text>“Southern Maryland region” means Calvert County, Charles County, and St. Mary's County.</text>
    </paragraph>
    <paragraph num="(13)">
      <text>“Western Maryland region” means Allegany County, Frederick County, Garrett County, and Washington County.</text>
    </paragraph>
  </paragraph>
</regulation>