For purposes of Insurance Article, §14-115(d)(11)(i), Annotated Code of Maryland, a modification is material if it modifies: The options available in a health benefit plan marketed in the State in a manner that results in a change of 20 percent or more in the actuarial benefit value of the health benefit plan; A provider network in a manner that results in a change of: 10 percent or more in the number of health care providers in the provider network: For the entire State: or In the Baltimore metro region or DC metro region; 7 percent or more in the number of health care providers in the provider network in the Southern Maryland region; 5 percent or more in the number of health care providers in the provider network in the Eastern Shore region or Western Maryland region; 10 percent or more in the number of health care providers in a key specialty in the provider network: For the entire State; or In the Baltimore metro region, DC metro region, Eastern Shore region, Southern Maryland region, or Western Maryland region; 10 percent or more in the amount of reimbursement paid to health care providers in the provider network: For the entire State; or In the Baltimore metro region or DC metro region; 7 percent or more in the amount of reimbursement paid to health care providers in the provider network in the Southern Maryland region; or 5 percent or more in the amount of reimbursement paid to health care providers in the provider network in the Eastern Shore region or the Western Maryland region; Underwriting guidelines for a product of a nonprofit health insurance plan in a manner that results in: A refusal to provide the least expensive rate for the product of a nonprofit health service plan to 20 percent or more of applicants for the product; or A relative increase of 50 percent or more in the current level of refusals to provide the least expensive rate for the product of a nonprofit health service plan to applicants; or Rates or rating plans that are required to be approved by the Commissioner in a manner that results in: A rate increase of 15 percent or more in 1 year for any product sold by a nonprofit health service plan in a particular market; or A rate increase of 25 percent or more in 1 year for coverage variations within a product sold by a nonprofit health service plan in a particular market.