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<regulation prefix="Regulation" num=".02" citation="COMAR 31.12.02.02" title_num="31" subtitle_num="12" chapter_num="02" 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>“Advertising” means:</text>
      <paragraph num="(a)">
        <text>Printed and published material;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Descriptive literature and sales aids;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Sales talks;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Sales materials, booklets, forms, pamphlets, brochures, illustrations, depictions, and form letters;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Newspaper, radio, television, or direct mail advertising; and</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Any other material used for the promotion of enrollment.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>“Carrier” means:</text>
      <paragraph num="(a)">
        <text>An HMO;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>An insurer;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>A nonprofit health service plan;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>A dental plan organization; or</text>
      </paragraph>
      <paragraph num="(e)">
        <text>A fraternal benefit society.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Contract on an Insert Page Basis.</text>
      <paragraph num="(a)">
        <text>“Contract on an insert page basis” means a contract that is composed of insert pages, with each insert page being identified with a unique form number.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Contract on an insert page basis” does not include a contract that contains an insert that is identified with a unique form number and is longer than one page.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>Contract on a Sectional Basis.</text>
      <paragraph num="(a)">
        <text>“Contract on a sectional basis” means a contract that is composed of sections, with each section being identified with a unique form number.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Contract on a sectional basis” includes a contract that contains sections that are only one page long.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>Form.</text>
      <paragraph num="(a)">
        <text>“Form” means:</text>
        <paragraph num="(i)">
          <text>A policy;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>A contract;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>A certificate;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>A rider;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>An endorsement; or</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>An application.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>“Form” does not include a provider contract.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>“Group certificate” means the description of benefits and rights which pertain to the members covered under a group policy.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>“Group contract” or “group policy” means a contractual agreement entered into between an HMO and an employer, union, trustee, association, or organization for the provision of health care services on a prepaid basis to:</text>
      <paragraph num="(a)">
        <text>Subscribers; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Subscribers and the subscriber's dependents, family members, or both.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(8)">
      <text>“HMO” means a health maintenance organization.</text>
    </paragraph>
    <paragraph num="(9)">
      <text>“Individual contract” means a contractual agreement for the provision of health care services on a prepaid basis entered into between an HMO and a subscriber, provided the contract covers only the following persons:</text>
      <paragraph num="(a)">
        <text>The subscriber;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The subscriber and the subscriber's dependents, family members, or both; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The subscriber's dependents, family members, or both.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(10)">
      <text>“Member” means the subscriber and any of the subscriber's dependents or family members who are entitled to receive health care benefits from the HMO.</text>
    </paragraph>
    <paragraph num="(11)">
      <text>“Subscriber” means for:</text>
      <paragraph num="(a)">
        <text>Group contracts, the person who is eligible to be covered under the contract, other than as a dependent or a family member by reason of satisfying the eligibility requirements of the group contract; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Individual contracts, the person who completes the application for coverage with the HMO and who is covered under the contract.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>