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<regulation prefix="Regulation" num=".02" citation="COMAR 31.14.03.02" title_num="31" subtitle_num="14" chapter_num="03" 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>“Applicant” means:</text>
      <paragraph num="(a)">
        <text>In the case of an individual long-term care insurance policy, the person who seeks to contract for benefits; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>In the case of a group long-term care insurance policy, the proposed certificate holder.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>“Carrier” means an insurer or a nonprofit health service plan.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>“Certificate” means any certificate issued under a group long-term care insurance policy, if the certificate is delivered or issued for delivery in Maryland.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>“Commissioner” has the meaning stated in Insurance Article, §1-101, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>“Department” has the meaning stated in Health-General Article, §1-101, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>“Insured” means an individual who is covered under a partnership policy.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>“Insurer” has the meaning stated in Insurance Article, §1-101, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Long-Term Care Insurance.</text>
      <paragraph num="(a)">
        <text>“Long-term care insurance” means any group or individual insurance policy, contract, certificate, or rider issued, delivered, or offered by a carrier that:</text>
        <paragraph num="(i)">
          <text>Is advertised, marketed, offered, or designed to provide coverage for not less than 24 consecutive months for covered persons on an expense incurred, indemnity, prepaid, or insured basis; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Provides one or more necessary or appropriate diagnostic, preventive, therapeutic, rehabilitative, maintenance, or personal care services furnished in a situation other than an acute care unit of a hospital.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>“Long-term care insurance” includes any product that is advertised, marketed, or offered as long-term care insurance.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>“Long-term care insurance” does not include any insurance policy, contract, certificate, or rider which is offered primarily to provide:</text>
        <paragraph num="(i)">
          <text>Basic Medicare supplement coverage;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Hospital confinement indemnity coverage;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Basic hospital expense or medical-surgical expense coverage;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Disability income protection coverage;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Accident only coverage;</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Specified disease or specified accident coverage; or</text>
        </paragraph>
        <paragraph num="(vii)">
          <text>Skilled nursing care.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(d)">
        <text>“Long-term care insurance” does not include a life insurance policy:</text>
        <paragraph num="(i)">
          <text>That accelerates the death benefit specifically for one or more of the qualifying events of terminal illness, a medical condition requiring extraordinary medical intervention, or permanent institutional confinement;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>That provides a lump sum payment for any of the events in §B(8)(d)(i) of this regulation; or</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>In which neither benefits nor eligibility for benefits is conditioned on receipt of long-term care.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(9)">
      <text>“Medicaid” means the Maryland Medical Assistance Program.</text>
    </paragraph>
    <paragraph num="(10)">
      <text>“Nonprofit health service plan” means an entity that holds a certificate of authority from the Commissioner to act as a nonprofit health service plan in Maryland.</text>
    </paragraph>
    <paragraph num="(11)">
      <text>“Partnership policy” or “partnership coverage” means a long-term care insurance policy that is:</text>
      <paragraph num="(a)">
        <text>Certified by the Commissioner to meet the requirements under §1917(b) of the Social Security Act; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Issued on or after the effective date of the State plan amendment.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(12)">
      <text>Policy.</text>
      <paragraph num="(a)">
        <text>“Policy” means any policy, contract, individual certificate, subscriber agreement, rider, or endorsement delivered or issued for delivery in this State by a carrier.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Policy” does not include a life insurance policy that contains an optional provision for acceleration of payment of all or a portion of the face amount under stated conditions relating to the medical condition, the disability, or the need for long-term care of the insured.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(13)">
      <text>“Qualified long-term care insurance” has the meaning stated in COMAR 31.14.01.02C.</text>
    </paragraph>
    <paragraph num="(14)">
      <text>“State plan amendment” means an amendment filed by the Department with the Centers for Medicare and Medicaid Services under Title 42, U.S.C., which provides for the disregard of any assets or resources by the Department in an amount equal to the insurance benefit payments that are made to, or on behalf of, the individual who is covered under a partnership policy.</text>
    </paragraph>
  </paragraph>
</regulation>