Ch. 604                                        1995 LAWS OF MARYLAND

(2) "CARRIER" MEANS:
(I) AN INSURER;

(II)     A NONPROFIT HEALTH SERVICE PLAN;

(III)   A HEALTH MAINTENANCE ORGANIZATION;

(IV)    A DENTAL PLAN ORGANIZATION; OR

(V) ANY OTHER PERSON OR ORGANIZATION THAT PROVIDES DENTAL
BENEFIT PLANS SUBJECT TO STATE REGULATION.

(3) "DENTAL POINT-OF-SERVICE OPTION" MEANS A DELIVERY SYSTEM
THAT PERMITS AN INSURED, AN ENROLLEE, OR OTHER COVERED PERSON OF A DENTAL
BENEFIT PLAN TO RECEIVE DENTAL SERVICES OUTSIDE THE PROVIDER PANEL.

(4) "PROVIDER PANEL" MEANS THOSE PROVIDERS WITH WHICH A CARRIER
CONTRACTS TO PROVIDE DENTAL SERVICES TO THE CARRIER'S INSUREDS, ENROLLEES,
OR OTHER COVERED PERSONS UNDER THE CARRIER'S DENTAL BENEFIT PLAN.

(B) IF AN EMPLOYER, ASSOCIATION OR OTHER PRIVATE GROUP ARRANGEMENT
OFFERS DENTAL BENEFIT PLAN COVERAGE TO EMPLOYEES OR INDIVIDUALS ONLY
THROUGH A CARRIER'S PROVIDER PANEL, THE CARRIER WITH WHICH THE EMPLOYER.
ASSOCIATION, OR OTHER PRIVATE GROUP ARRANGEMENT IS CONTRACTING FOR THE
COVERAGE SHALL OFFER, OR CONTRACT WITH ANOTHER CARRIER TO OFFER, A DENTAL
POINT-OF-SERVICE OPTION TO THE EMPLOYER, ASSOCIATION, OR OTHER PRIVATE
GROUP ARRANGEMENT AS AN ADDITIONAL BENEFIT FOR AN EMPLOYEE OR INDIVIDUAL,
AT THE EMPLOYEE'S OR INDIVIDUAL'S OPTION, TO ACCEPT OR REJECT.

(C) (1) AN EMPLOYER, ASSOCIATION OR OTHER PRIVATE GROUP
ARRANGEMENT MAY REQUIRE AN EMPLOYEE OR INDIVIDUAL THAT ACCEPTS THE
ADDITIONAL COVERAGE UNDER A DENTAL POINT-OF-SERVICE OPTION UNDER
SUBSECTION (B) OF THIS SECTION TO BE RESPONSIBLE FOR THE PAYMENT OF A
PREMIUM OVER THE AMOUNT OF THE PREMIUM FOR THE DENTAL BENEFIT COVERAGE
OFFERED BY THE CARRIER ONLY THROUGH ITS PROVIDER PANEL.

(2) A CARRIER MAY IMPOSE DIFFERENT COST SHARING PROVISIONS FOR
THE DENTAL POINT-OF-SERVICE OPTION BASED ON WHETHER THE DENTAL SERVICE IS
PROVIDED THROUGH THE CARRIER'S PROVIDER PANEL OR OUTSIDE THE CARRIER'S
PROVIDER PANEL.

Article—Health—General

19-710.

(R) (1) EXCEPT AS PROVIDED IN PARAGRAPH (3) OF THIS SUBSECTION, A
HEALTH MAINTENANCE ORGANIZATION IS SUBJECT TO THE PROVISIONS OF
ARTICLE 48A, § 657 OF THE CODE.

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