PARRIS N. GLENDENING, Governor

Ch. 70

19-727.

(b) (1) Each health maintenance organization that is authorized to operate
under this subtitle is exempted from paying the premium tax imposed under [Article
48A, § 632 of the Code] TITLE 6, SUBTITLE 1 OF THE INSURANCE ARTICLE.

(2) Premiums received by an insurer under policies that provide health
maintenance organization benefits are not subject to the premium tax imposed under
[Article 48A, § 632 of the Code] TITLE 6, SUBTITLE 1 OF THE INSURANCE ARTICLE to
the extent:

(i) Of the amounts actually paid by the insurer to a nonprofit health
maintenance organization that operates only as a health maintenance organization; or

(ii) The premiums have been paid by that nonprofit health

maintenance organization.

19-729.

(a) A health maintenance organization may not:

(9) Violate any applicable provision of [Subtitle 55 of Article 48A of the
Code] TITLE 15, SUBTITLE 12 OF THE INSURANCE ARTICLE; or

19-733.

Any party aggrieved by a final action of the Commissioner under this subtitle has
the right to a hearing and the right to appeal from the action of the Commissioner under
[Article 48A, §§ 35 through 40 of the Code] §§ 2-210 THROUGH 2-215 OF THE
INSURANCE ARTICLE.

19-1301.

(f) "Private review agent" means:

(1) A nonhospital-affiliated person or entity performing utilization review
that is either affiliated with, under contract with, or acting on behalf of:

(ii) A third party that provides or administers hospital benefits to
citizens of this State, including:

2. A health insurer, nonprofit health service plan, health
insurance service organization, or preferred provider organization authorized to offer
health insurance policies or contracts in this State in accordance with [Article 48A of the
Code] THE INSURANCE ARTICLE; or

19-1303.

(c) The Secretary may delegate the authority to issue a certificate to the
Commissioner for any health insurer or nonprofit health service plan regulated under
[Article 48A of the Code] THE INSURANCE ARTICLE or health maintenance
organization issued a certificate of authority in accordance with Subtitle 7 of this title that
meets the requirements of this subtitle and all applicable regulations of the Secretary.

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